Interferon beta-1a for patients with moderate to severe acute respiratory distress syndrome: a systematic review and meta-analysis of randomized trials

Introduction 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. Objectives We conducted this systematic review and meta‑ analysis to examine the use of interferon beta-1a in patients with ARDS. Methods 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. Results 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). Conclusions 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.