An article published November 12 in The Lancet Respiratory Medicine by Monk and others looked at the efficacy and safety of inhaled nebulised interferon beta-1a for the treatment of patients admitted to hospital with COVID-19.

They did a randomised, double blind, placebo-controlled, phase two pilot trial at nine UK sites.

Adults aged 18 years or older admitted to hospital with a positive PCR or point of care test or both were randomly assigned to receive placebo by inhalation via a mouthpiece or SNG001 and nebulised interferon beta-1a via a mouthpiece daily for 14 days.

101 patients were randomly assigned, 48 received SNG001 and 50 received placebo.

Patients receiving SNG001 had greater odds of improvement on day 15 or day 16 and were more likely than those receiving placebo to recover. The SNG001 was well tolerated. The most frequently reported treatment adverse event was headache 15% as compared to 10% in the placebo group. There were three deaths in the placebo group and none in the SNG001.

This study showed that patients who received SNG001 had greater odds of improvement and recovered more rapidly from SARS-CoV-2 infection than patients who received placebo and this provided a strong rationale for further trials.

Interferons are cytokines that modulate immune responses to viral infection. The type one interferons, interferon alpha and interferon beta, have been tested against coronavirus infections in vitro, with encouraging results. Antiviral responses mediated by interferon beta have been shown to be compromised in people susceptible to COVID-19, such as older people or those with chronic airways disease.

Furthermore SARS-CoV-2 suppresses cellular interferon production, thus limiting the strength of the initial innate immune response.

Exogenous use of inhaled interferon beta-1a in patients with asthma and respiratory viral infections has previously been shown to improve antiviral responses and improve lung function.

These properties might facilitate improvement or recovery in patients with SARS-CoV-2 infection where the need for effective therapeutic intervention is paramount.

This study showed the potential effects of an inhaled interferon beta-1a formulation in patients admitted to hospital with confirmed SARS-CoV-2 infection.

Dr Paul Ettlinger
London General Practice

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