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).
【저자키워드】 Respiratory tract diseases, 【초록키워드】 Lopinavir/ritonavir, Mortality, Open-label, Hydroxychloroquine, randomization, SARS-COV-2 infection, Lopinavir, Ritonavir, interferons, viral infections, discharge, adverse events, improvement, Registration, Viral, clinical, CT scan, therapeutic, Patient, Controlled trial, Clinical improvement, IFNs, single dose, IFNα, positive RT-PCR, Ordinal Scale, registration number, twice a day, Enrollment, subcutaneous injections, significant difference, control group, intervention group, no significant differences, P-value, 95% CI, no significant difference, Previous studies, intention-to-treat population, type 1 interferons, primary outcome measure, Chest CT scans, clinical seven-step ordinal scale, IFNβ, IFNβ1a, IFNβ1b, laboratory-confirmed SARS-CoV-2 infection, NCT04343768, Trial Registration Number, TTCI, injection, previous study, positive, Effect, Arm, time, FIVE, type 1 interferon, benefit, Randomly, Seven, defined, indicated, conducted, median, assigned, reduction in, ClinicalTrials.gov, NCT04343768, individually-randomized, severely ill patient, 【제목키워드】 Randomized controlled trial, therapy, interferon, role,