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Experimental antivirals can significantly speed the recovery of COVID-19 outpatients

 


A clinical study led by Dr. Jordanfeld, a hepatologist at the University Health Network’s (UHN) Toronto Liver Disease Center, showed that antiviral drugs can significantly speed the recovery of COVID-19 outpatients. Hospitalized.

The COVID-19 vaccine will be rolled out this year, although this could be an important intervention to help treat infected patients and curb community spread.

“This treatment has great potential, especially at this time, as aggressive variants of the virus, which are less sensitive to both vaccine and antibody treatments, are spreading around the world.” Dr. Feld, who is also co-director, said. R. Ferrand, Chairman of the Schwartz Reismann Liver Research Center and UHN’s Translated Liver Research.

According to a survey, it was released today Lancet Respiratory MedicinePatients who received a single injection of peg interferon lambda were more than four times more likely to clear the infection within 7 days when compared to the placebo-treated group.

“People who received treatment quickly cleared the virus, and the effect was most pronounced in those with the highest virus levels, and the treatment group tended to improve respiratory symptoms faster.” Dr. Feld explains. Use of peg interferon lambda for viral hepatitis in COVID-19 treatment studies.

Participants with high viral levels (more than 1 million copies per mL) were much more likely to get rid of therapeutic infections than placebo. 79% in the treatment group compared to 38% in the placebo group. Virus levels decreased rapidly across all treatment groups.

Therapeutic effect and public health impact

Rapid clearance has many advantages, especially at high levels of the virus, because it increases the risk of more serious illness and transmission to others. Of the 60 patients tracked in the study, 5 went to the emergency room with worsening respiratory symptoms. Four of them were in the placebo group, but only one was actually given the drug.

Quickly lowering virus levels can prevent people from getting worse and reduce the risk of the disease spreading to others. This can have significant additional implications for public health.

If the level of the virus can be lowered quickly, it is less likely that the infection will spread to others and may even reduce the time required for self-quarantine. “

Dr. Jordan Feld, Liver Specialist, Toronto Liver Disease Center, University Health Network

Interferon lambda is a protein produced by the body in response to a viral infection. It has the ability to activate many cellular pathways to kill invading viruses.

The coronavirus that causes COVID-19 prevents the body from producing interferon. This is one way to avoid control by the body’s immune system. Treatment with interferon lambda activates the same intracellular viral killing pathway.

Because interferon activates many viral killing pathways, resistance to “new strains” of the virus, which may be problematic with some treatments, is not a problem with interferon lambda.

Interferon Lambda differs from other interferons because it uses receptors that are only present in some tissues in the body. It is highly active in the lungs, liver and intestines wherever the COVID-19 virus can replicate, but is inactive elsewhere and has far fewer side effects than other interferons. In the study, patients treated with interferon lambda had the same side effects as those who received placebo.

Peg interferon lambda (used in this study) is a long-acting version of the drug developed by Eiger BioPharmaceuticals that can be injected once under the skin using a small needle (such as insulin).

Next step

This is a researcher initiated in a Phase 2 double-blind randomized trial in Toronto, with a total of 60 participants. The survey was conducted from May to November 2020 and was referred by six outpatient evaluation centers.

With these positive results, a large phase 3 trial will be launched in the near future. Additional studies are underway at the University of Toronto, Harvard, and Johns Hopkins University in an environment where inpatients can use peg interferon lambda to prevent infection in exposed patients.

Dr. UHN’s nurse practitioner and researcher Mia Biondi, Michael Garron Hospital’s infectious disease specialist Christopher Kandel, and UHN’s senior statistician Bettina Hansen co-led the trial.

Source:

Journal reference:

Feld, JJ, et al.. (2021) Peg interferon lambda for the treatment of outpatients with COVID-19: Phase 2, placebo-controlled, randomized trial. Lancet Respiratory Medicine.. doi.org/10.1016/S2213-2600 (20) 30566-X..

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