Inhaled interferon beta-1a did not meet its primary endpoint in patients who were hospitalised with COVID-19 but may improve clinical outcomes in patients with more severe disease or risk factors for disease progression, subgroup analyses of the SPRINTER trial displayed. Suggested is to evaluate inhaled interferon beta-1a in patients with severe viral lung infections in general, and in hospitalised patients with COVID-19 that have a more severe disease in particular.
“Inhaled interferon beta-1a has demonstrated anti-viral activity against a range of respiratory viruses, including SARS-CoV-2,” outlined Prof. Tom Wilkinson (University of Southampton, UK) . Moreover, inhaled delivery optimises the exposure of this agent to the tissue it should target, without ample systemic exposure [2,3]. Positive phase 2 results of this agent in COVID-19  led to the unfoldment of the phase 3 SPRINTER trial (NCT04732949). The trial randomised 623 patients who were hospitalised with moderate COVID-19 1:1 to a 14-day course of inhaled interferon beta-1a plus standard care or placebo plus standard care. The primary endpoints were the time to hospital discharge and the time to recovery to ‘no limitations of activities’ up to day 28.
No difference was observed in time to hospital discharge between the 2 arms of the study (HR 1.06; 95% CI 0.89‒1.27; P=0.509). Key secondary endpoints did not demonstrate a benefit of inhaled interferon beta-1a over placebo either but trended towards a benefit for the intervention arm: progression to severe disease or death (interferon beta-1a 10.7% vs placebo 14.4%; OR 0.71; P=0.161). Furthermore, in patients with O2 saturation ≤92% or respiratory rates ≥21 breaths per minute, the per-protocol analysis did show a trend towards a reduced risk of severe disease or death in those who were treated with inhaled interferon beta-1a instead of placebo (3.4% vs 12%; P=0.046).
The safety profile of inhaled interferon beta-1a was favourable and consistent with previously reported data. The rates of serious treatment-emergent adverse events were 12.6% and 18.2% in the experimental arm and placebo arm, respectively.
Prof. Wilkinson concluded that the favourable trends for inhaled interferon beta-1a over placebo that were observed in the current trial provide a clinical rationale to investigate the effect of this agent on the endpoint of progression of disease or mortality in hospitalised patients with COVID-19 and in patients with severe viral lung infections.
- Wilkinson TMA, et al. SPRINTER: A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial to Determine the Efficacy and Safety of Inhaled Interferon Beta-1a (SNG001) for the Treatment of Patients Hospitalised Due to COVID-19. ALERT 3, RCT2884, ERS International Congress 2022, Barcelona, Spain, 4–6 September.
- Djukanović R, et al. Am J Respir Crit Care Med. 2014;190(2):145‒54.
- Filipi ML, et al. Int J MS Care. 2014;16(1):55–60.
- Monk PD, et al. Lancet Respir Med. 2021;9(2):196‒206.
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Table of Contents: ERS 2022
Letter from the Editor
ERS 2022 Highlights Podcast
COVID-19: What Is New?
Does vilobelimab reduce mortality in severe COVID-19?
Awake proning not positive in COVID-19
Favipiravir may help patients over 60 years with COVID-19 to recover
Brensocatib fails in severe COVID-19
Inhaled agent under investigation for COVID-19
Accurate voice-based COVID-19 diagnostic test in development
Novel scoring tool for post-COVID syndrome aids clinicians and researchers
COPD: Therapies and Innovations
Icenticaftor achieves results on top of triple inhalation therapy in COPD
STARR2: A new approach for treating COPD exacerbations
COPD medication not effective in symptomatic smokers with preserved spirometry
Do digital tools improve physical activity in COPD?
Hyperpolarised gas MRI ready for clinical use
All About Asthma
Tezepelumab in asthma: mucus plugging down, lung function up
Digital asthma intervention improves health and reduces costs
Digitally enhanced therapy lowers treatment burden and costs in severe asthma
Mepolizumab beneficial for patients with severe eosinophilic asthma
Progress in Paediatrics
Antibiotics cause increased risk of wheezing in severe RSV bronchiolitis
Inhaled corticosteroids useful in preterms with decreased lung function
Fish oil or vitamin D during pregnancy can prevent croup
Encouraging results of nintedanib in children with fibrosing ILD
Focus on Interventional Pulmonology
Head-to-head: lung volume reduction surgery vs endobronchial valves
Durable effect of endobronchial valves in severe emphysema
Cone beam CT-guided ENB improves detection of pulmonary nodules
Confirmatory mediastinoscopy not needed in resectable NSCLC
Sleep and Breathing Disorders
In the spotlight: Cancer trends in obstructive sleep apnoea
Impact of CPAP on cardiac endpoints in OSA
Sustained hypoxaemia predicts unprovoked VTE in OSA
CPAP therapy in the prevention of cardiovascular risk in patients with OSA
Other Remarkable Research
Excellent results for high-flow nasal cannula oxygen therapy in acute respiratory failure
Antifibrotic therapy may slow down FVC decline in RAILD
Intravenous N-acetylcysteine performs well in hospitalised patients
Men and women respond differently to diesel exhaust
New trends in cystic lung diseases
Round-up of respiratory disease and reproduction topics