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A Study to Evaluate the Safety, Pharmacokinetics and Antiviral Effects of Galidesivir in Yellow Fever or COVID-19

Primary Purpose

COVID-19, Yellow Fever

Status
Terminated
Phase
Phase 1
Locations
Brazil
Study Type
Interventional
Intervention
Galidesivir
Placebo
Sponsored by
BioCryst Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring COVID-19, Galidesivir, Yellow Fever

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Group A - Yellow Fever

  • Ability to provide written informed consent
  • Males and nonpregnant, non-breast-feeding females, aged 18 years or older
  • Subject weight ≥ 50 kg (110 lb.)
  • Positive test for YFV by molecular amplification of the virus in the blood
  • First onset of symptoms of YF occurring within the previous 7 days
  • Male and female subjects must agree to the contraception requirements and must meet the inclusion criteria regarding contraception as outlined in the protocol
  • CLCR of at least 60 mL/min by Cockcroft-Gault equation
  • AST < 5000 u/L
  • Indirect bilirubin < 1.5 mg/dL
  • Neutrophil count < 7500 /mm3
  • International Normalized Ratio (INR) < 1.5

Exclusion Criteria: Group A - Yellow Fever

  • Any clinically significant medical condition or medical history that, in the opinion of the investigator or sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for that subject
  • Employment by the study site, or an immediate family relationship to either study site employees or Sponsor employee
  • Lack of suitable veins for venipuncture/cannulation as assessed by the Investigator at Screening
  • Participation in any other investigational drug or vaccine study currently or within the past 30 days
  • Diagnosis of YF vaccine-related viscerotropic disease
  • Subjects with hepatic encephalopathy as defined by Conn Score ≥ 1.
  • Subject has severe immunosuppression or immunodeficiency, leukemia, lymphoma, thymic disease, generalized malignancy, or radiation therapy (within the past 3 months), or is undergoing current treatment with immunosuppressive drugs, defined as drugs that impair immune responses to infections
  • A treatment plan for YF that would include concomitant administration of antiviral medications

Inclusion Criteria Group B - COVID-19

  • Ability to provide written informed consent, accept randomization to any assigned treatment arm, and comply with planned study procedures
  • Males and nonpregnant, non-breast-feeding females, aged 18 years or older
  • Male and female subjects must agree to the contraception requirements and must meet the inclusion criteria regarding contraception as outlined in the protocol
  • Subject weight ≥ 50 kg (110 lb.)
  • Clinical syndrome consistent with moderate-severe (but not critically ill) COVID-19, defined by at least one of the following:

    1. Symptoms of acute viral lower respiratory tract infection, such as fever, non-productive cough, dyspnea, and either 1) a pulse oximetry oxygen saturation (SpO2) ≤ 94% or a respiratory rate > 24 breaths/minute as measured at rest without use of supplemental oxygen or 2) a clinical requirement for supplemental oxygen treatment or non-invasive mechanical ventilation
    2. Radiographic pulmonary findings seen on chest imaging (chest X-ray or computed tomography [CT scan]) consistent with COVID-19
  • Positive test for SARS-CoV-2 by molecular amplification of the virus in a respiratory specimen (nasopharyngeal, oropharyngeal, lower respiratory tract [eg, expectorated sputum]) collected < 96 hours prior to randomization. Note: subjects may have a positive test recorded prior to screening if they are admitted to the hospital with a presumed case of COVID-19

Exclusion Criteria: Group B - COVID-19

  • Any clinically significant medical condition or medical history that, in the opinion of the investigator or sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for the subject
  • Lack of suitable veins for venipuncture/cannulation as assessed by the Investigator at Screening
  • Participation in any other investigational drug or vaccine study currently or within the past 30 days
  • A clinical treatment plan that would include concomitant administration of any other experimental treatment or off-label use of marketed medications that are intended as specific treatment for the COVID-19 clinical syndrome or the SARS-CoV-2 infection. Any such medications must be discontinued prior to study enrollment, unless a formal written standard of care policy document from the national, state, or institutional authorities requires otherwise.
  • Severe or rapidly progressive disease or medical condition of any type such that death is an expected or likely outcome within 72 hours or that would require referral or transfer to another medical facility
  • Severe renal impairment (estimated glomerular filtration rate (eGFR) ≤ 50 mL/min/1.73m2) or receiving continuous renal replacement therapy, hemodialysis, or peritoneal dialysis
  • Severe liver disease by medical history or ALT or AST > 5 times upper limit of normal
  • Congestive heart failure by medical history ≥ Class 3
  • Requiring invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) at the time of randomization

Sites / Locations

  • Hospital de Clinicas da Universidade Federal do Parana
  • Hospital Sao Vicente de Paulo-PPDS
  • Hospital Sao Lucas da Pucrs
  • Foundation Regional Faculty of Medicine of São José do Rio Preto
  • Clinical Research Unit and Department of Infectious and Parasitic Diseases Hospital das Clínicas, School of Medicine, USP

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Galidesivir

Placebo

Arm Description

Galidesivir IV infusion

Placebo IV infusion

Outcomes

Primary Outcome Measures

number of subjects with treatment emergent adverse events and serious adverse events
number of subjects with change in laboratory parameters
exposure of galidesivir as measured by plasma concentrations

Secondary Outcome Measures

yellow fever virus (YFV) titer (Group A)
antiviral effect on SARS-CoV-2 in the respiratory tract - COVID-19 (Group B)
changes in clinical status using 8-point ordinal scale in COVID-19 (Group B)
changes from baseline and time to improvement using NEWS in COVID-19 (Group B)
mortality

Full Information

First Posted
March 15, 2019
Last Updated
May 25, 2021
Sponsor
BioCryst Pharmaceuticals
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03891420
Brief Title
A Study to Evaluate the Safety, Pharmacokinetics and Antiviral Effects of Galidesivir in Yellow Fever or COVID-19
Official Title
A Phase 1b Double-blind, Placebo-controlled, Dose-ranging Study to Evaluate the Safety, Pharmacokinetics, and Anti-viral Effects of Galidesivir Administered Via Intravenous Infusion to Subjects With Yellow Fever or COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Terminated
Why Stopped
Sponsor decision to no longer pursue indications studied in this trial
Study Start Date
April 9, 2020 (Actual)
Primary Completion Date
January 31, 2021 (Actual)
Study Completion Date
April 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioCryst Pharmaceuticals
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

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

5. Study Description

Brief Summary
This is a placebo-controlled, randomized, double-blind study to evaluate the pharmacokinetics, safety and antiviral activity of galidesivir in subjects with yellow fever (YF) or COVID-19.
Detailed Description
This is a randomized, double-blind, placebo-controlled study to evaluate the pharmacokinetics (PK), safety, and antiviral effects of galidesivir administered via intravenous (IV) infusion vs. placebo in hospitalized adult subjects with either Yellow Fever (Group A) or COVID-19 (Group B). The study will be conducted in two parts, and each Group (A or B) will proceed independently through the study. Part 1 is a dose ranging study with three sequential cohorts of eight patients each that will be randomized 3:1 to receive IV galidesivir or placebo every 12 hours for 7 days. Upon completion of part 1, an optimized dosing regimen of galidesivir will be selected for part 2, based on part 1 results including safety, PK, viral load reduction, and improvement in signs and symptoms and clinical manifestations, and mortality. In part 2, up to 42 patients will be randomized 2:1 to receive IV galidesivir or placebo. After treatment, the patients will remain hospitalized until resolution of symptoms allows release. All patients will be followed for mortality through Day 56.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19, Yellow Fever
Keywords
COVID-19, Galidesivir, Yellow Fever

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Galidesivir
Arm Type
Experimental
Arm Description
Galidesivir IV infusion
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo IV infusion
Intervention Type
Drug
Intervention Name(s)
Galidesivir
Intervention Description
Galidesivir IV infusion
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo IV infusion
Primary Outcome Measure Information:
Title
number of subjects with treatment emergent adverse events and serious adverse events
Time Frame
absolute number through the end of the study, approximately 56 days
Title
number of subjects with change in laboratory parameters
Time Frame
absolute number and change from baseline through the end of the study, approximately 56 days
Title
exposure of galidesivir as measured by plasma concentrations
Time Frame
24 hours post dose on Day 1 through 12 hours post dose on Day 7
Secondary Outcome Measure Information:
Title
yellow fever virus (YFV) titer (Group A)
Time Frame
change in YFV titer from baseline through Day 21
Title
antiviral effect on SARS-CoV-2 in the respiratory tract - COVID-19 (Group B)
Time Frame
change in SARS-CoV-2 from baseline through Day 21
Title
changes in clinical status using 8-point ordinal scale in COVID-19 (Group B)
Time Frame
through Day 21
Title
changes from baseline and time to improvement using NEWS in COVID-19 (Group B)
Time Frame
through Day21
Title
mortality
Time Frame
mortality at Day 56

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Group A - Yellow Fever Ability to provide written informed consent Males and nonpregnant, non-breast-feeding females, aged 18 years or older Subject weight ≥ 50 kg (110 lb.) Positive test for YFV by molecular amplification of the virus in the blood First onset of symptoms of YF occurring within the previous 7 days Male and female subjects must agree to the contraception requirements and must meet the inclusion criteria regarding contraception as outlined in the protocol CLCR of at least 60 mL/min by Cockcroft-Gault equation AST < 5000 u/L Indirect bilirubin < 1.5 mg/dL Neutrophil count < 7500 /mm3 International Normalized Ratio (INR) < 1.5 Exclusion Criteria: Group A - Yellow Fever Any clinically significant medical condition or medical history that, in the opinion of the investigator or sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for that subject Employment by the study site, or an immediate family relationship to either study site employees or Sponsor employee Lack of suitable veins for venipuncture/cannulation as assessed by the Investigator at Screening Participation in any other investigational drug or vaccine study currently or within the past 30 days Diagnosis of YF vaccine-related viscerotropic disease Subjects with hepatic encephalopathy as defined by Conn Score ≥ 1. Subject has severe immunosuppression or immunodeficiency, leukemia, lymphoma, thymic disease, generalized malignancy, or radiation therapy (within the past 3 months), or is undergoing current treatment with immunosuppressive drugs, defined as drugs that impair immune responses to infections A treatment plan for YF that would include concomitant administration of antiviral medications Inclusion Criteria Group B - COVID-19 Ability to provide written informed consent, accept randomization to any assigned treatment arm, and comply with planned study procedures Males and nonpregnant, non-breast-feeding females, aged 18 years or older Male and female subjects must agree to the contraception requirements and must meet the inclusion criteria regarding contraception as outlined in the protocol Subject weight ≥ 50 kg (110 lb.) Clinical syndrome consistent with moderate-severe (but not critically ill) COVID-19, defined by at least one of the following: Symptoms of acute viral lower respiratory tract infection, such as fever, non-productive cough, dyspnea, and either 1) a pulse oximetry oxygen saturation (SpO2) ≤ 94% or a respiratory rate > 24 breaths/minute as measured at rest without use of supplemental oxygen or 2) a clinical requirement for supplemental oxygen treatment or non-invasive mechanical ventilation Radiographic pulmonary findings seen on chest imaging (chest X-ray or computed tomography [CT scan]) consistent with COVID-19 Positive test for SARS-CoV-2 by molecular amplification of the virus in a respiratory specimen (nasopharyngeal, oropharyngeal, lower respiratory tract [eg, expectorated sputum]) collected < 96 hours prior to randomization. Note: subjects may have a positive test recorded prior to screening if they are admitted to the hospital with a presumed case of COVID-19 Exclusion Criteria: Group B - COVID-19 Any clinically significant medical condition or medical history that, in the opinion of the investigator or sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for the subject Lack of suitable veins for venipuncture/cannulation as assessed by the Investigator at Screening Participation in any other investigational drug or vaccine study currently or within the past 30 days A clinical treatment plan that would include concomitant administration of any other experimental treatment or off-label use of marketed medications that are intended as specific treatment for the COVID-19 clinical syndrome or the SARS-CoV-2 infection. Any such medications must be discontinued prior to study enrollment, unless a formal written standard of care policy document from the national, state, or institutional authorities requires otherwise. Severe or rapidly progressive disease or medical condition of any type such that death is an expected or likely outcome within 72 hours or that would require referral or transfer to another medical facility Severe renal impairment (estimated glomerular filtration rate (eGFR) ≤ 50 mL/min/1.73m2) or receiving continuous renal replacement therapy, hemodialysis, or peritoneal dialysis Severe liver disease by medical history or ALT or AST > 5 times upper limit of normal Congestive heart failure by medical history ≥ Class 3 Requiring invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) at the time of randomization
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Esper Kallas, MD, PhD
Organizational Affiliation
University of Sao Paulo, Brazil
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital de Clinicas da Universidade Federal do Parana
City
Curitiba
State/Province
Parana
Country
Brazil
Facility Name
Hospital Sao Vicente de Paulo-PPDS
City
Passo Fundo
State/Province
Rio Grande Do Sul
Country
Brazil
Facility Name
Hospital Sao Lucas da Pucrs
City
Porto Alegre
State/Province
Rio Grande Do Sul
Country
Brazil
Facility Name
Foundation Regional Faculty of Medicine of São José do Rio Preto
City
São José Do Rio Preto
State/Province
SP
Country
Brazil
Facility Name
Clinical Research Unit and Department of Infectious and Parasitic Diseases Hospital das Clínicas, School of Medicine, USP
City
São Paulo
State/Province
SP
ZIP/Postal Code
05403-010
Country
Brazil

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Evaluate the Safety, Pharmacokinetics and Antiviral Effects of Galidesivir in Yellow Fever or COVID-19

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