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Study of Efficacy and Safety of TL-FVP-t vs. SOC in Patients With Mild to Moderate COVID-19

Primary Purpose

COVID-19

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
Favipiravir
Standard of care (SOC)
standard concomitant therapy
Sponsored by
R-Pharm
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, 2019-nCoV, 2019 novel coronavirus, Respiratory disease, lung disease

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Informed consent form signed.
  2. Males and females aged 18-60 years;
  3. Diagnosis of coronavirus disease caused by SARS-CoV-2 (COVID-19) in a mild or moderate form (without respiratory failure).
  4. Duration of infection symptoms shall be no more than 6 days before randomization.
  5. SARS-CoV-2 infection should be verified by PCR at the screening.
  6. Ability to follow the protocol and fulfill all the clinical study procedures.
  7. Ability and willingness of the subjects and their sexual partners with retained childbearing potential to use reliable contraception methods throughout the study and for 3 months after the treatment completion.
  8. Willingness not to take alcohol throughout the study.

Exclusion Criteria:

  1. Age < 18 and > 60 years.
  2. Any etiotropic therapy of coronavirus SARS-CoV-2 (COVID-19) infection prior to the study.
  3. Moderate infection with respiratory failure, severe or extremely severe SARS-CoV-2 (COVID-19) disease.
  4. Respiratory failure (RR > 30/min, SpO2 ≤ 93 %) or the need for mechanical ventilation at the screening.
  5. Decreased level of consciousness (disorientation of place, time and personality), agitation at the screening.
  6. Unstable hemodynamics (systolic BP < 100 mm Hg or diastolic BP < 60 mm Hg) found at the screening.
  7. Subtotal diffuse ground-glass induration of pulmonary tissue and pulmonary consolidation combined with reticular changes; involvement of ≥ 75 % of lung parenchyma; hydrothorax (CT findings corresponding to ≥ CT-4 according to Department of Health of Moscow guidelines).
  8. Presence of comorbidities:

    1. moderate or severe chronic obstructive pulmonary disease or asthma;
    2. severe chronic cardiovascular disorders (arrhythmia or conduction disorders, implanted pacemaker device, myocardial infarction or unstable angina in the medical history, heart failure);
    3. immunocompromised subjects (HIV, cancer, autoimmune diseases, immunodepressant therapy);
    4. severe obesity (body mass index [BMI] ≥ 40);
    5. diabetes mellitus;
    6. chronic renal failure;
    7. chronic moderate or severe hepatic disorders.
  9. Any of the following abnormal laboratory tests at the screening: AST or ALT level > 2.5 x upper normal level (UNL), platelet count < 50х109/L.
  10. Any history findings which, in the investigator's opinion, may complicate the interpretation of the study results or generate an additional risk for the subject due to his/her participation in the study.
  11. More than 2 CT diagnostic procedures within the last 6 months prior to randomization (except for chest CT no earlier than 4 days prior to enrollment).
  12. The subject takes the products significantly inhibiting CYP28С, and administration those products cannot be interrupted for the study duration.
  13. Malabsorption syndrome or another clinically relevant gastrointestinal disease which may affect the study product absorption (uncontrollable vomiting, diarrhea, ulcerative colitis, etc.).
  14. Pregnancy or breast-feeding; women with probable pregnancy at the screening, those planning to conceive during the study.
  15. Known (from the history) or suspected alcohol or psychotropic drug abuse; medicinal or illicit drug addiction.
  16. Mental disorders including those in the medical history.
  17. Condition or disease which, according to the investigator or medical monitor, will compromise the subject's safety or affect assessment of the study product safety.

Sites / Locations

  • Medical center LLC "Neuroprofi"
  • Federal budgetary institution of science "Central Research Institute of Epidemiology" of Russian Federal Supervision Service for Consumer Rights Protection and People's Welfare
  • Medical centers JSC "Medsi Group of Companies"
  • State budgetary institution of health care of the city of Moscow "City Clinical Hospital №52 of the Moscow City Healthcare Department"
  • State budgetary institution of health care of the city of Moscow "City Clinical Hospital №67 n.a. LA Vorokhobova of the Moscow City Healthcare Department"
  • State budgetary institution of health care of the city of Moscow "Infectious Diseases Clinical Hospital №1 of the Moscow City Healthcare Department"
  • Medical center LLC "Medical Center Eco-safety"
  • St. Petersburg State Budgetary Healthcare Institution "City Hospital No. 40 of the Kurortny District"
  • Budgetary healthcare institution of the Voronezh region "Voronezh Regional Clinical Hospital No. 1"
  • State Budgetary Healthcare Institution of the Moscow Region "Zhukovskaya City Clinical Hospital".

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

TL-FVP-t (favipiravir) Treatment Arm

Standard of Care Arm

Arm Description

Day 1: favipiravir 1800 mg BID plus Standard of Care (SOC); Days 2-10: 800 mg BID plus SOC.

Standard of Care including etiotropic therapy according to MoH of Russian Federation Recomendations for COVID-19 (umifenovir + intranasal recombinant interferon alpha, or hydroxychloroquine, or chloroquine, or mefloquine in recomended regimen) up to10 days

Outcomes

Primary Outcome Measures

Time to clinical improvement
To determine the effect of TL-FVP-t vs. SOC on time to clinical improvement. The clinical improvement is defined as reduction on at least 1 score of patient clinical status according to WHO 8-category Ordinal Scale for Clinical Improvement compared to screening
Time to viral clearance
To determine the effect of TL-FVP-t vs. SOC on time to viral clearance of SARS-CoV-2 virus as measured by PCR in oropharyngeal sampling

Secondary Outcome Measures

Rate of clinical improvement at separate time points
To determine the effect of TL-FVP-t vs. SOC on proportion of subjects (%) with clinical improvement according to WHO 8-category Ordinal Scale for Clinical Improvement
Rate of viral clearance at separate time points
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with viral clearance of SARS-CoV-2 virus as measured by PCR in oropharyngeal sampling at separate time points
Time to body temperature normalization
To determine the effect of TL-FVP-t vs. SOC on time to body temperature normalization determined as body temperature < 37°C without antipyretics for at least 48 hours.
Rate of resolution of lung changes on CT
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with resolution of lung changes on CT
Rate of adverse drug reactions (ADR) and serious ADR
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with ADR and serious ADR
Rate of severe ADR
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with severe ADR
Rate therapy termination due to ADR
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) discontinued therapy due ADR

Full Information

First Posted
August 5, 2020
Last Updated
January 18, 2023
Sponsor
R-Pharm
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1. Study Identification

Unique Protocol Identification Number
NCT04501783
Brief Title
Study of Efficacy and Safety of TL-FVP-t vs. SOC in Patients With Mild to Moderate COVID-19
Official Title
Randomized Open-label Multicenter Parallel-group Study of Efficacy and Safety of TL-FVP-t vs. Standard of Care Therapy in Patients With Mild to Moderate Coronavirus Disease (SARS-CoV-2/COVID-19)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
May 20, 2020 (Actual)
Primary Completion Date
July 29, 2020 (Actual)
Study Completion Date
August 4, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
R-Pharm

4. Oversight

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

5. Study Description

Brief Summary
Randomized open-label multicenter parallel-group study of efficacy and safety of TL-FVP-t vs. standard of care therapy in patients with mild to moderate coronavirus disease (SARS-CoV-2/COVID-19)
Detailed Description
This was an open label, randomized, controlled, multicenter Phase 3 study of TL-FVP-t in outpatients and inpatients with mild to moderate COVID-19. After stratification by the severity of their disease (mild or moderate), age (18-44 or ≥ 45 years) and CT severity subjects were randomized at a rate of 2:1 to receive either TL-FVP-t + standard concomitant therapy or standard ethiptropic therapy (standard of care - SOC) including standard concomitant therapy. Standard ethiptropic therapy according to MoH of Russian Federation included umifenovir + intranasal recombinant interferon alpha, hydroxichloroquine, or chloroquine. The dose regimen was the following: TL-FVP-t at a dose of 1800 mg BID on the Day 1 followed by 800 mg BID during the next 9 days. The study included the period of therapy (10 days) and follow-up period (18 days).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, 2019-nCoV, 2019 novel coronavirus, Respiratory disease, lung disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
168 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TL-FVP-t (favipiravir) Treatment Arm
Arm Type
Experimental
Arm Description
Day 1: favipiravir 1800 mg BID plus Standard of Care (SOC); Days 2-10: 800 mg BID plus SOC.
Arm Title
Standard of Care Arm
Arm Type
Active Comparator
Arm Description
Standard of Care including etiotropic therapy according to MoH of Russian Federation Recomendations for COVID-19 (umifenovir + intranasal recombinant interferon alpha, or hydroxychloroquine, or chloroquine, or mefloquine in recomended regimen) up to10 days
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Other Intervention Name(s)
TL-FVP-t, Koronavir
Intervention Description
TL-FVP-t will be administered orally
Intervention Type
Drug
Intervention Name(s)
Standard of care (SOC)
Intervention Description
SOC will include standard etiotropic therapy (umifenovir + intranasal recombinant interferon alpha, or hydroxychloroquine, or chloroquine) according to MoH of Russian Federation recomendations for COVID-19
Intervention Type
Drug
Intervention Name(s)
standard concomitant therapy
Intervention Description
Standard of care according to MoH of Russian Federation recomendation for COVID-19
Primary Outcome Measure Information:
Title
Time to clinical improvement
Description
To determine the effect of TL-FVP-t vs. SOC on time to clinical improvement. The clinical improvement is defined as reduction on at least 1 score of patient clinical status according to WHO 8-category Ordinal Scale for Clinical Improvement compared to screening
Time Frame
through Day 28
Title
Time to viral clearance
Description
To determine the effect of TL-FVP-t vs. SOC on time to viral clearance of SARS-CoV-2 virus as measured by PCR in oropharyngeal sampling
Time Frame
through Day 28
Secondary Outcome Measure Information:
Title
Rate of clinical improvement at separate time points
Description
To determine the effect of TL-FVP-t vs. SOC on proportion of subjects (%) with clinical improvement according to WHO 8-category Ordinal Scale for Clinical Improvement
Time Frame
Day 7
Title
Rate of viral clearance at separate time points
Description
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with viral clearance of SARS-CoV-2 virus as measured by PCR in oropharyngeal sampling at separate time points
Time Frame
Days 5 and 7
Title
Time to body temperature normalization
Description
To determine the effect of TL-FVP-t vs. SOC on time to body temperature normalization determined as body temperature < 37°C without antipyretics for at least 48 hours.
Time Frame
through Day 28
Title
Rate of resolution of lung changes on CT
Description
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with resolution of lung changes on CT
Time Frame
Day 14
Title
Rate of adverse drug reactions (ADR) and serious ADR
Description
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with ADR and serious ADR
Time Frame
through Day 28
Title
Rate of severe ADR
Description
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) with severe ADR
Time Frame
through Day 28
Title
Rate therapy termination due to ADR
Description
To determine the effect of TL-FVP-t vs. SOC on a proportion of subjects (%) discontinued therapy due ADR
Time Frame
through Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Informed consent form signed. Males and females aged 18-60 years; Diagnosis of coronavirus disease caused by SARS-CoV-2 (COVID-19) in a mild or moderate form (without respiratory failure). Duration of infection symptoms shall be no more than 6 days before randomization. SARS-CoV-2 infection should be verified by PCR at the screening. Ability to follow the protocol and fulfill all the clinical study procedures. Ability and willingness of the subjects and their sexual partners with retained childbearing potential to use reliable contraception methods throughout the study and for 3 months after the treatment completion. Willingness not to take alcohol throughout the study. Exclusion Criteria: Age < 18 and > 60 years. Any etiotropic therapy of coronavirus SARS-CoV-2 (COVID-19) infection prior to the study. Moderate infection with respiratory failure, severe or extremely severe SARS-CoV-2 (COVID-19) disease. Respiratory failure (RR > 30/min, SpO2 ≤ 93 %) or the need for mechanical ventilation at the screening. Decreased level of consciousness (disorientation of place, time and personality), agitation at the screening. Unstable hemodynamics (systolic BP < 100 mm Hg or diastolic BP < 60 mm Hg) found at the screening. Subtotal diffuse ground-glass induration of pulmonary tissue and pulmonary consolidation combined with reticular changes; involvement of ≥ 75 % of lung parenchyma; hydrothorax (CT findings corresponding to ≥ CT-4 according to Department of Health of Moscow guidelines). Presence of comorbidities: moderate or severe chronic obstructive pulmonary disease or asthma; severe chronic cardiovascular disorders (arrhythmia or conduction disorders, implanted pacemaker device, myocardial infarction or unstable angina in the medical history, heart failure); immunocompromised subjects (HIV, cancer, autoimmune diseases, immunodepressant therapy); severe obesity (body mass index [BMI] ≥ 40); diabetes mellitus; chronic renal failure; chronic moderate or severe hepatic disorders. Any of the following abnormal laboratory tests at the screening: AST or ALT level > 2.5 x upper normal level (UNL), platelet count < 50х109/L. Any history findings which, in the investigator's opinion, may complicate the interpretation of the study results or generate an additional risk for the subject due to his/her participation in the study. More than 2 CT diagnostic procedures within the last 6 months prior to randomization (except for chest CT no earlier than 4 days prior to enrollment). The subject takes the products significantly inhibiting CYP28С, and administration those products cannot be interrupted for the study duration. Malabsorption syndrome or another clinically relevant gastrointestinal disease which may affect the study product absorption (uncontrollable vomiting, diarrhea, ulcerative colitis, etc.). Pregnancy or breast-feeding; women with probable pregnancy at the screening, those planning to conceive during the study. Known (from the history) or suspected alcohol or psychotropic drug abuse; medicinal or illicit drug addiction. Mental disorders including those in the medical history. Condition or disease which, according to the investigator or medical monitor, will compromise the subject's safety or affect assessment of the study product safety.
Facility Information:
Facility Name
Medical center LLC "Neuroprofi"
City
Korolev
Country
Russian Federation
Facility Name
Federal budgetary institution of science "Central Research Institute of Epidemiology" of Russian Federal Supervision Service for Consumer Rights Protection and People's Welfare
City
Moscow
Country
Russian Federation
Facility Name
Medical centers JSC "Medsi Group of Companies"
City
Moscow
Country
Russian Federation
Facility Name
State budgetary institution of health care of the city of Moscow "City Clinical Hospital №52 of the Moscow City Healthcare Department"
City
Moscow
Country
Russian Federation
Facility Name
State budgetary institution of health care of the city of Moscow "City Clinical Hospital №67 n.a. LA Vorokhobova of the Moscow City Healthcare Department"
City
Moscow
Country
Russian Federation
Facility Name
State budgetary institution of health care of the city of Moscow "Infectious Diseases Clinical Hospital №1 of the Moscow City Healthcare Department"
City
Moscow
Country
Russian Federation
Facility Name
Medical center LLC "Medical Center Eco-safety"
City
Saint Petersburg
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Healthcare Institution "City Hospital No. 40 of the Kurortny District"
City
Saint Petersburg
Country
Russian Federation
Facility Name
Budgetary healthcare institution of the Voronezh region "Voronezh Regional Clinical Hospital No. 1"
City
Voronezh
Country
Russian Federation
Facility Name
State Budgetary Healthcare Institution of the Moscow Region "Zhukovskaya City Clinical Hospital".
City
Zhukovskiy
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of Efficacy and Safety of TL-FVP-t vs. SOC in Patients With Mild to Moderate COVID-19

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