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LB1148 for Pulmonary Dysfunction Associated With COVID-19 Pneumonia

Primary Purpose

COVID-19, Coronavirus Disease 2019, Covid19

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
LB1148
Placebo
Sponsored by
Leading BioSciences, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19

Eligibility Criteria

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

Inclusion Criteria:

  1. Adult patients (18 years of age or older) with the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, confirmed via an established standard reverse transcriptase polymerase chain reaction (RT-PCR) assay.
  2. Patient or patient's legally authorized representative is willing and able to provide informed consent prior to performing any study-related procedures.
  3. Patient is hospitalized and requires some form of supplemental oxygen, e.g., non-invasive ventilation, high flow oxygen device, or oxygen by mask or nasal cannula.
  4. Patient has radiographic evidence of pulmonary infiltrate(s) or lung inflammation.

Exclusion Criteria:

  1. Participation in any other interventional clinical trial using an experimental treatment (drug or device) for COVID-19.
  2. Expected survival or time to withdrawal of life-sustaining treatments is expected to be < 7 days.
  3. Patients with do not intubate orders.
  4. Patients who require invasive mechanical ventilation at the time of Screening.
  5. Patients who require renal replacement therapy (RRT) at the time of Screening.
  6. Patients with known aspiration problems.
  7. Has contraindications or potential risk factors to taking TXA. These include patients with:

    1. Known sensitivity to TXA;
    2. Recent craniotomy (past 30 days);
    3. Active cerebrovascular bleed;
    4. Active thromboembolic disease (such as deep vein thrombosis, pulmonary embolism, cerebral thrombosis, ischemic stroke, or acute coronary syndrome);
    5. Acute promyelocytic leukemia taking all-trans retinoic acid for remission induction
    6. Continuing use of a combined hormonal contraceptive and or combined hormonal replacement therapy (including combined hormonal pill, patch, or vaginal ring).
    7. Concomitant therapy with tissue plasminogen activators, Factor IX complex concentrates or anti-inhibitor coagulant concentrates.
  8. Known medical history of congenital or acquired thrombophilia such as, but not limited to patients with:

    1. Sickle cell disease
    2. Nephrotic syndrome
    3. Factor V Leiden
    4. Prothrombin gene mutation
    5. Protein C or S deficiency
    6. Antithrombin III deficiency
    7. Antiphospholipid syndrome
  9. Patients with myeloproliferative disorders.
  10. Any other condition that, in the opinion of the treating Investigator, would preclude the patient from being an appropriate candidate for the study.
  11. Female patients who are pregnant or breastfeeding at the time of Screening.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    LB1148

    Placebo

    Arm Description

    LB1148 contains 7.5 g TXA, polyethylene glycol (PEG), glucose, and electrolytes. A total of 700 mL of LB1148 Active will be administered daily as a split dose (350 mL, every 12 hours) for up to 7 days. LB1148 Active is given as a single bolus, to be delivered orally or enterally via NG/OG tube, and should be fully consumed or delivered within 2 hours of the start of administration.

    Placebo contains polyethylene glycol (PEG), glucose, and electrolytes. A total of 700 mL of LB1148 Placebo will be administered daily as a split dose (350 mL, every 12 hours) for up to 7 days. LB1148 Placebo is given as a single bolus, to be delivered orally or enterally via NG/OG tube, and should be fully consumed or delivered within 2 hours of the start of administration.

    Outcomes

    Primary Outcome Measures

    Effect of LB1148 on disease progression via measurement of the proportion of patients who are alive and free of respiratory failure.
    The proportion of subjects alive and free of respiratory failure at Day 28.

    Secondary Outcome Measures

    Clinical status at fixed time points
    Number and proportion of patients with improved clinical status as assessed by a 9-point ordinal scale of disease severity at fixed timepoints (Days 3, 5, 7, 8, 10, 14, 28)
    Duration of hospital stay
    Length of hospital stay (live discharge)
    Measurement of the number and proportion of patients requiring admission to the intensive care unit (ICU) during hospitalization
    Number and proportion of patients requiring admission to the intensive care unit
    Duration of ICU stay
    Length of ICU stay
    Invasive mechanical ventilation requirements
    Number and proportion of patients requiring invasive mechanical ventilation
    Duration of invasive mechanical ventilation
    Length of time patients require invasive mechanical ventilation
    All-cause 28-day mortality
    The number and proportion of patients deceased at Day 28
    Safety and tolerability of LB1148
    The incidence and severity of treatment emergent adverse events (TEAEs) and serious adverse events (SAEs)

    Full Information

    First Posted
    May 13, 2020
    Last Updated
    May 9, 2022
    Sponsor
    Leading BioSciences, Inc
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04390217
    Brief Title
    LB1148 for Pulmonary Dysfunction Associated With COVID-19 Pneumonia
    Official Title
    A Phase 2 Study to Evaluate LB1148 for the Treatment of Pulmonary Dysfunction Associated With COVID-19 Pneumonia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Company focused on other clinical programs
    Study Start Date
    October 31, 2021 (Anticipated)
    Primary Completion Date
    December 31, 2021 (Anticipated)
    Study Completion Date
    March 31, 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Leading BioSciences, Inc

    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 Phase 2, proof of concept, randomized, placebo-controlled, multicenter study to evaluate the ability of LB1148 to attenuate pulmonary dysfunction associated with COVID-19 pneumonia. The primary objective of this study is to determine if enteral administration of LB1148 will effect disease progression in hospitalized patients with moderate to severe COVID-19 via measurement of the proportion of subjects alive and free of respiratory failure at Day 28.
    Detailed Description
    The purpose of this study is to establish the safety and tolerability, along with preliminary evidence of efficacy, of LB1148 compared to placebo in hospitalized patients with moderate to severe coronavirus disease (COVID-19). All patients will be randomized into one of two treatment groups (LB1148 or Placebo) in a 1:1 ratio, and stratified by peripheral capillary oxygen saturation (SpO2) ≥ 93% on room air vs. < 93% on room air, and by PF ratio (PaO2, arterial oxygen partial pressure, to FiO2, fractional inspired oxygen) of ≥ 300 mmHg vs. PF ratio of < 300 mmHg at the time of Screening. (If PaO2 cannot be measured or acquired, SpO2 may be substituted to calculate the PF ratio.) LB1148 contains 7.5 g tranexamic acid (TXA), polyethylene glycol (PEG), glucose, and electrolytes. A total of 700 mL of LB1148 will be administered enterally, as a split dose (350 mL, every 12 hours). Study drug is given as a single bolus, to be delivered orally or via nasogastric (NG) or orogastric (OG) tube. For those patients assigned to placebo, a total of 700 mL of placebo will be administered enterally, as a split dose (350 mL, every 12 hours). The placebo contains PEG, glucose, and electrolytes.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    COVID-19, Coronavirus Disease 2019, Covid19, COVID-19 Pneumonia

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    All patients will be randomized into one of two treatment groups (LB1148 or Placebo) in a 1:1 ratio, and stratified by peripheral capillary oxygen saturation and by PF ratio at the time of Screening.
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Masking Description
    Quadruple blinding including the sponsor and all sponsor agents, subjects, investigators, care providers, and family members.
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    LB1148
    Arm Type
    Experimental
    Arm Description
    LB1148 contains 7.5 g TXA, polyethylene glycol (PEG), glucose, and electrolytes. A total of 700 mL of LB1148 Active will be administered daily as a split dose (350 mL, every 12 hours) for up to 7 days. LB1148 Active is given as a single bolus, to be delivered orally or enterally via NG/OG tube, and should be fully consumed or delivered within 2 hours of the start of administration.
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo contains polyethylene glycol (PEG), glucose, and electrolytes. A total of 700 mL of LB1148 Placebo will be administered daily as a split dose (350 mL, every 12 hours) for up to 7 days. LB1148 Placebo is given as a single bolus, to be delivered orally or enterally via NG/OG tube, and should be fully consumed or delivered within 2 hours of the start of administration.
    Intervention Type
    Drug
    Intervention Name(s)
    LB1148
    Other Intervention Name(s)
    tranexamic acid (TXA)
    Intervention Description
    LB1148 is delivered orally/enterally, 700 mL per day split into two administrations of 350 mL, approximately 12 hours apart, for up to 7 days.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo is delivered orally/enterally, 700 mL per day split into two administrations of 350 mL, approximately 12 hours apart, for up to 7 days.
    Primary Outcome Measure Information:
    Title
    Effect of LB1148 on disease progression via measurement of the proportion of patients who are alive and free of respiratory failure.
    Description
    The proportion of subjects alive and free of respiratory failure at Day 28.
    Time Frame
    28 Days
    Secondary Outcome Measure Information:
    Title
    Clinical status at fixed time points
    Description
    Number and proportion of patients with improved clinical status as assessed by a 9-point ordinal scale of disease severity at fixed timepoints (Days 3, 5, 7, 8, 10, 14, 28)
    Time Frame
    Measured at 3, 5, 7, 8, 10, 14 and 28 Days
    Title
    Duration of hospital stay
    Description
    Length of hospital stay (live discharge)
    Time Frame
    28 Days
    Title
    Measurement of the number and proportion of patients requiring admission to the intensive care unit (ICU) during hospitalization
    Description
    Number and proportion of patients requiring admission to the intensive care unit
    Time Frame
    28 Days
    Title
    Duration of ICU stay
    Description
    Length of ICU stay
    Time Frame
    28 Days
    Title
    Invasive mechanical ventilation requirements
    Description
    Number and proportion of patients requiring invasive mechanical ventilation
    Time Frame
    28 Days
    Title
    Duration of invasive mechanical ventilation
    Description
    Length of time patients require invasive mechanical ventilation
    Time Frame
    28 Days
    Title
    All-cause 28-day mortality
    Description
    The number and proportion of patients deceased at Day 28
    Time Frame
    28 Days
    Title
    Safety and tolerability of LB1148
    Description
    The incidence and severity of treatment emergent adverse events (TEAEs) and serious adverse events (SAEs)
    Time Frame
    28 Days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Adult patients (18 years of age or older) with the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, confirmed via an established standard reverse transcriptase polymerase chain reaction (RT-PCR) assay. Patient or patient's legally authorized representative is willing and able to provide informed consent prior to performing any study-related procedures. Patient is hospitalized and requires some form of supplemental oxygen, e.g., non-invasive ventilation, high flow oxygen device, or oxygen by mask or nasal cannula. Patient has radiographic evidence of pulmonary infiltrate(s) or lung inflammation. Exclusion Criteria: Participation in any other interventional clinical trial using an experimental treatment (drug or device) for COVID-19. Expected survival or time to withdrawal of life-sustaining treatments is expected to be < 7 days. Patients with do not intubate orders. Patients who require invasive mechanical ventilation at the time of Screening. Patients who require renal replacement therapy (RRT) at the time of Screening. Patients with known aspiration problems. Has contraindications or potential risk factors to taking TXA. These include patients with: Known sensitivity to TXA; Recent craniotomy (past 30 days); Active cerebrovascular bleed; Active thromboembolic disease (such as deep vein thrombosis, pulmonary embolism, cerebral thrombosis, ischemic stroke, or acute coronary syndrome); Acute promyelocytic leukemia taking all-trans retinoic acid for remission induction Continuing use of a combined hormonal contraceptive and or combined hormonal replacement therapy (including combined hormonal pill, patch, or vaginal ring). Concomitant therapy with tissue plasminogen activators, Factor IX complex concentrates or anti-inhibitor coagulant concentrates. Known medical history of congenital or acquired thrombophilia such as, but not limited to patients with: Sickle cell disease Nephrotic syndrome Factor V Leiden Prothrombin gene mutation Protein C or S deficiency Antithrombin III deficiency Antiphospholipid syndrome Patients with myeloproliferative disorders. Any other condition that, in the opinion of the treating Investigator, would preclude the patient from being an appropriate candidate for the study. Female patients who are pregnant or breastfeeding at the time of Screening.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Michael J Dawson, MD
    Organizational Affiliation
    Leading BioSciences, Inc
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    LB1148 for Pulmonary Dysfunction Associated With COVID-19 Pneumonia

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