Gut:非住院COVID-19患者口服法莫替丁的疗效分析

2022-02-11 MedSci原创 MedSci原创

法莫替丁在轻至中度COVID-19门诊患者中安全且耐受性良好。法莫替丁可以在不降低抵抗SARS-CoV-2免疫力的情况下提早缓解症状和炎症。

为寻找安全、有效和负担得起的COVID-19治疗方法仍然是全球卫生优先需要解决的事项。COVID-19作为大流行病,迄今为止,全世界估计有3.19亿例病例和550万例患者死亡。针对COVID-19的限制性公共卫生措施对社会造成了前所未有的负面影响。

近日,消化病领域权威杂志Gut上发表了一篇研究文章,研究人员旨在评估法莫替丁是否能改善轻度至中度COVID-19门诊患者的炎症和症状。

该研究为一项随机、双盲、安慰剂对照的2期临床试验(NCT04724720)。2021年1月至2021年4月期间,研究人员从两个美国中心招募了有症状的未接种疫苗的成年门诊患者,他们被确诊为COVID-19。患者每天口服3次80mg法莫替丁(n=28)或安慰剂(n=27),连续治疗14天。该研究的终点是(主要)症状消退时间或(次要)症状消退率,以及炎症消退(探索性终点)情况。

意向治疗组55名患者(中位年龄为35岁(IQR:20);35名女性(64%);18名非裔美国人(33%);14名西班牙裔(26%)),52名(95%)患者完成了试验,并提交了1358份电子症状调查。症状消退的时间没有统计学上的改善(p=0.4)。服用法莫替丁的患者症状缓解率有所提高(p<0.0001)。法莫替丁治疗组在8.2天(95%CI为7至9.8天)和安慰剂治疗患者11.4天(95%CI为10.3至12.6天)时,估计的总体基线症状评分降低了50%。差异与患者性别、种族或民族无关。研究期间共发生了五起自限性不良事件(法莫替丁,n=2(40%);安慰剂,n=3(60%))。在第7天,使用法莫替丁治疗的患者较少可检测到血浆中干扰素α水平(p=0.04)。血浆G型免疫球蛋白与SARS-CoV-2核衣壳核心蛋白的水平在两组之间相似。

由此可见,法莫替丁在轻至中度COVID-19门诊患者中安全且耐受性良好。法莫替丁可以在不降低抵抗SARS-CoV-2免疫力的情况下提早缓解症状和炎症。

原始出处:

Christina M Brennan.et al.Oral famotidine versus placebo in non-hospitalised patients with COVID-19: a randomised, double-blind, data-intense, phase 2 clinical trial.Gut.2022.https://gut.bmj.com/content/early/2022/02/09/gutjnl-2022-326952

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    2022-02-24 ms2000001254384452

    很好

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    2022-02-15 ms2000001254384452

    学习

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1647337, encodeId=cfc1164e33717, content=<a href='/topic/show?id=e9bae04003f' target=_blank style='color:#2F92EE;'>#疗效分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70400, encryptionId=e9bae04003f, topicName=疗效分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=219323401160, createdName=rebeccajiejie, createdTime=Sun May 22 20:16:44 CST 2022, time=2022-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196792, encodeId=4f1e1196e9271, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dfcf5562063, createdName=ms2000001254384452, createdTime=Thu Feb 24 13:00:06 CST 2022, time=2022-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1193621, encodeId=7f8611936211f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dfcf5562063, createdName=ms2000001254384452, createdTime=Tue Feb 15 14:37:04 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277856, encodeId=607d12e7856a5, content=<a href='/topic/show?id=5013648e5c7' target=_blank style='color:#2F92EE;'>#法莫替丁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64875, encryptionId=5013648e5c7, topicName=法莫替丁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9c94141, createdName=liuquanmn, createdTime=Sun Feb 13 06:16:44 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297571, encodeId=cadc129e571e4, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Sun Feb 13 06:16:44 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192610, encodeId=631511926106d, content=大流行病,迄今为止,全世界估计有3.19亿例病例和550万例患者死亡。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Feb 12 10:26:17 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192431, encodeId=f29e11924314d, content=有理有据的好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58001397990, createdName=yx1156, createdTime=Fri Feb 11 19:07:41 CST 2022, time=2022-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192425, encodeId=5ba2119242586, content=不错学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210606/e8b96fdba070433da10cd357c0646807/28bf16f46e314caaad8396c0c7df7a04.jpg, createdBy=adb15496357, createdName=仁术2021, createdTime=Fri Feb 11 18:51:45 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
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    2022-02-12 查查佳佳

    大流行病,迄今为止,全世界估计有3.19亿例病例和550万例患者死亡。

    0

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    2022-02-11 yx1156

    有理有据的好文章!

    0

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    2022-02-11 仁术2021

    不错学习了。

    0

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来自中国的轶事报道表明,在住院治疗的COVID-19患者中,服用法莫替丁(品牌名Pepcid)的疗效优于服用另一种名为质子泵抑制剂的抗酸剂的患者。

法莫替丁与布洛芬联合使用可降低布洛芬相关性溃疡

长期需要服用非甾体抗炎药(NSAID)的患者,如果同时服用布洛芬和单个高剂量法莫替丁片剂,比仅服用布洛芬的患者发生胃或十二指肠溃疡的可能性要小。该研究12月20日在线发表于《The American Journal of Gastroenterology》。 研究者说“与单独使用NSAID和抗分泌药任何一种药相比,联合用药理论上可以提高抗分泌药的依从性。” 既往研究表明双倍剂量的组

GUT:复发性特发性胃十二指肠溃疡出血的治疗

研究认为,对于幽门螺杆菌阴性的特发性溃疡出血患者,兰索拉唑和法莫替丁对反复出血的预防效果相当

Gastroenterology:法莫替丁的使用与住院COVID-19患者的临床结果改善相关

2019年年末开始的冠状病毒病(COVID-19)在全球造成3000万病例感染,超过90万例死亡。到目前为止,尚未有任何药物被证明可改善预后。

Gut:兰索拉唑和法莫替丁在预防复发性特发性胃十二指肠溃疡出血方向的效果

有幽门螺杆菌阴性特发性出血性溃疡病史的患者出现复发性溃疡并发症的风险较高。研究假设质子泵抑制剂(兰索拉唑)优于组胺2受体拮抗剂(法莫替丁),可预防此类患者的复发性溃疡出血。

Aliment Pharmacol Ther:雷尼替丁是否会增加消化道癌症的风险?

与使用奥美拉唑或法莫替丁相比,使用雷尼替丁并不增加发生胃肠道恶性肿瘤的几率