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Testing the Efficacy and Safety of BIO101 for the Prevention of Respiratory Deterioration in COVID-19 Patients (COVA)

Primary Purpose

Covid-19, SARS-CoV2

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
BIO101
Placebo
Sponsored by
Biophytis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid-19

Eligibility Criteria

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

Inclusion Criteria:

  1. Age: 45 and older (in France: 55 and older)
  2. A confirmed diagnosis of COVID-19 infection, within the last 28 days, prior to randomization, as determined by PCR or other approved commercial or public health assay, in a specimen as specified by the test used.
  3. Hospitalized, in observation or planned to be hospitalized due to COVID-19 infection symptoms with anticipated hospitalization duration >=3 days

    a. Patients can be included even if treated with: oxygen supplementation, High-flow oxygen (HFO2), BiPAP and CPAP

  4. With evidence of pneumonia based on all of the following:

    1. Clinical findings on a physical examination
    2. Respiratory symptoms developed within the past 14 days
  5. With evidence of respiratory decompensation that started not more than 7 days before start of study medication and present at screening, meeting one of the following criteria, as assessed by healthcare staff:

    1. Tachypnea: ≥25 breaths per minute
    2. Arterial oxygen saturation ≤92%
    3. A special note should be made if there is suspicion of COVID-19- related myocarditis or pericarditis, as the presence of these is a stratification criterion
  6. Without a significant deterioration in liver function tests:

    1. ALT and AST ≤ 5x upper limit of normal (ULN)
    2. Gamma-glutamyl transferase (GGT) ≤ 5x ULN
    3. Total bilirubin ≤ 5×ULN
  7. Willing to participate and able to sign an informed consent form (ICF)
  8. Female subjects should be:

    at least 5 years post-menopausal (i.e., persistent amenorrhea 5 years in the absence of an alternative medical cause) or surgically sterile; OR

    1. Have a negative urine pregnancy test at screening
    2. Be willing to use a contraceptive method as outlined in inclusion criterion 9 from screening to 30 days after last dose.
  9. Male subjects who are sexually active with a female partner must agree to the use of an effective method of birth control throughout the study and until 3 months after the last administration of investigational product; Note: medically acceptable methods of contraception that may be used by the subject and/or partner include combined oral contraceptive, contraceptive vaginal ring, contraceptive injection, intrauterine device, etonogestrel implant, each supplemented with a condom, as well as sterilization and vasectomy.
  10. Male subjects must agree not to donate sperm for the purpose of reproduction throughout the study and until 3 months after the last administration of investigational product;
  11. For France only: Being affiliated with a European Social Security.

Exclusion Criteria:

  1. Not needing or not willing to remain in a healthcare facility during the entire study medication (i.e. while receiving study medication)
  2. Moribund condition (death likely in days) or not expected to survive for >7 days - due to other and non-COVID-19 related conditions
  3. Patient on invasive mechanical ventilation via an endotracheal tube, or extracorporeal membrane oxygenation (ECMO)
  4. Patient within 7 days of participating in other therapeutic clinical trial with angiotensin-converting-enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB) or recombinant ACE-2
  5. Patient not able to take medications by mouth (as capsules or as a powder, mixed in water).
  6. Disallowed concomitant medication:

    a. Consumption of any herbal products containing 20-hydroxyecdysone and derived from Leuzea carthamoides; Cyanotis vaga or Cyanotis arachnoidea is not allowed (e.g. performance enhancing agents)

  7. Any known hypersensitivity to any of the ingredients, or excipients of the study medication, BIO101
  8. In France:

    • Non-affiliation to compulsory French social security scheme (beneficiary or right-holder)
    • Being under tutelage or legal guardianship

Sites / Locations

  • Abrazo Health
  • University of California, Irvine
  • Barnum Medical Research, Inc. 1029 Keyser Ave Suite H
  • Beaumont Health
  • United Health Services Hospitals
  • WellSpan Health
  • CHU Saint-Pierre
  • CHU Saint-Pierre
  • AZ-Sint Maarten
  • CHU CLU Namur (Saint-Elisabeth) Place Louise Godin
  • Hospital Vera Cruz
  • Santa Casa de Porto Alegre
  • Hospital Municipal de Barueri Dr. Francisco Moran
  • Hospital e Maternidade Celso Pierro - PUCCAMP
  • Hospital de Base Da Faculdade de Medicina de São José Do Rio Preto
  • Avenida Dr. Enéas de Carvalho Aguiar, 44 - Centro de Pesquisa Clínica Prof. Dr. Fúlvio Pileggi - Bloco 1 - 1º Andar
  • Unité ambulatoire Service de Pneumologie, Médecine Intensive et Réanimation (SPMIR) 47-83 Boulevard de l'Hôpital
  • Centre Hospitalier Argenteuil
  • Centre Hospitalier Universitaire Bordeaux
  • Centre Hospitalier Rene Dubos
  • Centre Hospitalier Départemental de Vendée
  • Hôpital Pitié-Salpêtrière, 47 bd de l'Hôpital, 75013 Paris
  • FDI Clinical Research - San Juan City Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

BIO101

Placebo

Arm Description

BIO101 350 mg bid

Placebo

Outcomes

Primary Outcome Measures

End-of-Part 1 interim analysis: Proportion of subjects with all cause mortality or with respiratory failure.
For interim analysis intended to obtain indication of activity of BIO101. Primary endpoint: • Proportion of subjects with negative events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
For part-2 sample size interim analysis: Proportion of subjects with all cause mortality or with respiratory failure.
For sample size re-assessment for part 2, time frame - up to 28 days: • Proportion of participants with negative events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
For the final analysis: Proportion of subjects with all cause mortality or respiratory failure.
• Proportion of participants with of subjects with negative events, of either of the following. All-cause mortality Respiratory failure, defined as any of the following: Mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO

Secondary Outcome Measures

Interim analysis; indication of activity of BIO101: Oxygen saturation by pulse oximetry (SpO2) SpO2 / Fraction of inspired oxygen (FiO2) ratio
• SpO2/FiO2
Interim analysis; indication of activity of BIO101: Inflammatory markers
• Inflammatory markers including: IL 6 TNFα D-dimer
Interim analysis; indication of activity of BIO101: Renin Angiotensin System biomarkers
• Renin Angiotensin System biomarkers: Angiotensin 2 Angiotensin-converting enzyme (ACE) levels
Key secondary endpoint for final analysis: Proportion of participants with positive events
• official discharge from hospital care by the department due to improvement in participant condition (self-discharge by participant is not considered a positive event)
Additional secondary endpoints for final analysis: Respiratory function
Oxygen saturation in arterial blood, measured by pulse-oximetry (SpO2) SpO2/FiO2 Proportion of participants with CPAP/BiPAP events, defined as requiring CPAP/BiPAP/HFO2 in participants entering the study on low flow oxygen)
Additional secondary endpoints for final analysis:proportion of patients who experienced negative events
Time to events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage); Requiring ECMO; • Proportion of participants with CPAP/BiPAP/HFO2 events, defined as requiring CPAP/BiPAP/HFO2 in participants entering the study on low flow oxygen)
Additional secondary endpoint for final analysis: The National Early Warning Score 2 (NewS2):
National Early Warning Score 2 (NewS2): scores: 0-7
Additional secondary endpoint for final analysis: Population Pharmacokinetics study (pop-PK)
Cmax: Peak Plasma concentration
Additional secondary endpoint : Population Pharmacokinetics study (pop-PK)
tmax: Time to reach peak plasma concentration
Additional secondary endpoint: Population Pharmacokinetics study (pop-PK)
AUC: Area under the plasma concentration versus time curve
Additional secondary endpoint: Proportion of participants with events of all-cause mortality
Proportion of participants with events of all-cause mortality
Additional secondary endpoint: time to event: negative events
Time to events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
Additional secondary endpoint: time to event: positive events
Time to event: official discharge from hospital care due to improvement

Full Information

First Posted
July 6, 2020
Last Updated
May 12, 2023
Sponsor
Biophytis
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1. Study Identification

Unique Protocol Identification Number
NCT04472728
Brief Title
Testing the Efficacy and Safety of BIO101 for the Prevention of Respiratory Deterioration in COVID-19 Patients
Acronym
COVA
Official Title
Adaptive Design Phase 2 to 3, Randomized, Double-blind, to Evaluate Safety, Efficacy, Pharmacokinetics and Pharmacodynamics of BIO101 in the Prevention of the Respiratory Deterioration in Hospitalized COVID-19 Patients
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Terminated
Why Stopped
Lack of eligible patients due to lower number of Covid-19 cases in all involved sites.
Study Start Date
August 26, 2020 (Actual)
Primary Completion Date
June 6, 2022 (Actual)
Study Completion Date
September 30, 2022 (Actual)

3. Sponsor/Collaborators

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

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
The COVA clinical study is a global multicentric, double-blind, placebo-controlled, group sequential and adaptive 2 parts phase 2-3 study targeting in patients with SARS-CoV-2 pneumonia. Part 1 is a Phase 2 exploratory Proof of Concept (PoC) study to provide preliminary data on the activity, safety and tolerability of BIO101 in the target population. Part 2 is a phase 3 pivotal randomized study to provide further evidence of safety and efficacy of BIO101 after 28 days of double-blind dosing. BIO101 is the investigational new drug that activates the Mas receptor (MasR) through the protective arm of the Renin Angiotensin System (RAS).
Detailed Description
Biophytis is developing BIO101, an investigational new drug, an oral preparation of immediate-release 20-hydroxyecdysone (20E) at ≥ 97% purity. BIO101 activates MasR on the protective arm of the Renin Angiotensin System (RAS). The engagement of MasR by BIO101 is responsible for a number of preclinical beneficial activities in normal and pathological contexts. The COVA clinical study is a global, multicentric, double-blind, placebo-controlled, group sequential and adaptive 2 parts phase 2-3 study in participants with SARS-CoV-2 pneumonia. Part 1 is a Phase 2 exploratory Proof of Concept (PoC) study to provide preliminary data on the activity, safety and tolerability of BIO101 in the target population. Part 2 is a phase 3 pivotal randomized study to provide further evidence of safety and efficacy of BIO101 after 28 days of dosing. The trial will use an adaptive design based on pre-specified criteria, using an independent external Data Monitoring Committee (DMC) to monitor safety, efficacy, and review data at appropriate intervals to allow the initiation of the confirmatory part of the study. The general objectives of the study are: The purpose of Part 1 is to obtain preliminary indication of activity of BIO101, in preventing respiratory deterioration in the target population (50 patients, age ≥ 55 years) and provide preliminary data on the safety and tolerability of BIO101 in the target population The purpose of Part 2 is to re-assess the sample size that is needed for the confirmatory part of the study and to provide confirmation on the benefit of BIO101 and safety in the larger target population (up to 310 patients)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid-19, SARS-CoV2

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
BIO101
Arm Type
Experimental
Arm Description
BIO101 350 mg bid
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
BIO101
Other Intervention Name(s)
Sarconeos (BIO101)
Intervention Description
BIO101 capsules
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Sarconeos (placebo)
Intervention Description
placebo capsules
Primary Outcome Measure Information:
Title
End-of-Part 1 interim analysis: Proportion of subjects with all cause mortality or with respiratory failure.
Description
For interim analysis intended to obtain indication of activity of BIO101. Primary endpoint: • Proportion of subjects with negative events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
Time Frame
up to 28 days
Title
For part-2 sample size interim analysis: Proportion of subjects with all cause mortality or with respiratory failure.
Description
For sample size re-assessment for part 2, time frame - up to 28 days: • Proportion of participants with negative events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
Time Frame
up to 28 days
Title
For the final analysis: Proportion of subjects with all cause mortality or respiratory failure.
Description
• Proportion of participants with of subjects with negative events, of either of the following. All-cause mortality Respiratory failure, defined as any of the following: Mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
Time Frame
up to 28 days
Secondary Outcome Measure Information:
Title
Interim analysis; indication of activity of BIO101: Oxygen saturation by pulse oximetry (SpO2) SpO2 / Fraction of inspired oxygen (FiO2) ratio
Description
• SpO2/FiO2
Time Frame
28 days
Title
Interim analysis; indication of activity of BIO101: Inflammatory markers
Description
• Inflammatory markers including: IL 6 TNFα D-dimer
Time Frame
28 days
Title
Interim analysis; indication of activity of BIO101: Renin Angiotensin System biomarkers
Description
• Renin Angiotensin System biomarkers: Angiotensin 2 Angiotensin-converting enzyme (ACE) levels
Time Frame
28 days
Title
Key secondary endpoint for final analysis: Proportion of participants with positive events
Description
• official discharge from hospital care by the department due to improvement in participant condition (self-discharge by participant is not considered a positive event)
Time Frame
Up to 28 days
Title
Additional secondary endpoints for final analysis: Respiratory function
Description
Oxygen saturation in arterial blood, measured by pulse-oximetry (SpO2) SpO2/FiO2 Proportion of participants with CPAP/BiPAP events, defined as requiring CPAP/BiPAP/HFO2 in participants entering the study on low flow oxygen)
Time Frame
28 days
Title
Additional secondary endpoints for final analysis:proportion of patients who experienced negative events
Description
Time to events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage); Requiring ECMO; • Proportion of participants with CPAP/BiPAP/HFO2 events, defined as requiring CPAP/BiPAP/HFO2 in participants entering the study on low flow oxygen)
Time Frame
28 days
Title
Additional secondary endpoint for final analysis: The National Early Warning Score 2 (NewS2):
Description
National Early Warning Score 2 (NewS2): scores: 0-7
Time Frame
28 days
Title
Additional secondary endpoint for final analysis: Population Pharmacokinetics study (pop-PK)
Description
Cmax: Peak Plasma concentration
Time Frame
1day
Title
Additional secondary endpoint : Population Pharmacokinetics study (pop-PK)
Description
tmax: Time to reach peak plasma concentration
Time Frame
1 day
Title
Additional secondary endpoint: Population Pharmacokinetics study (pop-PK)
Description
AUC: Area under the plasma concentration versus time curve
Time Frame
1 day
Title
Additional secondary endpoint: Proportion of participants with events of all-cause mortality
Description
Proportion of participants with events of all-cause mortality
Time Frame
Up to 28 days
Title
Additional secondary endpoint: time to event: negative events
Description
Time to events, of either of the following: All-cause mortality Respiratory failure, defined as any of the following: Requiring mechanical ventilation (including cases that will not be intubated due to resource restrictions and triage) Requiring ECMO
Time Frame
Up to 28 days
Title
Additional secondary endpoint: time to event: positive events
Description
Time to event: official discharge from hospital care due to improvement
Time Frame
Up to 28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age: 45 and older (in France: 55 and older) A confirmed diagnosis of COVID-19 infection, within the last 28 days, prior to randomization, as determined by PCR or other approved commercial or public health assay, in a specimen as specified by the test used. Hospitalized, in observation or planned to be hospitalized due to COVID-19 infection symptoms with anticipated hospitalization duration >=3 days a. Patients can be included even if treated with: oxygen supplementation, High-flow oxygen (HFO2), BiPAP and CPAP With evidence of pneumonia based on all of the following: Clinical findings on a physical examination Respiratory symptoms developed within the past 14 days With evidence of respiratory decompensation that started not more than 7 days before start of study medication and present at screening, meeting one of the following criteria, as assessed by healthcare staff: Tachypnea: ≥25 breaths per minute Arterial oxygen saturation ≤92% A special note should be made if there is suspicion of COVID-19- related myocarditis or pericarditis, as the presence of these is a stratification criterion Without a significant deterioration in liver function tests: ALT and AST ≤ 5x upper limit of normal (ULN) Gamma-glutamyl transferase (GGT) ≤ 5x ULN Total bilirubin ≤ 5×ULN Willing to participate and able to sign an informed consent form (ICF) Female subjects should be: at least 5 years post-menopausal (i.e., persistent amenorrhea 5 years in the absence of an alternative medical cause) or surgically sterile; OR Have a negative urine pregnancy test at screening Be willing to use a contraceptive method as outlined in inclusion criterion 9 from screening to 30 days after last dose. Male subjects who are sexually active with a female partner must agree to the use of an effective method of birth control throughout the study and until 3 months after the last administration of investigational product; Note: medically acceptable methods of contraception that may be used by the subject and/or partner include combined oral contraceptive, contraceptive vaginal ring, contraceptive injection, intrauterine device, etonogestrel implant, each supplemented with a condom, as well as sterilization and vasectomy. Male subjects must agree not to donate sperm for the purpose of reproduction throughout the study and until 3 months after the last administration of investigational product; For France only: Being affiliated with a European Social Security. Exclusion Criteria: Not needing or not willing to remain in a healthcare facility during the entire study medication (i.e. while receiving study medication) Moribund condition (death likely in days) or not expected to survive for >7 days - due to other and non-COVID-19 related conditions Patient on invasive mechanical ventilation via an endotracheal tube, or extracorporeal membrane oxygenation (ECMO) Patient within 7 days of participating in other therapeutic clinical trial with angiotensin-converting-enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB) or recombinant ACE-2 Patient not able to take medications by mouth (as capsules or as a powder, mixed in water). Disallowed concomitant medication: a. Consumption of any herbal products containing 20-hydroxyecdysone and derived from Leuzea carthamoides; Cyanotis vaga or Cyanotis arachnoidea is not allowed (e.g. performance enhancing agents) Any known hypersensitivity to any of the ingredients, or excipients of the study medication, BIO101 In France: Non-affiliation to compulsory French social security scheme (beneficiary or right-holder) Being under tutelage or legal guardianship
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Capucine Morelot-Panzini, MD
Organizational Affiliation
Département R3S GHU APHP-Sorbonne Université, Pitié Salpetrière
Official's Role
Principal Investigator
Facility Information:
Facility Name
Abrazo Health
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85015
Country
United States
Facility Name
University of California, Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
Barnum Medical Research, Inc. 1029 Keyser Ave Suite H
City
Natchitoches
State/Province
Louisiana
ZIP/Postal Code
71457
Country
United States
Facility Name
Beaumont Health
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
United Health Services Hospitals
City
Johnson City
State/Province
New York
ZIP/Postal Code
13903
Country
United States
Facility Name
WellSpan Health
City
York
State/Province
Pennsylvania
ZIP/Postal Code
17403
Country
United States
Facility Name
CHU Saint-Pierre
City
Brussels
Country
Belgium
Facility Name
CHU Saint-Pierre
City
Brussel
Country
Belgium
Facility Name
AZ-Sint Maarten
City
Mechelen
ZIP/Postal Code
2800
Country
Belgium
Facility Name
CHU CLU Namur (Saint-Elisabeth) Place Louise Godin
City
Namur
ZIP/Postal Code
15 5000
Country
Belgium
Facility Name
Hospital Vera Cruz
City
Belo Horizonte
State/Province
Minas Gerais
Country
Brazil
Facility Name
Santa Casa de Porto Alegre
City
Porto Alegre
State/Province
Rio Grande Do Sul
Country
Brazil
Facility Name
Hospital Municipal de Barueri Dr. Francisco Moran
City
Barueri
State/Province
São Paulo
Country
Brazil
Facility Name
Hospital e Maternidade Celso Pierro - PUCCAMP
City
Campinas
State/Province
São Paulo
Country
Brazil
Facility Name
Hospital de Base Da Faculdade de Medicina de São José Do Rio Preto
City
São José Do Rio Preto
State/Province
São Paulo
Country
Brazil
Facility Name
Avenida Dr. Enéas de Carvalho Aguiar, 44 - Centro de Pesquisa Clínica Prof. Dr. Fúlvio Pileggi - Bloco 1 - 1º Andar
City
São Paulo
ZIP/Postal Code
103.034
Country
Brazil
Facility Name
Unité ambulatoire Service de Pneumologie, Médecine Intensive et Réanimation (SPMIR) 47-83 Boulevard de l'Hôpital
City
Paris
State/Province
Paris Cedex 13
ZIP/Postal Code
75651
Country
France
Facility Name
Centre Hospitalier Argenteuil
City
Argenteuil
Country
France
Facility Name
Centre Hospitalier Universitaire Bordeaux
City
Bordeaux
Country
France
Facility Name
Centre Hospitalier Rene Dubos
City
Cergy-Pontoise
Country
France
Facility Name
Centre Hospitalier Départemental de Vendée
City
La Roche-sur-Yon
Country
France
Facility Name
Hôpital Pitié-Salpêtrière, 47 bd de l'Hôpital, 75013 Paris
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
FDI Clinical Research - San Juan City Hospital
City
San Juan
ZIP/Postal Code
00927
Country
Puerto Rico

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33430924
Citation
Dioh W, Chabane M, Tourette C, Azbekyan A, Morelot-Panzini C, Hajjar LA, Lins M, Nair GB, Whitehouse T, Mariani J, Latil M, Camelo S, Lafont R, Dilda PJ, Veillet S, Agus S. Testing the efficacy and safety of BIO101, for the prevention of respiratory deterioration, in patients with COVID-19 pneumonia (COVA study): a structured summary of a study protocol for a randomised controlled trial. Trials. 2021 Jan 11;22(1):42. doi: 10.1186/s13063-020-04998-5.
Results Reference
derived

Learn more about this trial

Testing the Efficacy and Safety of BIO101 for the Prevention of Respiratory Deterioration in COVID-19 Patients

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