Famotidine does not decrease risk for mortality in COVID-19
Results from a recent study did not demonstrate a correlation between in-hospital famotidine use and a reduced risk for mortality in COVID-19 patients.
“Until safety and efficacy of these drugs are established by randomized controlled trials, results from these observational studies should be interpreted with caution,” Samrat Yeramaneni, MBBS, PhD, from the Sarah Cannon Research Institute, HCA Healthcare in Nashville, and colleagues wrote.
Yeramaneni and colleagues identified 7,158 patients who tested positive for SARS-CoV-2. Thirty-day all-cause mortality served as the primary outcome. In-hospital famotidine use, regardless of dose or route, within 24 hours of hospital admission served as primary exposure. A Coarsened Exact Matching technique was used to mitigate bias from non-randomized treatment assignment among famotidine users and non-users on age, sex, race, ethnicity, BMI, comorbidities and in-hospital hydroxychloroquine use.
Additionally, the association between famotidine use and 30-day mortality was assessed with a multivariable logistic regression model.
Investigators reported exposure among 1,127 of 7,158 patients in the pre-match cohort. Results from CEM showed exposure among 410 of 1,156 patients.
According to researchers, patients received famotidine for a median 6 days and a median cumulative dose of 160 mg.
“Famotidine users were on average 6 years older (P < .0001), with higher admission WHO severity (P < .0001), higher proportions of comorbid conditions (all P < .001), more likely to receive [hydroxychloroquine, acetazolamide], ACE-I, [angiotensin II receptor blockers], antibiotics, antivirals, remdesivir, tocilizumab and steroids (all P < .001),” the investigators wrote.
Results showed 687 patients in the pre-match cohort and 113 in the post-match cohort died within 30-days of admission.
“Pre-match 30-day mortality was 18.2% famotidine users vs. 8% non-famotidine users (P < .0001). Post-match 30-day mortality was 15.1% famotidine users vs. 9.5% non-famotidine users (P = .007),” Yeramaneni and colleagues wrote.
Multivariable logistic regression results showed no correlation between in-hospital famotidine use and 30-day mortality (aOR = 1.59; 95% CI, 0.94-2.71) after adjusting for WHO severity, smoking status and listed medications.
“Secondary analysis, accounting for interaction between in-hospital and at-home famotidine use showed that patients not using famotidine at-home, but receiving famotidine in the hospital, were at higher risk of 30-day mortality (aOR = 1.77; 95% CI, 1.03-3.03),” they wrote.