Interferon alfacon-1 plus corticosteroids in severe acute respiratory syndrome: a preliminary study.
BACKGROUND
Severe acute respiratory syndrome (SARS) is a new clinical entity for which no effective therapeutic strategy has been developed.


OBJECTIVE
To provide preliminary results on the potential therapeutic benefit and tolerability of interferon alfacon-1 plus corticosteroids for SARS.


METHODS
Open-label study of 22 patients diagnosed as having probable SARS at North York General Hospital, Toronto, Ontario, between April 11 and May 30, 2003.


METHODS
Thirteen patients were treated with corticosteroids alone and 9 patients were treated with corticosteroids plus subcutaneous interferon alfacon-1.


METHODS
Clinical parameters, including oxygen saturation and requirement, laboratory measures, and serial chest radiography results.


RESULTS
Resolution of fever and lymphopenia were similar between the 2 treatment groups. Of the 13 patients treated with corticosteroids alone, 5 (38.5%) were transferred to the intensive care unit, 3 (23.1%) required intubation and mechanical ventilation, and 1 (7.7%) died. Of the 9 patients in the interferon alfacon-1 treatment group, 3 (33.3%) were transferred to the intensive care unit, 1 (11.1%) required intubation and mechanical ventilation, and none died. The interferon alfacon-1 treatment group had a shorter time to 50% resolution of lung radiographic abnormalities (median time, 4 days vs 9 days; P =.001), had better oxygen saturation (P =.02), resolved their need for supplemental oxygen more rapidly (median, 10 days vs 16 days; P =.02), had less of an increase in creatine kinase levels (P =.03), and showed a trend toward more rapid resolution of lactate dehydrogenase levels compared with the group receiving corticosteroids alone.


CONCLUSIONS
In this preliminary, uncontrolled study of patients with SARS, use of interferon alfacon-1 plus corticosteroids was associated with reduced disease-associated impaired oxygen saturation, more rapid resolution of radiographic lung abnormalities, and lower levels of creatine kinase. These findings suggest that further investigation may be warranted to determine the role of interferon alfacon-1 as a therapeutic agent for the treatment of SARS.
Loutfy
Mona R
MR
North York General Hospital, Toronto General Research Institute, Toronto, Ontario.
Blatt
Lawrence M
LM
Siminovitch
Katharine A
KA
Ward
Sarah
S
Wolff
Bryan
B
Lho
Hyoung
H
Pham
Dieu H
DH
Deif
Hassan
H
LaMere
Elizabeth A
EA
Chang
Margaret
M
Kain
Kevin C
KC
Farcas
Gabriella A
GA
Ferguson
Patti
P
Latchford
Mary
M
Levy
Gary
G
Dennis
James W
JW
Lai
Enoch K Y
EK
Fish
Eleanor N
EN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D003402:Creatine Kinase / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use*; D016898:Interferon-alpha; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010101:Oxygen Consumption; D011241:Prednisone / Q000627:therapeutic use; D011859:Radiography; D011994:Recombinant Proteins; D012121:Respiration, Artificial; D045169:Severe Acute Respiratory Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D005938:Glucocorticoids; D007370:Interferon Type I; D016898:Interferon-alpha; D011994:Recombinant Proteins; C050739:interferon alfacon-1; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase; D011241:Prednisone; D008775:Methylprednisolone