Summary of COVID-19 famotidine studies

208 patient famotidine ICU RCT: 16% lower mortality (p=0.53), 9% shorter ICU admission (p=0.33), 33% faster improvement (p<0.0001), and 7% faster recovery (p=0.14).
RCT 208 ICU patients in Bangladesh, showing improved recovery with famotidine. Famotidine 40mg (<60kg) or 60mg every 8 hours.
Aug 2022, World J. Clinical Cases, https://www.wjgnet.com/2307-8960/full/v10/i23/8170.htm, https://c19p.org/chowdhury2

2. Mather et al., Impact of Famotidine Use on Clinical Outcomes of Hospitalized Patients With COVID-19

772 patient famotidine prophylaxis PSM study: 61% lower mortality (p=0.004) and 50% lower combined mortality/intubation (p=0.003).
PSM retrospective 878 hospitalized patients in the USA, 83 with existing famotidine use, showing significantly lower mortality with treatment.
Aug 2020, American J. Gastroenterology, https://journals.lww.com/10.14309/ajg.0000000000000832, https://c19p.org/mather

3. Wagner et al., A retrospective analysis of clinical outcomes between hospitalized patients with COVID‐19 who received famotidine or pantoprazole

1,457 patient famotidine late treatment study: 64% lower mortality (p<0.0001) and 6% lower ventilation (p=0.77).
Retrospective 2,184 hospitalized patients in the USA, 638 treated with famotidine, showing lower mortality with treatment.
Oct 2021, JGH Open, https://onlinelibrary.wiley.com/doi/10.1002/jgh3.12905, https://c19p.org/wagner

4. Brennan et al., Oral famotidine versus placebo in non-hospitalised patients with COVID-19: a randomised, double-blind, data-intense, phase 2 clinical trial

55 patient famotidine early treatment RCT: 48% improved recovery (p=0.23).
Small RCT with 27 famotidine and 28 placebo patients, showing improved recovery with treatment. Recovery was faster with treatment for 14 of 16 symptoms. There was no mortality or hospitalization. NCT04724720.
Feb 2022, Gut, https://gut.bmj.com/content/early/2022/02/09/gutjnl-2022-326952, https://c19p.org/brennan

5. Freedberg et al., Famotidine Use Is Associated With Improved Clinical Outcomes in Hospitalized COVID-19 Patients: A Propensity Score Matched Retrospective Cohort Study

1,620 patient famotidine prophylaxis PSM study: 57% lower combined mortality/intubation (p=0.02).
PSM retrospective 1,620 hospitalized patients in the USA, 84 with existing famotidine use, showing lower risk of combined death/intubation with treatment.
May 2020, Gastroenterology, https://www.gastrojournal.org/article/S0016-5085(20)34706-5/fulltext, https://c19p.org/freedberg

6. Kim et al., Histamine-2 Receptor Antagonists and Proton Pump Inhibitors Are Associated With Reduced Risk of SARS-CoV-2 Infection Without Comorbidities Including Diabetes, Hypertension, and Dyslipidemia: A Propensity Score-Matched Nationwide Cohort Study

21,026 patient famotidine prophylaxis PSM study: 36% fewer cases (p<0.0001).
PSM retrospective in South Korea, showing lower risk of COVID-19 cases with H2RA (including famotidine) and PPI use, but no significant difference in severe outcomes (results provided for the combined groups only).
Mar 2023, J. Korean Medical Science, https://jkms.org/DOIx.php?id=10.3346/jkms.2023.38.e99, https://c19p.org/kim11

7. Siraj et al., Efficacy of Various Treatment Modalities on Patient-related Outcome in Hospitalized COVID-19 Patients – A Retrospective Study

1,000 patient famotidine late treatment study: 36% lower mortality (p=0.002).
Retrospective 1,000 COVID+ hospitalized patients in India, showing lower mortality with famotidine and remdesivir in multivariable logistic regression.
Feb 2022, Indian J. Clinical Practice, https://ijcp.in/Admin/CMS/PDF/6.%20OriginalResearch_IJCP_Feb2022.pdf, https://c19p.org/siraj

8. Razjouyan et al., Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans

10,074 patient famotidine prophylaxis study: 27% lower mortality (p=0.006).
Retrospective 10,074 hospitalized veterans with COVID-19 in the USA, showing lower mortality with existing famotidine use.
Oct 2021, Nicotine & Tobacco Research, https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntab223/6409756?login=false, https://c19p.org/razjouyan

9. Mura et al., Real-world evidence for improved outcomes with histamine antagonists and aspirin in 22,560 COVID-19 patients

1,126 patient famotidine late treatment PSM study: 21% lower mortality (p=0.02).
PSM retrospective TriNetX database analysis of 1,379 severe COVID-19 patients requiring respiratory support, showing lower mortality with aspirin (not reaching statistical significance) and famotidine, and improved results from the combination of both.
Mar 2021, Signal Transduction and Targeted Therapy, https://www.nature.com/articles/s41392-021-00689-y, https://c19p.org/murafm

10. Samimagham et al., The Efficacy of Famotidine in improvement of outcomes in Hospitalized COVID-19 Patients: A phase III randomised clinical trial

20 patient famotidine late treatment RCT: 33% shorter hospitalization (p=0.04) and no change in recovery (p=1).
Very small RCT with 20 patients in Iran, showing shorter hospitalization time with famotidine treatment. There was no mortality or ICU admission. Famotidine 160mg four times a day. IRCT20200509047364N2.
Apr 2021, Research Square, https://www.researchsquare.com/article/rs-462937/v1, https://c19p.org/samimagham

11. Pahwani et al., Efficacy of Oral Famotidine in Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2

178 patient famotidine late treatment RCT: 11% lower mortality (p=1), 12% lower ventilation (p=0.73), 10% lower ICU admission (p=0.86), and 17% shorter hospitalization (p<0.0001).
RCT with 89 famotidine and 89 control patients in Pakistan, showing faster recovery but no significant difference in mortality. 40mg oral famotidine daily.
Feb 2022, Cureus, https://www.cureus.com/articles/78980-efficacy-of-oral-famotidine-in-patients-hospitalized-with-severe-acute-respiratory-syndrome-coronavirus-2, https://c19p.org/pahwani

12. Balouch et al., Role of Famotidine and Other Acid Reflux Medications for SARS-CoV-2: A Pilot Study

307 patient famotidine prophylaxis study: 22% fewer symptomatic cases (p=0.49) and 37% faster recovery (p=0.32).
Survey of 307 patients in the USA, showing no significant difference in COVID-19 cases with famotidine use.
Jan 2021, J. Voice, https://www.sciencedirect.com/science/article/pii/S0892199721000321, https://c19p.org/balouch

13. Yeramaneni et al., Famotidine Use Is Not Associated With 30-day Mortality: A Coarsened Exact Match Study in 7158 Hospitalized Patients With Coronavirus Disease 2019 From a Large Healthcare System

7,158 patient famotidine prophylaxis study: 51% lower mortality (p=0.22).
Retrospective 7,158 hospitalized COVID-19 patients in the USA, showing higher risk or mortality with in-hospital famotidine use, but lower risk when there was pre-existing at-home use, without statistical significance in both cases.
Feb 2021, Gastroenterology, https://www.gastrojournal.org/article/S0016-5085(20)35249-5/fulltext, https://c19p.org/yeramaneni

14. Zangeneh et al., Survival analysis based on body mass index in patients with Covid-19 admitted to the intensive care unit of Amir Al-Momenin Hospital in Arak – 2021

famotidine ICU study: 39% lower mortality (p=0.01).
Retrospective 193 ICU patients in Iran, showing lower mortality with famotidine treatment.
May 2022, Obesity Medicine, https://www.sciencedirect.com/science/article/pii/S245184762200032Xhttps://www.sciencedirect.com/science/article/pii/S245184762200032X/pdf, https://c19p.org/zangeneh

15. Özden et al., Effects of Famotidine on COVID-19 Patients in Intensive Care Unit: A Retrospective Clinical Trial

59 patient famotidine ICU study: 29% lower mortality (p=0.19), 1% higher ventilation (p=1), and 26% shorter ICU admission (p=0.6).
Retrospective 59 ICU patients in Turkey, showing no significant difference in 30-day mortality or invasive mechanical ventilation with 160mg/day famotidine treatment. However, the famotidine group had lower fibrinogen and procalcitonin, suggesting possible benefits for coagulation, inflammation, and secondary infections. Limitations include the small sample size, lack of randomization, and other confounding treatments.
Feb 2023, Boğazi̇çi̇ Tip Dergi̇si̇, https://jag.journalagent.com/bmj/pdfs/BMJ-77044-ORIGINAL_RESEARCH-OZDEN.pdf, https://c19p.org/ozden

16. Mehrizi et al., Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data

917,198 patient famotidine late treatment study: 19% lower mortality (p<0.0001).
Retrospective study of 917,198 hospitalized COVID-19 cases covered by the Iran Health Insurance Organization over 26 months showing that antithrombotics, corticosteroids, and antivirals reduced mortality while diuretics, antibiotics, and antidiabetics increased it. Confounding makes some results very unreliable. For example, diuretics like furosemide are often used to treat fluid overload, which is more likely in ICU or advanced disease requiring aggressive fluid resuscitation. Hospitalization length has increased risk of significant confounding, for example longer hospitalization increases the chance of receiving a medication, and death may result in shorter hospitalization. Mortality results may be more reliable. Confounding by indication is likely to be significant for many medications. Authors adjustments have very limited severity information (admission type refers to ward vs. ER department on initial arrival). We can estimate the impact of confounding from typical usage..
Dec 2023, Frontiers in Public Health, https://www.frontiersin.org/articles/10.3389/fpubh.2023.1280434/full, https://c19p.org/mehrizifm

17. Taşdemir et al., Famotidine in COVID-19 treatment

179 patient famotidine late treatment study: 45% lower mortality (p=0.29), 37% lower ICU admission (p=0.36), 18% shorter hospitalization (p=0.003), and 20% faster recovery (p=0.04).
Retrospective 179 hospitalized patients in Turkey, 85 treated with famotidine and 94 treated with pantoprazole, showing faster recovery with famotidine in unadjusted results.
Jul 2021, Konuralp Tıp Dergisi, https://dergipark.org.tr/en/pub/ktd/article/935888, https://c19p.org/tasdemir

18. Loucera et al., Real-world evidence with a retrospective cohort of 15,968 COVID-19 hospitalized patients suggests 21 new effective treatments

15,968 patient famotidine prophylaxis study: 18% lower mortality (p=0.25).
Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, azithromycin, aspirin, vitamin D, vitamin C, and budesonide. Since only hospitalized patients are included, results do not reflect different probabilities of hospitalization across treatments.
Aug 2022, Virology J., https://virologyj.biomedcentral.com/articles/10.1186/s12985-023-02195-9, https://c19p.org/loucera3fm

19. Shamsi et al., Survival and Mortality in Hospitalized Children with COVID-19: A Referral Center Experience in Yazd, Iran

183 patient famotidine late treatment study: 75% lower mortality (p=0.21).
Retrospective 183 hospitalized pediatric COVID-19 patients in Iran, showing no significant difference in mortality with in unadjusted results.
Jul 2023, Canadian J. Infectious Diseases and Medical Microbiology, https://www.hindawi.com/journals/cjidmm/2023/5205188/, https://c19p.org/shamsifm

20. MacFadden et al., Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications

famotidine prophylaxis study: 7% fewer cases (p=0.16).
Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing no significant difference in cases with chronic use of famotidine.
Mar 2022, Open Forum Infectious Diseases, https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofac156/6555707, https://c19p.org/macfaddenfm

21. Kuno et al., The association between famotidine and in-hospital mortality of patients with COVID-19

9,565 patient famotidine late treatment PSM study: no change in mortality (p=0.97).
PSM retrospective 9,565 COVID-19 hospitalized patients in the USA, 1,593 receiving famotidine, showing no significant difference in mortality.
Oct 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.27375, https://c19p.org/kuno2

22. Fung et al., Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients

famotidine prophylaxis study: no change in mortality (p=1), 6% lower hospitalization (p=0.0002), and 12% more cases (p<0.0001).
Retrospective database analysis of 374,229 patients in the USA, showing higher cases, lower hospitalizations, and no change in mortality with famotidine use.
Sep 2021, PLoS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266922, https://c19p.org/fungfm

23. Elhadi et al., Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study

465 patient famotidine ICU study: 7% lower mortality (p=0.57).
Prospective study of 465 COVID-19 ICU patients in Libya showing no significant differences with treatment.
Apr 2021, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251085, https://c19p.org/elhadifm

24. Wallace et al., Association of the patterns of use of medications with mortality of COVID-19 infection: a hospital-based observational study

7,944 patient famotidine prophylaxis study: 11% higher mortality (p=0.33).
Retrospective 9,532 hospitalized COVID+ veterans in the USA, showing no significant difference in mortality with famotidine use. The study provides results for use before, after, and before+after. Before+after should more accurately represent prophylaxis up to COVID-19 infection (and continued use). Before included use up to 2 years before, and after included use up to 60 days later.
Dec 2021, BMJ Open, https://bmjopen.bmj.com/content/11/12/e050051.info, https://c19p.org/wallacefm

25. Cheung et al., Association Between Famotidine Use and COVID-19 Severity in Hong Kong: A Territory-wide Study

952 patient famotidine prophylaxis study: 34% higher severe cases (p=0.72).
Retrospective 952 COVID-19 patients in Hong Kong, showing no significant difference in severe disease with famotidine use or PPI use.
Apr 2021, Gastroenterology, https://www.gastrojournal.org/article/S0016-5085(20)34940-4/fulltext, https://c19p.org/cheung

26. Shoaibi et al., Comparative Effectiveness of Famotidine in Hospitalized COVID-19 Patients

28,636 patient famotidine late treatment study: 3% higher mortality (p=0.67) and 3% higher combined mortality/ICU admission (p=0.62).
Retrospective 1,816 famotidine users and 26,820 non-users hospitalized for COVID-19 in the USA, showing no significant differences with treatment.
Sep 2020, American J. Gastroenterology, https://journals.lww.com/10.14309/ajg.0000000000001153, https://c19p.org/shoaibif

27. Zhou et al., Proton pump inhibitor or famotidine use and severe COVID-19 disease: a propensity score-matched territory-wide study

3,114 patient famotidine late treatment PSM study: 84% higher severe cases (p=0.0001).
Retrospective 4,445 COVID+ patients in China, showing higher risk of combined death/intubation/ICU with famotidine and with PPIs.
Dec 2020, Gut, https://gut.bmj.com/content/70/10/2012.full, https://c19p.org/zhou3

28. Kwon et al., Effectiveness of famotidine on the risk of poor prognosis in patients with COVID-19: A nationwide cohort study in Korea

6,556 patient famotidine prophylaxis study: 107% higher progression (p=0.06) and 109% higher need for oxygen therapy (p=0.07).
PSM retrospective 6,556 COVID-19 patients in South Korea, showing higher risk of poor outcomes with famotidine vs. other H2-blocker use.
May 2023, Heliyon, https://www.sciencedirect.com/science/article/pii/S2405844023033789, https://c19p.org/kwon2

29. Stolow et al., A Retrospective Review: Famotidine Use Is Not Associated With Improved Outcomes in Hospitalized Patients With COVID-19

489 patient famotidine late treatment study: 519% higher mortality (p=0.001) and 2390% higher ICU admission (p=0.001).
Retrospective 489 COVID+ hospitalized patients in the USA, showing higher mortality with famotidine treatment.
Oct 2021, American J. Gastroenterology, https://journals.lww.com/ajg/Fulltext/2021/10001/S1301_A_Retrospective_Review__Famotidine_Use_Is.1305.aspx, https://c19p.org/stolow

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