Sharyn Alfonsi reports on the unusual way fluvoxamine, a drug commonly used to treat obsessive-compulsive disorder, had to be treated early in a candidate for COVID-19

The COVID-19 vaccine race has dominated the headlines, but there’s less news on how to keep people with COVID out of hospital Tonight we’re going to tell you a story about a possible treatment that’s called Fluvoxamine The Generic was developed 40 years ago as an antidepressant and was mainly used to treat obsessive-compulsive disorder A small but ingenious clinical study and a number of coincidences have led scientists to consider fluvoxamine as a possible tool to prevent newly diagnosed COVID-19 Patients Get Seriously Ill How did a 60 cents pill become a dark horse for the treatment of COVID? We went to a place that knows all about long shots to find out

Golden Gate Fields is located in Berkeley, California.The grandstands have been empty since the COVID hit last year, but the races continue here200 thoroughbreds trained and looked after by more than 500 people Last November, COVID raged in the barn where many workers live

Dr David Seftel: We had four cases that were initially reported and because we have a community there we decided to test all of them and then we saw that the first round of testing revealed 200 positive people

Dr David Seftel has been the doctor for employees and their families at Golden Gate Fields

for 20 years

Sharyn Alfonsi: Who was sick? Was it the jockeys, was it the boys who work in the stables, their families?

Dr David Seftel: It was really across the spectrum. And what is interesting about our community is that it really is a reflection of the community that is most affected by COVID, a predominantly Latin American community that is incredibly hardworking that you don’t have that The Luxury of Working from Home or Working on Zoom You have to be out there every day

There are few options for early treatment for COVID, however; the handful of approved drugs are for high-risk patients and must be administered intravenously, often in a hospital

Dr David Seftel: When I looked at this community I said I know the numbers, I know the statistics There will be deaths and disabilities if I don’t do anything

Dr Seftel felt that his only choice to keep his patients from getting sick was to respond to a tip he received only hours before the doctor offered them the antidepressant fluvoxamine To understand why, you must return to the starting gate of our story

Eight months earlier in March, Dr Angela Reiersen, child psychiatrist at Washington University in St Louis was sick at home with symptoms of COVID and she thought of old medical studies she had read

Sharyn Alfonsi: Most people who have COVID at home say, “Look, I just want to sit on the couch and take that out”

Dr Angela Reiersen: Well, I didn’t want to just sit there and be sick. I was really motivated to find answers

Dr Reiersen recalled a study on mice published a year earlier by these researchers at the University of Virginia who found that fluvoxamine stopped sepsis Sepsis is an out of control immune response in which inflammation gets out of hand, damaging organs and can be fatal, a similar phenomenon is believed to occur in COVID patients

Dr Angela Reiersen: And I thought I was wondering if we could use fluvoxamine to treat COVID and prevent this clinical deterioration?

Sharyn Alfonsi: You thought this could keep inflammation from going into overdrive?

Dr Angela Reiersen: Right. Either you keep the inflammation from going into overdrive or it will shut off as soon as it starts to prevent our own bodies from basically destroying ourselves. So I emailed Eric Lenze and in one Email the full rationale explained

Dr Eric Lenze is also a Washington University psychiatrist specializing in finding new uses for drugs that are already approved by the Food and Drug Administration

Dr Eric Lenze: Amazingly, I haven’t presented a very compelling and innovative case for this drug to Angela. And it turns out that there are many properties of – like psychotropic drugs Security and Ease of Use and the fact that they can get into the body quickly, which actually makes them ideal for reuse

The doctors received last April 20$ 000 from Washington University to start a small randomized clinical trial of fluvoxamine, however, getting patients to try an antidepressant for COVID has been difficult

Dr Eric Lenze: Yes, and that was a very steep learning curve for us too, which we make with this antidepressant that we normally use for OCD. Imagine you are a patient at home, you have COVID and you receive such a call

Patients who agreed didn’t have to leave their homes The researchers would give a paper bag of fluvoxamine pills to half of the COVID patients, the other half would be given a placebo, with instructions to take the pills for 15 days

Dr Eric Lenze: Our team acted like couriers, or, if you will, delivery men who left it at your home. And then we would work with them over the phone and the Internet Fortunately, at the time, I was reading about the COVID Early Treatment Fund in the New York Times of all places

Steve Kirsch is the founder of the group Lenze read about Kirsch is a Silicon Valley entrepreneur who made a fortune developing the optical computer mouse. He raised a million dollars of his own money and then put together a group of scientists to decide which covid research to fund

Steve Kirsch: You know, we thought, oh, we We have received a grant application This is exciting for us And it is for 67$ 000 … and it’s a very modest amount so we ran it through the Scientific Advisory Board and they said, you know, this is new

Steve Kirsch wrote the check, which Dr Lenze to complete the enrollment of the 152 patients he needed for his study It was completed in August

Dr Eric Lenze: So the results were really incredible. Of the 80 people who got fluvoxamine, none got worse, zero got worse versus 8% of those who got placebo

You heard that right. Patients on fluvoxamine did not worsen to severe lung damage

Steve Kirsch: He said, “Well, look, we have to get this out or no one will believe it. We want to submit it to JAMA – the journal of the American Medical Association, because this will be the top journal for that once you do have it included in JAMA and they publish it, everyone will believe it “

It was released in November.Although the editors highly praised the study’s methodology, they said the results “shouldn’t be used as a basis for making current treatment decisions,” because the editors didn’t want endorsement in a larger process the speed Steve Kirsch is used to in Silicon Valley

Sharyn Alfonsi: I can imagine the next morning thinking you will be front-page news of the New York Times –

Steve Kirsch: And everyone starts taking it, and all doctors start – you know, people are calling it

It was for Harvard Business School alumni and the host was David Seftel The Circuit Doctor It was just hours after Dr Seftel hosted the group he learned about the massive outbreak at Golden Gate Fields

Dr David Seftel: Definitely. And I’m a born skeptic. Right after the webinar, I did a lot of research into science. And then I looked at Eric Lenze’s newspaper A paper published by JAMA from 10000 other papers was selected for publication because its methodology was strong This is something I was happy to bring to patients

So Dr Seftel decided to offer route workers with COVID a 15-day prescription for fluvoxamine

Sharyn Alfonsi: Did you feel like you were placing a bet on these patients at all?

Dr David Seftel: No, because I weighed the risks and benefits. And under these particular circumstances, strong biochemistry, good initial clinical results, minimal drawbacks I felt I had to act

Dr Seftel’s decision to use a prescription drug off-label is an accepted medical practice – with the patient’s consent. The most common side effect of fluvoxamine is mild nausea

Sharyn Alfonsi: How many of you have taken fluvoxamine and what was the result?

Dr David Seftel: 65 Patients Chose Fluvoxamine Forty-eight Refused 125% of Those Who Refused Fluvoxamine were hospitalized and one died In the group taking fluvoxamine, none of them were hospitalized

Dr David Seftel: I don’t think so. You can’t influence a virus that is as clever and evil as COVID by chance

Fluvoxamine needed a larger study to be trusted by the wider medical community so Steve Kirsch’s fund poured half a million dollars into a new trial led by Dr Eric Lenze paper bag deliveries have been replaced with FedEx cardboard boxes the team plans to ship to more than a thousand COVID patients across the country and Canada

Dr Eric Lenze: I have to be a scientist We tested it in a study But – in my opinion, this has to be confirmed in a larger study

Dr Francis Collins: Fluvoxamine Certainly Could Be Something You Want To Put In The Toolbox Because It Looks Like It Has The Promise To Reduce The Chances Of Getting Serious Illness

Dr Francis Collins is the director of the National Institutes of Health.As part of the pandemic response, Collins is overseeing federal efforts to identify drugs to be reused for COVID treatment.This is a priority because of concerns about new variants of COVID could affect the effectiveness of vaccines

Dr Francis Collins: Dr Lenze is a great example of a doctor who probably never intended to work on an infectious disease and yet it approaches anything that is not entirely safe with reasonable skepticism because you don’t want to make that recommendation unless you know it exactly

Dr Francis Collins: The entire scientific community is watching his study and trying to see if there is a way we can help in our own trials. We are deeply contemplating adding an arm to one of these studies to test fluvoxamine. which could be generated

Great caution was advised to recommend reused drugs for COVID after the malaria drug hydroxychloroquine was promoted as a potential “game changer” by former President Trump – before it was tested in a large clinical trial on COVID patients. p>

Dr Francis Collins: Well it is the FDA that needs to figure out whether to get approval for this use of this drug and it will be about the benefit and risk and the benefit is maybe even a 20% reduction in the chances that you are in Landing hospital that’s probably a good thing that should be added to the mix

The first results of the national process could be released next month, just over a year after Dr Angela Reiersen sent Dr Eric Lenze this email about fluvoxamine

Sharyn Alfonsi: Your colleague had to read the study. The Silicon Valley guy had to step in. Then there are some people on a racetrack who are going to try it out. It seems unbelievable

Dr Eric Lenze: If you had told me at the beginning what the odds were, I might have reconsidered

Produced by Guy Campanile Associate Producer Lucy Hatcher Broadcaster Elizabeth Germino Ed By Peter M Berman


World News – US – Finding Potential Early Treatment for COVID-19 in 40-Year-Old Antidepressant