Randomized Surgical Adjuvant Trial of Interferon Alfa-n1 in Recurrent Papillomatosis

Abstract

\s=b\ Sixty-six patients with recurrent respiratory papillomatosis of juvenile onset were treated for six months with interferon alfa-n1 (Wellferon) in a randomized crossover trial. Half received interferon alfa-n1 intramuscularly at a dosage of 5 megaunits per square meter daily for 28 days and then thrice weekly for five months, followed by six months of observation. The other half were observed for six months and then treated. Operations were performed every two months to assess disease extent by a scale developed for this purpose. The score for the patients during the first observation period was stable. There was a statistically significant lowering of score in patients receiving interferon alfa-n1 during both periods of drug administration. Eight of 57 patients with assessable airway disease achieved complete remission, as did one additional patient with disease limited to the nasopharynx. No patients achieved complete remission during six months of observation alone. This difference was statistically significant. Patients without tracheostomy were significantly more likely to achieve remission than those with a tracheostomy. The patients who were observed after discontinuation of the drug therapy showed a significant rise in score within four months. Symptoms of toxicity included transient fever, fatigue, nausea, and headache. Elevations in serum aspartate aminotransferase levels occurred in 64% of the patients. There was an inverse correlation between age and the ability to tolerate the medication. The dose studied may be close to the maximum tolerated dose. It appears that interferon alfa-n1 as an adjuvant to routine surgical management is effective in slowing the growth of respiratory papillomas.(Arch Otolaryngol Head Neck Surg

Adjuvant drug strategies in the treatment of recurrent respiratory papillomatosis

“…DNA typing of HPV from previous studies has identified HPV types 6 and 11 as being responsible for infection in RRP 5 , 9 . Six of our patients were included in the study by Leventhal et al, 9 which identified no significant difference in clinical outcome and response to IF based on HPV type.…”

“…DNA typing of HPV from previous studies has identified HPV types 6 and 11 as being responsible for infection in RRP. 5,9 Six of our patients were included in the study by Leventhal et al,9 which identified no significant difference in clinical outcome and response to IF based on HPV type. We did not analyze HPV DNA typing any further in our study because it appears that the type of HPV DNA virus is not predictive of response to IF therapy.…”

Current advances in the basic research and clinical management of juvenile-onset recurrent respiratory papillomatosis

“…This effect was observed within a 4-month period after the treatment with interferon was interrupted in the study reported by Leventhal et al [41]. However, they also reported that almost half of the patients responded to a second course of interferon therapy.…”

Longitudinal Voice Outcomes Following Serial Potassium Titanyl Phosphate Laser Procedures for Recurrent Respiratory Papillomatosis

“…27 Interferon has been proposed for RRP treatment based on its antiviral, antiproliferative, and immunomodulatory effects, although the exact mechanism is not well understood. 28,29 Nevertheless, clinical application of interferon has been losing popularity because of its prominent systemic side effects. Indole-3-carbinol, derived from cruciferous vegetables, is known to affect papilloma growth in vitro through its effect on estrogen metabolism.…”