Table 4. Treatment for SSPE
Study
Treatment Groups and Regimen
Number of Subjects Duration of
Reference
Outcome
Comments
No difference
1. Large drop out
follow up
Treatments evaluated by Randomized Controlled Trials
[27] Gascon,
1. Isoprinosine 100 mg/kg/d
Randomized
6 months
2003
2. Isoprinosine plus
N=121
between the groups
intraventricular IFN-alpha 2b,
1. N=62
on any outcome
2. No ITT analysis
one million U/m2 2x/week
2. N=59
measure: death, NDI,
3. Single blinding
Final groups
BAE or stages
After dropouts:
(30%)
(clinical raters)
4. Short follow up
1. N=39
2. N=28
[37] Anlar,
1993
1. Cimetidine 20 mg/kg/d (max.
200 mg tid)
2. Placebo
1. N=7
Two months of
Clinical benefit seen
1. Small N
2. N=7
treatment and
with Cimetidine on
2. Short follow up
two months after
NDI (not statistically
treatment
different)
[50] Sobczyk,
1991
1. IFN inducer and
Unknown
6 months
Isoprinosine
2. Thymus extract and
Isoprinosine
Combined treatments
Not reviewed fully as
appeared better than
only published in
Isoprinosine alone
Polish
(not statistically
3. Isoprinosine only
significant)
Treatment evaluated by Observational Studies
[51] Aydin,
2003
1. Isoprinosine 100
1. N=19
mg/kg/day, plus
2. N=13
Treatment group had
1. No reason given
lower mortality,
why controls not able
Lamivudine 10
longer survival,
to have treatment
mg/kg/day, plus
higher remission rate
subcutaneous IFN-α 2a
10million U/m2 three
times/week
2. Natural history
controls
6 months
[28] Anlar,
1. Intraventricular
1. N=22
1997
IFN- α, 1million U/m2/day for 5 2. N=35
days/ week for six weeks.
1. Longest follow up
of 108 months.
2. Longest follow up
Courses repeated every 2-6
110 months
months up to 6 times, plus
Percentage of those
1. Little
alive higher in treated
information on
group by about 30%
control group.
until 8 years of follow
2.Not clear why
up then equal.
controls could
Isoprinosine.
not receive IFN.
2. Controls treated with
Isoprinosine
[35] Yalaz,
1. IFN- α and Isoprinosine
1. N=22
1992
2. Natural history controls
2. N=77
2-54 months
Improved scores on the
NDI in 50%. Remission
rate higher than controls.
[34]
Fukuyama,
1987
1. Isoprinosine 26-190
mg/kg/day (median 63).
1. N=89
Groups followed
1. Significant difference in
1.Retrospective
2. N=62
beyond 10 years.
survival on analysis of
review.
survival curves favoring
2.Treated group
Isoprinosine.
older and
2. Proportion of mild
diagnosed later.
disease higher in
3. Treated group
Isoprinosine group.
more often on
2. Controls (may be taking
other treatments).
IFN.
[36] Jones,
1982
1. Isoprinosone 100
mg/kg/day
2. Historical controls from 3
different SSPE registries
1. N=98
Life table comparisons
Survival significantly better
2. N=590
made up to 132 months at all intervals in the
controls from
of follow up
differing
Isoprinosine group
1. Historical
populations
2. No
information
on treatments
in control
group
Treatments evaluated by case report or series
Similar
references
[52] Tomoda,
Intraventricular Ribavirin 1-3
2003
mg/day for 5 days. Total
N=10
Unclear
1. Decreased CSF measles
antibiodies.
course 2 months. Plus
2. Clinical improvement in
intraventricular IFN.
6/10.
3. Side effects minimal.
[38] Tomoda,
Intravenous Ribavirin
2001
30mg/kg/day x 7 days then 50-
N=2
5 and 13 months
Mild improvement and no
deterioration. Mild side
70 mg/kg/day for three months.
effects.
Exact interval of Ribavirin
treatment not clear. Plus
intraventricular IFN.
[40] Bobele,
Amantadine for 21 days
N=1
7 months
No benefit
[26] Anlar,
Subcutaneous Beta-IFN 1a
N=7
N=7 (all children not
4-24 months
1998
3 million U 2-3 times/week or
able to take
2/7 rapid death and 5/7
IFN 1b 8 million U 2x/week for
intraventricular IFN)
stable.
12-105 months
Treatment effective Side
[15] effective
effects: acquired motor
[30] not effective
neuron disease
[31] effective
1999
at least six months.
Isoprinosine as well
[53] Cianchetti, Intraventricular IFN- α 2a
1998
2.2 million U/m2 twice a week
N=8
[32] effective
[33] not effective
[54] effective
[39] Gurer,
IVIG 400 mg/kg/day for 5 days
1996
once a month for two months
[23] Dyken,
Isoprinosine 100 mg/kg/day
1982
1 patient
18 months
Child clinically improved
and remained stable.
N=15
Longest 158 months
1. 4/15 showed continued
[55]
deterioration and rapid
death.
2. 10/11 survivors showed
some clinical
improvement.
Note: Randomized controlled trials identified through a Medline search looking for all randomized controlled trials in SSPE. Other
trials identified by an English language, clinical trials search using text word subacute sclerosing panencephalitis.