Safety and effectiveness of long-term interferon gamma therapy in patients with chronic granulomatous disease.
In chronic granulomatous disease (CGD), diminished or absent neutrophil NADPH oxidase function leads to recurrent pyogenic infections and granuloma formation. In a recent randomized, placebo-controlled trail, short-term prophylactic use of recombinant human interferon gamma (rIFN-gamma 1b) reduced the risk of serious infection in CGD patients by 67%, The current study evaluated the safety and effectiveness of long-term rIFN-gamma therapy in CGD patients. Patients were treated three times weekly with rIFN-gamma and evaluated semiannually. Serious infections (requiring hospitalization and parenteral antibiotic therapy), adverse clinical events, and measures of growth and development were noted. Thirty patients were evaluated for 12 months. The total average duration of rIFN-gamma therapy was 2.5 years. Three patients developed a total of four serious infections (0.13 infections per patient year). This rate compare favorably with rates of 1.10 and 0.38 infections per patient year found in the placebo and rIFN-gamma groups, respectively, during a previous study. Common adverse events were fever (23%), diarrhea (13%), and flu-like illness (13%). No serious adverse event was attributable to rIFN-gamma therapy and no obvious effects on growth and development were observed. rIFN-gamma is a safe and effective adjunctive therapy for reducing the frequency and severity of serious infections in CGD patients.
Bemiller
L S
LS
Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, California, USA.
Roberts
D H
DH
Starko
K M
KM
Curnutte
J T
JT
D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000139:chemically induced; D005500:Follow-Up Studies; D006105:Granulomatous Disease, Chronic / Q000201:enzymology / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D006130:Growth Disorders / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology; D007371:Interferon-gamma / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009247:NADH, NADPH Oxidoreductases / Q000737:chemistry / Q000172:deficiency / Q000235:genetics; D019255:NADPH Oxidases; D009503:Neutropenia / Q000139:chemically induced; D010586:Phagocytes / Q000201:enzymology; D011994:Recombinant Proteins; D012449:Safety; D013972:Thyrotropin / Q000097:blood; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D011994:Recombinant Proteins; D007371:Interferon-gamma; D013972:Thyrotropin; D009247:NADH, NADPH Oxidoreductases; D019255:NADPH Oxidases