[Trial of intraventricular ribavirin and interferon-alpha combination therapy for subacute sclerosing panencephalitis (SSPE) in Japan].
A survey was made on 10 patients with subacute sclerosing panencephalitis (SSPE) during the last four years from the viewpoint of clinical safety of ribavirin therapy in Japan. Although the age of onset, latent period, and effectiveness were variable among the cases, they were treated safely with intraventricular ribavirin combined with high doses of interferon (IFN). Their clinical stages on admission ranged from the first to fourth of Jabbour's classification, and those on the beginning of ribavirin therapy also ranged from the first to fourth. Seven of them were first treated with intraventricular IFN-alpha monotherapy, however, the combination of intraventricular IFN-alpha and ribavirin was started after clinical worsening. Although 5 patients showed slow progression, seven responded to the therapy with clinical improvement or decreased measles antibody titers in the CSF. Especially, one patient showed improvement to Jabbour's first stage and no further progression during the following 3 years. Ribavirin therapy caused no severe effects. Lip swelling (50%), sleepiness (40%), and headache (30%) were noted. Although we were unable to perform a double-blinded clinical study for ethical reasons, our results suggest that treatment with intraventricular ribavirin and high doses of IFN may be effective for SSPE. Early administration of intraventricular ribavirin and IFN might be considered especially to IFN in non-responders. To establish this combination therapy as a safe and effective treatment of SSPE, further studies are necessary on the role of ribavirin in the pathogenesis as well as its effects in the central nervous system.
Tomoda
Akemi
A
Department of Child Development, Kumamoto University School of Medicine, Kumamoto. tomo@kaiju.medic.kumamoto-u.ac.jp
Nomura
Keiko
K
Shiraishi
Seiji
S
Miike
Teruhisa
T
Hamada
Akinobu
A
Hosoya
Mitsuaki
M
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006801:Humans; D007276:Injections, Intraventricular; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D012254:Ribavirin / Q000008:administration & dosage*; D013344:Subacute Sclerosing Panencephalitis / Q000188:drug therapy*; D011795:Surveys and Questionnaires
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin