Single dose of Pegylated interferon lambda significantly lowers Covid-19 related events: NEJM

Dr Gilmar Reis and team have found in a new study that single dose of pegylated interferon lambda used as early treatment in patients with COVID-19 was effective in lowering the total occurrences of hospitalization and ED visits. Further in these Covid-19-vaccinated outpatients, likelihood of hospitalization or an urgent care visit (observation for more than six hours) was considerably lower.

The findings of this study were published in The New England Journal of Medicine. 

It is uncertain if a single dose of pegylated interferon lambda can prevent clinical events in outpatients with acute symptomatic coronavirus disease 2019 (Covid-19). Therefore, this study was conducted in order to assess the efficiency of pegylated interferon lambda in Covid-19.

In Brazil and Canada, a controlled, randomized, adaptive platform study enrolling mostly vaccinated persons with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was done. Outpatients with an acute clinical state compatible with Covid-19 who came within 7 days of the beginning of symptoms were given either pegylated interferon lambda (single subcutaneous injection, 180 g) or placebo (single injection or oral). Within 28 days of randomization, the key composite outcome was hospitalization (or transfer to a tertiary hospital) or an emergency department visit (observation for >6 hours) owing to Covid-19.

The key findings of this study were:

A total of 933 individuals were given pegylated interferon lambda, whereas 1018 were given a placebo. 

Overall, 83% of the patients had been immunized, and numerous SARS-CoV-2 variants appeared during the experiment. 

A total of 25 of 931 patients in the interferon group experienced a main outcome event, compared to 57 of 1018 in the placebo group, representing a 51% difference. 

Secondary outcome studies revealed broadly consistent results, including time to hospitalization for Covid-19 and Covid-19-related hospitalization or mortality. 

The effects were consistent among dominant variations and were unaffected by immunization. 

Patients with a high viral load at the start of the study who acquired pegylated interferon lambda had lower viral levels on day 7 than those who received placebo.

The risk of hospitalization or ER visit owing to Covid-19 was considerably lower among individuals who got a single dose of pegylated interferon lambda than among those who received a placebo in this trial including predominantly immunized outpatients who arrived with acute symptoms. These outcomes, which were seen irrespective of viral type, raise the idea that a single-dose regimen might contribute to the Covid-19 response.

Reference: 

Reis, G., Moreira Silva, E. A. S., Medeiros Silva, D. C., Thabane, L., Campos, V. H. S., Ferreira, T. S., Santos, C. V. Q., Nogueira, A. M. R., Bitarães, C., Milagres, A. C., Callegari, E. D., Simplicio, M. I. C., Ribeiro, L. B., Oliveira, R., … Glenn, J. S. (2023). Early Treatment with Pegylated Interferon Lambda for Covid-19. In New England Journal of Medicine (Vol. 388, Issue 6, pp. 518–528). Massachusetts Medical Society. https://doi.org/10.1056/nejmoa2209760