Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial
Abstract Type 1 Interferons (IFNs) have been associated with positive effects on Coronaviruses. Previous studies point towards the superior potency of IFNβ compared to IFNα against viral infections. We conducted a three-armed, individually-randomized, open-label, controlled trial of IFNβ1a and IFNβ1...
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2021
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oai:doaj.org-article:bbc2697fc1fd457d813cc65f8ee5f8442021-12-02T18:03:07ZRole of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial10.1038/s41598-021-86859-y2045-2322https://doaj.org/article/bbc2697fc1fd457d813cc65f8ee5f8442021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86859-yhttps://doaj.org/toc/2045-2322Abstract Type 1 Interferons (IFNs) have been associated with positive effects on Coronaviruses. Previous studies point towards the superior potency of IFNβ compared to IFNα against viral infections. We conducted a three-armed, individually-randomized, open-label, controlled trial of IFNβ1a and IFNβ1b, comparing them against each other and a control group. Patients were randomly assigned in a 1:1:1 ratio to IFNβ1a (subcutaneous injections of 12,000 IU on days 1, 3, 6), IFNβ1b (subcutaneous injections of 8,000,000 IU on days 1, 3, 6), or the control group. All three arms orally received Lopinavir/Ritonavir (400 mg/100 mg twice a day for ten days) and a single dose of Hydroxychloroquine 400 mg on the first day. Our utilized primary outcome measure was Time To Clinical Improvement (TTCI) defined as the time from enrollment to discharge or a decline of two steps on the clinical seven-step ordinal scale, whichsoever came first. A total of 60 severely ill patients with positive RT-PCR and Chest CT scans underwent randomization (20 patients to each arm). In the Intention-To-Treat population, IFNβ1a was associated with a significant difference against the control group, in the TTCI; (HR; 2.36, 95% CI 1.10–5.17, P-value = 0.031) while the IFNβ1b indicated no significant difference compared with the control; HR; 1.42, (95% CI 0.63–3.16, P-value = 0.395). The median TTCI for both of the intervention groups was five days vs. seven days for the control group. The mortality was numerically lower in both of the intervention groups (20% in the IFNβ1a group and 30% in the IFNβ1b group vs. 45% in the control group). There were no significant differences between the three arms regarding the adverse events. In patients with laboratory-confirmed SARS-CoV-2 infection, as compared with the base therapeutic regiment, the benefit of a significant reduction in TTCI was observed in the IFNβ1a arm. This finding needs further confirmation in larger studies. Trial Registration Number: ClinicalTrials.gov, NCT04343768. (Submitted: 08/04/2020; First Online: 13/04/2020) (Registration Number: NCT04343768).Ilad Alavi DarazamShervin ShokouhiMohamad Amin PourhoseingholiSeyed Sina Naghibi IrvaniMajid MokhtariMinoosh ShabaniMahdi AmirdosaraParham TorabinavidMaryam GolmohammadiSayedPayam HashemiArsalan AzimiMohammad Hossein Jafarazadeh MaivanOmidvar RezaeiAlireza ZaliMohammadreza HajiesmaeiliHadiseh Shabanpour DehbsnehAkram Hoseyni KushaMaryam Taleb ShoushtariNegar KhaliliAzam SoleymaniniaLatif GachkarAli KhoshkarNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021) |
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Medicine R Science Q Ilad Alavi Darazam Shervin Shokouhi Mohamad Amin Pourhoseingholi Seyed Sina Naghibi Irvani Majid Mokhtari Minoosh Shabani Mahdi Amirdosara Parham Torabinavid Maryam Golmohammadi SayedPayam Hashemi Arsalan Azimi Mohammad Hossein Jafarazadeh Maivan Omidvar Rezaei Alireza Zali Mohammadreza Hajiesmaeili Hadiseh Shabanpour Dehbsneh Akram Hoseyni Kusha Maryam Taleb Shoushtari Negar Khalili Azam Soleymaninia Latif Gachkar Ali Khoshkar Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial |
| description |
Abstract Type 1 Interferons (IFNs) have been associated with positive effects on Coronaviruses. Previous studies point towards the superior potency of IFNβ compared to IFNα against viral infections. We conducted a three-armed, individually-randomized, open-label, controlled trial of IFNβ1a and IFNβ1b, comparing them against each other and a control group. Patients were randomly assigned in a 1:1:1 ratio to IFNβ1a (subcutaneous injections of 12,000 IU on days 1, 3, 6), IFNβ1b (subcutaneous injections of 8,000,000 IU on days 1, 3, 6), or the control group. All three arms orally received Lopinavir/Ritonavir (400 mg/100 mg twice a day for ten days) and a single dose of Hydroxychloroquine 400 mg on the first day. Our utilized primary outcome measure was Time To Clinical Improvement (TTCI) defined as the time from enrollment to discharge or a decline of two steps on the clinical seven-step ordinal scale, whichsoever came first. A total of 60 severely ill patients with positive RT-PCR and Chest CT scans underwent randomization (20 patients to each arm). In the Intention-To-Treat population, IFNβ1a was associated with a significant difference against the control group, in the TTCI; (HR; 2.36, 95% CI 1.10–5.17, P-value = 0.031) while the IFNβ1b indicated no significant difference compared with the control; HR; 1.42, (95% CI 0.63–3.16, P-value = 0.395). The median TTCI for both of the intervention groups was five days vs. seven days for the control group. The mortality was numerically lower in both of the intervention groups (20% in the IFNβ1a group and 30% in the IFNβ1b group vs. 45% in the control group). There were no significant differences between the three arms regarding the adverse events. In patients with laboratory-confirmed SARS-CoV-2 infection, as compared with the base therapeutic regiment, the benefit of a significant reduction in TTCI was observed in the IFNβ1a arm. This finding needs further confirmation in larger studies. Trial Registration Number: ClinicalTrials.gov, NCT04343768. (Submitted: 08/04/2020; First Online: 13/04/2020) (Registration Number: NCT04343768). |
| format |
article |
| author |
Ilad Alavi Darazam Shervin Shokouhi Mohamad Amin Pourhoseingholi Seyed Sina Naghibi Irvani Majid Mokhtari Minoosh Shabani Mahdi Amirdosara Parham Torabinavid Maryam Golmohammadi SayedPayam Hashemi Arsalan Azimi Mohammad Hossein Jafarazadeh Maivan Omidvar Rezaei Alireza Zali Mohammadreza Hajiesmaeili Hadiseh Shabanpour Dehbsneh Akram Hoseyni Kusha Maryam Taleb Shoushtari Negar Khalili Azam Soleymaninia Latif Gachkar Ali Khoshkar |
| author_facet |
Ilad Alavi Darazam Shervin Shokouhi Mohamad Amin Pourhoseingholi Seyed Sina Naghibi Irvani Majid Mokhtari Minoosh Shabani Mahdi Amirdosara Parham Torabinavid Maryam Golmohammadi SayedPayam Hashemi Arsalan Azimi Mohammad Hossein Jafarazadeh Maivan Omidvar Rezaei Alireza Zali Mohammadreza Hajiesmaeili Hadiseh Shabanpour Dehbsneh Akram Hoseyni Kusha Maryam Taleb Shoushtari Negar Khalili Azam Soleymaninia Latif Gachkar Ali Khoshkar |
| author_sort |
Ilad Alavi Darazam |
| title |
Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial |
| title_short |
Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial |
| title_full |
Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial |
| title_fullStr |
Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial |
| title_full_unstemmed |
Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial |
| title_sort |
role of interferon therapy in severe covid-19: the coviferon randomized controlled trial |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/bbc2697fc1fd457d813cc65f8ee5f844 |
| work_keys_str_mv |
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