Famotidine: Study of popular heartburn medication shows mixed results against Covid-19
Famotidine: Study of popular heartburn medication shows mixed results against Covid-19

Famotidine: Study of popular heartburn medication shows mixed results against Covid-19

In it clinical trialspeople with mild to moderate Covid-19 who took very high doses of famotidine, the active ingredient in Pepcid, got some improvement in their symptoms faster than those who took placebo, a pill that does nothing.

But the lawsuit, believed to be the first of its kind, was small and the effect was far from dramatic. Among the 55 study participants, those given famotidine had an estimated 50% reduction in symptoms after 8.2 days, and those given placebo saw this reduction of 11.4 days.

“I am completely overwhelmed,” said Dr. Carlos del Rio, newly elected president of the Infectious Disease Society of America.

“It certainly does not make my engine speed,” said Dr. William Schaffner, an infectious disease expert who works as a vaccine consultant for the U.S. Centers for Disease Control and Prevention. Neither he nor del Rio worked on the investigation.

In the clinical trial, participants took 80 milligrams of famotidine three times a day for 14 days. This dose is six times higher than highest recommended dose of maximum strength Pepcid.

The editor-in-chief of Gut, the magazine that published the newspaper on Thursday, called the improvements for famotidine patients “modest but significant.”

Dr. Emad El-Omar pointed out that after two weeks, twice as many people receiving placebo remained symptomatic as those taking famotidine.

“This is impressive!” El-Omar, a professor of medicine at the University of New South Wales Sydney in Australia, wrote in an email to CNN.

Interest in famotidine started in China

That interest in famotidine for the treatment of Covid-19 has roots in China, according to Dr. Kevin Tracey, a co-author of the Gut study.

In April 2020, Tracey told CNN that doctors who had observed that some lower-income people affected by coronavirus survived longer than their wealthier counterparts, who also had heartburn. Upon closer inspection, they found that many of the lower-income patients took famotidine, whereas the richer patients tended to take a more expensive drug to treat their heartburn.

“The poor farmers really seemed to be doing well on famotidine,” Tracey, president of the Feinstein Institutes of Medical Research at Northwell Health in New York, said at the time. “There are a lot of anecdotes going around that give us hope.”

The hope was particularly strong because Covid-19 was raging through New York at the time, and famotidine is cheap and has a long track record as a safe drug.

A few months later, Tracey and his team at Northwell and Cold Spring Harbor Laboratory in New York reported that 10 people who recovered from Covid-19 at home in the US and Sweden noticed “rapid improvement” in their condition within a day or two after starting famotidine.

The team then tried to conduct an experiment with the drug in inpatients, but it ran into problems as other treatment options became available to the dwindling number of Covid-19 patients in New York. That investigation was eventually rejected.

Famotidine came back with news when former President Donald Trump was treated with the drug when he was admitted with Covid-19 in December 2020.
Pfizer's Covid-19 antiviral pill was hailed as a game changer, but supplies are scarce
But a few months later, one examination conducted by researchers at two pharmaceutical companies found that famotidine did not help hospitalized people.
That Infectious Disease Society of America discourages the use of famotidine in the treatment of hospitalized Covid-19 patients and has no recommendations for or against its use in non-hospitalized persons.
In April 2020 became National Institutes of Health announced a public-private partnership to accelerate the study of potential drugs for the treatment of Covid-19, including about two dozen “recycled“medicines that are already being used to treat other conditions. Famotidine is not on the list.

The next steps are unclear

Now the study of famotidine for the treatment of Covid-19 is at a crossroads.

The team at Northwell and Cold Spring Harbor are considering how best to design a major clinical trial that would put famotidine to the test.

“Can we take a safe medicine from the shelf, one that could be manufactured? [and essentially] given away to countries that have nothing to treat Covid? “Tracey asked.” It’s an important issue for global health. ”

Not everyone agrees.

Schaffner and del Rio, infectious disease experts, say there is no reason to spend money on a major clinical trial of famotidine, especially because in the United States there are antiviral drugs and a monoclonal antibody authorized to treat Covid at an early stage. .

They added that if someone with Covid-19 wants to try famotidine, there would probably be no harm.

“The downside of this is practically zero, so I would say try it, but don’t expect too much,” said Schaffner, an infectious disease expert at Vanderbilt University Medical Center.

Another expert in infectious diseases sees more potential in famotidine.

Dr. Paul Offit pointed to results in the new study that examined inflammatory markers in the blood of 35 of the participants. These results showed that those who received famotidine had their inflammation go away faster than those who received placebo.

That NIH recommends using tocilizumab, an arthritis anti-inflammatory drug, for the treatment of hospitalized Covid patients.

“Famotidine is a kind of poor man’s tocilizumab,” said Offit, a member of the U.S. Food and Drug Administration’s advisory committee on vaccines and related biological products. He added that famotidine would have a far less dramatic effect than tocilizumab, but it would also have fewer side effects.

Offit called for more research into famotidine to treat Covid-19.

“I’m always ready to study more. It’s the last resort for the academic villain: more studies,” Offit said.

CNN’s Danielle Herman and Naomi Thomas contributed to this report.

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