Early triple antiviral therapy shortens the duration of viral shedding and hospital stay, according to results from an open-label, randomised, phase 2 trial published in Lancet.
Hospitalised patients testing positive for SARS-CoV-2 were randomised to a 14-day combination of lopinavir 400 mg and ritonavir 100 mg every 12 hours, ribavirin 400 mg every 12 hours, and three doses of 8 million IU interferon beta-1b on alternate days (combination group)(N=86) or to 14 days of lopinavir 400 mg and ritonavir 100 mg every 12 h (control group)(N=41). The median number of days from symptom onset to treatment was five days.
The primary outcome was time to achieve negative nasopharyngeal swab.
The combination group had significantly shorter median time to negative nasopharyngeal swab (7 days IQR 5-11) than the control group (12 days; hazard ratio 4.37; 95% CI 1.86-10.24], P=.0010). No significant difference was seen if therapy started >7 days after symptom onset. A shorter mean hospital stay was seen in the combination group vs the control group (9 days versus 14.5 days; P=.016).
Post-treatment, the IL-6 concentration was significantly lower in the combination group, although no differences were seen with IL-10 or TNF-α. No patients died.