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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 0% Improvement Relative Risk Hospitalization 6% Case -12% Famotidine for COVID-19  Fung et al.  Prophylaxis Is prophylaxis with famotidine beneficial for COVID-19? Retrospective study in the USA Lower hospitalization (p=0.00016) and more cases (p<0.0001) c19early.org Fung et al., PLoS ONE, October 2021 Favors famotidine Favors control

Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients

Fung et al., PLoS ONE, doi:10.1371/journal.pone.0266922 (date from preprint)
Oct 2021  
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Famotidine for COVID-19
25th treatment shown to reduce risk in October 2021
 
*, now known with p = 0.00026 from 30 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Retrospective database analysis of 374,229 patients in the USA, showing higher cases, lower hospitalizations, and no change in mortality with famotidine use.
This study is excluded in the after exclusion results of meta analysis: not fully adjusting for the different baseline risk of systemic autoimmune patients.
Study covers HCQ and famotidine.
risk of death, no change, HR 1.00, p = 1.00, vs. never used.
risk of hospitalization, 6.0% lower, HR 0.94, p < 0.001, vs. never used.
risk of case, 12.0% higher, HR 1.12, p < 0.001, vs. never used.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fung et al., 1 Oct 2021, retrospective, population-based cohort, USA, peer-reviewed, 6 authors.
This PaperFamotidineAll
Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients
Kin Wah Fung, Seo H Baik, Fitsum Baye, Zhaonian Zheng, Vojtech Huser, Clement J Mcdonald
PLOS ONE, doi:10.1371/journal.pone.0266922
Background Maintenance drugs are used to treat chronic conditions. Several classes of maintenance drugs have attracted attention because of their potential to affect susceptibility to and severity of COVID-19. Methods Using claims data on 20% random sample of Part D Medicare enrollees from April to December 2020, we identified patients diagnosed with COVID-19. Using a nested case-control design, non-COVID-19 controls were identified by 1:5 matching on age, race, sex, dualeligibility status, and geographical region. We identified usage of angiotensin-converting enzyme inhibitors (ACEI), angiotensin-receptor blockers (ARB), statins, warfarin, direct factor Xa inhibitors, P2Y12 inhibitors, famotidine and hydroxychloroquine based on Medicare prescription claims data. Using extended Cox regression models with time-varying propensity score adjustment we examined the independent effect of each study drug on contracting COVID-19. For severity of COVID-19, we performed extended Cox regressions on all COVID-19 patients, using COVID-19-related hospitalization and all-cause mortality as outcomes. Covariates included gender, age, race, geographic region, low-income indicator, and co-morbidities. To compensate for indication bias related to the use of hydroxychloroquine for the prophylaxis or treatment of COVID-19, we censored patients who only started on hydroxychloroquine in 2020. Results Up to December 2020, our sample contained 374,229 Medicare patients over 65 who were diagnosed with COVID-19. Among the COVID-19 patients, 278,912 (74.6%) were on at least one study drug. The three most common study drugs among COVID-19 patients were statins 187,374 (50.1%), ACEI 97,843 (26.2%) and ARB 83,290 (22.3%). For all three outcomes (diagnosis, hospitalization and death), current users of ACEI, ARB,
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{ 'DOI': '10.1371/journal.pone.0266922', 'ISSN': ['1932-6203'], 'URL': 'http://dx.doi.org/10.1371/journal.pone.0266922', 'abstract': '<jats:sec id="sec001">\n' '<jats:title>Background</jats:title>\n' '<jats:p>Maintenance drugs are used to treat chronic conditions. Several classes of ' 'maintenance drugs have attracted attention because of their potential to affect ' 'susceptibility to and severity of COVID-19.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec002">\n' '<jats:title>Methods</jats:title>\n' '<jats:p>Using claims data on 20% random sample of Part D Medicare enrollees from April to ' 'December 2020, we identified patients diagnosed with COVID-19. Using a nested case-control ' 'design, non-COVID-19 controls were identified by 1:5 matching on age, race, sex, ' 'dual-eligibility status, and geographical region. We identified usage of ' 'angiotensin-converting enzyme inhibitors (ACEI), angiotensin-receptor blockers (ARB), ' 'statins, warfarin, direct factor Xa inhibitors, P2Y12 inhibitors, famotidine and ' 'hydroxychloroquine based on Medicare prescription claims data. Using extended Cox regression ' 'models with time-varying propensity score adjustment we examined the independent effect of ' 'each study drug on contracting COVID-19. For severity of COVID-19, we performed extended Cox ' 'regressions on all COVID-19 patients, using COVID-19-related hospitalization and all-cause ' 'mortality as outcomes. Covariates included gender, age, race, geographic region, low-income ' 'indicator, and co-morbidities. To compensate for indication bias related to the use of ' 'hydroxychloroquine for the prophylaxis or treatment of COVID-19, we censored patients who ' 'only started on hydroxychloroquine in 2020.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec003">\n' '<jats:title>Results</jats:title>\n' '<jats:p>Up to December 2020, our sample contained 374,229 Medicare patients over 65 who were ' 'diagnosed with COVID-19. Among the COVID-19 patients, 278,912 (74.6%) were on at least one ' 'study drug. The three most common study drugs among COVID-19 patients were statins 187,374 ' '(50.1%), ACEI 97,843 (26.2%) and ARB 83,290 (22.3%). For all three outcomes (diagnosis, ' 'hospitalization and death), current users of ACEI, ARB, statins, warfarin, direct factor Xa ' 'inhibitors and P2Y12 inhibitors were associated with reduced risks, compared to never users. ' 'Famotidine did not show consistent significant effects. Hydroxychloroquine did not show ' 'significant effects after censoring of recent starters.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec004">\n' '<jats:title>Conclusion</jats:title>\n' '<jats:p>Maintenance use of ACEI, ARB, warfarin, statins, direct factor Xa inhibitors and ' 'P2Y12 inhibitors was associated with reduction in risk of acquiring COVID-19 and dying from ' 'it.</jats:p>\n' '</jats:sec>', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-0593-5377', 'affiliation': [], 'authenticated-orcid': True, 'family': 'Fung', 'given': 'Kin Wah', 'sequence': 'first'}, {'affiliation': [], 'family': 'Baik', 'given': 'Seo H.', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Baye', 'given': 'Fitsum', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Zheng', 'given': 'Zhaonian', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Huser', 'given': 'Vojtech', 'sequence': 'additional'}, {'affiliation': [], 'family': 'McDonald', 'given': 'Clement J.', 'sequence': 'additional'}], 'container-title': 'PLOS ONE', 'container-title-short': 'PLoS ONE', 'content-domain': {'crossmark-restriction': False, 'domain': ['www.plosone.org']}, 'created': {'date-parts': [[2022, 4, 18]], 'date-time': '2022-04-18T17:27:56Z', 'timestamp': 1650302876000}, 'deposited': { 'date-parts': [[2022, 4, 18]], 'date-time': '2022-04-18T17:28:41Z', 'timestamp': 1650302921000}, 'editor': [{'affiliation': [], 'family': 'Mogi', 'given': 'Masaki', 'sequence': 'first'}], 'funder': [ { 'DOI': '10.13039/100000092', 'award': ['Intramural research program'], 'doi-asserted-by': 'publisher', 'name': 'U.S. National Library of Medicine'}], 'indexed': {'date-parts': [[2023, 10, 4]], 'date-time': '2023-10-04T10:32:07Z', 'timestamp': 1696415527413}, 'is-referenced-by-count': 7, 'issue': '4', 'issued': {'date-parts': [[2022, 4, 18]]}, 'journal-issue': {'issue': '4', 'published-online': {'date-parts': [[2022, 4, 18]]}}, 'language': 'en', 'license': [ { 'URL': 'https://creativecommons.org/publicdomain/zero/1.0/', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2022, 4, 18]], 'date-time': '2022-04-18T00:00:00Z', 'timestamp': 1650240000000}}], 'link': [ { 'URL': 'https://dx.plos.org/10.1371/journal.pone.0266922', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '340', 'original-title': [], 'page': 'e0266922', 'prefix': '10.1371', 'published': {'date-parts': [[2022, 4, 18]]}, 'published-online': {'date-parts': [[2022, 4, 18]]}, 'publisher': 'Public Library of Science (PLoS)', 'reference': [ { 'DOI': '10.1161/CIRCULATIONAHA.104.510461', 'article-title': 'Effect of angiotensin-converting enzyme inhibition and angiotensin II ' 'receptor blockers on cardiac angiotensin-converting enzyme 2', 'author': 'C.M. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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