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Study to Investigate the Efficacy and Safety of Apomivir®

Primary Purpose

Influenza

Status
Unknown status
Phase
Phase 2
Locations
Taiwan
Study Type
Interventional
Intervention
Apomivir®
Placebo
Sponsored by
Far East Bio-Tec Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Influenza focused on measuring oral temperature, respiratory symptom, cough, nasal obstruction, sore throat, fever

Eligibility Criteria

20 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

1. Main inclusion criteria:

  1. Females and males aged between 20 and 65
  2. Presumptive diagnosis of influenza based on the following clinical characteristics:

    • Present at least one respiratory symptom (e.g. cough, nasal obstruction, sore throat) and at least one constitutional symptom other than fever (e.g. fatigue, headache, myalgias) of less than 48-hour duration
    • Positive for influenza A or B (nasopharyngeal/throat swab - rapid test)
  3. Able and willing to comply with the study procedure and give written informed consent

2. Main exclusion criteria:

  1. Female who is pregnant/lactating or planning to be pregnant, or female of childbearing potential* who is not using medically recognized method of contraception

    * Other than those who have been surgically sterilized (defined as having undergone hysterectomy or bilateral oophorectomy or bilateral salpingectomy; tubal ligation alone is not considered sufficient) or one year post-menopausal

  2. Subject with chronic pulmonary diseases or critical condition or already developed severe respiratory distress with hypoxaemia on presentation
  3. Subject with a history of non-febrile convulsions, neuromuscular disorders or cognitive dysfunction that may compromise respiratory secretions, or who are currently receiving anticonvulsive agents
  4. Subject with clinically important illness, malignancies, systemic infection, other medical or psychiatric condition which places the subject at unacceptable risk to participate in the study or confounds the ability to interpret data from the study
  5. Subject with significant abnormal laboratory findings (hemoglobin level < 9.0 g/dL, WBC < 4000/mm3, platelet count < 100,000/mm3, ALT or AST > 2.5 x upper limit of normal (ULN), or estimated creatinine clearance < 30 mL/min within 4 weeks prior to baseline)
  6. Subject who are currently receiving immunosuppressive therapy,
  7. Subject has taken daily supplement(s) containing blue agar within 1 month prior to screening, or any other medication that may affect the study results
  8. Known hypersensitivity to any ingredients in Apomivir® or other blue agar
  9. Use of any investigational product within 1 month prior to screening

Sites / Locations

  • China Medical University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Control Group

Study Group

Arm Description

Placebo 1 capsule twice daily. All subjects will be treated for 5 days, and all drugs should be taken orally after meal

Apomivir® 1 capsule twice daily. All subjects will be treated for 5 days, and all drugs should be taken orally after meal.

Outcomes

Primary Outcome Measures

To evaluate the safety profile of Apomivir® treatment (120 mg b.i.d.).
Safety endpoints: Change in laboratory data Adverse events Serious adverse events (SAE)
To evaluate the time to resolution of influenza symptoms defined as all flu symptom scores ≤ 1 after initiation of study treatment.
The time to resolution of influenza symptom is defined as the duration from the study drug initiation to all flu symptom scores ≤ 1. Subject who is withdrawn prior to the resolution of influenza symptom is censored at the last known time point.

Secondary Outcome Measures

Change in virus titer.
To evaluate the change in virus titer assessed by real-time RT-PCR15.
Time to achieve afebrile
Time to bring down a fever (oral temperature < 37.2˚C)
Severity of influenza symptom score during study period
All subjects should complete the diary card twice daily from Day 1 to Day 6 and cut down to once daily until Day 29 or completely cured.
Level of interference on daily activity and time to alleviation of the interference during study period
All subjects should complete the diary card twice daily from Day 1 to Day 6 and cut down to once daily until Day 29 or completely cured.
Proportion of rescue medication used for fever or influenza symptoms during study period
All subjects should complete the diary card twice daily from Day 1 to Day 6 and cut down to once daily until Day 29 or completely cured.
Proportion and time to treatment failure during study period
Proportion and time to treatment failure (including secondary illnesses, antibiotic use and hospitalization due to disease progression) during study period

Full Information

First Posted
August 30, 2012
Last Updated
August 2, 2017
Sponsor
Far East Bio-Tec Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT01677689
Brief Title
Study to Investigate the Efficacy and Safety of Apomivir®
Official Title
A Prospective, Randomized, Double-blind, Parallel, Placebo-controlled, Multi-center Study to Investigate the Efficacy and Safety of Apomivir® in Relieving Influenza Symptoms
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Unknown status
Study Start Date
September 1, 2018 (Anticipated)
Primary Completion Date
April 30, 2019 (Anticipated)
Study Completion Date
October 31, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Far East Bio-Tec Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Apomivir® is extracted from a proprietary spirulina strain, FEM-101, a kind of blue cyanobacterium with patented freeze-thaw lysis and extraction method. According to the preclinical studies, Apomivir® have been proven to have excellent broad-spectrum anti-viral ability, especially for seasonal influenza viruses (Influenza virus A and B) that may cause illness, paralysis and even death, especially in children and elderly people. This phase II study is designed to evaluate the efficacy and safety of Apomivir® (120 mg b.i.d.) in subjects with seasonal influenza.
Detailed Description
This is a prospective, randomized, double-blind, parallel, placebo-controlled, multi-center study. Approximately 196 subjects with fever defined as body temperature >= 38˚C, with at least one respiratory symptom and one other constitutional symptom will be invited into this study to target 156 evaluable subjects. A nasopharyngeal/throat swabs rapid test for influenza A and B will be conducted and only subjects with positive results could be recruited. All eligible subjects will be randomized to one of the following treatment group in a 1:1 ratio. Study Group: Apomivir® 1 capsule (120 mg/cap) twice daily for 5 days Control Group: Placebo 1 capsule twice daily for 5 days A pack of acetaminophen (500 mg) will be provided at enrollment. All flu symptom relief agents could be used only for rescue use of persistent fever or flu symptoms (>= 24 hours). A digital thermometer and diary card will be dispensed at baseline (Day 1). Subjects will be instructed to complete the body temperature record, and daily record regarding the severity of their influenza symptoms and the level of interference on daily activity. The monitoring frequency will be twice daily (after drug administration) from Day 1 to Day 5, and cut down to once daily until Day 29 or completed cure (defined as remission of all flu symptoms and interferences). Treatment failure is defined as secondary illnesses, antibiotic use and hospitalization due to disease progression. For safety and efficacy assessments, all subjects should return on Day 3, 6 and 15. For subjects who are not completely cured before Day 15 (Visit 4), further therapy will be conducted and they should return on Day 29; for those who are completely cured, only a telephone follow-up will be conducted on Day 29. The severity of fever will be scored using a 4-point scale: 0 = < 37.2°C = >= 37.2 to < 38.0°C = >= 38.0 to < 39.0°C = >= 39.0 °C Other influenza symptoms (such as cough, nasal obstruction, sore throat, fatigue, headache and myalgias) will also be assessed using a 4-point scale: 0 = none, = mild, = moderate, = severe The level of interference on daily activities (including running, lifting heavy objects, participating in strenuous sports, moderate activities), such as moving a table, pushing a vacuum cleaner, bowling, or playing golf, lifting or carrying groceries, climbing several flights of stairs, climbing one flight of stairs, bending, kneeling, or stooping, walking more than a mile, walking several blocks, walking one blocks, and bathing or dressing yourself, will be assessed according to a 3-point scale 0 = no, no limited = yes, limited a little = yes, limited a lot Confirmatory tests for infective virus strain, real-time RT-PCR and viral culture will be conducted at baseline. In the following study visits, real-time RT-PCR will be performed to measure the influenza viral load/titer in nasopharyngeal/throat swabs specimen. For those who have been completely cured prior to Day 15, the real-time RT-PCR assessment could be omitted on Day 29. All subjects enrolled will be followed until the end of study, but only subjects with influenza PCR or viral culture positive could be evaluable population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
oral temperature, respiratory symptom, cough, nasal obstruction, sore throat, fever

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
196 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Control Group
Arm Type
Placebo Comparator
Arm Description
Placebo 1 capsule twice daily. All subjects will be treated for 5 days, and all drugs should be taken orally after meal
Arm Title
Study Group
Arm Type
Experimental
Arm Description
Apomivir® 1 capsule twice daily. All subjects will be treated for 5 days, and all drugs should be taken orally after meal.
Intervention Type
Drug
Intervention Name(s)
Apomivir®
Other Intervention Name(s)
FE-L-APO(drug substance)
Intervention Description
Study Group: Apomivir® 1 capsule twice daily. All subjects will be treated for 5 days, and all drugs should be taken orally after meal.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Control Group: Placebo 1 capsule twice daily. All subjects will be treated for 5 days, and all drugs should be taken orally after meal.
Primary Outcome Measure Information:
Title
To evaluate the safety profile of Apomivir® treatment (120 mg b.i.d.).
Description
Safety endpoints: Change in laboratory data Adverse events Serious adverse events (SAE)
Time Frame
from day1 to day 29, the entire treatment period and follow-up period.
Title
To evaluate the time to resolution of influenza symptoms defined as all flu symptom scores ≤ 1 after initiation of study treatment.
Description
The time to resolution of influenza symptom is defined as the duration from the study drug initiation to all flu symptom scores ≤ 1. Subject who is withdrawn prior to the resolution of influenza symptom is censored at the last known time point.
Time Frame
from day 1 to day 29, depends on the time to sympton resolution of individual subjects.
Secondary Outcome Measure Information:
Title
Change in virus titer.
Description
To evaluate the change in virus titer assessed by real-time RT-PCR15.
Time Frame
Day 3, 6 compared to baseline (Day 1)
Title
Time to achieve afebrile
Description
Time to bring down a fever (oral temperature < 37.2˚C)
Time Frame
after initiation of study treatment
Title
Severity of influenza symptom score during study period
Description
All subjects should complete the diary card twice daily from Day 1 to Day 6 and cut down to once daily until Day 29 or completely cured.
Time Frame
twice daily from Day 1 to Day 6 and once daily until Day 29 or completely cured
Title
Level of interference on daily activity and time to alleviation of the interference during study period
Description
All subjects should complete the diary card twice daily from Day 1 to Day 6 and cut down to once daily until Day 29 or completely cured.
Time Frame
twice daily from Day 1 to Day 6 and once daily until Day 29 or completely cured
Title
Proportion of rescue medication used for fever or influenza symptoms during study period
Description
All subjects should complete the diary card twice daily from Day 1 to Day 6 and cut down to once daily until Day 29 or completely cured.
Time Frame
twice daily from Day 1 to Day 6 and once daily until Day 29 or completely cured
Title
Proportion and time to treatment failure during study period
Description
Proportion and time to treatment failure (including secondary illnesses, antibiotic use and hospitalization due to disease progression) during study period
Time Frame
from day 1 to day 29, including treatment period and follow-up period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
1. Main inclusion criteria: Females and males aged between 20 and 65 Presumptive diagnosis of influenza based on the following clinical characteristics: Present at least one respiratory symptom (e.g. cough, nasal obstruction, sore throat) and at least one constitutional symptom other than fever (e.g. fatigue, headache, myalgias) of less than 48-hour duration Positive for influenza A or B (nasopharyngeal/throat swab - rapid test) Able and willing to comply with the study procedure and give written informed consent 2. Main exclusion criteria: Female who is pregnant/lactating or planning to be pregnant, or female of childbearing potential* who is not using medically recognized method of contraception * Other than those who have been surgically sterilized (defined as having undergone hysterectomy or bilateral oophorectomy or bilateral salpingectomy; tubal ligation alone is not considered sufficient) or one year post-menopausal Subject with chronic pulmonary diseases or critical condition or already developed severe respiratory distress with hypoxaemia on presentation Subject with a history of non-febrile convulsions, neuromuscular disorders or cognitive dysfunction that may compromise respiratory secretions, or who are currently receiving anticonvulsive agents Subject with clinically important illness, malignancies, systemic infection, other medical or psychiatric condition which places the subject at unacceptable risk to participate in the study or confounds the ability to interpret data from the study Subject with significant abnormal laboratory findings (hemoglobin level < 9.0 g/dL, WBC < 4000/mm3, platelet count < 100,000/mm3, ALT or AST > 2.5 x upper limit of normal (ULN), or estimated creatinine clearance < 30 mL/min within 4 weeks prior to baseline) Subject who are currently receiving immunosuppressive therapy, Subject has taken daily supplement(s) containing blue agar within 1 month prior to screening, or any other medication that may affect the study results Known hypersensitivity to any ingredients in Apomivir® or other blue agar Use of any investigational product within 1 month prior to screening
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
YI-HSIANG CHEN
Phone
+886-2-2655-8198
Email
mrx1025@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Liang-Wen Hang, MD
Organizational Affiliation
China Medical University Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
YI-HSIANG CHEN
Organizational Affiliation
Far East Bio-Tec Co., Ltd
Official's Role
Study Director
Facility Information:
Facility Name
China Medical University Hospital
City
Taichung City
ZIP/Postal Code
40447
Country
Taiwan
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Der-Yang Cho, M.D.
Phone
+886-4-22052121
Email
answer@mail.cmuh.org.tw
First Name & Middle Initial & Last Name & Degree
Liang-Wen Hang, M.D.

12. IPD Sharing Statement

Citations:
PubMed Identifier
7521897
Citation
Lynch G, Low L, Li S, Sloane A, Adams S, Parish C, Kemp B, Cunningham AL. Sulfated polyanions prevent HIV infection of lymphocytes by disruption of the CD4-gp120 interaction, but do not inhibit monocyte infection. J Leukoc Biol. 1994 Sep;56(3):266-72. doi: 10.1002/jlb.56.3.266.
Results Reference
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PubMed Identifier
19299804
Citation
Shih CM, Cheng SN, Wong CS, Kuo YL, Chou TC. Antiinflammatory and antihyperalgesic activity of C-phycocyanin. Anesth Analg. 2009 Apr;108(4):1303-10. doi: 10.1213/ane.0b013e318193e919.
Results Reference
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PubMed Identifier
10366332
Citation
Gonzalez R, Rodriguez S, Romay C, Ancheta O, Gonzalez A, Armesto J, Remirez D, Merino N. Anti-inflammatory activity of phycocyanin extract in acetic acid-induced colitis in rats. Pharmacol Res. 1999 Jan;39(1):55-9.
Results Reference
background
PubMed Identifier
12629652
Citation
Shih SR, Tsai KN, Li YS, Chueh CC, Chan EC. Inhibition of enterovirus 71-induced apoptosis by allophycocyanin isolated from a blue-green alga Spirulina platensis. J Med Virol. 2003 May;70(1):119-25. doi: 10.1002/jmv.10363.
Results Reference
background
PubMed Identifier
17942826
Citation
Reagan-Shaw S, Nihal M, Ahmad N. Dose translation from animal to human studies revisited. FASEB J. 2008 Mar;22(3):659-61. doi: 10.1096/fj.07-9574LSF. Epub 2007 Oct 17.
Results Reference
background
Links:
URL
http://www.febico.com.tw
Description
The drug substance of the IP is the same with a marked nutrition supplement. And this is the official product page of the marked nutrition supplement.

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Study to Investigate the Efficacy and Safety of Apomivir®

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