The effect of famotidine on hospitalized patients with COVID-19: a systematic review and meta-analysis

Key Messages

This meta-analysis of observational studies included 46,435 patients, 3,110 of whom were using famotidine. The study did not find any association between famotidine use and various outcomes for patients hospitalized with COVID-19.

The authors stress the considerable variability across the studies and proposed that future randomized, controlled clinical trials may help determine the effectiveness of famotidine for treating and managing COVID-19.

medRxiv

Publication Date: March 24, 2021
Peer Reviewed: No
Publication Type: Review/Commentary/Letter
DOI: https://www.doi.org/10.1101/2021.03.14.21253537

The Effect of Famotidine on Hospitalized Patients with COVID-19: a Systematic Review and Meta-analysis

Leonard Chiu, Max Shen, Ronald Chow, Chun-Han Lo, Nicholas Chiu, Austin Chen, Hyun Joon Shin, Elizabeth Horn Prsic, Chin Hur, Benjamin Lebwohl

Abstract

Introduction:
Famotidine is a competitive histamine H2-receptor antagonist most commonly used for gastric acid suppression but thought to have potential efficacy in treating patients with COVID-19. The aims of this systematic review and meta-analysis are to summarize the current literature and report clinical outcomes on the use of famotidine for treatment of hospitalized patients with COVID-19.

Methods:
Five databases were searched through February 12, 2021 to identify observational studies that reported on associations of famotidine use with outcomes in COVID-19. Meta-analysis was conducted for composite primary clinical outcome (e.g. rate of death, intubation, or intensive care unit admissions) and death separately, where either aggregate odds ratio (OR) or hazard ratio (HR) was calculated.

Results:
Four studies, reporting on 46,435 total patients and 3,110 patients treated with famotidine, were included in this meta-analysis. There was no significant association between famotidine use and composite outcomes in patients with COVID-19: HR 0.63 (95% CI: 0.35, 1.16). Across the three studies that reported mortality separated from other endpoints, there was no association between famotidine use during hospitalization and risk of death – HR 0.67 (95% CI: 0.26, 1.73) and OR 0.79 (95% CI: 0.19, 3.34). Heterogeneity ranged from 83.69% to 88.07%.

Conclusion:
Based on the existing observational studies, famotidine use is not associated with a reduced risk of mortality or combined outcome of mortality, intubation, and/or intensive care services in hospitalized individuals with COVID-19, though heterogeneity was high, and point estimates suggested a possible protective effect for the composite outcome that may not have been observed due to lack of power. Further RCTs may help determine the efficacy and safety of famotidine as a treatment for COVID-19 patients in various care settings of the disease.