Researchers examine metformin, ivermectin, and fluvoxamine for COVID-19

The research community is challenged to identify safe and effective treatments for early COVID-19 disease that patients can take at home. While monoclonal antibodies represent one option, the constant evolution of the coronavirus creates barriers.

Three established medications repurposed as potential COVID-19 interventions—metformin, ivermectin, and fluvoxamine—were evaluated as part of a Phase III clinical trial. A total of 1,323 outpatients age 30 to 58 years, all overweight or obese, participated in the COVID-OUT study. Results were published in The New England Journal of Medicine. The adjusted odds ration for one of four primary events—hypoxemia, visit to the emergency department, hospitalization, or death—was 0.84 with metformin, 1.05 with ivermectin, and 0.94 with fluvoxamine.

Based on the evidence, the authors conclude that none of the 3 drugs studied prevented these outcomes in patients experiencing COVID symptoms for less than 1 week. The medications also did not reduce the severity of symptoms compared with matched placebo.

“Further investigation is needed to determine whether any of these proposed mechanisms has any clinically meaningful activity in the treatment of COVID-19,” they wrote.