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Safety and Efficacy Trial of Zavegepant* Intranasal for Hospitalized Patients With COVID-19 Requiring Supplemental Oxygen

Primary Purpose

COVID-19 Infection

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Zavegepant (BHV-3500)
Placebo
Sponsored by
Pfizer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 Infection focused on measuring COVID-19, COVID, Coronavirus, Biohaven, Intranasal, SARS-CoV-2, BHV-3500, Zavegepant

Eligibility Criteria

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

Inclusion Criteria:

  1. Subjects must provide informed consent in accordance with requirements of the study center's institutional review board (IRB) or eithics committee prior to the initiation of any protocol-required procedures
  2. Subjects must agree to provide all requested demographic information (i.e. gender, race)
  3. Subjects must be able to read and understand English or Spanish
  4. Subjects must be over the age of 18 years
  5. Subjects must have laboratory-confirmed SARS-CoV-2 infection as determined by PCR-based commercial or public health assay
  6. Subjects must have symptoms that require hospitalization with supplemental oxygen and / or non-invasive ventilation as determined by the admitting physician. The maximum nasal cannula O2 concentration should be determined by the treating clinician and the limitations of the specific equipment
  7. Subjects must be willing and able to comply with study-related procedures/assessments

Exclusion Criteria:

  1. Subjects in immediate need of invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO)
  2. Subjects with an eGFR < 30 mL/min, at the Screening Visit
  3. Prisoners or subjects who are involuntarily incarcerated
  4. Subjects who are participating in any other investigational clinical trial while participating in this clinical trial
  5. Subjects who are under the age of 18 years
  6. Subjects who are pregnant (all potential female enrollees need to have a negative pregnancy test prior to IP administration)
  7. Subjects with multi-organ failure
  8. Subjects who have received more than 48 hours of supplemental oxygen prior to randomization
  9. Subjects with prior significant pulmonary disease (e.g., severe COPD/ILD/CHF/IPF) are excluded
  10. Subjects receiving investigational therapies as part of a formal clinical trial for the treatment of COVID-19. During the course of this study, investigational therapies that may become "standard of care" to treat COVID-19, but are not part of a clinical trial, are allowed
  11. Subjects who are on long-acting CGRP monoclonal antibodies will be excluded including Aimovig (erenumab), Emgality (galcanezumab), Ajovy (fremanezumab), and Vyepti (eptinezumab). Additionally, the investigational oral CGRP receptor antagonist, atogepant, that is taken daily will also be excluded. Oral CGRP receptor antagonists, Nurtec ODT (rimegepant) and Ubelvy (ubrogepant) that are typically used PRN infrequently will not be excluded as long the subject was not taking them on a daily basis and does not take them during the current study
  12. Subjects who are unlikely to survive for more than 48 hours from the Screening Visit
  13. Subjects with any of the following abnormal laboratory values at screening: aspartate AST or ALT greater than 5x ULN or bilirubin greater than 2x ULN
  14. Subjects with known active TB, history of incompletely treated TB, suspected or known extrapulmonary TB
  15. Subjects with suspected or known systemic bacterial or fungal infections. However, empiric antibiotics are permitted.
  16. Subjects who have participated in any clinical research study evaluating an IP or therapy within 3 months and less than 5 half-lives of IP prior to the screening visit
  17. Subjects with any physical examination findings and/or history of any illness that, in the opinion of the study investigator, might confound the results of the study or pose an additional risk to the subject by their participation in the study

Sites / Locations

  • Georgetown University Medical Center
  • Thomas Jefferson University Hospital
  • Roper Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Zavegepant

Placebo

Arm Description

Zavegepant (BHV-3500) 10 mg intranasal (IN) dosed every 8 hours (3 times/day) (Q8h) for 14 days

Placebo Q8h for 14 days Subjects dosed every 8 hours; 3 times/day (Q8h)

Outcomes

Primary Outcome Measures

To compare the efficacy of zavegepant (BHV-3500) to placebo in subjects hospitalized with COVID-19 infection requiring supplemental oxygen, using a six-point rating scale at Day 15. .
a. Efficacy will be measured by the difference between groups in the meah 6-point severity rating at Day 15. The severity ratings are: Death Hospitalized, on invasive mechanical ventilation or ECMO Hospitalized, on non-invasive ventilation or high flow oxygen devices Hospitalized, requiring supplemental oxygen Hospitalized, not requiring supplemental oxygen Not hospitalized

Secondary Outcome Measures

Proportion of subjects who have a 6-point severity rating of 5 or 6, are alive, and do not use supplemental oxygen as a procedure at Day 29.
Proportion of subjects who have a 6-point severity rating of 2 or 3, or use any ventilation or high-flow nasal cannula as procedures, on any day through Day 29.
Proportion of subjects admitted into an ICU on any day through Day 29 from AE eCRFs.
Number of subjects with deaths, SAEs, severe AEs, and Grade 3 or 4 laboratory test abnormalities at any time on study.
Number and percentage of subjects with severe or life-threatening bacterial, invasive fungal, or opportunistic infections at any time through Day 29 from AE/SAE eCRFs.
Number and percentage of subjects with intranasal administration reactions at any time through Day 29 from AE/SAE eCRFs.
Proportion of subjects with ≥ 50% reduction in eGFR from baseline at any time on study from laboratory test eCRFs.

Full Information

First Posted
April 9, 2020
Last Updated
June 7, 2023
Sponsor
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT04346615
Brief Title
Safety and Efficacy Trial of Zavegepant* Intranasal for Hospitalized Patients With COVID-19 Requiring Supplemental Oxygen
Official Title
BHV3500-203: Double-Blind, Randomized, Placebo Controlled, Safety and Efficacy Trial of Zavegepant* (BHV-3500) Intranasal (IN) for Hospitalized Patients With COVID-19 Requiring Supplemental Oxygen
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Terminated
Why Stopped
Lack of enrollment due to evolution of COVID-19 pandemic with reduction in patients at risk for severe disease and growing number of effective alternative therapies
Study Start Date
April 25, 2020 (Actual)
Primary Completion Date
March 11, 2022 (Actual)
Study Completion Date
April 29, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pfizer

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to determine if a CGRP receptor antagonist may potentially blunt the severe inflammatory response at the alveolar level, delaying or reversing the path towards oxygen desaturation, Acute respiratory distress syndrome (ARDS), requirement for supplemental oxygenation, artificial ventilation or death in patients with COVID-19 on supplemental oxygen. * BHV-3500, formerly "vazegepant", is now referred to as "zavegepant" (za ve' je pant). The World Health Organization (WHO) International Nonproprietary Names (INN) Expert Committee revised the name to "zavegepant" which was accepted by the United States Adopted Names (USAN ) Council for use in the U.S. and is pending formal adoption by the INN for international use.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19 Infection
Keywords
COVID-19, COVID, Coronavirus, Biohaven, Intranasal, SARS-CoV-2, BHV-3500, Zavegepant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Zavegepant
Arm Type
Experimental
Arm Description
Zavegepant (BHV-3500) 10 mg intranasal (IN) dosed every 8 hours (3 times/day) (Q8h) for 14 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo Q8h for 14 days Subjects dosed every 8 hours; 3 times/day (Q8h)
Intervention Type
Drug
Intervention Name(s)
Zavegepant (BHV-3500)
Intervention Description
10 mg intranasal (IN) for 14 days
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo Q8h for 14 days
Primary Outcome Measure Information:
Title
To compare the efficacy of zavegepant (BHV-3500) to placebo in subjects hospitalized with COVID-19 infection requiring supplemental oxygen, using a six-point rating scale at Day 15. .
Description
a. Efficacy will be measured by the difference between groups in the meah 6-point severity rating at Day 15. The severity ratings are: Death Hospitalized, on invasive mechanical ventilation or ECMO Hospitalized, on non-invasive ventilation or high flow oxygen devices Hospitalized, requiring supplemental oxygen Hospitalized, not requiring supplemental oxygen Not hospitalized
Time Frame
Baseline to Day 15
Secondary Outcome Measure Information:
Title
Proportion of subjects who have a 6-point severity rating of 5 or 6, are alive, and do not use supplemental oxygen as a procedure at Day 29.
Time Frame
Baseline to Day 29
Title
Proportion of subjects who have a 6-point severity rating of 2 or 3, or use any ventilation or high-flow nasal cannula as procedures, on any day through Day 29.
Time Frame
Baseline to Day 29
Title
Proportion of subjects admitted into an ICU on any day through Day 29 from AE eCRFs.
Time Frame
Baseline to Day 29
Title
Number of subjects with deaths, SAEs, severe AEs, and Grade 3 or 4 laboratory test abnormalities at any time on study.
Time Frame
Screening to Day 60
Title
Number and percentage of subjects with severe or life-threatening bacterial, invasive fungal, or opportunistic infections at any time through Day 29 from AE/SAE eCRFs.
Time Frame
Baseline to Day 29
Title
Number and percentage of subjects with intranasal administration reactions at any time through Day 29 from AE/SAE eCRFs.
Time Frame
Baseline to Day 29
Title
Proportion of subjects with ≥ 50% reduction in eGFR from baseline at any time on study from laboratory test eCRFs.
Time Frame
Baseline to Day 60

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must provide informed consent in accordance with requirements of the study center's institutional review board (IRB) or eithics committee prior to the initiation of any protocol-required procedures Subjects must agree to provide all requested demographic information (i.e. gender, race) Subjects must be able to read and understand English or Spanish Subjects must be over the age of 18 years Subjects must have laboratory-confirmed SARS-CoV-2 infection as determined by PCR-based commercial or public health assay Subjects must have symptoms that require hospitalization with supplemental oxygen and / or non-invasive ventilation as determined by the admitting physician. The maximum nasal cannula O2 concentration should be determined by the treating clinician and the limitations of the specific equipment Subjects must be willing and able to comply with study-related procedures/assessments Exclusion Criteria: Subjects in immediate need of invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) Subjects with an eGFR < 30 mL/min, at the Screening Visit Prisoners or subjects who are involuntarily incarcerated Subjects who are participating in any other investigational clinical trial while participating in this clinical trial Subjects who are under the age of 18 years Subjects who are pregnant (all potential female enrollees need to have a negative pregnancy test prior to IP administration) Subjects with multi-organ failure Subjects who have received more than 48 hours of supplemental oxygen prior to randomization Subjects with prior significant pulmonary disease (e.g., severe COPD/ILD/CHF/IPF) are excluded Subjects receiving investigational therapies as part of a formal clinical trial for the treatment of COVID-19. During the course of this study, investigational therapies that may become "standard of care" to treat COVID-19, but are not part of a clinical trial, are allowed Subjects who are on long-acting CGRP monoclonal antibodies will be excluded including Aimovig (erenumab), Emgality (galcanezumab), Ajovy (fremanezumab), and Vyepti (eptinezumab). Additionally, the investigational oral CGRP receptor antagonist, atogepant, that is taken daily will also be excluded. Oral CGRP receptor antagonists, Nurtec ODT (rimegepant) and Ubelvy (ubrogepant) that are typically used PRN infrequently will not be excluded as long the subject was not taking them on a daily basis and does not take them during the current study Subjects who are unlikely to survive for more than 48 hours from the Screening Visit Subjects with any of the following abnormal laboratory values at screening: aspartate AST or ALT greater than 5x ULN or bilirubin greater than 2x ULN Subjects with known active TB, history of incompletely treated TB, suspected or known extrapulmonary TB Subjects with suspected or known systemic bacterial or fungal infections. However, empiric antibiotics are permitted. Subjects who have participated in any clinical research study evaluating an IP or therapy within 3 months and less than 5 half-lives of IP prior to the screening visit Subjects with any physical examination findings and/or history of any illness that, in the opinion of the study investigator, might confound the results of the study or pose an additional risk to the subject by their participation in the study
Facility Information:
Facility Name
Georgetown University Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Thomas Jefferson University Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Roper Hospital
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29401
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
IPD Sharing URL
https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests
Links:
URL
https://pmiform.com/clinical-trial-info-request?StudyID=BHV3500-203
Description
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Learn more about this trial

Safety and Efficacy Trial of Zavegepant* Intranasal for Hospitalized Patients With COVID-19 Requiring Supplemental Oxygen

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