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
Yeramaneni et al.
, Famotidine Use Is Not Associated With 30-day Mortality: A Coarsened Exact Match Study in 7158 Hospitalized..
, Gastroenterology, doi:10.1053/j.gastro.2020.10.011
Retrospective 7,158 hospitalized COVID-19 patients in the USA, showing higher risk or mortality with in-hospital famotidine use and lower risk with pre-existing use, without statistical significance in both cases.
risk of death, 51.0% lower, OR 0.49, p = 0.22, treatment 351, control 6,807, adjusted per study, home use, multivariable, RR approximated with OR.
risk of death, 59.0% higher, OR 1.59, p = 0.09, treatment 410, control 746, adjusted per study, hospital use, multivariable, RR approximated with OR, late treatment result.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yeramaneni et al., 28 Feb 2021, retrospective, USA, peer-reviewed, 6 authors, study period 11 February, 2020 - 8 May, 2020.
Abstract: Gastroenterology 2021;160:919–921
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
Samrat Yeramaneni,1 Pratik Doshi,1 Kenneth Sands,2 Mandelin Cooper,2 Dax Kurbegov,1 and
Sarah Cannon Research Institute, HCA Healthcare, Nashville, Tennessee; 2Clinical Operations Group, HCA Healthcare,
Nashville, Tennessee; 3HCA Research Institute, HCA Healthcare, Nashville, Tennessee
revious reports have found that in-hospital famotidine
use in coronavirus disease 2019 (COVID-19) patients
was associated with reduced risk of death or intubation.1,2 In 1
of these studies the authors proposed that famotidine inhibits
the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) protease, 3-chymotrypsin-like protease, that is essential for breakdown of the immature SARS-CoV-2 protein particles that contribute to the inﬂammatory response seen in
some COVID-19–infected individuals,1 which in turn can lead
to acute respiratory distress syndrome, multiorgan dysfunction, physiologic deterioration, and death.3
In a global pandemic with a lack of US Food and Drug
Administration–approved targeted therapeutic agents,
identiﬁcation and repurposing of well-established drugs
with a proven track record of safety, affordability, and
widespread availability are necessary.4 The purpose of this
study was to evaluate the reported protective effect of
famotidine on mortality in hospitalized COVID-19 patients.
Refer to Supplementary Methods for complete details. In
brief, admitted adults to afﬁliated hospitals who tested positive
for SARS-CoV-2 by reverse transcriptase polymerase chain reaction between February 11, 2020 and May 8, 2020 were
included. Exclusion criteria were death or intubation within 48
hours of admission or if famotidine was received >24 hours
after admission. The primary outcome was 30-day all-cause
mortality. Primary exposure was in-hospital famotidine use,
regardless of dose and route, within 24 hours of admission.
To mitigate bias from nonrandomized assignment of treatment, a coarsened exact matching (CEM)5 technique was used
for famotidine users and nonusers on age (by 10-year intervals), sex, race, ethnicity, body mass index, comorbidities,
and in-hospital hydroxychloroquine (HCQ) use. A multivariable
logistic regression model within the CEM cohort and adjusted
for baseline World Health Organization (WHO) severity and use
of other medications was performed to evaluate the association
between famotidine use and 30-day mortality.
A total of 8915 patients were assessed for eligibility. Of
these, 1441 patients (16.2%) were excluded because of death
(1.4%), intubation (5.0%), or famotidine >24 hours after
admission (9.8%). Of the 7474 eligible patients, 316 patients
were excluded for missing discharge disposition status
(0.9%) or >30-day mortality (3.4%), resulting in a ﬁnal
sample of 7158 patients. Of the 7158 patients included in the
analysis, 1127 patients (15.7%) were exposed and 6031 patients (84.3%) were unexposed. After CEM of the 1156 patients, 410 patients (35.5%) were exposed and 746 patients
(64.5%) were unexposed (Supplementary Figure 1).
Prematch and Postmatch Characteristics
Overall, 15.7% of patients (n ¼ 1127) received famotidine and 84.3% (n ¼ 6031) did not. Mean age was 57.9 ±
19.3 years, 50.9% were women, 44.6% white, and 25.2%
black. Famotidine was used for a median of..
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