Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
Pol Arch Intern Med. 2020 Apr 30;130(4):287-296. doi: 10.20452/pamw.15279. Epub 2020 Apr 3.
Acute respiratory distress syndrome (ARDS) is a life-threatening disease characterized by respiratory failure with rapidly progressing inflammation. Currently, no effective pharmacological treatment for ARDS is available.
We conducted this systematic review and meta‑ analysis to examine the use of interferon beta-1a in patients with ARDS.
Data sources included the following databases: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. We retained trials from 1996 to February 25, 2020 that comparatively examined the use of interferon beta-1a in patients with ARDS. Two reviewers identified eligible studies, independently extracted study data, and assessed the risk of bias. The authors evaluated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
We included 2 trials (n = 392 patients). No significant differences in 28-day hospital mortality (risk ratio [RR], 0.59; 95% CI, 0.13-2.67; P = 0.49; very low certainty) and the number of ventilator-free days (mean difference, 4.85 days; 95% CI, -3.25 to 12.93; P = 0.24, very low certainty) were observed in patients treated with interferon beta-1a compared with those not receiving this drug. Interferon beta-1a also had no significant impact on the risk of adverse events (RR, 0.98%; 95% CI, 0.94-1.03; P = 0.47; low certainty).
The use of interferon beta-1a does not appear to improve mortality or reduce the number of ventilator-free days and adverse events in patients with ARDS. This review is based on 2 small studies reporting a limited number of events, which raises questions regarding the true effects of interferon beta-1a. The analysis of 1 study revealed increased mortality with the concomitant use of corticosteroids and interferon beta-1a, suggesting a need for careful consideration of this drug-drug interaction.
急性呼吸窘迫综合征（ARDS）是一种以呼吸衰竭为特征的危及生命的疾病，其特点是炎症迅速进展。目前，尚无有效的 ARDS 药物治疗方法。
我们进行了这项系统评价和荟萃分析，以研究干扰素-β1a 在 ARDS 患者中的应用。
资料来源包括以下数据库：MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库。我们保留了 1996 年至 2020 年 2 月 25 日期间比较干扰素-β1a 治疗 ARDS 患者的试验。两位审查员确定了合格的研究，独立提取了研究数据，并评估了偏倚风险。作者使用推荐、评估、发展和评估（GRADE）方法评估证据的确定性。
我们纳入了 2 项试验（n = 392 名患者）。与未接受该药治疗的患者相比，接受干扰素-β1a 治疗的患者 28 天住院死亡率（风险比 [RR]，0.59；95%置信区间，0.13-2.67；P = 0.49；极低确定性）和无呼吸机天数（平均差异，4.85 天；95%置信区间，-3.25 至 12.93；P = 0.24，极低确定性）无显著差异。干扰素-β1a 对不良事件的风险也没有显著影响（RR，0.98%；95%置信区间，0.94-1.03；P = 0.47；低确定性）。
使用干扰素-β1a 似乎不能改善 ARDS 患者的死亡率或减少无呼吸机天数和不良事件。这篇综述基于 2 项小型研究报告的有限数量的事件，这引发了对干扰素-β1a 真实效果的质疑。对 1 项研究的分析显示，皮质类固醇和干扰素-β1a 联合使用时死亡率增加，这表明需要仔细考虑这种药物-药物相互作用。
