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2020 ; 395
(10238
): 1695-1704
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Triple combination of interferon beta-1b, lopinavir-ritonavir, and ribavirin in
the treatment of patients admitted to hospital with COVID-19: an open-label,
randomised, phase 2 trial
#MMPMID32401715
Hung IF
; Lung KC
; Tso EY
; Liu R
; Chung TW
; Chu MY
; Ng YY
; Lo J
; Chan J
; Tam AR
; Shum HP
; Chan V
; Wu AK
; Sin KM
; Leung WS
; Law WL
; Lung DC
; Sin S
; Yeung P
; Yip CC
; Zhang RR
; Fung AY
; Yan EY
; Leung KH
; Ip JD
; Chu AW
; Chan WM
; Ng AC
; Lee R
; Fung K
; Yeung A
; Wu TC
; Chan JW
; Yan WW
; Chan WM
; Chan JF
; Lie AK
; Tsang OT
; Cheng VC
; Que TL
; Lau CS
; Chan KH
; To KK
; Yuen KY
Lancet
2020[May]; 395
(10238
): 1695-1704
PMID32401715
show ga
BACKGROUND: Effective antiviral therapy is important for tackling the coronavirus
disease 2019 (COVID-19) pandemic. We assessed the efficacy and safety of combined
interferon beta-1b, lopinavir-ritonavir, and ribavirin for treating patients with
COVID-19. METHODS: This was a multicentre, prospective, open-label, randomised,
phase 2 trial in adults with COVID-19 who were admitted to six hospitals in Hong
Kong. Patients were randomly assigned (2:1) to a 14-day combination of lopinavir
400 mg and ritonavir 100 mg every 12 h, ribavirin 400 mg every 12 h, and three
doses of 8 million international units of interferon beta-1b on alternate days
(combination group) or to 14 days of lopinavir 400 mg and ritonavir 100 mg every
12 h (control group). The primary endpoint was the time to providing a
nasopharyngeal swab negative for severe acute respiratory syndrome coronavirus 2
RT-PCR, and was done in the intention-to-treat population. The study is
registered with ClinicalTrials.gov, NCT04276688. FINDINGS: Between Feb 10 and
March 20, 2020, 127 patients were recruited; 86 were randomly assigned to the
combination group and 41 were assigned to the control group. The median number of
days from symptom onset to start of study treatment was 5 days (IQR 3-7). The
combination group had a significantly shorter median time from start of study
treatment to negative nasopharyngeal swab (7 days [IQR 5-11]) than the control
group (12 days [8-15]; hazard ratio 4·37 [95% CI 1·86-10·24], p=0·0010). Adverse
events included self-limited nausea and diarrhoea with no difference between the
two groups. One patient in the control group discontinued lopinavir-ritonavir
because of biochemical hepatitis. No patients died during the study.
INTERPRETATION: Early triple antiviral therapy was safe and superior to
lopinavir-ritonavir alone in alleviating symptoms and shortening the duration of
viral shedding and hospital stay in patients with mild to moderate COVID-19.
Future clinical study of a double antiviral therapy with interferon beta-1b as a
backbone is warranted. FUNDING: The Shaw-Foundation, Richard and Carol Yu, May
Tam Mak Mei Yin, and Sanming Project of Medicine.