沙特国民警卫队卫生事务部Yaseen M. Arabi团队研究了干扰素β-1b和洛匹那韦-利托那韦治疗中东呼吸综合征的疗效。2020年10月7日，该研究发表在《新英格兰医学杂志》上。
Title: Interferon Beta-1b and Lopinavir–Ritonavir for Middle East Respiratory Syndrome | NEJM
Author: Yaseen M. Arabi, M.D.,, Ayed Y. Asiri, M.D.,, Abdullah M. Assiri, M.D.,, Hanan H. Balkhy, M.D.,, Ali Al Bshabshe, M.D.,, Majed Al Jeraisy, Pharm.D.,, Yasser Mandourah, M.D.,, Mohamed H.A. Azzam, M.D.,, Abdulhadi M. Bin Eshaq, M.D.,, Sameera Al Johani, M.B., B.S.,, Shmeylan Al Harbi, Pharm.D., B.C.P.S,, Hani A.A. Jokhdar, M.B., Ch.B., Ph.D.,, Ahmad M. Deeb, R.N., M.S.N.,, Ziad A. Memish, M.D.,, Jesna Jose, M.Sc.,, Sameeh Ghazal, M.D.,, Sarah Al Faraj, M.D.,, Ghaleb A. Al Mekhlafi, M.D.,, Nisreen M. Sherbeeni, M.D.,, Fatehi E. Elzein, M.D.,, Fahad Al-Hameed, M.D.,, Asim Al Saedi, M.D.,, Naif K. Alharbi, Ph.D.,, Robert A. Fowler, M.D.C.M.,, Frederick G. Hayden, M.D.,, Abdulaziz Al-Dawood, M.D.,, Mohamed Abdelzaher, M.D.,, Wail Bajhmom, M.B., B.S., Ph.D.,, Badriah M. AlMutairi, R.N.,, Mohamed A. Hussein, M.S.C.S., M.S.P.H., Ph.D.,, and Adel Alothman, M.D.
Whether combined treatment with recombinant interferon beta-1b and lopinavir–ritonavir reduces mortality among patients hospitalized with Middle East respiratory syndrome (MERS) is unclear.
We conducted a randomized, adaptive, double-blind, placebo-controlled trial that enrolled patients at nine sites in Saudi Arabia. Hospitalized adults with laboratory-confirmed MERS were randomly assigned to receive recombinant interferon beta-1b plus lopinavir–ritonavir (intervention) or placebo for 14 days. The primary outcome was 90-day all-cause mortality, with a one-sided P-value threshold of 0.025. Prespecified subgroup analyses and safety analyses were conducted. Because of the pandemic of coronavirus disease 2019, the data and safety monitoring board requested an unplanned interim analysis and subsequently recommended the termination of enrollment and the reporting of the results.
A total of 95 patients were enrolled; 43 patients were assigned to the intervention group and 52 to the placebo group. A total of 12 patients (28%) in the intervention group and 23 (44%) in the placebo group died by day 90. The analysis of the primary outcome, with accounting for the adaptive design, yielded a risk difference of 19 percentage points (upper boundary of the 97.5% confidence interval [CI], 3; one-sided P=0.024). In a prespecified subgroup analysis, treatment within 7 days after symptom onset led to lower 90-day mortality than use of placebo (relative risk, 0.19; 95% CI, 0.05 to 0.75), whereas later treatment did not. Serious adverse events occurred in 4 patients (9%) in the intervention group and in 10 (19%) in the placebo group.
A combination of recombinant interferon beta-1b and lopinavir–ritonavir led to lower mortality than placebo among patients who had been hospitalized with laboratory-confirmed MERS. The effect was greatest when treatment was started within 7 days after symptom onset.