Interferon alfacon-1 plus corticosteroids in severe acute respiratory syndrome: a preliminary study

JAMA. 2003 Dec 24;290(24):3222-8. doi: 10.1001/jama.290.24.3222.


Context: Severe acute respiratory syndrome (SARS) is a new clinical entity for which no effective therapeutic strategy has been developed.

Objective: To provide preliminary results on the potential therapeutic benefit and tolerability of interferon alfacon-1 plus corticosteroids for SARS.

Design, setting, and patients: Open-label study of 22 patients diagnosed as having probable SARS at North York General Hospital, Toronto, Ontario, between April 11 and May 30, 2003.

Interventions: Thirteen patients were treated with corticosteroids alone and 9 patients were treated with corticosteroids plus subcutaneous interferon alfacon-1.

Main outcome measures: Clinical parameters, including oxygen saturation and requirement, laboratory measures, and serial chest radiography results.

Results: Resolution of fever and lymphopenia were similar between the 2 treatment groups. Of the 13 patients treated with corticosteroids alone, 5 (38.5%) were transferred to the intensive care unit, 3 (23.1%) required intubation and mechanical ventilation, and 1 (7.7%) died. Of the 9 patients in the interferon alfacon-1 treatment group, 3 (33.3%) were transferred to the intensive care unit, 1 (11.1%) required intubation and mechanical ventilation, and none died. The interferon alfacon-1 treatment group had a shorter time to 50% resolution of lung radiographic abnormalities (median time, 4 days vs 9 days; P =.001), had better oxygen saturation (P =.02), resolved their need for supplemental oxygen more rapidly (median, 10 days vs 16 days; P =.02), had less of an increase in creatine kinase levels (P =.03), and showed a trend toward more rapid resolution of lactate dehydrogenase levels compared with the group receiving corticosteroids alone.

Conclusions: In this preliminary, uncontrolled study of patients with SARS, use of interferon alfacon-1 plus corticosteroids was associated with reduced disease-associated impaired oxygen saturation, more rapid resolution of radiographic lung abnormalities, and lower levels of creatine kinase. These findings suggest that further investigation may be warranted to determine the role of interferon alfacon-1 as a therapeutic agent for the treatment of SARS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Creatine Kinase / metabolism
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Interferon Type I / therapeutic use*
  • Interferon-alpha
  • L-Lactate Dehydrogenase / metabolism
  • Lung / diagnostic imaging
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Oxygen Consumption
  • Prednisone / therapeutic use
  • Radiography
  • Recombinant Proteins
  • Respiration, Artificial
  • Severe Acute Respiratory Syndrome / diagnostic imaging
  • Severe Acute Respiratory Syndrome / drug therapy*
  • Severe Acute Respiratory Syndrome / metabolism


  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Glucocorticoids
  • Interferon Type I
  • Interferon-alpha
  • Recombinant Proteins
  • interferon alfacon-1
  • L-Lactate Dehydrogenase
  • Creatine Kinase
  • Prednisone
  • Methylprednisolone