Efficacy of Interferon-β in Moderate-to-Severe Hospitalised Cases of COVID-19: A Systematic Review and Meta-analysis

Kumar, Subodh; Saurabh, Manoj Kumar; Narasimha, Venkata Lakshmi; Maharshi, Vikas

doi:10.1007/s40261-021-01092-9

Cited by 9 publications

(8 citation statements)

References 24 publications

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“…Previous reviews have several limitations with regard to the evaluation of IFN efficacy in the treatment of COVID-19. Previous meta-analyses were restricted to IFN-β [ 37 , 38 ], and data synthesis of the included studies did not consider the study design, such as retrospective observational/cohort and RCT, leading to imprecision in estimating the effect estimate of IFN [ 39 ]. A major limitation of previous reviews was that they evaluated the efficacy of IFN therapy in heterogeneous patients with different severities of COVID-19 [ 37 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy and safety of interferon (Type I and Type III) therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Ryoo

Koh

et al. 2023

PLoS ONE

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Interferon (IFN) has been highlighted in several randomized controlled trials as an attractive therapeutic candidate based plausible mode of action, suppressed response in severe COVID-19, and inhibition of SARS-CoV-2 replication. This study investigated the efficacy and safety of IFN in patients with COVID-19 according to clinical severity. Randomized controlled trials evaluating the efficacy and safety of IFN (systemic or inhaled IFN-α, -β, and -λ) treatment in adult patients with COVID-19 were identified by systematically searching electronic databases until January 2023. Risk of bias were assessed using the Cochrane risk of bias tool, meta-analysis, and certainty of evidence grading were followed for the systematic review. We included 11 trials comprising 6,124 patients. Compared with exclusive standard care or placebo, IFN therapy did not provide significant clinical benefits for mortality at day 28 (pooled risk ratio [RR] = 0.86, 95% confidence interval [CI]: 0.62–1.18, 9 studies, low-certainty evidence) and progression to mechanical ventilation (pooled RR = 1.08, 95% CI: 0.81–1.43, 6 studies, low-certainty evidence) in patients with COVID-19. IFN therapy resulted in significantly increased hospital discharge on day 14 relative to the control arm (pooled RR = 1.29, 95% CI: 1.04–1.59). These results were inconsistent compared to other comparable outcomes such as recovery at day 14 and time to clinical improvement. The IFN-treated arm was as safe as the control arm, regardless of clinical severity (pooled RR = 0.87, 95% CI: 0.64–1.19, 9 studies, low-certainty evidence). In conclusion, IFN therapy was safe but did not demonstrate favorable outcomes for major clinical indices in patients with COVID-19, particularly those with higher than moderate severity. IFN therapy was not associated with worsening outcomes in patients with severe COVID-19. Future clinical trials should evaluate the clinical efficacy of IFN therapy in patients with mild COVID-19 or at an earlier stage. Trial registration: The protocol for this review was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42022301413.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy and safety of interferon (Type I and Type III) therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Ryoo

Koh

et al. 2023

PLoS ONE

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“…For instance, Kumar S. et al. (2021) ( 20 ) conducted a meta-analysis of IFN-β to determine its effect on moderate-to-severe COVID-19 patients. Seven randomized controlled trials (RCTs) were permitted to perform a meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Separate clinical trials have found different outcomes for IFN treatment in COVID-19 ( 18 ). There are several meta-analyses on the efficacy of IFN-β ( 19 , 20 ), but there are no such data on IFN-α that has a wide range of antiviral properties and is used as a first-line drug in the treatment of various viral diseases. Since we need more information about possible treatments for Covid-19, and there is not enough data on the potential of IFN -α against Covid-19, this meta-analysis allows us to understand the effectiveness of this line of therapy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of interferon alpha for the treatment of hospitalized patients with COVID-19: A meta-analysis

et al. 2023

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IntroductionIFN-α intervention may block SARS-CoV-2 replication and normalize the deregulated innate immunity of COVID-19.AimThis meta-analysis aimed to investigate the efficacy of interferon IFN-α–containing regimens when treating patients with moderate-to-severe COVID-19.Material and methodsPubMed, SCOPUS, and ClinicalTrials.gov were searched from inception to 15 January 2022. A systematic literature search was conducted by applying relevant terms for ‘COVID-19’ and ‘interferon-α’. The primary outcome enclosed the all-cause hospital mortality. The secondary outcomes constituted the length of hospital stay; hospital discharge; nucleic acid negative conversion.ResultsEleven studies are enclosed in the meta-analysis. No significant difference in the all-cause mortality rate was found between the study and control groups (OR 0.2; 95% CI 0.05-1.2; I2 = 96%). The implementation of interferon did not influence such outcomes as the length of hospital stay (OR 0.9; 95% CІ, 0.3-2.6; I2 = 91%), nucleic acid negative conversion (OR 0.8; 95% CI, 0.04-17.2; I2 = 94%). Nevertheless, IFN-α treatment resulted in a higher number of patients discharged from the hospital (OR 26.6; 95% CІ, 2.7-254.3; I2 = 95%).ConclusionsThus, IFN-α does not benefit the survival of hospitalized COVID-19 patients but may increase the number of patients discharged from the hospital.Systematic review registrationwww.crd.york.ac.uk/prospero, identifier (CRD42022374589).

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“…One hallmark of COVID 19 pathophysiology is disruption of normal interferon signaling [ 99 , 100 ]. Nonetheless, the WHO Solidarity trial [ 101 ] and studies of interferon-β [ 102 ] and pegylated interferon lambda [ 103 ] have shown interferon treatment does not reduce COVID-19 mortality.…”

Section: Treatments Targeting the Virusmentioning

confidence: 99%

Treating COVID-19: Targeting the Host Response, Not the Virus

Fedson¹

2023

Life

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In low- and middle-income countries (LMICs), inexpensive generic drugs like statins, ACE inhibitors, and ARBs, especially if used in combination, might be the only practical way to save the lives of patients with severe COVID-19. These drugs will already be available in all countries on the first pandemic day. Because they target the host response to infection instead of the virus, they could be used to save lives during any pandemic. Observational studies show that inpatient statin treatment reduces 28–30-day mortality but randomized controlled trials have failed to show this benefit. Combination treatment has been tested for antivirals and dexamethasone but, with the exception of one observational study in Belgium, not for inexpensive generic drugs. Future pandemic research must include testing combination generic drug treatments that could be used in LMICs.

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Efficacy of Interferon-β in Moderate-to-Severe Hospitalised Cases of COVID-19: A Systematic Review and Meta-analysis

Cited by 9 publications

References 24 publications

Clinical efficacy and safety of interferon (Type I and Type III) therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Clinical efficacy and safety of interferon (Type I and Type III) therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Efficacy of interferon alpha for the treatment of hospitalized patients with COVID-19: A meta-analysis

Treating COVID-19: Targeting the Host Response, Not the Virus

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