Effectiveness of ribavirin and corticosteroids for severe acute respiratory syndrome.
OBJECTIVE
Ribavirin and corticosteroids were used widely as front-line treatments for severe acute respiratory syndrome; however, previous evaluations were inconclusive. We assessed the effectiveness of ribavirin and corticosteroids as the initial treatment for severe acute respiratory syndrome using propensity score analysis.


METHODS
We analyzed data on 1755 patients in Hong Kong and 191 patients in Toronto with severe acute respiratory syndrome using a generalized propensity score approach.


RESULTS
The adjusted excess case fatality ratios of patients with severe acute respiratory syndrome receiving the combined therapy of ribavirin and corticosteroids within 2 days of admission, compared with those receiving neither treatment within 2 days of admission, were 3.8% (95% confidence interval, -1.5 to 9.2) in Hong Kong and 2.1% (95% confidence interval, -44.3 to 48.5) in Toronto.


CONCLUSIONS
Our results add strength to the hypothesis that the combination of ribavirin and corticosteroids has no therapeutic benefit when given early during severe acute respiratory syndrome infection. Further studies may investigate the effects of these treatments later in disease course.
Lau
Eric H Y
EH
School of Public Health, The University of Hong Kong, Hong Kong.
Cowling
Benjamin J
BJ
Muller
Matthew P
MP
Ho
Lai-Ming
LM
Tsang
Thomas
T
Lo
Su-Vui
SV
Louie
Marie
M
Leung
Gabriel M
GM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007770:L-Lactate Dehydrogenase; D008875:Middle Aged; D057216:Propensity Score; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D012254:Ribavirin; D007770:L-Lactate Dehydrogenase