Efficacy of Famotidine for COVID-19: A Systematic Review and Meta-analysis

  1. Rahul Sethia
  2. Manya Prasad
  3. Soumya Jagannath Mahapatra
  4. Neeraj Nischal
  5. Manish Soneja
  6. Pramod Garg
  7. Shalimar

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Abstract

Background

Coronavirus Disease 2019 (COVID-19) pandemic continues unabated in many parts of the world. In the absence of any definite antiviral therapy except some benefit of remdesivir, there is an ongoing search for effective therapy. Famotidine has been shown to reduce mortality in hospitalized patients in a few studies. We conducted a systematic review on the use of famotidine in COVID-19.

Methods

We searched the databases Medline, Embase, Cochrane CENTRAL and Medrxiv. Title/abstract screening, full text screening and data abstraction were carried out in by two reviewers. Case series, cohort studies and randomized trials were included.

Results

Five studies were eligible for inclusion: all were retrospective cohort or case series. Low quality evidence suggests a likely clinical benefit for the use of famotidine in decreasing mortality in hospitalized patients with moderate to severe COVID-19. A meta-analysis of two cohort studies showed a statistically significant decrease in the composite outcome for death and intubation with famotidine (HR 0.44, 95% CI 0.27 to 0.73).

Conclusion

Further evidence from RCTs is required for famotidine to treat COVID 19.

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  1. ScreenIT

    SciScore for 10.1101/2020.09.28.20203463: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationType of outcomes: We included studies reporting the following outcomes: Primary outcome: Overall mortality Secondary outcomes: Type of studies: We included randomized controlled trials, cohort studies and case series. 2.3.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data sources and searches: We searched the following databases for articles published till 20th September 2020: Medline, Cochrane CENTRAL, Trip database, Pubmed (for articles not yet indexed in Medline) and Medrxiv and SSRN for pre-print articles.
    Cochrane CENTRAL
    suggested: (Cochrane Central Register of Controlled Trials, RRID:SCR_006576)
    Pubmed
    suggested: (PubMed, RRID:SCR_004846)
    Medline
    suggested: (MEDLINE, RRID:SCR_002185)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are many limitations of the present study which are inherent to the included studies. First, the studies included in the analysis had a small number of patients treated with famotidine. Studies were single-center and retrospective observational studies with their associated bias. Multiple other drugs were used for the management of patients, which could have influenced the clinical outcomes In conclusion, the available evidence suggests a potential role of famotidine in the management of COVID-19, which needs to be explored in randomized controlled trials.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT0437020262Trial number did not resolve on clinicaltrials.gov. Is the number correct?NA

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.09.28.20203463v1 on medRxiv