title: Interferon alfacon-1 plus corticosteroids in severe acute respiratory syndrome: a preliminary study.
abstract: 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.
authors.affiliation: North York General Hospital, Toronto General Research Institute, Toronto, Ontario.
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Blatt
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Siminovitch
authors.forename: Sarah
authors.initials: S
authors.lastname: Ward
authors.forename: Bryan
authors.initials: B
authors.lastname: Wolff
authors.forename: Hyoung
authors.initials: H
authors.lastname: Lho
authors.forename: Dieu H
authors.initials: DH
authors.lastname: Pham
authors.forename: Hassan
authors.initials: H
authors.lastname: Deif
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: LaMere
authors.forename: Margaret
authors.initials: M
authors.lastname: Chang
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Kain
authors.forename: Gabriella A
authors.initials: GA
authors.lastname: Farcas
authors.forename: Patti
authors.initials: P
authors.lastname: Ferguson
authors.forename: Mary
authors.initials: M
authors.lastname: Latchford
authors.forename: Gary
authors.initials: G
authors.lastname: Levy
authors.forename: James W
authors.initials: JW
authors.lastname: Dennis
authors.forename: Enoch K Y
authors.initials: EK
authors.lastname: Lai
authors.forename: Eleanor N
authors.initials: EN
authors.lastname: Fish
mesh_terms: 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
chemical_list: 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