Promising new approach using heartburn medication quietly studied at NYC hospital

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This article describes newly reported efforts to study famotidine, the active compound in OTC heartburn drug Pepcid to treat covid-19 patients. It apparently binds to a key enzyme in SARS-CoV-2 that is key to its replication. A key player in this discovery is Michael Callahan from Massachusetts general hospital.

It is a good example of data science at work: the idea came from Chinese scientists looking at medical record data, noting patients with heartburn seemed to be doing better than others, and seeing a connection to use of Pepcid. Not wanting to promote this approach based solely on this scant association that could be spurious, Callahan sought to understand potential mechanisms, and linked the active compound in the drug to a key enzyme in SARS-CoV-2. Given that it would take a long time to precisely identify 3D crystal structure of this enzyme, they turned to ongoing drug screens by Alchemy Laboratories using science modeling combining information about the 3D structure of similar coronaviruses and the sequence of SARS-CoV-2 that suggested this drug could possibly bind to this enzyme. Based on these results, Callan coordinated with Northwell hospital leader Kevin Tracey to commence blinded, randomized clinical trials of an intravenous version of this drug.

This study has been quietly ongoing to prevent potential hoarding of the drug, and has currently treated 187 patients, almost halfway to the first interim analysis at 391 patients. There is some remarkable anecdotal evidence it may be working, but of course that is not sufficient so we await results from the randomized trial.

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