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Infectious Diseases

Updated 30 April 2020

Heartburn remedy in clinical trial for coronavirus

While several existing drugs are being researched to find an effective cure for the new coronavirus, an unlikely candidate has entered clinical trial – an ingredient in a common heartburn remedy.

As the list for possible treatments for the new coronavirus grows, a new ingredient, famotidine, has joined the ranks.

This is the active ingredient found in common over-the-counter heartburn remedies.

Testing this compound against the novel coronavirus began, when on 7 April 2020, Covid-19 patients at Northwell Health in the New York City area began receiving famotidine intravenously, according to reports.

Why was it kept quiet?

The dose given to these patients is nine times higher than the dose needed to treat heartburn. The hospital kept quiet about the test to prevent people from stockpiling this common drug before it was even proven to work.

“If we talked about this to the wrong people or too soon, the drug supply would be gone,” stated Kevin Tracey, a former neurosurgeon in charge of the hospital system’s research.

What did the 'secret' trial entail?

On Saturday 25 April 2020, 187 patients with Covid-19, including some in a critical condition and on ventilators, were added to the trial, involving 1 174 people.

According to reports from China and some molecular modelling research results, the drug is able to bind to a key enzyme in the new coronavirus and could possibly make a difference. However, researchers in this trial had to be careful – as chloroquine and hydroxychloroquine were hyped up before any efficacy was even proven; people were starting to become too enthusiastic; and it was a risk that demand for those medicines would soar, depleting the stock of those areas that really needed it.

Why famotidine?

In the early days of the novel coronavirus, Dr Michael Callahan, who specialises in infectious diseases, first spoke about the possibility of using this drug against the new coronavirus in the United States.

He spent a lot of time in areas where disease outbreaks were rife in the past, including Hong Kong, where the 2003 SARS outbreak originated. As the new coronavirus started making headlines, he was working on an avian flu project in Nanjing, China, and soon made his way to Wuhan as new coronavirus cases escalated.

Reviewing 6 212 patients, he noticed that a large portion of those who survived suffered from heartburn and took regular remedies containing famotidine. According to the analyses, patients who took famotidine died at a rate of 14% instead of the 27% of those who didn’t.

It should be noticed that the analysis was crude and the results not significant.

However, back in the USA, he teamed up with Robert Kadlec, assistant secretary for preparedness and response at the Department of Health and Human Services, and with Robert Malone, chief medical officer of Florida-based Alchem Laboratories.

Malone wanted to see whether a viral enzyme called the papainlike protease, could be replicated the new coronavirus pathogen. Then, it needed to be determined if famotidine could bind to this protein.

Is the drug working?

Researchers don’t want to get too excited. According to Tracey, they will only know the prospects once the results from the first 391 patients are available. In the meantime, he doesn’t want to reveal too much too soon.

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