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Randomized, Controlled, Double-blind Clinical Trial Comparing the Efficacy and Safety of Chemoprophylaxis With Hydroxychloroquine in Patients Under Biological Treatment and / or JAK Inhibitors in the Prevention of SARS-CoV-2 Infection

Primary Purpose

COVID 19, Immunomediated Inflammatory Disease in Treatment With Biological Agents and / or Jak Inhibitors

Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Hidroxicloroquina
Control group
Sponsored by
Instituto de Investigación Marqués de Valdecilla
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for COVID 19

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients who meet the requirements of the New Coronavirus Infection Diagnosis (Acute respiratory infection symptoms or acute cough alone and positive PCR)
  2. Aged ≥18 and < 75 years male or female;
  3. In women of childbearing potential, negative pregnancy test and commitment to use contraceptive method throughout the study.
  4. Willing to take study medication
  5. Willing to comply with all study procedures,
  6. Diagnosis of IBD disease, rheumatoid arthritis, seronegative spondyloarthritis or psoriasis for more than 6 months.
  7. Be on stable treatment with biological agents, for a minimum period of 6 months, including treatment with Infliximab, etanercept, adalimumab, certolizumab, golimumab, rituximab, abatacept, tocilizumab, sarilumab, secukinumab, vedolizumab, natalizumab, ustekinumab, tofacit
  8. Able to provide oral and written informed consent

Exclusion Criteria

  1. Previous infection with SARS-CoV-2.
  2. Current treatment with hydroxychloroquine / chloroquine.
  3. Previous or current treatment with tamoxifen or raloxifene.
  4. Previous eye disease, especially maculopathy.
  5. Known heart failure grade III-IV of the classification of the New York Heart Association).
  6. Any type of cancer (except basal cell) in the last 5 years.
  7. Pregnancy.
  8. Refusal to give informed consent.
  9. Evidence of any other unstable or clinically significant unstable, clinically significant, immunological, endocrine, hematologic, gastrointestinal, neurological, neoplastic, or psychiatric illness.
  10. Instability or mental incompetence, so that the validity of the informed consent or the ability to complete the study is uncertain.
  11. Positive antibodies to the human immunodeficiency virus.
  12. Data on decompensated liver disease:

to. Aspartate aminotransferase (AST) and / or ALT> 10 x upper limit of normal (LSN).

b. Total bilirubin> 25 μmol / l (1.5 mg / dl). c. International normalized index> 1.4. d. Platelet count <100,000 / mm3. 17. Serum creatinine levels> 135 μmol / l (> 1.53 mg / dl) in men and> 110 μmol / l (> 24 mg / dl) in women.

18.Significant kidney disease, including nephrotic syndrome, chronic kidney disease (patients with markers of liver injury or estimated glomerular filtration rate [eGFR] of less than 60 ml / min / 1.73 m2). If an abnormal value is obtained at the first screening visit, the measurement of eGFR may be repeated before randomization within the following time frame: minimum 4 weeks after the initial test and maximum 2 weeks before the planned randomization. Repeated abnormal eGFR (less than 60 ml / min / 1.73 m2) leads to exclusion from the study.Pregnant or lactating women; 19. Inability to consent and/or comply with study protocol; 20. Individuals with known hypersensitivity to the study drugs. 21. Any contraindications as per the Data Sheet of or Hydroxychloroquine.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Testing and prophylaxis of SARS-CoV-2

    placebo

    Arm Description

    Chemoprophylaxis with hydroxychloroquine at a dose of 200 mg twice a day for 6 months.

    Testing of SARS-CoV-2 and prescription of placebo (Hydroxychloroquine placebo) twice daily for 6 months

    Outcomes

    Primary Outcome Measures

    Incidence rate of new COVID-19 cases in both arms
    number of new cases divided by number of persons-time at risk
    Prevalence of COVID-19 cases in both arms
    percentage of cases of COVID 19
    Mortality rate secondary to COVID-19 cases in both groups
    Case fatality rate (CFR): the proportion of diagnosed cases of COVID 19 that lead to death
    Intensive Care Unit (CU) admission rate secondary to COVID-19 cases in both groups
    percentage of patients who need admission in an ICU due to COVID 19 infection

    Secondary Outcome Measures

    Adverse events
    Presence and type of adverse events at this point.
    Adverse events
    Proportion of participants that drop out of study

    Full Information

    First Posted
    March 31, 2020
    Last Updated
    September 8, 2021
    Sponsor
    Instituto de Investigación Marqués de Valdecilla
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04330495
    Brief Title
    Randomized, Controlled, Double-blind Clinical Trial Comparing the Efficacy and Safety of Chemoprophylaxis With Hydroxychloroquine in Patients Under Biological Treatment and / or JAK Inhibitors in the Prevention of SARS-CoV-2 Infection
    Official Title
    Randomized, Controlled, Double-blind Clinical Trial Comparing the Efficacy and Safety of Chemoprophylaxis With Hydroxychloroquine in Patients Under Biological Treatment and / or JAK Inhibitors in the Prevention of SARS-CoV-2 Infection
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Care pressures on the investigator team during the COVID-19 pandemic. Subsequent appearance of scientific evidence on the lack of efficacy of hydroxychloroquine in the treatment or prophylaxis of COVID-19 infection.
    Study Start Date
    April 6, 2020 (Anticipated)
    Primary Completion Date
    November 6, 2020 (Anticipated)
    Study Completion Date
    August 27, 2021 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Instituto de Investigación Marqués de Valdecilla

    4. Oversight

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

    5. Study Description

    Brief Summary
    The investigators plan to evaluate a strategy of chemoprophylaxis with hydroxyloquine (HCQ) against COVID-19 infection in patients diagnosed with an immunomediated inflammatory disease who are following a treatment with biological agents and / or Jak inhibitors. The strategy will be carried out through a randomised double blind, placebo-controlled clinical trial and will assess comparative rates of infection (prevalence, incidence), severity including mortality, impact on clínical course of the primary diseases and toxicity. Such evaluation will require prospective surveillance to assess the different end-points. Drug interventions in this protocol will follow the Spanish law about off-label use of medicines.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    COVID 19, Immunomediated Inflammatory Disease in Treatment With Biological Agents and / or Jak Inhibitors

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Model Description
    Randomized, controlled, double-blind clinical trial
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Testing and prophylaxis of SARS-CoV-2
    Arm Type
    Experimental
    Arm Description
    Chemoprophylaxis with hydroxychloroquine at a dose of 200 mg twice a day for 6 months.
    Arm Title
    placebo
    Arm Type
    Active Comparator
    Arm Description
    Testing of SARS-CoV-2 and prescription of placebo (Hydroxychloroquine placebo) twice daily for 6 months
    Intervention Type
    Drug
    Intervention Name(s)
    Hidroxicloroquina
    Intervention Description
    Chemoprophylaxis with hydroxychloroquine at a dose of 200 mg twice a day for 6 months.
    Intervention Type
    Drug
    Intervention Name(s)
    Control group
    Intervention Description
    Testing of SARS-CoV-2 and prescription of placebo (Hydroxychloroquine placebo) twice daily for 6 months
    Primary Outcome Measure Information:
    Title
    Incidence rate of new COVID-19 cases in both arms
    Description
    number of new cases divided by number of persons-time at risk
    Time Frame
    From day 14 after start of treatment up to the end of follow-up: week 27
    Title
    Prevalence of COVID-19 cases in both arms
    Description
    percentage of cases of COVID 19
    Time Frame
    27 weeks after the beginning of the study
    Title
    Mortality rate secondary to COVID-19 cases in both groups
    Description
    Case fatality rate (CFR): the proportion of diagnosed cases of COVID 19 that lead to death
    Time Frame
    27 weeks after the beginning of the study
    Title
    Intensive Care Unit (CU) admission rate secondary to COVID-19 cases in both groups
    Description
    percentage of patients who need admission in an ICU due to COVID 19 infection
    Time Frame
    27 weeks after the beginning of the study
    Secondary Outcome Measure Information:
    Title
    Adverse events
    Description
    Presence and type of adverse events at this point.
    Time Frame
    12 weeks after the start of treatment
    Title
    Adverse events
    Description
    Proportion of participants that drop out of study
    Time Frame
    27 weeks after the beginning of the study

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients who meet the requirements of the New Coronavirus Infection Diagnosis (Acute respiratory infection symptoms or acute cough alone and positive PCR) Aged ≥18 and < 75 years male or female; In women of childbearing potential, negative pregnancy test and commitment to use contraceptive method throughout the study. Willing to take study medication Willing to comply with all study procedures, Diagnosis of IBD disease, rheumatoid arthritis, seronegative spondyloarthritis or psoriasis for more than 6 months. Be on stable treatment with biological agents, for a minimum period of 6 months, including treatment with Infliximab, etanercept, adalimumab, certolizumab, golimumab, rituximab, abatacept, tocilizumab, sarilumab, secukinumab, vedolizumab, natalizumab, ustekinumab, tofacit Able to provide oral and written informed consent Exclusion Criteria Previous infection with SARS-CoV-2. Current treatment with hydroxychloroquine / chloroquine. Previous or current treatment with tamoxifen or raloxifene. Previous eye disease, especially maculopathy. Known heart failure grade III-IV of the classification of the New York Heart Association). Any type of cancer (except basal cell) in the last 5 years. Pregnancy. Refusal to give informed consent. Evidence of any other unstable or clinically significant unstable, clinically significant, immunological, endocrine, hematologic, gastrointestinal, neurological, neoplastic, or psychiatric illness. Instability or mental incompetence, so that the validity of the informed consent or the ability to complete the study is uncertain. Positive antibodies to the human immunodeficiency virus. Data on decompensated liver disease: to. Aspartate aminotransferase (AST) and / or ALT> 10 x upper limit of normal (LSN). b. Total bilirubin> 25 μmol / l (1.5 mg / dl). c. International normalized index> 1.4. d. Platelet count <100,000 / mm3. 17. Serum creatinine levels> 135 μmol / l (> 1.53 mg / dl) in men and> 110 μmol / l (> 24 mg / dl) in women. 18.Significant kidney disease, including nephrotic syndrome, chronic kidney disease (patients with markers of liver injury or estimated glomerular filtration rate [eGFR] of less than 60 ml / min / 1.73 m2). If an abnormal value is obtained at the first screening visit, the measurement of eGFR may be repeated before randomization within the following time frame: minimum 4 weeks after the initial test and maximum 2 weeks before the planned randomization. Repeated abnormal eGFR (less than 60 ml / min / 1.73 m2) leads to exclusion from the study.Pregnant or lactating women; 19. Inability to consent and/or comply with study protocol; 20. Individuals with known hypersensitivity to the study drugs. 21. Any contraindications as per the Data Sheet of or Hydroxychloroquine.

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

    Learn more about this trial

    Randomized, Controlled, Double-blind Clinical Trial Comparing the Efficacy and Safety of Chemoprophylaxis With Hydroxychloroquine in Patients Under Biological Treatment and / or JAK Inhibitors in the Prevention of SARS-CoV-2 Infection

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