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Triple Antiviral Therapy Promising for Mild-to-Moderate COVID-19

Duration of viral shedding shorter with combination of lopinavir-ritonavir, ribavarin, interferon beta-1b

MONDAY, May 11, 2020 (HealthDay News) — For patients with COVID-19, early triple antiviral therapy (lopinavir-ritonavir, ribavirin, and interferon beta-1b) is better than lopinavir-ritonavir for reducing the time to providing a nasopharyngeal swab negative for severe acute respiratory syndrome coronavirus 2, according to a study published online May 8 in The Lancet.

Ivan Fan-Ngai Hung, M.D., from Queen Mary Hospital in Hong Kong, and colleagues conducted a multicenter, randomized phase 2 trial involving 127 adults with COVID-19 admitted to six hospitals in Hong Kong. Patients were randomly assigned to a 14-day combination of lopinavir and ritonavir, ribavirin, and three doses of interferon beta-1b on alternate days (86 patients, combination group) or 14 days of lopinavir and ritonavir (41 patients, control group).

There was a median of five days from symptom onset to start of study treatment. The researchers found that compared with the control group, the combination group had a significantly shorter median time from start of study treatment to a negative nasopharyngeal swab (seven versus 12 days; hazard ratio, 4.37). Adverse events included self-limited nausea and diarrhea, which did not differ between the groups.

“Triple antiviral therapy with interferon beta-1b, lopinavir-ritonavir, and ribavirin [was] safe and superior to lopinavir-ritonavir alone in shortening virus shedding, alleviating symptoms, and facilitating discharge of patients with mild-to-moderate COVID-19,” the authors write.

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