C-SMART trial results presented at ESCMID show a reduction of COVID-19 incidence in cancer patients.
Administering intranasal Interferon-alpha (IFN-a) at a daily dose of 40,000 IU via nasal spray to cancer patients has demonstrated significant efficacy in reducing the incidence of COVID-19. A rigorous study, involving 433 participants aged 62 years on average, divided them evenly between IFN-a and placebo groups. Among them, nearly half were males, with approximately 47% having hematological malignancies and 52% with solid tumors. Findings from the study were presented as late-breaking research at the ESCMID Global Congress.
The overall incidence of COVID-19 was 11.3%, with the IFN-a group experiencing a notably lower incidence at 8.3% compared to the placebo group at 14.4%. This translated to a relative risk reduction of 0.60 (95% CI: 0.33-0.97). Moreover, no significant difference was observed in the incidence of other respiratory viruses between the IFN-a and placebo groups, (5.1% vs 5.1%).
In a detailed per-protocol analysis involving 389 participants, the IFN-a group continued to exhibit a markedly lower incidence of COVID-19 at 7.7% compared to 16% in the placebo group, with a relative risk of 0.50 (95% CI: 0.26-0.84). Similar trends were observed in the incidence of other respiratory viruses, with rates of 4.6% vs 5.7%, respectively.
Subgroup analysis further underscored the efficacy of IFN-a, particularly among participants under 65 years old, females, and those vaccinated against COVID-19. However, no significant differences were observed based on underlying malignancy or active cancer treatment. In addition, endpoints including WHO severity score and hospitalization rates did not vary significantly between the 2 groups.
Previous studies investigating the efficacy of IFN-a for treating hospitalized patients with COVID-19 concluded, “IFN-a does not benefit the survival of hospitalized COVID-19 patients but may increase the number of patients discharged from the hospital.”2
Serious adverse events, totaling 44 cases, were unrelated to the intervention, with no adverse impact noted from IFN-a administration, including 2 deaths attributed to underlying disease. Conducted from 2020 to 2023, this randomized, double-blinded, placebo-controlled study sheds light on the potential of intranasal IFN-a as a complementary preventive measure against COVID-19, alongside vaccination and monoclonal antibodies.
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