Objective: To evaluate whether antiviral and immunomodulatory treatments meaningfully improve true functional status and disease stabilization, or if they merely prolong survival in a state of severe neurological disability

Background: The clinical trajectory of Subacute Sclerosing Panencephalitis (SSPE) invariably progresses through debilitating stages of cognitive and motor decline, ultimately leading to death. While therapies like Isoprinosine and intraventricular interferons are commonly administered, their definitive impact on altering the disease’s natural history remains heavily debated

Method: Following a prospectively designed protocol, we systematically searched MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, and Scopus for studies reporting clinical outcomes in SSPE patients following pharmacological intervention. We extracted mortality rates, overall survival duration, and shifts in functional status via standardized clinical staging and Neurological Disability Index (NDI) scores. This review is registered on PROSPERO (ID: CRD42024574988). We are presenting preliminary data from our ongoing systematic review.

Results: We found 1188 studies based on the database search. After removing duplicates and conducting thorough screening and full-text reviews, we included 83 studies for final data extraction. Preliminary analysis reveals survival heavily depends on baseline Jabbour Stage. Rapidly progressive cases showed a minimum survival of 2 months, whereas treated cohorts lived 16 to 160 months. Although 132–137 patients achieved clinical “stabilization” (ranging from 31% to 73% in specific cohorts), this strictly meant maintaining the current stage rather than functional recovery. Most importantly, NDI changes exposed a striking “survival-disability paradox.” While interventions prolonged life, they failed to halt the insidious rise in NDI scores.

Conclusion: The preliminary data forces a shift in how we view SSPE treatment success. Antiviral and immunomodulatory therapies effectively extend overall survival but fundamentally fail to prevent the relentless progression of neurological disability. Rather than curing the disease, these treatments often result in a prolonged state of profound impairment. A detailed analysis will be conducted later to definitively establish long-term impacts.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-functional-outcomes-of-antiviral-and-immunomodulatory-therapies-in-subacute-sclerosing-panencephalitis/