Cargando…

A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature

This Perspective examines a recent surge of information regarding the potential benefits of acid-suppression drugs in the context of COVID-19, with a particular eye on the great variability (and, thus, confusion) that has arisen across the reported findings, at least as regards the popular antacid f...

Descripción completa

Detalles Bibliográficos
Autores principales: Mura, Cameron, Preissner, Saskia, Preissner, Robert, Bourne, Philip E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385362/
https://www.ncbi.nlm.nih.gov/pubmed/34456726
http://dx.doi.org/10.3389/fphar.2021.700703
_version_ 1783742077399465984
author Mura, Cameron
Preissner, Saskia
Preissner, Robert
Bourne, Philip E.
author_facet Mura, Cameron
Preissner, Saskia
Preissner, Robert
Bourne, Philip E.
author_sort Mura, Cameron
collection PubMed
description This Perspective examines a recent surge of information regarding the potential benefits of acid-suppression drugs in the context of COVID-19, with a particular eye on the great variability (and, thus, confusion) that has arisen across the reported findings, at least as regards the popular antacid famotidine. The degree of inconsistency and discordance reflects contradictory conclusions from independent, clinical-based studies that took roughly similar approaches, in terms of both experimental design (retrospective, observational, cohort-based, etc.) and statistical analysis workflows (propensity-score matching and stratification into sub-cohorts, etc.). The contradictions and potential confusion have ramifications for clinicians faced with choosing therapeutically optimal courses of intervention: e.g., do any potential benefits of famotidine suggest its use in a particular COVID-19 case? (If so, what administration route, dosage regimen, duration, etc. are likely optimal?) As succinctly put this March in Freedberg et al. (2021), “…several retrospective studies show relationships between famotidine and outcomes in COVID-19 and several do not.” Beyond the pressing issue of possible therapeutic indications, the conflicting data and conclusions related to famotidine must be resolved before its inclusion/integration in ontological and knowledge graph (KG)–based frameworks, which in turn are useful for drug discovery and repurposing. As a broader methodological issue, note that reconciling inconsistencies would bolster the validity of meta-analyses which draw upon the relevant data-sources. And, perhaps most broadly, developing a system for treating inconsistencies would stand to improve the qualities of both 1) real world evidence-based studies (retrospective), on the one hand, and 2) placebo-controlled, randomized multi-center clinical trials (prospective), on the other hand. In other words, a systematic approach to reconciling the two types of studies would inherently improve the quality and utility of each type of study individually.
format Online
Article
Text
id pubmed-8385362
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-83853622021-08-26 A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature Mura, Cameron Preissner, Saskia Preissner, Robert Bourne, Philip E. Front Pharmacol Pharmacology This Perspective examines a recent surge of information regarding the potential benefits of acid-suppression drugs in the context of COVID-19, with a particular eye on the great variability (and, thus, confusion) that has arisen across the reported findings, at least as regards the popular antacid famotidine. The degree of inconsistency and discordance reflects contradictory conclusions from independent, clinical-based studies that took roughly similar approaches, in terms of both experimental design (retrospective, observational, cohort-based, etc.) and statistical analysis workflows (propensity-score matching and stratification into sub-cohorts, etc.). The contradictions and potential confusion have ramifications for clinicians faced with choosing therapeutically optimal courses of intervention: e.g., do any potential benefits of famotidine suggest its use in a particular COVID-19 case? (If so, what administration route, dosage regimen, duration, etc. are likely optimal?) As succinctly put this March in Freedberg et al. (2021), “…several retrospective studies show relationships between famotidine and outcomes in COVID-19 and several do not.” Beyond the pressing issue of possible therapeutic indications, the conflicting data and conclusions related to famotidine must be resolved before its inclusion/integration in ontological and knowledge graph (KG)–based frameworks, which in turn are useful for drug discovery and repurposing. As a broader methodological issue, note that reconciling inconsistencies would bolster the validity of meta-analyses which draw upon the relevant data-sources. And, perhaps most broadly, developing a system for treating inconsistencies would stand to improve the qualities of both 1) real world evidence-based studies (retrospective), on the one hand, and 2) placebo-controlled, randomized multi-center clinical trials (prospective), on the other hand. In other words, a systematic approach to reconciling the two types of studies would inherently improve the quality and utility of each type of study individually. Frontiers Media S.A. 2021-08-11 /pmc/articles/PMC8385362/ /pubmed/34456726 http://dx.doi.org/10.3389/fphar.2021.700703 Text en Copyright © 2021 Mura, Preissner, Preissner and Bourne. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Mura, Cameron
Preissner, Saskia
Preissner, Robert
Bourne, Philip E.
A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature
title A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature
title_full A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature
title_fullStr A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature
title_full_unstemmed A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature
title_short A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature
title_sort birds-eye (re)view of acid-suppression drugs, covid-19, and the highly variable literature
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385362/
https://www.ncbi.nlm.nih.gov/pubmed/34456726
http://dx.doi.org/10.3389/fphar.2021.700703
work_keys_str_mv AT muracameron abirdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT preissnersaskia abirdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT preissnerrobert abirdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT bournephilipe abirdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT muracameron birdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT preissnersaskia birdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT preissnerrobert birdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature
AT bournephilipe birdseyereviewofacidsuppressiondrugscovid19andthehighlyvariableliterature