To The Editor:
Kow and colleagues' interest in our recent letter to the editor1 regarding the potential for famotidine in COVID-19 infection was much appreciated. Obviously, their meta-analysis is small and probably not adequately powered but still suggested 37% and 7% reductions in severe disease in the general and adjusted analyses, respectively: obviously, with wide confidence intervals that were not close to statistical significance. A large-scale randomized study that was adequately powered, preferably with famotidine, started early in COVID-19, would be required to fully determine the full potential of the benefits of famotidine in COVID-19; this type of study is likely not coming in this pandemic. However, their meta-analysis does not provide much reason for concern regarding significant harms or risks with famotidine in COVID-19.
At present, many clinicians are recommending not only famotidine but several other nonprescription fairly harmless therapies including vitamins C and D, zinc, melatonin, and H1 antihistamine agents for outpatient therapy in COVID -19, all with various degrees of evidence.2 At present, an old generic prescription medication, colchicine, typically used for gout,3 but also for pericarditis, is now used with considerable evidence for coronary artery disease.3 Colchicine is now being considered in COVID-19, originally based on the Greek Study in the Effects of Colchicine in Covid-19 Complications Prevention (GREECO-19) study4 , 5 and now with considerably more evidence in the recently released Colchicine Coronavirus SARS-CoV2 (COLCORONA) trial.6 In this latter major trial, 4159 patients with polymerase chain reaction-confirmed COVID-19, colchicine (0.5 mg twice daily for 3 days, then once daily for 27 days) reduced the primary end point of hospitalization and death significantly by 25%, including significant reductions in hospitalization by 25%, and trends for mechanical ventilation and death (–50% and –44%, respectively). Certainly, evidence for various therapies in COVID-19 continues to evolve rapidly.7 , 8
Footnotes
Potential Competing Interests: The author reports no competing interests.
References
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