Interferon is the latest advancement in Covid-19 treatment.
The photo is by Emin Baycan. A frontline doc unpacks the results of a new clinical trial that shows that interferon may reduce the odds of severe illness or death.
Recent studies show that a lot of people who become ill from Covid-19 have anti-instagines antibodies that are disabling. The autoantibodies act against the body’s own immune system. As someone who provides care for those with Covid-19 in a hospital approaching its capacity, I am constantly on the lookout for safe and effective treatment strategies, anything to help my patients recover faster and get home sooner. It can be difficult to determine which new data is worth more. The trial was published in The Lancet on November 12 and caught my attention.
There are studies that show the importance of the genes that code for interferon production. Patients who suffer from more severe symptoms of Covid-19 when their interferons are diminished are more likely to have a mutated genes. If you don’t get the alarm out, you could have a lot of viruses. Interferons function to alert the immune system of a developing infections. The novel coronaviruses are able to evade the body’s early warning alarms when the interferons are deactivated.
Monk and colleagues wanted to answer that question by treating patients with an inhaled version of interferon. Researchers wanted to deliver interferon to the lungs, which are the most affected by the disease. It would make sense that giving the body an extra supply of interferon could improve its response to the disease. Studies on animals with other coronaviruses support the theory. The concept did not work well for humans with Covid-19 as evidenced by the Solidarity trial conducted by the WHO earlier this year. If the medication was administered by a different route, what would happen to the patients in this study?
The 97 hospitalized patients in the United Kingdom were given either placebo or the drug SNG001 for up to two weeks. At the end of four weeks, 42% of patients who received interferon recovered compared to 34% who received placebo. The thoughtful design of this study makes it different from other pharmaceutical trials. Being a randomized, double-blind, placebo-controlled trial allows this investigation to ignore many of the elements that plague retrospective and observational studies. The data found on preprint server have become so prevalent that publication in a peer-reviewed journal elevated its findings above them.
This time of year when co-infections are more likely to occur, the lung’s defense against pathogens could be boosted by the use of interferon. When Covid-19 is encountered with another respiratory virus in the winter, it might carry additional advantages of treating it. Three patients in the placebo group died, while 48 patients in the interferon group survived. Mary Van Beusekom, a writer for the Center for Infectious Disease Research and Policy, said in her report that SNG001 patients were more likely to recover than those who did not.
The group is studying the effects of the drug on the immune system, because it plays a role in the initial response to a pathogen. They hope to examine the response to interferon inventilated, critically ill patients with Covid-19 who have evidence of active viral infections in the lungs. The study did not involve enough patients for the trend to be considered statistically significant. The authors of the commentary called for more research on the safety and efficacy of the drug. There is need for larger randomised clinical trials to investigate the effectiveness of nebulised interferon alpha-1a therapy in this setting.
None of the serious adverse events that occurred during the study were attributed to the drug, and all of them were thought to have been caused by Covid-19. 15% of the interferon group and 10% of the placebo group had headaches, which was the most frequently reported adverse event. Randomization of a small sample of patients can cause an unbalanced group characteristics. The authors note that the SNG001 and placebo groups were well matched for age, sex, and overall comorbidities, but were less well matched for disease severity at recruitment and for specific comorbid conditions.
Information regarding its cost is lacking, but price will factor into its chance of widespread success because it is not currently marketed to treat other diseases. I believe that the novel therapeutic has a good chance of becoming a game-changer in the epidemic. Here is to take a deep breath and wait.
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