Covid-19: WHO advises against using two drugs in the treatment of the disease

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The World Health Organization (WHO) released new guidelines advising against the use of two specific drugs to treat Covid-19: colchicine and fluvoxamine. The new guidelines were published in the British Medical Journal (BMJ) on the 14th.

The WHO Guideline Development Group (GDG) no longer recommends the use of the two drugs for patients with mild or moderate Covid-19 because, in addition to not having sufficient evidence that they bring benefits to patients, both carry risks.

The new guidance is for the antidepressant fluvoxamine to be used only in clinical trials. The anti-inflammatory colchicine has a strong recommendation not to be used in mild and moderate cases of Covid-19.

In October of last year, a study published in the journal The Lancet had pointed out that fluvoxamine could reduce hospitalizations for the disease by up to 32%.

The two drugs “are commonly used and inexpensive drugs that have received considerable interest as potential treatments for Covid-19 during the pandemic,” the WHO said.

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Covid-19 WHO advises against the use of two drugs in the treatment of the disease

Justifications

The organization’s Guideline Development Group, which issued the recommendations, said they “reflect uncertainty” about how the drugs work in the body, in addition to evidence gathered so far that the substances do not help with Covid-19 survival or reduce risk of hospitalization or need for intubation.

According to the WHO assessment, “fluvoxamine likely has little or no effect on mortality”, in addition to having “little or no effect on mechanical ventilation and hospitalization”.

The opinion was given based on three clinical trials involving more than 2,000 patients. The organization’s Guideline Development Group concluded, among other things, that the balance between potential benefits and harms does not favor treatment.

As with fluvoxamine, the group assessed that colchicine also likely has “little or no impact on mortality and mechanical ventilation, may have little or no impact on hospitalizations” and, in addition, may “increase the likelihood of adverse effects that may occur.” lead to discontinuation of the drug.

In addition, the international expert panel also discussed the risk of interactions of colchicine with other drugs and the narrow therapeutic window, particularly in patients with or at risk of liver and kidney failure. Experts even pointed out that colchicine toxicity can be serious and sometimes fatal.

The non-recommendation of use was based on data from seven clinical trials, which involved 16,484 patients.

Know more: Every day, Covid-19 is responsible for the death of two children under 5 in Brazil

Recommendations to doctors

For the treatment of mild cases of Covid-19, the WHO strongly recommends the use of Paxlovid, a combination of nirmatrelvir and ritonavir.

The entity has conditional recommendations for sotrovimab, remdesivir and molnupiravir for patients with non-severe Covid-19 who are considered to be at high risk.

In severe cases, the organization strongly recommends the use of corticosteroids, with the addition of receptor blockers of a specific cytokine (IL-6) or baricitinib. On the other hand, the use of convalescent plasma, ivermectin and hydroxychloroquine in patients with Covid-19 is not recommended, regardless of its severity.

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