Effectiveness of Interferon Gamma for the Treatment of Moderate and Severe Influenza by Neuraminidase Inhibitors: The Results of an Open-Label Randomized Controlled Clinical Trial (Season 2018-2019)

Abstract

Background: Interferon gamma for intranasal administration has been approved for the prevention and treatment of influenza in complex therapy. Its effectiveness and safety was proved in randomized controlled clinical trials. This open-label comparative clinical trial aimed to evaluate the effectiveness and safety of interferon gamma in therapy of influenza. Citation: Shestakova, IV., Ivanova, MR., Ulyanova, YS., Go, A., Shabalkin, PI. (2020) Effectiveness of Interferon Gamma for the Treatment of Moderate and Severe Influenza by Neuraminidase Inhibitors: The Results of an Open-Label Randomized Controlled Clinical Trial (Season 2018-2019). J Pulm Med Respir Care, 2(1): 01-07. Journal of Pulmonary Medicine and Respiratory Care © 2020 Somato Publications. All rights reserved. Volume 2 Issue 1 - 1004 02 Methods: 300 patients were included. The main inclusion criterion was diagnosis of moderate or severe influenza that required hospitalization. The patients were randomly allocated to one of three groups (1:1:1/2). — Group A: interferon gamma + zanamivir + symptomatic treatment. — Group B: interferon gamma + oseltamivir + symptomatic treatment. — Group C (control): zanamivir or oseltamivir (1:1) + symptomatic treatment. The patients were observed daily throughout the hospitalization period. All patients underwent scheduled clinical examinations including body temperature measurement, registration of complaints and clinical parameters, blood count, biochemical blood test, urinalysis. In case of clinical signs of pneumonia, patients received chest radiography. If this complication was confirmed, the patient would have received antibacterial therapy. Results and Conclusion: We noted a trend towards earlier disappearance of the symptoms of intoxication in patients treated with interferon gamma. The study showed that interferon gamma influences the hospitalization length in patients with moderate influenza; compared to the control group, there was a statistically significant reduction of the duration of hospital stay in patients, who received interferon gamma. Good tolerance to interferon gamma was demonstrated. Further studies are needed to evaluate the effectiveness of interferon gamma for the treatment of complicated influenza. Background Influenza is one of the most widespread infectious diseases, and it puts a significant social and economic burden on health care systems worldwide. The morbidity with influenza in 2018 in Russia was 26.33 per 100,000 persons (24.5% lower compared to 34.86 per 100,000 in 2017); 113.90 per 100,000 children age 1-2; and 93.91 per 100,000 children age 3-6 according to Rospotrebnadzor. The WHO estimates that influenza epidemics account for 3-5 million severe cases of the disease and 250,000—500,000 deaths from respiratory diseases annually. Lethal cases of influenza in industrialized countries most often occur after 65 years of age. Complications of influenza may also develop in young and healthy persons, who are not a risk group and therefore are not covered by mandatory annual vaccination against influenza. Drugs of choice for the treatment of influenza are neuraminidase inhibitors (zanamivir and oseltamivir). Interferons are also effective against this disease and are recommended as a part of a combined treatment. The results of this study confirm the effectiveness and safety of interferon gamma in a combined hospital treatment of patients with moderate-to-severe and severe influenza.