Department of Pharmacology, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India.
Drug Res (Stuttg). 2021 Jul;71(6):295-301. doi: 10.1055/a-1397-6763. Epub 2021 Mar 23.
COVID-19 caused by SARS-CoV-2 was declared as a global pandemic by the WHO. Famotidine is a histamine-2 (H2) receptor antagonist which blocks the H2 receptors in the parietal cells, decreasing gastric acid secretion. Our review aims to study all the available scientific evidence on famotidine research outcomes systematically to introspect its clinical efficacy and probable mechanisms and clinical efficacy against SARS-CoV-2.
An electronic search of PubMed, Scopus and Google Scholar was performed using MeSH terms "SARS CoV-2" OR "COVID-19" AND"FAMOTIDINE". Relevant informationwas extracted from studies reporting the efficacy of famotidine in COVID-19.
We found a total of 32 studies, out of which only 14 were relevant and were included in our review.Molecular computational studies showed that famotidine selectively acts on viral replication proteases papain-like protease (PLpro) and 3-chymotrypsin-like protease (3CLpro). Additionally, it acts via inverse-agonism on the H2 receptors present in neutrophils and eosinophils which leads to inhibition of cytokine release. Clinical study findings have pointed toward significant improvements in COVID-19 patient-reported symptoms in non-hospitalized patients and reduction in intubation or death in critically ill patients associated with the usage of famotidine. However,in one of the studies,famotidine has failed to show any significant benefit in reducing mortality due to COVID-19.
Famotidine has the potential to answer the ongoing global challenge owing to its selective action on viral replication. Additionally, clinical findings in COVID-19 patients support its efficacy to reduce clinical symptoms of COVID-19.We suggest that further optimally powered randomized clinical trials should be carried out to come up with definitive conclusions.
世界卫生组织（WHO）宣布由 SARS-CoV-2 引起的 COVID-19 为全球大流行。法莫替丁是一种组胺 2（H2）受体拮抗剂，可阻断壁细胞中的 H2 受体，减少胃酸分泌。我们的综述旨在系统地研究所有关于法莫替丁研究结果的现有科学证据，以反思其对 SARS-CoV-2 的临床疗效和可能机制。
使用 MeSH 术语“SARS CoV-2”或“COVID-19”和“法莫替丁”，对 PubMed、Scopus 和 Google Scholar 进行电子检索。从报道法莫替丁在 COVID-19 中的疗效的研究中提取相关信息。
我们共发现 32 项研究，其中只有 14 项与我们的综述相关并被纳入。分子计算研究表明，法莫替丁选择性作用于病毒复制蛋白酶木瓜蛋白酶样蛋白酶（PLpro）和 3-糜蛋白酶样蛋白酶（3CLpro）。此外，它通过对存在于中性粒细胞和嗜酸性粒细胞中的 H2 受体的反向激动作用，抑制细胞因子释放。临床研究结果表明，非住院 COVID-19 患者的症状报告有显著改善，与使用法莫替丁相关的重症患者的插管或死亡减少。然而，在一项研究中法莫替丁未能显示出在降低 COVID-19 死亡率方面有任何显著益处。
由于其对病毒复制的选择性作用，法莫替丁有可能应对当前的全球挑战。此外，COVID-19 患者的临床研究结果支持其疗效可减轻 COVID-19 的临床症状。我们建议应进行进一步的、最佳设计的随机临床试验，以得出明确的结论。
