COVID-19 Treatments: Study Shows Using Dual Antihistamines Such As Cetirizine And Famotidine Helps Pulmonary Symptoms In COVID-19 Patients
: Researchers from Mississippi have in a new study found that utilizing both the antihistamines Cetirizine and Famotidine appears to reduce pulmonary symptoms and may have other benefits in patients with COVID-19.
The study findings were published in the journal: Pulmonary Pharmacology & Therapeutics https://www.sciencedirect.com/science/article/pii/S1094553920301462?via%3Dihub#
Lead researcher Dr Reed B. Hogan II of GI Associates, in Flowood, Mississippi told media, “Our team is excited about the global potential application of this unique approach to the cytokine storm which drives morbidity and mortality in this pandemic.
The study team says that antihistamines are generally safe and effective treatments for reducing inflammation and cytokine release. They might thus be of help in reducing the respiratory distress associated with COVID-19.
It has been known that Histamine-1 (H1)-receptor antagonists such as cetirizine are administered for allergies, and histamine-2 (H2)-receptor antagonists such as famotidine are used to control stomach acid and heartburn. Urticaria has been successfully treated with dual histamine-receptor blockade since the 1970s.
The researchers say that both classes of drugs are already approved cheap pharmaceuticals with safety records and available both by prescription and over the counter worldwide.
In order to investigate the potential utility of this approach, the researchers studied 110 COVID-19-positive patients with severe and critical pulmonary symptoms.
It was reported that eleven of the patients had "do not resuscitate" (DNR) directives.
The patients median age was 63.7 years, and among the most common comorbidities were hypertension (78%), obesity and morbid obesity (58%) and diabetes (43%).
Besides the standard-of-care treatment, the patients were also given cetirizine 10 mg and famotidine 20 mg twice daily for at least 48 hours. This resulted in the rate of intubation falling from an initial 16.4% to 7.3%.
It was found that the inpatient mortality rate was 15.5% overall and 8.2% after exclusion of the DNR patients. The average number of days to discharge was 11.0.
Interestingly in another group of 12 patients at the same hospital who did not receive cetirizine and famotidine the intubation rate was 41.7%, there were five deaths (41.7%) and the average hospital stay was 19.0 days.
The study team observed that these and other numbers "were not deemed sufficient for comparative statistical analysis," but "are consistent with high symptom severity and high rate of inpatient fatality in the overall admitted patient population."
However pats studies in the U.S., the U.K. and China have shown inpatient fatality rates ranging from 21% to 28%. Thus, say the researchers, "In essence, we observed an approximately one third reduction in inpatient deaths in the cetirizine - famotidine cohort relative to well documented clinical studies."
The study team are now treating most of
their COVID-19 patients with the cetirizine and famotidine combination.
Dr Hogan added, "The science is solid and combined with these early results is suggestive of significant potential benefit in the early disease states to blunt the inflammatory cascade and avoid hospitalization and deterioration. We are seeing many using this approach prophylactically, especially among some healthcare providers."
He has applied for a US patent on dual histamine-receptor blockade in the treatment of COVID-19. He has patents on dual histamine-receptor blockade in the treatment of diarrhea and owns a related biomedical business.
Importantly this physician-sponsored cohort study of cetirizine and famotidine provides proof-of-concept of a safe and effective method to reduce the progression in symptom severity, presumably by minimizing the histamine-mediated cytokine storm.
The study team also says that further clinical studies in COVID-19 are warranted of the repurposed off-label combination of two historically-safe histamine receptor blockers.
It should be noted that Famotidine in other studies have been shown to be able to treat COVID-19 plus it has a cellular mode that also display antiviral actions against the SARS-CoV-2 coronavirus.
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