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Early Intervention in COVID-19: Favipiravir Verses Standard Care (PIONEER)

Primary Purpose

Coronavirus Infection

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Favipiravir
Standard of care management
Sponsored by
Chelsea and Westminster NHS Foundation Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronavirus Infection focused on measuring COVID-19, Coronavirus

Eligibility Criteria

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

Inclusion Criteria:

  1. Adult participants: Signed informed consent
  2. New admission to hospital for period expected to last ≥ 1 night
  3. Suspected or confirmed COVID-19 infection

    Patients are suspected of COVID-19 infection if they have the following:

    · Influenza like illness (fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset: persistent cough, hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing or sneezing).

    And

    · Finding from either a chest x-ray or CT suggestive of Covid-19 infection

    And

    · Alternative causes are considered unlikely

  4. For women to be eligible to enter and participate in the study they should be: of non-child-bearing

    • potential defined as either post-menopausal (12 months of spontaneous amenorrhea and ≥ 45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or,
    • or of child-bearing potential have a negative pregnancy test at screening and agrees to remain sexually abstinent or use a method of contraception with a failure rate of < 1% per year as indicated in Appendix B during the treatment and for a period of 7 days after the last dose. Hormonal contraceptive methods must be supplemented by a barrier method.
  5. Men who are sexually active must use an adequate method of contraception as listed in Appendix B, for a period of at least 7 days after the last dose

Exclusion Criteria:

  1. Pregnant or breast feeding, due to potential teratogenicity
  2. Hepatic impairment - (AST or ALT > 3.5 x upper limit of normal)
  3. Presently enrolled in an interventional drug study
  4. Unable to take medication via the oral or nasogastric route
  5. Known sensitivity Favipiravir

Sites / Locations

  • Grupo Hospitalar Conceição
  • Fundação Oswaldo Cruz - Instituto Nacional de Infectologia Evandro Chagas (Fiocruz/INI)
  • Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran
  • Hull University Teaching Hospitals NHS Trust - Castle Hill Hospital
  • Chelsea and Westminster Hospital
  • West Middlesex University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Favipiravir & Standard of Care

Standard of care

Arm Description

Favipiravir: Day 1 1800mg twice per day, Days 2-10 800mg twice per day

No trial intervention

Outcomes

Primary Outcome Measures

Time from randomisation to a sustained clinical improvement (maintained for 24 hours) by two points on a seven-category ordinal scale or to discharge, whichever occurs first
Time from randomisation to a sustained clinical improvement (maintained for 24 hours) by two points on a seven-category ordinal scale or to discharge, whichever occurs first The seven-category ordinal scale is : Not hospitalised with resumption of normal activities Not hospitalised, but unable to resume normal Hospitalised, not requiring supplemental oxygen Hospitalised, requiring supplemental oxygen Hospitalised, requiring nasal high-flow oxygen therapy, non-invasive mechanical ventilation or both Hospitalised, requiring ECMO (Extra-corporal membrane oxygenation), invasive mechanical ventilation or both Death

Secondary Outcome Measures

Clinical status on a seven-category ordinal scale (Day 7)
Clinical status of patients at given on the seven-category ordinal scale (see primary endpoint for scale)
Clinical status on a seven-category ordinal scale (Day 14)
Clinical status of patients at given on the seven-category ordinal scale (see primary endpoint for scale)
Overall survival
Survival of patients to end of study
Time to improvement by two points on the NEWS score
Time from randomisation to improvement by two points on the NEWS score of patient condition, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time to improvement by two points on the NEWS element score for temperature
Time from randomisation to improvement by two points on the NEWS element score for temperature, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time to improvement by two points on the NEWS element score for heartrate
Time from randomisation to improvement by two points on the NEWS element score for heartrate, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time to improvement by two points on the NEWS element score for respiratory rate
Time from randomisation to improvement by two points on the NEWS element score for respiratory rate, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time to improvement by two points on the NEWS element score for oxygen saturation.
Time from randomisation to improvement by two points on the NEWS element score for oxygen saturation, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Admission to intensive care
Frequency of admission of patients to intensive care
Requirement for mechanical ventilation
Frequency of requirement to administer mechanical ventilation to patients
Requirement for non-invasive ventilation, continuous positive airways pressure or high-flow oxygen
Frequency of requirement to administer non-invasive ventilation, continuous positive airways pressure or high-flow oxygen to patients
Incidence of bacterial or fungal infection
Frequency of culture-confirmed bacterial or fungal infection in patients
Incidence of adverse events not directly caused by COVID-19 infection.
Frequency and severity of adverse events in patients not directly attributed by clinicians to COVID-19 infection.

Full Information

First Posted
May 1, 2020
Last Updated
November 17, 2021
Sponsor
Chelsea and Westminster NHS Foundation Trust
Collaborators
NEAT ID Foundation, FUJIFILM Toyama Chemical Co., Ltd., Imperial College London
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1. Study Identification

Unique Protocol Identification Number
NCT04373733
Brief Title
Early Intervention in COVID-19: Favipiravir Verses Standard Care
Acronym
PIONEER
Official Title
A Randomised Controlled Trial of Early Intervention in Patients HospItalised With COVID-19: Favipiravir and StaNdard Care vErsEs Standard CaRe
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
May 1, 2020 (Actual)
Primary Completion Date
June 25, 2021 (Actual)
Study Completion Date
June 25, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chelsea and Westminster NHS Foundation Trust
Collaborators
NEAT ID Foundation, FUJIFILM Toyama Chemical Co., Ltd., Imperial College London

4. Oversight

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

5. Study Description

Brief Summary
Currently we do not know how best to treat patients infected with COVID-19. This study is looking at whether randomising participants to either favipiravir or to usual care, can help patients with suspected or proven COVID-19 infection.
Detailed Description
A prospective, randomised, open label study of the combined use of favipiravir and standard clinical care verses standard clinical care alone. A computer-based software will randomise participants 1:1 to either receive favipiravir and standard medical care or standard medical care alone. The allocated medical regime will commence for 10 days. Research blood, sputum nose swab and urine samples will be collected at baseline, as well as between day 5 and 10, and between day 14 and 28 to enable comparative analyses. A COVID-19 antibody test will also be performed 14-28 days after randomisation. In the event of clinically indicated bronchoscopy taking place within 28 days of consent then additional bronchoscopy washing and brushing samples and paired blood sample will be taken for research purposes If a participant is discharged before one of the latter time points, they will be required to return to hospital (provided they are well enough) for the collection of repeat samples. Participants will be closely monitored whilst taking the study medications. Participants will study exit at subject death or 28 days post-randomisation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronavirus Infection
Keywords
COVID-19, Coronavirus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Open-label parallel group randomised control trial. One trial treatment arm and one standard of care comparator arm.
Masking
None (Open Label)
Masking Description
Open label
Allocation
Randomized
Enrollment
502 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Favipiravir & Standard of Care
Arm Type
Experimental
Arm Description
Favipiravir: Day 1 1800mg twice per day, Days 2-10 800mg twice per day
Arm Title
Standard of care
Arm Type
Other
Arm Description
No trial intervention
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Other Intervention Name(s)
Avigan
Intervention Description
Anti-viral
Intervention Type
Other
Intervention Name(s)
Standard of care management
Intervention Description
Standard of care management for COVID-19
Primary Outcome Measure Information:
Title
Time from randomisation to a sustained clinical improvement (maintained for 24 hours) by two points on a seven-category ordinal scale or to discharge, whichever occurs first
Description
Time from randomisation to a sustained clinical improvement (maintained for 24 hours) by two points on a seven-category ordinal scale or to discharge, whichever occurs first The seven-category ordinal scale is : Not hospitalised with resumption of normal activities Not hospitalised, but unable to resume normal Hospitalised, not requiring supplemental oxygen Hospitalised, requiring supplemental oxygen Hospitalised, requiring nasal high-flow oxygen therapy, non-invasive mechanical ventilation or both Hospitalised, requiring ECMO (Extra-corporal membrane oxygenation), invasive mechanical ventilation or both Death
Time Frame
Up to 28 days from randomisation
Secondary Outcome Measure Information:
Title
Clinical status on a seven-category ordinal scale (Day 7)
Description
Clinical status of patients at given on the seven-category ordinal scale (see primary endpoint for scale)
Time Frame
Day 7 from randomisation
Title
Clinical status on a seven-category ordinal scale (Day 14)
Description
Clinical status of patients at given on the seven-category ordinal scale (see primary endpoint for scale)
Time Frame
Day 14 from randomisation
Title
Overall survival
Description
Survival of patients to end of study
Time Frame
28 days from randomisation
Title
Time to improvement by two points on the NEWS score
Description
Time from randomisation to improvement by two points on the NEWS score of patient condition, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time Frame
Up to 28 days from randomisation
Title
Time to improvement by two points on the NEWS element score for temperature
Description
Time from randomisation to improvement by two points on the NEWS element score for temperature, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time Frame
Up to 28 days from randomisation
Title
Time to improvement by two points on the NEWS element score for heartrate
Description
Time from randomisation to improvement by two points on the NEWS element score for heartrate, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time Frame
Up to 28 days from randomisation
Title
Time to improvement by two points on the NEWS element score for respiratory rate
Description
Time from randomisation to improvement by two points on the NEWS element score for respiratory rate, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time Frame
Up to 28 days from randomisation
Title
Time to improvement by two points on the NEWS element score for oxygen saturation.
Description
Time from randomisation to improvement by two points on the NEWS element score for oxygen saturation, if maintained for 24 hours. For details of NEWS score see https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Time Frame
Up to 28 days from randomisation
Title
Admission to intensive care
Description
Frequency of admission of patients to intensive care
Time Frame
Up to 28 days from randomisation
Title
Requirement for mechanical ventilation
Description
Frequency of requirement to administer mechanical ventilation to patients
Time Frame
Up to 28 days from randomisation
Title
Requirement for non-invasive ventilation, continuous positive airways pressure or high-flow oxygen
Description
Frequency of requirement to administer non-invasive ventilation, continuous positive airways pressure or high-flow oxygen to patients
Time Frame
Up to 28 days from randomisation
Title
Incidence of bacterial or fungal infection
Description
Frequency of culture-confirmed bacterial or fungal infection in patients
Time Frame
Up to 28 days from randomisation
Title
Incidence of adverse events not directly caused by COVID-19 infection.
Description
Frequency and severity of adverse events in patients not directly attributed by clinicians to COVID-19 infection.
Time Frame
Up to 28 days from randomisation.
Other Pre-specified Outcome Measures:
Title
Readmission to inpatient care
Description
Frequency of readmission to inpatient care of patients discharged from hospital.
Time Frame
Up to 28 days from randomisation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult participants: Signed informed consent New admission to hospital for period expected to last ≥ 1 night Suspected or confirmed COVID-19 infection Patients are suspected of COVID-19 infection if they have the following: · Influenza like illness (fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset: persistent cough, hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing or sneezing). And · Finding from either a chest x-ray or CT suggestive of Covid-19 infection And · Alternative causes are considered unlikely For women to be eligible to enter and participate in the study they should be: of non-child-bearing potential defined as either post-menopausal (12 months of spontaneous amenorrhea and ≥ 45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or, or of child-bearing potential have a negative pregnancy test at screening and agrees to remain sexually abstinent or use a method of contraception with a failure rate of < 1% per year as indicated in Appendix B during the treatment and for a period of 7 days after the last dose. Hormonal contraceptive methods must be supplemented by a barrier method. Men who are sexually active must use an adequate method of contraception as listed in Appendix B, for a period of at least 7 days after the last dose Exclusion Criteria: Pregnant or breast feeding, due to potential teratogenicity Hepatic impairment - (AST or ALT > 3.5 x upper limit of normal) Presently enrolled in an interventional drug study Unable to take medication via the oral or nasogastric route Known sensitivity Favipiravir
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pallav Shah
Organizational Affiliation
Chelsea and Westminster NHS Foundation Trust
Official's Role
Principal Investigator
Facility Information:
Facility Name
Grupo Hospitalar Conceição
City
Porto Alegre
Country
Brazil
Facility Name
Fundação Oswaldo Cruz - Instituto Nacional de Infectologia Evandro Chagas (Fiocruz/INI)
City
Rio De Janeiro
Country
Brazil
Facility Name
Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran
City
Mexico City
Country
Mexico
Facility Name
Hull University Teaching Hospitals NHS Trust - Castle Hill Hospital
City
Hull
Country
United Kingdom
Facility Name
Chelsea and Westminster Hospital
City
London
Country
United Kingdom
Facility Name
West Middlesex University Hospital
City
London
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Research team wishes to enable any meta-analyses of COVID-19 trials making appropriate requests. No plan to share IPD has been made at this time.

Learn more about this trial

Early Intervention in COVID-19: Favipiravir Verses Standard Care

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