Trial ISRCTN83971151; NCT04315948
Publication Pan H, N Engl J Med, 2020 (published paper)
Dates: 2020-03-22 to 2020-10-04
Funding: Mixed (World Health Organization; Merck KGaA and Faron (drug donation))
Conflict of interest: No
Multicenter / Multinational (30) |
Follow-up duration (days): 28
|Inclusion criteria||Age ≥18 years, hospitalized with a diagnosis of COVID-19, not known to have received any study drug, without anticipated transfer elsewhere within 72 hours, and, in the physician’s view, with no contra-indication to any study drug.|
|Exclusion criteria||The only exclusions were patients without clear consent to follow-up|
Interferon beta-1a (44 mcg)
Co-Intervention: Standard care
Duration : 6 days
Definition of Standard care: Local standard of care
4127 participants (n1=2063 / n2= 2064)
|Characteristics of participants|
Mean age : NR
Severity : Mild: n=972 / Moderate: n=*/ Severe: n=* Critical: n=*
|In the register|
All-cause mortality, subdivided by the severity of disease at the time of randomization, measured using patient records throughout the study
|In the report|
Yes. In English
|Risk of bias
The overall risk of bias reported in the table corresponds to the highest risk of bias for the outcomes assessed for the systematic review
In addition to all available versions of the published manuscript, the pre-print article, the study registry and protocol were used in data extraction and risk of bias assessment. This was a report of interim results of an adaptive trial evaluating 4 drugs: Remdesivir, Hydroxychloroquine, Lopinavir, and Interferon-β1a. No target sample size was pre-specified.
Quote: "The protocol stated “The larger the number entered the more accurate the results will be, but numbers entered will depend on how the epidemic develops… it may be possible to enter several thousand hospitalised patients with relatively mild disease and a few thousand with severe disease, but realistic, appropriate sample sizes could not be estimated at the start of the trial.” The Executive Group, blind to any findings, decided the timing of release of interim results."
Quote: "The hydroxychloroquine, lopinavir, and interferon regimens were discontinued for futility on, respectively, June 19, July 4, and October 16, 2020."
Of the 2063 patients allocated to the active interferon arm, 1412 were allocated interferon and local standard of care, while 651 patients were allocated interferon and lopinavir. Furthermore, of the 2064 patients allocated to the control arm for interferon, 1385 were allocated local standard of care, while 679 were allocated lopinavir.
There was no change from the trial registration in the intervention and control treatments, nor in the primary and secondary outcomes. QUote: "The regimen for interferon (mainly subcutaneous) was three doses over a period of 6 days (the day of randomization and days 3 and 6) of 44 μg of subcutaneous interferon beta-1a; where intravenous interferon was available, patients receiving high-flow oxygen, ventilation, or extracorporeal membrane oxygenation (ECMO) were instead to be given 10 μg intravenously daily for 6 days."
This study was updated on December 9th using data from the published manuscript.