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NY Hospitals Testing Pepcid Ingredient as COVID-19 Treatment

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NY Hospitals Testing Pepcid Ingredient as COVID-19 Treatment

2020-04-28 16:50:12

By Laura Tucker, Staff writer; Image: Pepcid Complete (Image source: Pepcid)

With so much talk about the use of hydroxychloroquine and chloroquine to treat coronavirus COVID-19, no one knew there was another drug test going on. Hospitals in New York have also been testing famotidine, the active ingredient in the over-the-counter heartburn medicine Pepcid, on patients. 

In the next few weeks, everyone should learn the preliminary results for the clinical trial with famotidine, Dr. Kevin Tracey, the president of Feinstein Institutes for Medical Research at Northwell Health, said. There are 23 hospitals in the system in the New York City area. 187 patients have been enrolled in the clinical trial, and Northwell would like to eventually enroll 1,200.

"There are many examples in the history of medicine where a drug that was designed for one purpose turns out to have an effect on another disease," explained Tracey. 

He added that if famotidine works, it would be easy to use it for widespread treatment. "It's generic, it's plentiful, and it's inexpensive," said Tracey. Yet, he also admitted that it may not work. "We don't know if it has any benefit. We really don't. I swear we don't," he promised. "People are hoping for anything. But we need to do this clinical trial."

Additionally, hospital patients in the study are taking famotidine in very large doses intravenously. These doses are about nine times the amount that is normally taken by a person with heartburn. 

"You should not go to the drugstore and take a bunch of heartburn medicine," warned the doctor.

He and the other doctors thought about trying famotidine on COVID-19 patients after they realized some patients in China who were taking the drug were doing better than patients who were not taking the drug. 

Tracey explained that the studies on patients in China haven't been published yet. The studies started after infectious disease specialist Dr. Michael Callahan at Massachusetts General Hospital worked with COVID-19 patients in China. He realized that some patients with lower incomes were surviving longer than wealthier patients.

Upon closer inspection, Callahan, along with the Chinese doctors, realized that many of the people with lower incomes were taking famotidine, while the wealthier patients were more likely to be taking a more expensive drug. 

"The poor peasants really seemed to do well on famotidine," recalled Tracey. "There are a lot of anecdotes passing around that give us some hope."

In addition to the China study, Tracey said Florida-based Alchem Laboratories used a computer model to make a list of drugs that may work on coronavirus COVID-19, and famotidine was near the top of the list. 

In theory, Tracey believes this is because the structure of famotidine could stop the virus from replicating in the same way that protease inhibitors treat HIV.

Additionally, in the Northwell trial, all the patients were taking hydroxychloroquine, as Tracey notes that when the study began early this month, doctors and patients were insisting that the anti-malaria drug be used, and it more or less became the standard of care. 

Hydroxychloroquine is one of the drugs that Trump has been frequently pushing as a "game-changer" to fight the coronavirus pandemic. However, recent studies show that not only is it not helpful, patients taking it had a higher rate of death than those who did not.

"You have to be fair to people — they're reading in the paper and hearing on the news that hydroxychloroquine works, and they look at their dying wife or grandma or child, and they want to try it, and how could we say no? What kind of person would say no," asked Tracey. 

Half of the patients in the study will be given famotidine as well as hydroxychloroquine. The other half will be given a placebo of intravenous saline, which will not have an effect. However, the future of the use of the anti-malaria drug is unknown, as the Food and Drug Administration warned against it being used on coronavirus patients because of possible side effects.

Because of this, Tracey said the independent board monitoring the trial will decide whether to continue with hydroxychloroquine in the trial.  

Northwell had not gone public with the trial until now because of what they witnessed with hydroxychloroquine and the rush to add the drug to patients' care. He doesn't want the same thing to happen with intravenous famotidine. If it's unproven and there's a rush on it, the research team may not have enough for the study.

It's also a concern that people who don't have heartburn will storm the stores and buy famotidine pills, misunderstanding and thinking it will help fight COVID-19. It could leave heartburn patients without the drug, which is in more of a need since the FDA pulled another heartburn medicine, Zantac, off the shelf. 

Tracey said these are unusual concerns during an unusual time. "That's the reality oftrying to do the right thing in a pandemic. It's very, very hard," he reasoned.

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