{"id":38019,"date":"2020-06-01T07:33:34","date_gmt":"2020-06-01T07:33:34","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=38019"},"modified":"2020-06-01T15:54:03","modified_gmt":"2020-06-01T15:54:03","slug":"famotidine-associated-with-improved-clinical-outcomes-in-people-hospitalised-with-covid-19","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/38019","title":{"rendered":"Famotidine associated with improved clinical outcomes in people hospitalised with COVID-19"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/span><\/strong><\/p>\n

A retrospective analysis reports a positive association between open label use of antacid famotidine (an H2 receptor agonist with antiviral properties) and better clinical outcomes in people hospitalised with COVID-19, compared to a control group matched by baseline characteristics. [1]<\/span><\/strong><\/p>\n

Famotidine had previously been identified from a database of potential compounds screened for repurposing for COVID-19 based on computational analysis of structures encoded by SARS-CoV-2 proteins. [2]<\/span><\/p>\n

This paper reported on clinical outcomes from 84\/1,620 (5%) adults who were given famotodine within 24 hours of admission to a single centre from 25 February to 13 April 2020 with PCR confirmed COVID-19. Comparison to a control group used propensity score matching to balance the baseline characteristics of patients who did and did not use famotidine.<\/span><\/p>\n

Factors in the analysis included pre-existing diabetes, hypertension, coronary artery disease (CAD), heart failure, end-stage renal disease or chronic kidney disease, and chronic pulmonary disorders; obesity, based on BMI; and age, classified as <50 years old, 50-65 years old, and >65 years old. <\/span><\/p>\n

Overall, 340\/1,620 (21%) met the composite primary endpoint of progression to intubation (n=<\/span>142, 8.8%) or death<\/span> <\/b>(n=238, 15%). In adjusted analysis, famotidine was associated with reduced risk for intubation or death (aHR) 0.43; 95% CI: 0.21 to 0.88) and also for death alone (aHR 0.30; 95% CI: 0.11 to 0.80), both p<0.01. <\/span>When those who died prior to intubation were excluded, there was no association between use of famotidine and intubation (log-rank p=0.40)<\/p>\n

Participants using famotidine received a total median dose of 136 mg (63 \u2013 233 mg) for a median 5.8 days. \u00a028% of all famotidine doses were intravenous; 47% were 20 mg, 35% were 40 mg, and 17% were 10 mg. \u00a0Famotidine was used prior to admission by 15% of those who used famotidine while hospitalised compared to 1% of those who did not (p<0.01).<\/span><\/p>\n

The results were similar in several sensitivity analyses, including use of proton pump inhibitors that had no impact on either endpoint, indicating any mechanism was unrelated to acid suppression.<\/span><\/p>\n

The study reported that a<\/span> lower peak ferritin value was observed among users of famotidine, supporting the hypothesis that use of famotidine may decrease cytokine release in the setting of SARS-CoV-2 infection.<\/p>\n

A randomised phase study of high-dose IV famotidine with hydroxychloroquine (HCQ) vs HCQ is already underway in 1170 participants with mild or moderate COVID-19. [3]<\/p>\n

comment<\/span><\/h3>\n

This report is from a paper that has not yet been peer-reviewed.<\/strong><\/p>\n

This article was first published on 26 May 2020.<\/em><\/p>\n

References<\/span><\/p>\n

    \n
  1. Freedberg DE et al. Famotidine use is associated with improved clinical outcomes in hospitalized COVID-19 patients: a propensity score matched retrospective cohort study. Pre-peer review. DOI:\u00a010.1101\/2020.05.01.20086694.(19 May 2020).
    \n<\/span>https:\/\/www.medrxiv.org\/content\/10.1101\/2020.05.01.20086694v2<\/span><\/a><\/li>\n
  2. Wu C et al. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharm Sin B. 2020.
    \n    https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7102550<\/span><\/a><\/li>\n
  3. clinicaltrials.gov. <\/span>A multi-site, randomized, double-blind, multi-arm historical control, comparative trial of the safety and efficacy of hydroxychloroquine, and the combination of HCQ and famotidine for the treatment of COVID-19 (MATCH). NCT04370262.
    \n<\/span>    https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04370262<\/span><\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base A retrospective analysis reports a positive association between open label use of antacid famotidine (an H2 receptor agonist with antiviral properties) and better clinical outcomes in people hospitalised with COVID-19, compared to a control group matched …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[283,278],"tags":[],"class_list":["post-38019","post","type-post","status-publish","format-standard","hentry","category-covid-19-investigational-drugs","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/38019","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=38019"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/38019\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=38019"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=38019"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=38019"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}