Status:

SUSPENDED

Fluvoxamine for Adults With Mild to Moderate COVID-19

Lead Sponsor:

Asan Medical Center

Conditions:

Severe Acute Respiratory Syndrome Coronavirus 2

Coronavirus Infection

Eligibility:

All Genders

18-85 years

Phase:

PHASE2

Brief Summary

This clinical trial aims to determine if fluvoxamine, a selective serotonin reuptake inhibitor with high affinity for the sigma-1 receptor, can be used in mild to moderate COVID-19 to prevent the prog...

Detailed Description

The investigators will randomize approximately 400 participants, age 18 and older, who have laboratory-confirmed, mild to moderate COVID-19 and are admitted to community treatment centers. All interac...

Eligibility Criteria

Inclusion

  • Men and women age 18 and older
  • Laboratory-confirmed SARS-CoV-2 patients who have mild to moderate symptoms related to COVID-19 infection and are admitted to community treatment centers in Seoul, Korea
  • Has symptoms consistent with COVID-19 with onset ≤7 days of randomization
  • Currently symptomatic with one or more of the following symptoms: fever, cough, myalgia, shortness of breath, nausea, anorexia, diarrhea, vomiting, anosmia (inability to smell), ageusia (inability to taste), sore throat, headache
  • Has laboratory-confirmed SARS-COV-2 infection (positive RT-PCR test) ≤ 3 days of randomization
  • Able to provide informed consent

Exclusion

  • Severe illness enough to require hospitalization or already meeting the study's primary endpoint for clinical deterioration
  • Patients who cannot take oral medication
  • Pregnancy or breastfeeding
  • History of the psychiatric disorder including major depressive disorder
  • Patients who are taking or took selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitor, or tricyclic anti-depressants within 2 weeks
  • Patients who are taking an anti-epileptic drug
  • Patients who are taking co-prescribed drugs (as below) which are contraindicated by manufacturers due to drug-drug interaction
  • Alosetron, tizanidine, theophylline, clozapine, olanzapine (drugs with a narrow therapeutic index that are primarily metabolized by cytochrome P450 1A2)
  • Donepezil, sertraline (sigma-1 receptor agonists)
  • Warfarin (increased risk of bleeding)
  • Phenytoin (rationale: fluvoxamine inhibits its metabolism)
  • Clopidogrel (fluvoxamine inhibits its metabolism from pro-drug to active drug which raises the risk of cardiovascular events)
  • Monoamine oxidase inhibitors (linezolid, rasagiline, selegiline), triptans (sumatriptan, naratriptan, almotriptan, frovatriptan, zolmitriptan, rizatriptan), lithium, tramadol (rationale: to prevent the possible development of serotonin syndrome)
  • Alprazolam, diazepam (fluvoxamine modestly inhibits the metabolism of these drugs): The patient could be enrolled in case of agreeing 25% dose reduction of these medications.
  • Already enrolled in another COVID-19 medication trial
  • Medical comorbidities such as severe underlying lung disease (chronic obstructive pulmonary disease on home oxygen, interstitial lung disease, pulmonary hypertension), decompensated cirrhosis, chronic viral hepatitis, congestive heart failure (stage 3 or 4 per patient report and/or medical records), chronic kidney disease, or end-stage renal disease requiring renal replacement therapy
  • Immunocompromised (solid organ transplant, bone-marrow transplant, acquired immune deficiency syndrome, on biologics and/or high dose steroids \[\>20mg prednisone per day\])
  • Unable to provide informed consent (e.g., moderate-severe dementia diagnosis)
  • Unable to perform the study procedures (self-assessment of oxygen saturation, blood pressure, and temperature using self-monitoring equipment)

Key Trial Info

Start Date :

January 16 2021

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 31 2021

Estimated Enrollment :

400 Patients enrolled

Trial Details

Trial ID

NCT04711863

Start Date

January 16 2021

End Date

July 31 2021

Last Update

April 19 2021

Active Locations (1)

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Asan Medical Center

Seoul, South Korea, 05505