A new study, published online in The Lancet, has found that a triple-antiviral therapy regimen of interferon-beta1 (Avonex), lopinavir/ritonavir (Kaletra), and ribavirin shortened the time of COVID-19 recovery by 5 days.
Interferon-beta1 is used to treat relapsing multiple sclerosis, Kaletra is an HIV medication, and ribavirin is used to treat certain viral respiratory infections and hepatitis C.
Dr. Ivan Fan-Ngai Hung from Gleaneagles Hospital in Hong Kong and colleagues wrote, “Triple-antiviral therapy with interferon beta-1b, lopinavir/ritonavir, and ribavirin were safe and superior to lopinavir/ritonavir alone in shortening virus shedding, alleviating symptoms, and facilitating discharge of patients with mild to moderate COVID-19.”
Participants who received the combination of these drugs were also found to have a significantly shorter time of complete alleviation in the symptoms of COVID-19. The average hospital stay was 9 days for patients treated these antiviral drugs, compared with 14.5 days for those who did not receive the combination of these drugs.
In most patients, COVID-19 viral load was effectively suppressed, including throat swabs, nasopharyngeal swabs, posterior oropharyngeal saliva, and stool.
In addition, an intense inflammatory response called a cytokine storm, which is commonly seen in COVID-19 patients, was significantly lowered in patients treated with the combination of these drugs.
Lead investigator Dr. Kwok-Yung Yuen said, “Our trial demonstrates that early treatment of mild to moderate COVID-19 with a triple combination of antiviral drugs may rapidly suppress the amount of virus in a patient’s body, relieve symptoms, and reduce the risk to health care workers by reducing the duration and quantity of viral shedding.
“Furthermore, the treatment combination appeared safe and well-tolerated by patients,” he added. “Despite these encouraging findings, we must confirm in larger phase 3 trials that interferon beta-1b alone or in combination with other drugs is effective in patients with more severe illness.”
Dr. Benjamin Medoff of Massachusetts General Hospital in Boston, who was not part of the study, said, “I think this is a promising study that suggests that a regimen of interferon beta-1b, lopinavir/ritonavir, and ribavirin can shorten the duration of infection and improve symptoms in COVID-19 patients especially if started early in the disease, in less than 7 days of symptom onset.”
“The open-label nature and small size of the study limits the broad use of the regimen as noted by the authors, and it’s important to emphasize that the subjects enrolled did not have very severe disease (not in the ICU),” he added. “However, the study does suggest that a larger truly randomized study is warranted.”
Side effects were reported in nearly half of the participants. The most common side effects were diarrhea, fever, nausea, and elevated alanine transaminase level, which resolved within 3 days of the treatment. No serious side effects were reported in the combination group. No patient died during the trial.
