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30 famotidine COVID-19 controlled studies, 4 RCTs
Supplementary Data — Famotidine reduces COVID-19 risk: real-time meta analysis of 30 studies
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2+ Brennan (DB RCT) 48% 0.52 [0.20-1.32] no recov. 5/27 10/28 Improvement, RR [CI] Treatment Control Brennan (DB RCT) 43% 0.57 [0.21-1.55] no recov. 4/19 10/27 Brennan (DB RCT) 28% 0.72 [0.56-0.92] recov. time 27 (n) 28 (n) Shoaibi -3% 1.03 [0.89-1.18] death 1,816 (n) 26,820 (n) Shoaibi -3% 1.03 [0.92-1.15] death/ICU 1,816 (n) 26,820 (n) Zhou (PSM) -84% 1.84 [1.16-2.92] severe case 72/519 198/2,595 Yeramaneni -59% 1.59 [0.94-2.71] death 410 (n) 746 (n) Mura (PSM) 21% 0.79 [0.65-0.96] death 563 (n) 563 (n) Mura (PSM) 37% 0.63 [0.47-0.83] death 305 (n) 305 (n) Samim.. (SB RCT) 33% 0.67 [0.45-0.98] hosp. time 10 (n) 10 (n) Samim.. (SB RCT) 0% 1.00 [0.42-2.40] no recov. 5/10 5/10 Samim.. (SB RCT) 50% 0.50 [0.17-1.46] no recov. 3/10 6/10 Elhadi (ICU) 7% 0.93 [0.73-1.17] death 34/60 247/405 ICU patients Taşdemir 45% 0.55 [0.20-1.55] death 5/85 10/94 OT1 Taşdemir 37% 0.63 [0.28-1.43] ICU 8/85 14/94 OT1 Taşdemir 18% 0.82 [0.72-0.93] hosp. time 85 (n) 94 (n) OT1 Taşdemir 20% 0.80 [0.65-0.99] recov. time 85 (n) 94 (n) OT1 Kuno (PSM) 0% 1.00 [0.86-1.17] death 1,593 (n) 7,972 (n) Stolow -519% 6.19 [2.10-18.3] death 137 (n) 352 (n) Stolow -2390% 24.90 [3.70-168] ICU 137 (n) 352 (n) Wagner 64% 0.36 [0.24-0.50] death 82/638 182/819 Wagner 6% 0.94 [0.61-1.41] ventilation 48/638 75/819 Pahwani (RCT) 11% 0.89 [0.36-2.20] death 8/89 9/89 Pahwani (RCT) 12% 0.88 [0.53-1.45] ventilation 21/89 24/89 Pahwani (RCT) 10% 0.90 [0.51-1.58] ICU 18/89 20/89 Pahwani (RCT) 17% 0.83 [0.79-0.89] hosp. time 89 (n) 89 (n) Pahwani (RCT) 10% 0.90 [0.85-0.96] recov. time 89 (n) 89 (n) Siraj 36% 0.64 [0.48-0.83] death 183/711 122/289 Zangeneh (ICU) 39% 0.61 [0.42-0.90] death n/a n/a ICU patients Chowdhury (RCT) 16% 0.84 [0.54-1.31] death 26/104 31/104 ICU patients Chowdhury (RCT) 9% 0.91 [0.75-1.10] ICU 78 (n) 73 (n) ICU patients Chowdhury (RCT) 33% 0.67 [0.58-0.78] no improv. 78 (n) 73 (n) ICU patients Chowdhury (RCT) 7% 0.93 [0.84-1.03] recov. time 78 (n) 73 (n) ICU patients Chowdhury (RCT) 17% 0.83 [0.72-0.96] hosp. time 78 (n) 73 (n) ICU patients Chowdhury (RCT) 13% 0.87 [0.80-0.95] viral time 78 (n) 73 (n) ICU patients Özden (ICU) 29% 0.71 [0.45-1.13] death 14/30 19/29 ICU patients Özden (ICU) -1% 1.01 [0.76-1.34] ventilation 23/30 22/29 ICU patients Özden (ICU) -33% 1.33 [0.80-2.23] ventilation time 30 (n) 29 (n) ICU patients Özden (ICU) 26% 0.74 [0.26-2.16] ICU 30 (n) 29 (n) ICU patients Shamsi 75% 0.25 [0.04-1.78] death 1/27 23/156 Mehrizi 19% 0.81 [0.79-0.83] death population-based cohort Freedberg (PSM) 57% 0.43 [0.21-0.86] death/int. 8/84 332/1,536 Mather (PSM) 61% 0.39 [0.20-0.74] death 83 (n) 689 (n) Mather (PSM) 50% 0.49 [0.31-0.79] death/int. 83 (n) 689 (n) Balouch 22% 0.78 [0.36-1.51] symp. case 18/80 49/227 Balouch 37% 0.63 [0.26-1.54] recov. time 80 (n) 227 (n) Yeramaneni 51% 0.49 [0.16-1.52] death 351 (n) 6,807 (n) Cheung -34% 1.34 [0.24-6.06] severe case 23 (n) 929 (n) Fung 0% 1.00 [0.96-1.04] death population-based cohort Fung 6% 0.94 [0.91-0.97] hosp. population-based cohort Fung -12% 1.12 [1.10-1.15] cases population-based cohort Razjouyan 27% 0.73 [0.59-0.92] death 93 (n) 9,981 (n) Wallace -11% 1.11 [0.89-1.35] death 98/423 1,436/7,521 MacFadden 7% 0.93 [0.84-1.03] cases n/a n/a Loucera 18% 0.82 [0.59-1.15] death 207 (n) 15,761 (n) Kim (PSM) 36% 0.64 [0.51-0.80] cases 105/5,594 480/15,432 Kwon -107% 2.07 [0.96-4.47] progression 204 (n) 204 (n) Kwon -256% 3.56 [1.03-12.3] progression 204 (n) 204 (n) Kwon -109% 2.09 [0.94-4.61] oxygen 204 (n) 204 (n) Famotidine COVID-19 outcomes c19 earlyMay 2025 1 OT: comparison with other treatment Favors famotidine Favors control
Figure S2. Comparison of results for RCTs versus observational studies.
For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.
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