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

Rahul Sethia; Manya Prasad; Soumya Jagannath Mahapatra; Neeraj Nischal; Manish Soneja; Pramod Garg; Shalimar

Rahul Sethia, Manya Prasad, MD Soumya Jagannath Mahapatra, MD Neeraj Nischal, MD Manish Soneja, MD Pramod Garg, MD Shalimar

doi:10.1101/2020.09.28.20203463

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.

References

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DOI record: { "DOI": "10.1101/2020.09.28.20203463", "URL": "http://dx.doi.org/10.1101/2020.09.28.20203463", "abstract": "Abstract\n \n Background\n 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.\n \n \n Methods\n 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.\n \n \n Results\n 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).\n \n \n Conclusion\n Further evidence from RCTs is required for famotidine to treat COVID 19.\n ", "accepted": { "date-parts": [ [ 2020, 9, 29 ] ] }, "author": [ { "affiliation": [], "family": "Sethia", "given": "Rahul", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "first" }, { "affiliation": [], "family": "Prasad", "given": "Manya", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Mahapatra", "given": "Soumya Jagannath", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Nischal", "given": "Neeraj", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Soneja", "given": "Manish", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Garg", "given": "Pramod", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0003-1247-437X", "affiliation": [], "authenticated-orcid": false, "family": "Shalimar", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" } ], "container-title": [], "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2020, 9, 30 ] ], "date-time": "2020-09-30T15:35:22Z", "timestamp": 1601480122000 }, "deposited": { "date-parts": [ [ 2026, 1, 15 ] ], "date-time": "2026-01-15T13:55:29Z", "timestamp": 1768485329000 }, "group-title": "Infectious Diseases (except HIV/AIDS)", "indexed": { "date-parts": [ [ 2026, 1, 16 ] ], "date-time": "2026-01-16T07:54:21Z", "timestamp": 1768550061727, "version": "3.49.0" }, "institution": [ { "name": "medRxiv" } ], "is-referenced-by-count": 8, "issued": { "date-parts": [ [ 2020, 9, 30 ] ] }, "link": [ { "URL": "https://syndication.highwire.org/content/doi/10.1101/2020.09.28.20203463", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "54368", "original-title": [], "posted": { "date-parts": [ [ 2020, 9, 30 ] ] }, "prefix": "10.64898", "published": { "date-parts": [ [ 2020, 9, 30 ] ] }, "publisher": "openRxiv", "reference": [ { "key": "2021021307400560000_2020.09.28.20203463v1.1", "unstructured": "COVID-19 Map [Internet]. 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Outcome	Improvement
Mortality	17% lower [8‑26%]
Ventilation	4% lower [-18‑21%]
ICU admission	2% higher [-41‑75%]
Hospitalization	15% lower [7‑22%]
Cases	12% fewer [-10‑30%]