フルボキサミン vs プラセボとCOVID-19の症状のある患者における臨床悪化:ランダム化臨床試験
Eric J Lenze1, Caline Mattar2, Charles F Zorumski1
1Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri.
JAMA
|November 12, 2020
まとめ
フルボキサミンは,軽度のコロナウイルス病 2019 (COVID-19) の患者の臨床悪化を軽減する可能性があります. この研究では,プラセボと比較してフルボキサミンで治療された患者の悪化の確率は低いことが判明しました.
科学分野:
- 感染症
- 薬理学について
- クリティカル ケア 医療
背景:
- 2019年新型コロナウイルス病 (COVID-19) は,過剰な免疫反応により重度の病気を引き起こす可能性があります.
- 選択的セロトニン再吸収阻害剤であるフルーヴヴォクサミンは,シグマ1受容体を刺激することで免疫反応を調節し,潜在的にサイトカインの産生を調節する可能性があります.
研究 の 目的:
- 軽度のCOVID-19で入院していない成人の臨床悪化を予防するフルボキサミンの有効性を調査する.
- フルボキサミンの早期治療が病気の重症度を軽減するかどうかを評価する.
主な方法:
- ダブルブラインド,ランダム化,プラセボ対照試験は遠隔で行われました.
- 7日以内にSARS-CoV-2感染と症状の発症が確認された152人の参加者が登録されました.
- 参加者はフルボキサミン (100 mg1日3回) またはプラセボを15日間投与された.
主要な成果:
- フルボキサミンを投与した80人中0人の患者で,プラセボを投与した72人中6人の患者で,臨床悪化が15日以内に発生した.
- 臨床悪化の差は統計的に有意であった (ログランクP=0. 009).
- プラセボ群と比較して,フルボキサミン群で報告された重篤な有害事象は少なかった.
結論:
- フルボキサミンの治療は,症状のあるCOVID-19患者の臨床悪化の確率を低下させた.
- この研究は,軽度のCOVID-19の管理におけるフルーボキサミンの潜在的な役割を示唆しています.
- 臨床効果と決定的な結果を確認するには,より長い追跡期間を持つ大規模な試験が必要です.
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