Severe acute respiratory syndrome (SARS) is a new clinical entity for
which no effective therapeutic strategy has been developed.
To provide preliminary results on the potential therapeutic benefit
and tolerability of interferon alfacon-1 plus corticosteroids for SARS.
Design, Setting, and Patients
Open-label study of 22 patients diagnosed as having probable SARS at
North York General Hospital, Toronto, Ontario, between April 11 and May 30,
Thirteen patients were treated with corticosteroids alone and 9 patients
were treated with corticosteroids plus subcutaneous interferon alfacon-1.
Main Outcome Measures
Clinical parameters, including oxygen saturation and requirement, laboratory
measures, and serial chest radiography results.
Resolution of fever and lymphopenia were similar between the 2 treatment
groups. Of the 13 patients treated with corticosteroids alone, 5 (38.5%) were
transferred to the intensive care unit, 3 (23.1%) required intubation and
mechanical ventilation, and 1 (7.7%) died. Of the 9 patients in the interferon
alfacon-1 treatment group, 3 (33.3%) were transferred to the intensive care
unit, 1 (11.1%) required intubation and mechanical ventilation, and none died.
The interferon alfacon-1 treatment group had a shorter time to 50% resolution
of lung radiographic abnormalities (median time, 4 days vs 9 days; P = .001), had better oxygen saturation (P =
.02), resolved their need for supplemental oxygen more rapidly (median, 10
days vs 16 days; P = .02), had less of an increase
in creatine kinase levels (P = .03), and showed a
trend toward more rapid resolution of lactate dehydrogenase levels compared
with the group receiving corticosteroids alone.
In this preliminary, uncontrolled study of patients with SARS, use of
interferon alfacon-1 plus corticosteroids was associated with reduced disease-associated
impaired oxygen saturation, more rapid resolution of radiographic lung abnormalities,
and lower levels of creatine kinase. These findings suggest that further investigation
may be warranted to determine the role of interferon alfacon-1 as a therapeutic
agent for the treatment of SARS.