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An Open Non-comparative Study of the Efficacy and Safety of Aprotinin in Patients Hospitalized With COVID-19

Primary Purpose

COVID-19

Status
Unknown status
Phase
Not Applicable
Locations
Russian Federation
Study Type
Interventional
Intervention
Aprotinin
Sponsored by
Aviron LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring COVID-19, SARS-CoV-2, pneumonia, inpatients

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed Patient Information Sheet and Informed Consent Form for participation in the study;
  2. Adult male or female ≥18 years of age;
  3. Body mass < 90 kg;
  4. Positive qualitative RNA SARS-CoV-2 PCR analysis at screening;
  5. Score 4 on the WHO-OSCI (added at Stage 2);
  6. Subjects with moderate-to-severe disease with the follow conditions and symptoms:

    • Pneumonia;
    • Fever > 38°C;
    • Blood serum CRP > 10 mg/L.
  7. Agreement to use medically acceptable forms of birth control during the study (contraceptive with spermicide).

Exclusion Criteria:

  1. Severe disease with one of the follow criteria:

    • Respiratory rate > 35 per minute that doesn't decrease after body temperature reducing to normal or subfebrile level;
    • Saturation ≤ 93% at rest;
    • Partial pressure of arterial oxygen (PaO2) < 60 mmHg;
    • Oxygenation index (РаО2/FiO2) ≤ 200 mmHg;
    • Partial pressure of arterial CO2 (PaCO2) > 60 mmHg;
    • Septic shock.
  2. Chronic liver and kidney diseases in terminal stage;
  3. Other organs failure requiring control and treatment in the ICU;
  4. Subjects with HIV;
  5. Using of Aprotinin during 6 months prior to screening; hypersensitivity to any of the drug components;
  6. Participation in any other clinical trial or using of other study drugs during 28 days prior to screening;
  7. Pregnant or lactating women or women planning pregnancy during the clinical study; women with child-bearing potential (including women non-sterilized surgically and in postmenopause for less than 2 years) not using medically acceptable forms of birth control;
  8. Inability to read or write; unwillingness to understand and follow the Protocol procedures; non-compliance with the regimen of taking medications or performing procedures that, according to the Investigator, may affect the results of the study or the safety of the patient and prevent the patient from further participation in the study; any other comorbid medical or serious mental conditions that make patient ineligible for participation in the clinical study, limits the ability to obtain informed consent, or may affect patient's ability to participate in the study.

Sites / Locations

  • Regional State Budgetary Healthcare Institution "Clinical Hospital №1"

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Stage 1/Group 1

Stage 2/Group 2

Stage 2/Group 3

Arm Description

Intravenous Aprotinin in addition to standard care: 1 000 000 KIU IV daily during 3 days

Inhaled Aprotinin in addition to standard care: 625 KIU 4 times per day during 5 days

Intravenous Aprotinin in addition to standard care that includes Favipiravir: 1 000 000 KIU IV daily during 5 days

Outcomes

Primary Outcome Measures

Time to elimination of SARS-CoV-2 virus
Time to two negative PCR tests with at least 24 hours interval [days]
Time to CRP normalization
Time to CRP <10 mg/L [days]
Time to D-dimer normalization
Time to D-dimer <243 ng/mL [days]

Secondary Outcome Measures

Time to body temperature normalization
Time to body temperature <37oC [days]
Change in absolute neutrophil count (ANC)
Change of ANC [cells/L]
Change in white blood cells (WBC)
Change of WBC [cells/L]
Change of CRP
Change of CRP [mg/L]
Change of D-dimer
Change of D-dimer [ng/mL]
Change in fibrinogen
Change of fibrinogen [g/L]
Change of Quick's value
Change of Quick's value [%]
Change of international normalized ratio (INR)
Change of INR [score]
Changes of lung injury on CT scan
Improvement, no change or worsening of the lung injury on CT scan [proportion of patients]
Frequency of clinical status improvement by 2 scores in accordance with the WHO-OSCI or discharge from the hospital
Frequency of clinical status improvement by 2 scores in accordance with the WHO-OSCI or discharge from the hospital [proportion of patients]
Frequency of deterioration of the patients' status
Frequency of transfer to the ICU, non-invasive ventilation, invasive ventilation and mortality rate [proportion of patients]
Frequency of AEs and SAEs
Frequency of AEs and SAEs of various severity according to subjective complains, physical examination, vital signs, laboratory tests and ECG [% of patients]

Full Information

First Posted
August 24, 2020
Last Updated
August 25, 2020
Sponsor
Aviron LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04527133
Brief Title
An Open Non-comparative Study of the Efficacy and Safety of Aprotinin in Patients Hospitalized With COVID-19
Official Title
An Open Non-comparative Study of the Efficacy and Safety of Aprotinin in Patients Hospitalized With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 11, 2020 (Actual)
Primary Completion Date
August 11, 2020 (Actual)
Study Completion Date
August 31, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aviron LLC

4. Oversight

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

5. Study Description

Brief Summary
The observational study will be carried out in two stages. At the first stage, the efficacy and safety of Aprotinin intravenous infusion as add-on therapy to the standard of care will be studied. At the second stage, two groups will be included: the first group will be the inhaled Aprotinin add-on therapy, the second group will be intravenous Aprotinin in combination with Favipiravir.
Detailed Description
Primary objective of the study is to evaluate the efficacy of Aprotinin as add-on therapy in patients hospitalized with COVID-19 using the following parameters: The time to elimination of SARS-CoV-2 virus until Day 10; The time to C-reactive protein (CRP) normalization until Day 10; The time to D-dimer normalization until Day 10. Secondary objectives are to evaluate the following parameters of efficacy and safety of Aprotinin add-on therapy in patients hospitalized with COVID-19: The time to body temperature normalization (<37oC); Changes from baseline of the laboratory parameters during 14 days: hematology, CRP, coagulogram; Changes of lung injury on CT scan on Day 7 and Day 14 from baseline; Frequency of clinical status improvement by 2 scores in accordance with the WHO Ordinal scale of clinical improvement (WHO-OSCI) or discharge from the hospital before Day 14; Frequency of transfer to the Intensive Care Unit (ICU), frequency of the non-invasive ventilation, frequency of the invasive ventilation and mortality rate; Frequency of Adverse Events (AEs) and Serious Adverse Events (SAEs) of various severity according to subjective complains, physical examination, vital signs, laboratory tests and ECG.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
COVID-19, SARS-CoV-2, pneumonia, inpatients

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Sequential Assignment
Model Description
A non-comparative study of the efficacy and safety
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stage 1/Group 1
Arm Type
Experimental
Arm Description
Intravenous Aprotinin in addition to standard care: 1 000 000 KIU IV daily during 3 days
Arm Title
Stage 2/Group 2
Arm Type
Experimental
Arm Description
Inhaled Aprotinin in addition to standard care: 625 KIU 4 times per day during 5 days
Arm Title
Stage 2/Group 3
Arm Type
Experimental
Arm Description
Intravenous Aprotinin in addition to standard care that includes Favipiravir: 1 000 000 KIU IV daily during 5 days
Intervention Type
Drug
Intervention Name(s)
Aprotinin
Other Intervention Name(s)
Gordox®
Intervention Description
Intravenous or inhalation
Primary Outcome Measure Information:
Title
Time to elimination of SARS-CoV-2 virus
Description
Time to two negative PCR tests with at least 24 hours interval [days]
Time Frame
10 days
Title
Time to CRP normalization
Description
Time to CRP <10 mg/L [days]
Time Frame
10 days
Title
Time to D-dimer normalization
Description
Time to D-dimer <243 ng/mL [days]
Time Frame
10 days
Secondary Outcome Measure Information:
Title
Time to body temperature normalization
Description
Time to body temperature <37oC [days]
Time Frame
14 days
Title
Change in absolute neutrophil count (ANC)
Description
Change of ANC [cells/L]
Time Frame
Baseline to Day 14
Title
Change in white blood cells (WBC)
Description
Change of WBC [cells/L]
Time Frame
Baseline to Day 14
Title
Change of CRP
Description
Change of CRP [mg/L]
Time Frame
Baseline to Day 14
Title
Change of D-dimer
Description
Change of D-dimer [ng/mL]
Time Frame
Baseline to Day 14
Title
Change in fibrinogen
Description
Change of fibrinogen [g/L]
Time Frame
Baseline to Day 14
Title
Change of Quick's value
Description
Change of Quick's value [%]
Time Frame
Baseline to Day 14
Title
Change of international normalized ratio (INR)
Description
Change of INR [score]
Time Frame
Baseline to Day 14
Title
Changes of lung injury on CT scan
Description
Improvement, no change or worsening of the lung injury on CT scan [proportion of patients]
Time Frame
Baseline to Day 14
Title
Frequency of clinical status improvement by 2 scores in accordance with the WHO-OSCI or discharge from the hospital
Description
Frequency of clinical status improvement by 2 scores in accordance with the WHO-OSCI or discharge from the hospital [proportion of patients]
Time Frame
14 days
Title
Frequency of deterioration of the patients' status
Description
Frequency of transfer to the ICU, non-invasive ventilation, invasive ventilation and mortality rate [proportion of patients]
Time Frame
14 days
Title
Frequency of AEs and SAEs
Description
Frequency of AEs and SAEs of various severity according to subjective complains, physical examination, vital signs, laboratory tests and ECG [% of patients]
Time Frame
14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed Patient Information Sheet and Informed Consent Form for participation in the study; Adult male or female ≥18 years of age; Body mass < 90 kg; Positive qualitative RNA SARS-CoV-2 PCR analysis at screening; Score 4 on the WHO-OSCI (added at Stage 2); Subjects with moderate-to-severe disease with the follow conditions and symptoms: Pneumonia; Fever > 38°C; Blood serum CRP > 10 mg/L. Agreement to use medically acceptable forms of birth control during the study (contraceptive with spermicide). Exclusion Criteria: Severe disease with one of the follow criteria: Respiratory rate > 35 per minute that doesn't decrease after body temperature reducing to normal or subfebrile level; Saturation ≤ 93% at rest; Partial pressure of arterial oxygen (PaO2) < 60 mmHg; Oxygenation index (РаО2/FiO2) ≤ 200 mmHg; Partial pressure of arterial CO2 (PaCO2) > 60 mmHg; Septic shock. Chronic liver and kidney diseases in terminal stage; Other organs failure requiring control and treatment in the ICU; Subjects with HIV; Using of Aprotinin during 6 months prior to screening; hypersensitivity to any of the drug components; Participation in any other clinical trial or using of other study drugs during 28 days prior to screening; Pregnant or lactating women or women planning pregnancy during the clinical study; women with child-bearing potential (including women non-sterilized surgically and in postmenopause for less than 2 years) not using medically acceptable forms of birth control; Inability to read or write; unwillingness to understand and follow the Protocol procedures; non-compliance with the regimen of taking medications or performing procedures that, according to the Investigator, may affect the results of the study or the safety of the patient and prevent the patient from further participation in the study; any other comorbid medical or serious mental conditions that make patient ineligible for participation in the clinical study, limits the ability to obtain informed consent, or may affect patient's ability to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elena Simakina, MD
Organizational Affiliation
Clinical Hospital #1, Smolensk
Official's Role
Principal Investigator
Facility Information:
Facility Name
Regional State Budgetary Healthcare Institution "Clinical Hospital №1"
City
Smolensk
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
not planned

Learn more about this trial

An Open Non-comparative Study of the Efficacy and Safety of Aprotinin in Patients Hospitalized With COVID-19

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