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Famotidine Against SARS-CoV2: A Hope or Hype?

      Coronavirus disease 2019 (COVID-19) is globe-trotting, and thousands of researchers and stakeholders are spending repose-less days and sleepless nights in search of effective therapies. Currently, the entire research sphere is dealing with a pandemic triad: hypes, hypotheses, and hopes. In the absence of a specific antiviral agent or vaccine against novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), “repurposing” of old time-tested medications is being tried. Famotidine is the most recent addition to this trend, creating a lot of hustle among the public and stirring criticism in the scientific arena.
      • Borrell B.
      New York clinical trial quietly tests heartburn remedy against coronavirus. Science.
      A phase 3 trial “Multi-site Adaptive Trials Using Hydroxychloroquine for COVID-19” (MATCH; ClinicalTrials.gov identifier: NCT04370262) has already been launched inconspicuously.
      • Borrell B.
      New York clinical trial quietly tests heartburn remedy against coronavirus. Science.
      ,
      Multi-site Adaptive Trials Using Hydroxychloroquine for COVID-19 (MATCH). ClinicalTrials.gov website.
      This randomized double-blind clinical trial (N=1170) has been designed to compare clinical outcomes between 2 arms: one receiving hydroxychloroquine 200 mg plus famotidine (360 mg/d intravenously) and the other receiving hydroxychloroquine plus placebo. Famotidine will be administered for a maximum of 14 days or up to hospital discharge, whichever will come earlier.
      Multi-site Adaptive Trials Using Hydroxychloroquine for COVID-19 (MATCH). ClinicalTrials.gov website.
      In this briefing, we will try to enlighten some facts regarding whether it is truly possible for famotidine to have a beneficial effect in COVID-19 or is it just hitting the castle in a Don Quixote way.
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      Linked Article

      • Use of Famotidine and Risk of Severe Course of Illness in Patients With COVID-19: A Meta-analysis
        Mayo Clinic ProceedingsVol. 96Issue 5
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          The article by Ghosh et al,1 in which they discuss the potential of famotidine to regulate innate and adaptive immune responses, provides a rationale to repurpose famotidine for the treatment of coronavirus disease 2019 (COVID-19). There have been few studies evaluating the use of famotidine in patients with COVID-19, and thus we performed a meta-analysis to summarize the overall effect of famotidine on the clinical outcomes in this patient population.
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      • In Reply–Use of Famotidine and Risk of Severe Course of Illness in Patients With COVID-19: A Meta-analysis
        Mayo Clinic ProceedingsVol. 96Issue 5
        • Preview
          Kow and colleagues' interest in our recent letter to the editor1 regarding the potential for famotidine in COVID-19 infection was much appreciated. Obviously, their meta-analysis is small and probably not adequately powered but still suggested 37% and 7% reductions in severe disease in the general and adjusted analyses, respectively: obviously, with wide confidence intervals that were not close to statistical significance. A large-scale randomized study that was adequately powered, preferably with famotidine, started early in COVID-19, would be required to fully determine the full potential of the benefits of famotidine in COVID-19; this type of study is likely not coming in this pandemic.
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