Evidence map›Paper›PMID 33556319›Full record

Trial reportThe Lancet. Respiratory medicine2021

Peginterferon lambda for the treatment of outpatients with COVID-19: a phase 2, placebo-controlled randomised trial.

Jordan J Feld, Christopher Kandel, Mia J Biondi, Robert A Kozak, Muhammad Atif Zahoor, Camille Lemieux, Sergio M Borgia, Andrea K Boggild, Jeff Powis, Janine McCready and 25 more

Open access · bronzeAbstract readClinical Trial, Phase IIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Lancet. Respiratory medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 160 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
160citing papers in PubMed, 8 pooled it
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

160 citing papers in PubMed, 8 syntheses or guidelines pooled it, 235 citations in OpenAlex.

  1. Pooled it
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  9. Early Treatment with Pegylated Interferon Lambda for Covid-19.The New England journal of medicine · 2023
    Trial
  10. Trial
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  16. The rhinovirus puzzle: Linking virus and host factors to childhood asthma.The Journal of allergy and clinical immunology · 2026
    Review
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100 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors at 14 institutions in 2 countries.

Jordan J FeldToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada. Electronic address: jordan.feld@uhn.ca.
Christopher KandelFaculty of Medicine, University of Toronto, Toronto, ON, Canada.
Mia J BiondiToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Robert A KozakSunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Muhammad Atif ZahoorToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Camille LemieuxUniversity Health Network, University of Toronto, Toronto, ON, Canada.
Sergio M BorgiaDivision of Infectious Diseases, William Osler Health System and McMaster University, Hamilton, ON, Canada.
Andrea K BoggildUniversity Health Network, University of Toronto, Toronto, ON, Canada.
Jeff PowisMichael Garron Hospital, University of Toronto, Toronto, ON, Canada.
Janine McCreadyMichael Garron Hospital, University of Toronto, Toronto, ON, Canada.
Darrell H S TanSt Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Tiffany ChanTrillium Health Partners, Toronto, ON, Canada.
Bryan CoburnUniversity Health Network, University of Toronto, Toronto, ON, Canada.
Deepali KumarToronto General Hospital, Multiorgan Transplant Centre, University of Toronto, Toronto, ON, Canada.
Atul HumarToronto General Hospital, Multiorgan Transplant Centre, University of Toronto, Toronto, ON, Canada.
Adrienne ChanSunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Braden O'NeilNorth York General Hospital, University of Toronto, Toronto, ON, Canada.
Seham NoureldinToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Joshua BoothToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Rachel HongToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
David SmooklerToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Wesam AleyadehToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Anjali PatelToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Bethany BarberToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Julia CaseyToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Ryan HiebertSunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Henna MistrySunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Ingrid ChoongEiger BioPharmaceuticals, Palo Alto, CA, USA.
Colin HislopEiger BioPharmaceuticals, Palo Alto, CA, USA.
Deanna M SanterThe Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada.
D Lorne TyrrellThe Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada.
Jeffrey S GlennDepartments of Medicine and Microbiology & Immunology, Stanford University School of Medicine, Palo Alto, CA, USA.
Adam J GehringToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Harry L A JanssenToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada.
Bettina E HansenToronto Centre for Liver Disease, University of Toronto, Toronto, ON, Canada; University Health Network, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
University of Toronto · CAUniversity Health Network · CAToronto Liver Centre · CAEiger Biopharmaceuticals (United States) · USHealth Sciences Centre · CAUniversity of Alberta · CANorth York General Hospital · CAStanford University · USSt. Michael's Hospital · CASunnybrook Health Science Centre · CAToronto East General Hospital · CAToronto General Hospital · CATrillium Health Centre · CAWilliam Osler Health System · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo date, only monoclonal antibodies have been shown to be effective for outpatients with COVID-19. Interferon lambda-1 is a type III interferon involved in innate antiviral responses with activity against respiratory pathogens. We aimed to investigate the safety and efficacy of peginterferon lambda in the treatment of outpatients with mild-to-moderate COVID-19.

methodsIn this double-blind, placebo-controlled trial, outpatients with laboratory-confirmed COVID-19 were randomly assigned to a single subcutaneous injection of peginterferon lambda 180 μg or placebo within 7 days of symptom onset or first positive swab if asymptomatic. Participants were randomly assigned (1:1) using a computer-generated randomisation list created with a randomisation schedule in blocks of four. At the time of administration, study nurses received a sealed opaque envelope with the treatment allocation number. The primary endpoint was the proportion of patients who were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA on day 7 after the injection, analysed by a χ

findingsBetween May 18, and Sept 4, 2020, we recruited 30 patients per group. The decline in SARS-CoV-2 RNA was greater in those treated with peginterferon lambda than placebo from day 3 onwards, with a difference of 2·42 log copies per mL at day 7 (p=0·0041). By day 7, 24 (80%) participants in the peginterferon lambda group had an undetectable viral load, compared with 19 (63%) in the placebo group (p=0·15). After controlling for baseline viral load, patients in the peginterferon lambda group were more likely to have undetectable virus by day 7 than were those in the placebo group (odds ratio [OR] 4·12 [95% CI 1·15-16·73; p=0·029). Of those with baseline viral load above 10

interpretationPeginterferon lambda accelerated viral decline in outpatients with COVID-19, increasing the proportion of patients with viral clearance by day 7, particularly in those with high baseline viral load. Peginterferon lambda has potential to prevent clinical deterioration and shorten duration of viral shedding.

fundingThe Toronto COVID-19 Action Initiative, University of Toronto, and the Ontario First COVID-19 Rapid Research Fund, Toronto General & Western Hospital Foundation.

Indexed as

COVID-19COVID-19 Drug TreatmentInterleukinsPolyethylene GlycolsSARS-CoV-2Ambulatory CareAntiviral AgentsDouble-Blind MethodDrug MonitoringFemaleHumansIntention to Treat AnalysisInterferon LambdaMaleMiddle AgedRNA, ViralAntiviral AgentsInterferon LambdaInterleukinspeginterferon lambda-1aPolyethylene GlycolsRNA, Viral

Identifiers

PMID33556319
PMCPMC7906707
OpenAlexW3127381644

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.