Treatment of Recurrent Respiratory Papillomatosis with Human Leukocyte Interferon

Abstract

Recurrent respiratory papillomatosis is a relentless disease of viral origin in which squamous papillomas frequently obstruct the respiratory tract of children and young adults. No therapy has been proved to be curative for this process. Recent reports have suggested that interferon may cure or dramatically control airway papillomatosis. We evaluated the efficacy of human leukocyte interferon in the treatment of respiratory papillomatosis. One hundred twenty-three patients were randomly assigned to receive treatment with either surgery plus interferon or surgery alone. Interferon (2 X 10(6) IU per square meter of body-surface area) was given daily for one week, then three times per week for one year; treatment was followed by a year of observation, without the drug. Both study groups underwent serial endoscopy to remove papillomas and to document the efficacy of treatment during the two years of study. During the first six months, the growth rate of papillomas in the interferon group was significantly lower than in the control group (P = 0.0007). This difference diminished during the second six months and was no longer statistically significant (P = 0.68). Our data do not show that interferon is either curative or of substantial value as an adjunctive agent in the long-term management of recurrent respiratory papillomatosis. The initial benefit of interferon is not sustained.

Efficacy of Long-term Interferon-alpha Therapy in Adult Patients with Recurrent Respiratory Papillomatosis

“…A recent study revealed the maximal effectiveness of INF-α therapy in patients having RRP with HPV 6 as compared to HPV 11 12 . In addition, these results suggest that long-term IFN-α therapy (mean 32.4±21.6 months) 12 was more effective in preventing relapse than the a short course (0.5 or 1 year) 13,15 of injection. Accumulation of additional evidence, however, is required to determine the dosage and duration of IFN-α treatment suitable for patients with RRP.…”

“…Since the early 1980s, interferon has been used as an adjuvant agent in treating patients with RRP and is the most extensively investigated of these agents. However, debate is ongoing regarding the effectiveness of long-term IFN-α therapy, with even multicenter studies on the application of IFN-α as an adjuvant for RRP therapy providing contradictory results 13,15 . A recent study revealed the maximal effectiveness of INF-α therapy in patients having RRP with HPV 6 as compared to HPV 11 12 .…”

Pegylated interferon for treating severe recurrent respiratory papillomatosis in a child: case report

“…Alpha-interferon is an immunomodulatory cytokine with antiviral and antiproliferative properties and was the first widely used adjuvant drug for treating RRP, with diverse results ranging from better prognosis to absence of response. 6,9 The evidence has failed to support its use, since the reports have mostly been based on case reports and clinical trials have shown varied results with limited follow-up. 6,9,10 The association between interferon and polyethylene glycol, which is called pegylated interferon, increases the half-life of the drug, eliminates immunogenicity and improves the pharmacokinetics of the protein, such that it can be administered once a week.…”

Development of Pediatric Otolaryngology in North America

“…This resulted in the 1988 article Treatment of recurrent respiratory papillomatosis with human leukocyte interferon. Results of a multicenter randomized clinical trial [26].…”