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Early Treatment with Pegylated Interferon Lambda for Covid-19.

Gilmar Reis1, Eduardo A S Moreira Silva1, Daniela C Medeiros Silva1

  • 1From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.).

The New England Journal of Medicine
|February 13, 2023
PubMed
Summary

A single dose of pegylated interferon lambda significantly reduced hospitalizations and emergency visits in COVID-19 outpatients. This antiviral treatment proved effective across variants and vaccination statuses, offering a promising therapeutic option.

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Area of Science:

  • Virology
  • Immunology
  • Clinical Medicine

Background:

  • The clinical effectiveness of pegylated interferon lambda for treating COVID-19 outpatients remained uncertain.
  • Investigating novel antiviral therapies is crucial for managing the evolving SARS-CoV-2 pandemic.

Purpose of the Study:

  • To evaluate the efficacy of a single dose of pegylated interferon lambda in preventing severe clinical outcomes in outpatients with acute COVID-19.
  • To assess the safety and effectiveness of pegylated interferon lambda against various SARS-CoV-2 variants.

Main Methods:

  • A randomized, controlled, adaptive platform trial was conducted in Brazil and Canada.
  • Predominantly vaccinated adults with SARS-CoV-2 infection received either pegylated interferon lambda (180 μg subcutaneous) or placebo.
  • The primary outcome was hospitalization or an emergency department visit within 28 days.

Main Results:

  • Pegylated interferon lambda reduced the primary composite outcome by 51% compared to placebo (2.7% vs 5.6%).
  • Secondary outcomes, including hospitalization and COVID-19-related death, also showed significant reductions.
  • Treatment effects were consistent across dominant SARS-CoV-2 variants and independent of vaccination status. Adverse events were similar between groups.

Conclusions:

  • A single dose of pegylated interferon lambda significantly lowered hospitalization and emergency department visits in COVID-19 outpatients.
  • The findings support pegylated interferon lambda as an effective treatment for acute COVID-19, regardless of variant or vaccination status.