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In this retrospective cohort study of 1620 patients with COVID-19, 84 (5.1%) who received famotidine (an H2 blocker) were observed to have a significantly reduced risk for the composite outcome of death or intubation. After adjusting for baseline patient characteristics, the use of famotidine remained independently associated with risk for death or intubation (aHR, 0.42), and this remained unchanged after propensity score matching (HR, 0.43). There was a no protective effect associated with use of PPIs (aHR, 1.34). The median ferritin concentration was 708 ng/mL among users of famotidine versus 846 ng/mL among nonusers.
In patients hospitalized with COVID-19 and not initially intubated, famotidine use was associated with a twofold reduction in clinical deterioration leading to intubation or death. Randomized controlled trials are underway.
– Omar Khan, MD
This abstract is available on the publisher's site.
COVID-19 caused 2 million cases and over 150,000 deaths worldwide as of mid-April 2020 (1). Clinical trials are underway to assess the efficacy of a variety of antiviral drugs. However, many of these drugs have toxicities and thus far no drug has been proven to improve outcomes in COVID-19 patients.
Famotidine is a histamine-2 receptor antagonist that suppresses gastric acid production. In vitro, famotidine inhibits HIV replication (2). Recently, Wu et al. (3) used computational methods to predict structures of proteins encoded by the SARS-CoV-2 genome and identified famotidine as one of the drugs most likely to inhibit the 3-chymotrypsin-like protease (3CLpro) which processes proteins essential for viral replication (4). We hypothesized that famotidine would be associated with improved clinical outcomes among hospitalized patients with COVID-19. To explore this, we performed a retrospective cohort study at a single academic center located at the epicenter of the COVID-19 pandemic in the United States.
Famotidine Use Is Associated With Improved Clinical Outcomes in Hospitalized COVID-19 Patients: A Propensity Score Matched Retrospective Cohort Study
Gastroenterology 2020 May 21;[EPub Ahead of Print], DE Freedberg, J Conigliaro, TC Wang, KJ Tracey, MV Callahan, JA Abrams, , ME Sobieszczyk, DD Markowitz, A Gupta, MR O'Donnell, J Li, DA Tuveson, Z Jin, WC Turner, DW Landry