A Phase III, Randomized, Double-Blind, Placebo Controlled Trial to Evaluate the Efficacy and Safety of Nitazoxanide in the Treatment of Uncomplicated Influenza
Primary Purpose
Influenza
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Nitazoxanide
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Influenza focused on measuring Influenza
Eligibility Criteria
Inclusion Criteria:
- Male and female subjects at least 12 years of age
Presence of clinical signs and/or symptoms consistent with an acute illness compatible with influenza infection (each of the following is required):
- oral temperature ≥99.4°F or ≥37.4°C (obtained in office or self- measured within 12 hours prior to screening - if self-measured, subjects must also have taken an antipyretic within 4 hours prior to screening), AND
- at least one of the following respiratory symptoms (cough, sore throat, nasal obstruction), AND
- one of the following constitutional symptoms (fatigue, headache, myalgia, feverishness).
Confirmation of influenza A or B infection in the local community by one of the following means:
- the institution's local laboratory,
- the local public health system,
- the national public health system, OR
- a laboratory of a recognized national or multinational influenza surveillance scheme.
Onset of illness no more than 40 hours before enrollment in the trial.
Note: Time of onset of illness is defined as either the earlier of:
- the time when the temperature was first measured as elevated, OR
- the time when the subject experienced the presence of at least one respiratory symptom AND the presence of at least one constitutional symptom.
- Willing and able to provide written informed consent (including assent by legal guardian if under 18 years of age) and comply with the requirements of the protocol, including completion of the patient diary.
Exclusion Criteria:
- Severity of illness requiring or anticipated to require in-hospital care.
- Moderate or severe persistent asthma.
- Cystic fibrosis in children.
- Stage III or IV (severe or very severe) chronic obstructive pulmonary disease (COPD).
- Class III or IV congestive heart failure (at least marked limitation of physical activity in which minimal ordinary activity results in fatigue, palpitation, dyspnea, or angina pain)
- Arrhythmia
- Immunosuppressive disorders or who are receiving immunosuppressive therapy (e.g., for organ or bone marrow transplants)
- Untreated HIV infection or treated HIV infection with a CD4 count below 350 cells/mm3 in the last 6 months
- Persons with sickle cell anemia or other hemoglobinopathies
- Poorly controlled insulin-dependent diabetes mellitus (HBA1C > 8%)
- Residents of any age of nursing homes or other long-term care institutions
- Concurrent infection at the screening examination that requires systemic antimicrobial therapy.
- Females of childbearing potential who are either pregnant, breast-feeding or are sexually active without the use of birth control. Female subjects of child-bearing potential that are sexually active must have a negative baseline pregnancy test and must agree to continue an acceptable method of birth control for the duration of the study and for 1 month post- treatment. A double barrier method, oral birth control pills administered for at least 2 monthly cycles prior to study drug administration, an IUD, or medroxyprogesterone acetate administered intramuscularly for a minimum of one month prior to study drug administration are acceptable methods of birth control for inclusion into the study. Female subjects are considered of childbearing potential unless they are postmenopausal (absence of menstrual bleeding for 1 year - or 6 months if laboratory confirmation of hormonal status), or have had a hysterectomy, bilateral tubular ligation or bilateral oophorectomy.
- Receipt of any dose of NTZ, oseltamivir, zanamivir, peramivir, laninamivir, baloxavir, amantadine or rimantadine within 3 days prior to screening.
- Prior treatment with any investigational drug therapy within 30 days prior to screening.
- Subjects with active respiratory allergies or subjects expected to require anti-allergy medications during the study period for respiratory allergies.
- Known sensitivity to NTZ or any of the excipients comprising the NTZ tablets.
- Subjects unable to take oral medications.
- Presence of any pre-existing illness that, in the opinion of the Investigator, would place the subject at an unreasonably increased risk through participation in this study.
- Subjects who, in the judgment of the Investigator, will be unlikely to comply with the requirements of this protocol.
Sites / Locations
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
- Vanguard Study Site
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Nitazoxanide
Placebo
Arm Description
Two Nitazoxanide 300 mg tablets orally twice daily (b.i.d.) for 5 days
Two Placebo tablets orally twice daily (b.i.d.) for 5 days
Outcomes
Primary Outcome Measures
Time From First Dose to Symptom Response
Subjects used the FLU-PRO questionnaire once daily in the evening to score the severity of 32 FLU-PRO symptoms. Symptom response was deemed achieved when the rating for each of the 32 FLU-PRO symptoms was ≤ its assigned threshold for 2 consecutive daily diary periods without use of symptom relief medication. The symptom response thresholds were developed by applying an algorithm to blinded symptoms data to select the set of 32 symptom thresholds most closely associated with patient-reported usual health.
Secondary Outcome Measures
Time From First Dose to Ability to Perform All Normal Activities
Subjects completed a diary including rating ability to perform normal activities on a scale from 0 (able to perform no normal activities) to 10 (able to perform all normal activities) daily in the evening. The time from first dose to ability to perform all normal activities is the time in hours between the first dose of study medication and that time when the subject first reported a score of "10" (able to perform all normal activities) for two consecutive daily diary periods without use of symptom relief medication.
Number of Subjects Experiencing One or More Complications of Influenza
Complications of influenza infection included pneumonia, otitis media, bronchitis, sinusitis, worsening of pre-existing health conditions, systemic antibiotic use for infections secondary to influenza infection, hospitalization due to influenza or complications of influenza and death.
Time to Symptom Response Excluding the FLU-PRO Gastrointestinal and Eye Domains
Subjects used the FLU-PRO questionnaire once daily in the evening to score the severity of 32 FLU-PRO symptoms. Symptom response was deemed achieved when the rating for each of the 25 FLU-PRO symptoms (excluding gastrointestinal and eye symptoms) was ≤ its assigned threshold for 2 consecutive daily diary periods without use of symptom relief medication. The symptom response thresholds were developed by applying an algorithm to blinded symptoms data to select the set of 25 symptom thresholds most closely associated with patient-reported usual health.
Full Information
NCT ID
NCT03336619
First Posted
November 6, 2017
Last Updated
June 2, 2022
Sponsor
Romark Laboratories L.C.
1. Study Identification
Unique Protocol Identification Number
NCT03336619
Brief Title
A Phase III, Randomized, Double-Blind, Placebo Controlled Trial to Evaluate the Efficacy and Safety of Nitazoxanide in the Treatment of Uncomplicated Influenza
Official Title
A Phase III, Randomized, Double-Blind, Placebo Controlled Trial to Evaluate the Efficacy and Safety of Nitazoxanide in the Treatment of Uncomplicated Influenza
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
January 17, 2018 (Actual)
Primary Completion Date
April 17, 2019 (Actual)
Study Completion Date
April 17, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Romark Laboratories L.C.
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
Trial to evaluate efficacy and safety of nitazoxanide (NTZ) in the treatment of uncomplicated influenza.
Detailed Description
A multicenter, randomized, double-blind, placebo controlled trial to evaluate efficacy and safety of nitazoxanide (NTZ) in the treatment of uncomplicated influenza.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
Influenza
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1030 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Nitazoxanide
Arm Type
Active Comparator
Arm Description
Two Nitazoxanide 300 mg tablets orally twice daily (b.i.d.) for 5 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Two Placebo tablets orally twice daily (b.i.d.) for 5 days
Intervention Type
Drug
Intervention Name(s)
Nitazoxanide
Other Intervention Name(s)
NTZ, NT-300
Intervention Description
Nitazoxanide 600 mg administered orally twice daily for five days
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo administered orally twice daily for five days
Primary Outcome Measure Information:
Title
Time From First Dose to Symptom Response
Description
Subjects used the FLU-PRO questionnaire once daily in the evening to score the severity of 32 FLU-PRO symptoms. Symptom response was deemed achieved when the rating for each of the 32 FLU-PRO symptoms was ≤ its assigned threshold for 2 consecutive daily diary periods without use of symptom relief medication. The symptom response thresholds were developed by applying an algorithm to blinded symptoms data to select the set of 32 symptom thresholds most closely associated with patient-reported usual health.
Time Frame
Up to 21 days
Secondary Outcome Measure Information:
Title
Time From First Dose to Ability to Perform All Normal Activities
Description
Subjects completed a diary including rating ability to perform normal activities on a scale from 0 (able to perform no normal activities) to 10 (able to perform all normal activities) daily in the evening. The time from first dose to ability to perform all normal activities is the time in hours between the first dose of study medication and that time when the subject first reported a score of "10" (able to perform all normal activities) for two consecutive daily diary periods without use of symptom relief medication.
Time Frame
Up to 21 days
Title
Number of Subjects Experiencing One or More Complications of Influenza
Description
Complications of influenza infection included pneumonia, otitis media, bronchitis, sinusitis, worsening of pre-existing health conditions, systemic antibiotic use for infections secondary to influenza infection, hospitalization due to influenza or complications of influenza and death.
Time Frame
Up to 21 days
Title
Time to Symptom Response Excluding the FLU-PRO Gastrointestinal and Eye Domains
Description
Subjects used the FLU-PRO questionnaire once daily in the evening to score the severity of 32 FLU-PRO symptoms. Symptom response was deemed achieved when the rating for each of the 25 FLU-PRO symptoms (excluding gastrointestinal and eye symptoms) was ≤ its assigned threshold for 2 consecutive daily diary periods without use of symptom relief medication. The symptom response thresholds were developed by applying an algorithm to blinded symptoms data to select the set of 25 symptom thresholds most closely associated with patient-reported usual health.
Time Frame
Up to 21 days
Other Pre-specified Outcome Measures:
Title
Time to Return to Usual Health
Description
Subjects completed the FLU-PRO questionnaire including global assessment questions daily in the evening. The time from first dose to ability to return to usual health is the time in hours from the first dose of study medication to the first time when the subject answered "Have you returned to your usual health?" with "yes" for two consecutive daily diary periods without the use of symptom relief medication.
Time Frame
21 days
Title
Proportion of Diaries Misclassified by Novel Response Definition
Description
The proportion of patient diaries misclassified by the response definition used for the primary efficacy analysis compared to patient reported usual health. A diary was considered "misclassified" if the response definition predicted "responded" and the patient reported not being at usual health or if the response definition predicted "not responded" and the patient reported being at usual health.
Time Frame
21 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male and female subjects at least 12 years of age
Presence of clinical signs and/or symptoms consistent with an acute illness compatible with influenza infection (each of the following is required):
oral temperature ≥99.4°F or ≥37.4°C (obtained in office or self- measured within 12 hours prior to screening - if self-measured, subjects must also have taken an antipyretic within 4 hours prior to screening), AND
at least one of the following respiratory symptoms (cough, sore throat, nasal obstruction), AND
one of the following constitutional symptoms (fatigue, headache, myalgia, feverishness).
Confirmation of influenza A or B infection in the local community by one of the following means:
the institution's local laboratory,
the local public health system,
the national public health system, OR
a laboratory of a recognized national or multinational influenza surveillance scheme.
Onset of illness no more than 40 hours before enrollment in the trial.
Note: Time of onset of illness is defined as either the earlier of:
the time when the temperature was first measured as elevated, OR
the time when the subject experienced the presence of at least one respiratory symptom AND the presence of at least one constitutional symptom.
Willing and able to provide written informed consent (including assent by legal guardian if under 18 years of age) and comply with the requirements of the protocol, including completion of the patient diary.
Exclusion Criteria:
Severity of illness requiring or anticipated to require in-hospital care.
Moderate or severe persistent asthma.
Cystic fibrosis in children.
Stage III or IV (severe or very severe) chronic obstructive pulmonary disease (COPD).
Class III or IV congestive heart failure (at least marked limitation of physical activity in which minimal ordinary activity results in fatigue, palpitation, dyspnea, or angina pain)
Arrhythmia
Immunosuppressive disorders or who are receiving immunosuppressive therapy (e.g., for organ or bone marrow transplants)
Untreated HIV infection or treated HIV infection with a CD4 count below 350 cells/mm3 in the last 6 months
Persons with sickle cell anemia or other hemoglobinopathies
Poorly controlled insulin-dependent diabetes mellitus (HBA1C > 8%)
Residents of any age of nursing homes or other long-term care institutions
Concurrent infection at the screening examination that requires systemic antimicrobial therapy.
Females of childbearing potential who are either pregnant, breast-feeding or are sexually active without the use of birth control. Female subjects of child-bearing potential that are sexually active must have a negative baseline pregnancy test and must agree to continue an acceptable method of birth control for the duration of the study and for 1 month post- treatment. A double barrier method, oral birth control pills administered for at least 2 monthly cycles prior to study drug administration, an IUD, or medroxyprogesterone acetate administered intramuscularly for a minimum of one month prior to study drug administration are acceptable methods of birth control for inclusion into the study. Female subjects are considered of childbearing potential unless they are postmenopausal (absence of menstrual bleeding for 1 year - or 6 months if laboratory confirmation of hormonal status), or have had a hysterectomy, bilateral tubular ligation or bilateral oophorectomy.
Receipt of any dose of NTZ, oseltamivir, zanamivir, peramivir, laninamivir, baloxavir, amantadine or rimantadine within 3 days prior to screening.
Prior treatment with any investigational drug therapy within 30 days prior to screening.
Subjects with active respiratory allergies or subjects expected to require anti-allergy medications during the study period for respiratory allergies.
Known sensitivity to NTZ or any of the excipients comprising the NTZ tablets.
Subjects unable to take oral medications.
Presence of any pre-existing illness that, in the opinion of the Investigator, would place the subject at an unreasonably increased risk through participation in this study.
Subjects who, in the judgment of the Investigator, will be unlikely to comply with the requirements of this protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Francois Rossignol, M.D., Ph.D.
Organizational Affiliation
Romark Laboratories L.C.
Official's Role
Study Director
Facility Information:
Facility Name
Vanguard Study Site
City
Alabaster
State/Province
Alabama
ZIP/Postal Code
35007
Country
United States
Facility Name
Vanguard Study Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35235
Country
United States
Facility Name
Vanguard Study Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35242
Country
United States
Facility Name
Vanguard Study Site
City
Hoover
State/Province
Alabama
ZIP/Postal Code
35216
Country
United States
Facility Name
Vanguard Study Site
City
Pelham
State/Province
Alabama
ZIP/Postal Code
35124
Country
United States
Facility Name
Vanguard Study Site
City
Goodyear
State/Province
Arizona
ZIP/Postal Code
85338
Country
United States
Facility Name
Vanguard Study Site
City
Tolleson
State/Province
Arizona
ZIP/Postal Code
85353
Country
United States
Facility Name
Vanguard Study Site
City
Hot Springs
State/Province
Arkansas
ZIP/Postal Code
71913
Country
United States
Facility Name
Vanguard Study Site
City
Anaheim
State/Province
California
ZIP/Postal Code
92805
Country
United States
Facility Name
Vanguard Study Site
City
Westminster
State/Province
California
ZIP/Postal Code
92683
Country
United States
Facility Name
Vanguard Study Site
City
Lauderdale Lakes
State/Province
Florida
ZIP/Postal Code
33319
Country
United States
Facility Name
Vanguard Study Site
City
Orlando
State/Province
Florida
ZIP/Postal Code
32806
Country
United States
Facility Name
Vanguard Study Site
City
Valparaiso
State/Province
Indiana
ZIP/Postal Code
46383
Country
United States
Facility Name
Vanguard Study Site
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70124
Country
United States
Facility Name
Vanguard Study Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Vanguard Study Site
City
Missoula
State/Province
Montana
ZIP/Postal Code
59808
Country
United States
Facility Name
Vanguard Study Site
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11229
Country
United States
Facility Name
Vanguard Study Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45215
Country
United States
Facility Name
Vanguard Study Site
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Vanguard Study Site
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45424
Country
United States
Facility Name
Vanguard Study Site
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Vanguard Study Site
City
Rapid City
State/Province
South Dakota
ZIP/Postal Code
57702
Country
United States
Facility Name
Vanguard Study Site
City
Jackson
State/Province
Tennessee
ZIP/Postal Code
38305
Country
United States
Facility Name
Vanguard Study Site
City
Smyrna
State/Province
Tennessee
ZIP/Postal Code
37167
Country
United States
Facility Name
Vanguard Study Site
City
Austin
State/Province
Texas
ZIP/Postal Code
78735
Country
United States
Facility Name
Vanguard Study Site
City
Carrollton
State/Province
Texas
ZIP/Postal Code
75010
Country
United States
Facility Name
Vanguard Study Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75204
Country
United States
Facility Name
Vanguard Study Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
Vanguard Study Site
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76107
Country
United States
Facility Name
Vanguard Study Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77058
Country
United States
Facility Name
Vanguard Study Site
City
Pharr
State/Province
Texas
ZIP/Postal Code
78577
Country
United States
Facility Name
Vanguard Study Site
City
Plano
State/Province
Texas
ZIP/Postal Code
75024
Country
United States
Facility Name
Vanguard Study Site
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Facility Name
Vanguard Study Site
City
Saint George
State/Province
Utah
ZIP/Postal Code
84790
Country
United States
Facility Name
Vanguard Study Site
City
Morayfield
State/Province
Queensland
ZIP/Postal Code
4506
Country
Australia
Facility Name
Vanguard Study Site
City
Sherwood
State/Province
Queensland
ZIP/Postal Code
4075
Country
Australia
Facility Name
Vanguard Study Site
City
Victoria Point
State/Province
Queensland
ZIP/Postal Code
4165
Country
Australia
Facility Name
Vanguard Study Site
City
Ponce
ZIP/Postal Code
00780
Country
Puerto Rico
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Phase III, Randomized, Double-Blind, Placebo Controlled Trial to Evaluate the Efficacy and Safety of Nitazoxanide in the Treatment of Uncomplicated Influenza
We'll reach out to this number within 24 hrs