Comparative Effectiveness of Famotidine in Hospitalized COVID-19 Patients
Comparative Effectiveness of Famotidine in Hospitalized COVID-19 Patients
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DOI：
10.14309/ajg.0000000000001153
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发表时间：
2021-04-01
影响因子：
9.8
通讯作者：
Ryan, Patrick
中科院分区：
文献类型：
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作者：
Shoaibi, Azza;Fortin, Stephen Patrick;Ryan, Patrick
引言：法莫替丁被认为是2019冠状病毒病（COVID-19）的潜在治疗药物。我们比较了COVID-19结局的发生率（即，住院法莫替丁使用者与质子泵抑制剂（PPI）使用者、羟氯喹使用者或法莫替丁非使用者之间的死亡和死亡或强化服务使用）。方法：我们使用COVID-19 Premier医院电子健康记录的数据构建了一项回顾性队列研究。研究人群为18岁或以上的COVID-19住院患者。法莫替丁、PPI和羟氯喹暴露组定义为患者在入院当天分发含有3种药物之一的任何药物。法莫替丁非使用者组来自相同来源人群，在入院前或入院当天无任何以法莫替丁为活性成分的药物暴露史。基于意向治疗原则定义风险时间，从入院后1天开始至入院后30天。对于每个研究对照组，我们通过大规模正则化逻辑回归拟合倾向评分模型。使用生存模型对结局进行建模。结果：我们确定了2，193名PPI使用者，5，950名羟氯喹使用者，1，816名法莫替丁使用者和26，820名非法莫替丁使用者。倾向评分分层后，死亡的风险比（HR）如下：法莫替丁vs无法莫替丁HR 1.03（0.89-1.18），vs PPI：HR 1.14（0.94-1.39），vs羟氯喹：1.03（0.85-1.24）。在死亡风险或密集服务使用方面也观察到了类似的结果。讨论内容：我们没有发现使用法莫替丁的住院COVID-19患者与未使用者或PPI或羟氯喹使用者相比COVID-19结局风险降低的证据。
INTRODUCTION: Famotidine has been posited as a potential treatment for coronavirus disease 2019 (COVID-19). We compared the incidence of COVID-19 outcomes (i.e., death and death or intensive services use) among hospitalized famotidine users vs proton pump inhibitors (PPIs) users, hydroxychloroquine users, or famotidine nonusers separately. METHODS: We constructed a retrospective cohort study using data from COVID-19 Premier Hospital electronic health records. The study population was COVID-19 hospitalized patients aged 18 years or older. Famotidine, PPI, and hydroxychloroquine exposure groups were defined as patients dispensed any medication containing 1 of the 3 drugs on the day of admission. The famotidine nonuser group was derived from the same source population with no history of exposure to any drug with famotidine as an active ingredient before or on the day of admission. Time at risk was defined based on the intention-to-treat principle starting 1 day after admission to 30 days after admission. For each study comparison group, we fit a propensity score model through large-scale regularized logistic regression. The outcome was modeled using a survival model. RESULTS: We identified 2,193 users of PPI, 5,950 users of the hydroxychloroquine, 1,816 users of famotidine, and 26,820 nonfamotidine users. After propensity score stratification, the hazard ratios (HRs) for death were as follows: famotidine vs no famotidine HR 1.03 (0.89-1.18), vs PPIs: HR 1.14 (0.94-1.39), and vs hydroxychloroquine: 1.03 (0.85-1.24). Similar results were observed for the risk of death or intensive services use. DISCUSSION: We found no evidence of a reduced risk of COVID-19 outcomes among hospitalized COVID-19 patients who used famotidine compared with those who did not or compared with PPI or hydroxychloroquine users.