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Combined oral isoprinosine-intraventricular alpha-interferon therapy for subacute sclerosing panencephalitis
G Gascon1, S Yamani, J Crowell
1Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
This study shows that combining oral isoprinosine and intraventricular alpha-interferon effectively treats subacute sclerosing panencephalitis (SSPE), leading to remissions in 44% of patients.
Area of Science:
- Neurology
- Virology
- Immunology
Background:
- Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder.
- SSPE is a late complication of measles virus infection.
- Current treatment options for SSPE are limited and often ineffective.
Purpose of the Study:
- To evaluate the efficacy of combined oral isoprinosine and intraventricular alpha-interferon 2b in treating SSPE.
- To assess treatment outcomes based on the Neurological Disability Index (NDI) and patient staging.
Main Methods:
- Eighteen pediatric patients (5-14 years) with SSPE received oral isoprinosine and intraventricular alpha-interferon 2b.
- Treatment involved escalating doses of alpha-interferon 2b.
- Patients were monitored for a minimum of 12 months.
Main Results:
- A 44% remission or improvement rate (8/18 patients) was observed.
- This rate is significantly higher than historical controls (9%) and spontaneous remission rates (5%).
- 3 patients improved, 5 achieved arrested disease, 4 worsened, and 6 died.
Conclusions:
- Combined oral isoprinosine and intraventricular alpha-interferon 2b demonstrates significant efficacy in treating SSPE.
- This combination therapy offers a promising therapeutic strategy for SSPE patients.
- Further research is warranted to optimize treatment protocols and long-term outcomes.
Abstract:
Eighteen patients, 16 boys and 2 girls, aged 5-14 years, with subacute sclerosing panencephalitis (SSPE) were treated with oral isoprinosine (100 mg/kg/day) and intraventricular alpha-interferon 2b (Intron A, Schering Corp.), starting at 500,000 U twice a week and later increasing to 3 million U biweekly. Minimal follow-up of living patients is 12 months; maximal 40 months. On the basis of the Neurological Disability Index (NDI) scores and staging, 8 have treatment-induced remissions (3 improved, 5 arrested), 4 are worse and 6 died. This 44% (8/18) rate of remission/improvement compares well with the 9% (1/11) remission in historical controls in the same institution (p = < 0.05) and 5% spontaneous remission in the literature. Combined oral isoprinosine-intraventricular alpha-interferon appears to be an effective treatment for SSPE.