UNMC researcher finds one COVID treatment not justified

Scientists around the world are racing to find viable treatments for COVID-19.

University of Nebraska Medical Center Andre Kalil, MD, has joined the race by conducting multiple COVID-19 studies that were published in major journals.

Dr. Kalil recently was first author of a study published in the major British medical journal Lancet Respiratory Medicine. The study evaluated whether the combination of interferon beta-1a and remdesivir compared to remdesivir alone might work as a COVID-19 treatment in hospitalized patients.

It did not.

The study, funded by the National Institutes of Health Adaptive COVID-19 Treatment Trial Network, chose interferon beta-1a based on robust pre-clinical and clinical evidence that interferon could work in addition to other treatments. Interferon beta has had a strong biological rationale to fight infections such as COVID-19 and other viral infections based on in vitro, in vivo animal and human studies.

"When interferon was tested in a rigorous study — that is, a randomized double-blind placebo-controlled trial — it did not show clinical benefits regarding recovery speed or survival in hospitalized patients with COVID-19," said Dr. Kalil, professor in the UNMC Department of Internal Medicine Division of Infectious Diseases. "For hospitalized patients with COVID-19, the use of subcutaneous (injected) interferon beta-1a cannot be justified anymore based on the results of our randomized controlled trial.

However, Dr. Kalil said, other forms of administration, such as inhaled interferon in earlier stages of the disease, may have a different effect, and those are being studied by other research groups.

"Our interferon beta-1a trial shows how essential it is to test all potential treatments, including the most promising ones, in rigorous randomized placebo-controlled trials," Dr. Kalil said. "Otherwise, these therapies may be used off-label for many years without providing any benefit to patients."

So far, Dr. Kalil said, the most effective anti-viral therapy for hospitalized COVID-19 patients is remdesivir, which is the only FDA-approved anti-viral treatment, while baricitinib and dexamethasone are the most effective anti-inflammatory treatments.

The study, called the Adaptive COVID-19 Treatment Trial 3 (ACTT 3), enrolled 970 hospitalized adults with COVID-19. UNMC was among the top enrollers for the 63 sites in the United States and abroad.  

Read the Lancet article here. An accompanying editorial is posted here.