Anyone saying an unproven medicine works is on very dangerous ground.
My issue is about how this whole issue has been politicised, reported, and the dangerous spreading of misinformation by the media in all directions.
You just cannot trust the mainstream media to report the truth anymore. To me, that is the most (nonmedical) issue to have been highlighted during the pandemic.
Because when it’s Facebook, Instagram, tinder or whatever non government app, people are so willing to share everything about their lives but if it is government issued, oh there must be conspiracies over what they do with the data.
Interesting, but still only pre-clinical data. In the transition from lab science to clinical investigation the overwhelming majority of treatments fail.
The Treatment Guidelines for Fluvoxamine point to that as well. You can have good pre-clinical data identifying potentially useful mechanisms of action, but until you have clinical data it cannot be recommended one way or the other. Note the very careful language they used back in April - they didn’t say they recommend against it, they say there is insufficient evidence to recommend for or against. That is a statement that will necessarily change as more data is generated.
The UK regulator, the MHRA, said the drug had been authorised for use in people who have mild to moderate Covid and at least one risk factor for developing severe illness such as obesity, old age, diabetes or heart disease.
If it works, why limit it to only people with a risk factor? You hear about people catching covid without any risk factors ending up in hospital.
Could also be a cost-benefit function therapeutically. If you don’t have risk factors for severe illness, the side effect risk might be too high.
Same sort of logic for Astra-Zeneca here, which was used aggressively in the face of our third wave when Pfizer/Moderna supplies were limited, but withdrawn when case incidence fell and the mRNA alternatives became widely available. The decision to use it was not wrong, but the cost-benefit shifted so the decision did too.
It’s just a reflection on who the product has been tested on so far. Regulators will only approve products for the populations who were part of the trials, and the trials will always start out with a narrowly defined population who are most likely to observe the benefit, (in this case high risk). This is partly an issue of ethics (do not expose people to the risks of an experimental product who don’t have a reasonable expectation of experiencing benefit) but also statistics (don’t dilute your results with data on people less likely to experience benefit).
Once we see this initial approval with a narrow indication you’ll see additional studies done in wider populations and, where appropriate, formal approval later given for a broader indication for use. Of course, as soon as it is approved a Dr can Rx off label for anyone, there are just issues with access and payment associated with off label use.