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Study of Isoquercetin (IQC-950AN) Plus Standard of Care Versus Standard of Care Only for the Treatment of COVID-19

Primary Purpose

COVID-19

Status
Unknown status
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Isoquercetin (IQC-950AN)
Sponsored by
Institut de Recherches Cliniques de Montreal
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring Isoquercetin, Quercetin, Antiviral Agents

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must exhibit symptoms of COVID-19 disease at screening;
  2. Patients must be 18 years of age or older, of either gender;
  3. Patients must have a documented SARS-CoV-2 RNA-positive test virus within 3 days prior to randomization;
  4. Patients must be admitted (or under observation to be admitted) to a controlled facility or hospital to receive standard-of-care for COVID-19 disease;
  5. Patient's health status must be 3 (if hospitalized for comorbidities), 4, or 5 on the WHO clinical progression scale defined as hospitalized moderate disease (no oxygen therapy or oxygen by mask or nasal prongs);
  6. If female, must be either post-menopausal (one year or greater without menses), surgically sterile, or, for female subjects of child-bearing potential who are capable of conception, must be: practicing a highly effective method of birth control during the study and through 30 days after the last dose of the study medication.
  7. Patients must have the ability to understand and give informed consent, which can be verbal with a witness, according to local requirements;
  8. Patients deemed capable of adequate compliance including attending scheduled visits for the duration of the study;
  9. Patients must be able to swallow the study drug capsules

Exclusion Criteria:

  1. Patients with a history of allergy or anaphylaxis to ingredients in Isoquercetin (IQC-950AN) including known intolerance of niacin or ascorbic acid or known glucose-6-phosphate dehydrogenase (G6PD) deficiency;
  2. Patients with known chronic kidney disease with estimated creatinine clearance < 50 mL/minute or need for dialysis;
  3. Patients receiving an intensified dose regimen of low molecular weight heparin (LMWH) or unfractionated heparin (defined as doses of LMWH or unfractionated heparin greater than those approved for thromboprophylaxis) or dual antiplatelet therapy;
  4. Patients who are severely hypotensive defined as needing hemodynamic pressors to maintain blood pressure;
  5. Patients with moderate or severe thrombocytopenia (platelet count <100 × 10⁹/L);
  6. Patients who are breast-feeding an infant or child;
  7. Patients who are pregnant or unwilling to use an appropriate form of contraception, except for heterosexual celibacy
  8. Any other condition that, in the opinion of the investigator, may adversely affect the patient's ability to complete this study or its measures, or pose a significant risk to the patient;
  9. Any reason the investigator suspects that data collected from this patient would be incomplete or of poor quality

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    No Intervention

    Arm Label

    Isoquercetin (IQC-950AN)

    Standard of care

    Arm Description

    1000 mg Isoquercetin b.i.d. on day 1, then 500 mg Isoquercetin b.i.d. for 27 more days, plus standard of care (as defined below)

    This arm will receive standard of care based on national guidelines. This may change as new information regarding best practice emerges.

    Outcomes

    Primary Outcome Measures

    Disease Progression
    Disease progression is defined as WHO Clinical Progression Scale ≥6, at any time between Day 1 and Day 28

    Secondary Outcome Measures

    Changes in viral load from baseline to end of treatment - Mean viral load
    Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Changes in viral load from baseline to end of treatment - Area under the viral load vs. time profiles
    Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Changes in viral load from baseline to end of treatment - Time profile of viral load
    Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Changes in viral load from baseline to end of treatment - Percentage of patients that are viral negative
    Defined as below the level of quantitation of the assay (qRT-PCR). Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Disease Recovery
    Disease recovery is defined as WHO Clinical Progression Scale score of ≤2
    Change in WHO Clinical Progression Scale score
    Change in score from baseline to day 28
    Incidence of all-cause mortality
    All-cause mortality calculated at Day 30
    Progression to supplementary oxygen requirement
    If the patient required supplementary oxygen during hospitalization
    Incidence of mechanical ventilation
    If the patient required mechanical ventilation during hospitalization
    Incidence of ICU admission
    If the patient was admitted to ICU
    Time to hospital discharge
    Length of time in hospital prior to being discharged
    Changes in serum C reactive protein levels (CRP)
    Changes in serum CRP levels
    Changes in D-dimer levels
    Changes in D-dimer levels
    Changes in soluble low-density lipoprotein receptor (sLDLR) expression and proprotein convertase subtilisin/kexin type 9 (PCSK9) and soluble angiotensin converting enzyme 2 (sACE2) levels
    Changes in sLDLR expression, and PCSK9 and sACE2 levels
    Changes in LDL-cholesterol
    Changes in LDL-cholesterol
    Changes in creatinine
    Changes in creatinine
    Changes in liver enzymes
    Changes in liver enzymes

    Full Information

    First Posted
    August 31, 2020
    Last Updated
    August 20, 2021
    Sponsor
    Institut de Recherches Cliniques de Montreal
    Collaborators
    Pharmascience Inc., SCiAN Services, Inc., Quercis Pharma AG
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04536090
    Brief Title
    Study of Isoquercetin (IQC-950AN) Plus Standard of Care Versus Standard of Care Only for the Treatment of COVID-19
    Official Title
    An Open-Label Randomized Study of Isoquercetin (IQC-950AN) Plus Standard of Care Versus Standard of Care Only for the Treatment of 2019 Novel Coronavirus Disease (COVID-19)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2021
    Overall Recruitment Status
    Unknown status
    Study Start Date
    January 2022 (Anticipated)
    Primary Completion Date
    December 2022 (Anticipated)
    Study Completion Date
    June 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Institut de Recherches Cliniques de Montreal
    Collaborators
    Pharmascience Inc., SCiAN Services, Inc., Quercis Pharma AG

    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
    This is an open-label, randomized, multi-centre study where hospitalized subjects will be randomized in a 2:1 ratio to receive Isoquercetin (IQC-950AN) in addition to standard of care or standard of care only for 28 days following confirmation of a COVID-19 infection.
    Detailed Description
    The primary purpose of this randomized study will be to evaluate the effect of Isoquercetin (IQC-950AN) treatment on disease progression (defined as ≥ 6 on the World Health Organization (WHO) clinical progression scale) when given to subjects with confirmed COVID-19 in addition to standard of care. The secondary purpose of this study is to evaluate the effect of Isoquercetin (IQC-950AN) treatment on the reduction of severe acute respiratory coronavirus 2 (SARS-CoV-2) viral titers in these subjects and their recovery. In addition, certain parameters which may help elucidate the mechanism of action (sLDLR, PCSK9, sACE2, D-dimers and CRP) will be followed. The safety of Isoquercetin (IQC-950AN) will be evaluated at each visit. Subjects will be randomized to receive treatment for 28 days and then will return 30 days following the discontinuation of treatment for a final safety visit. The results of this study will be used to design an adequately powered randomized controlled pivotal study to evaluate the efficacy and safety of Isoquercetin (IQC-950AN) in all or a subset of subjects with confirmed COVID-19.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    COVID-19
    Keywords
    Isoquercetin, Quercetin, Antiviral Agents

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Allocation
    Randomized
    Enrollment
    150 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Isoquercetin (IQC-950AN)
    Arm Type
    Experimental
    Arm Description
    1000 mg Isoquercetin b.i.d. on day 1, then 500 mg Isoquercetin b.i.d. for 27 more days, plus standard of care (as defined below)
    Arm Title
    Standard of care
    Arm Type
    No Intervention
    Arm Description
    This arm will receive standard of care based on national guidelines. This may change as new information regarding best practice emerges.
    Intervention Type
    Drug
    Intervention Name(s)
    Isoquercetin (IQC-950AN)
    Other Intervention Name(s)
    IQC-950AN
    Intervention Description
    Isoquercetin will be administered by mouth twice daily for 28 days
    Primary Outcome Measure Information:
    Title
    Disease Progression
    Description
    Disease progression is defined as WHO Clinical Progression Scale ≥6, at any time between Day 1 and Day 28
    Time Frame
    28 days
    Secondary Outcome Measure Information:
    Title
    Changes in viral load from baseline to end of treatment - Mean viral load
    Description
    Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Time Frame
    28 days
    Title
    Changes in viral load from baseline to end of treatment - Area under the viral load vs. time profiles
    Description
    Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Time Frame
    28 days
    Title
    Changes in viral load from baseline to end of treatment - Time profile of viral load
    Description
    Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Time Frame
    28 days
    Title
    Changes in viral load from baseline to end of treatment - Percentage of patients that are viral negative
    Description
    Defined as below the level of quantitation of the assay (qRT-PCR). Viral load of SARS-CoV-2 RNA (# of viral copies) assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR)
    Time Frame
    28 days
    Title
    Disease Recovery
    Description
    Disease recovery is defined as WHO Clinical Progression Scale score of ≤2
    Time Frame
    28 days
    Title
    Change in WHO Clinical Progression Scale score
    Description
    Change in score from baseline to day 28
    Time Frame
    28 days
    Title
    Incidence of all-cause mortality
    Description
    All-cause mortality calculated at Day 30
    Time Frame
    30 days
    Title
    Progression to supplementary oxygen requirement
    Description
    If the patient required supplementary oxygen during hospitalization
    Time Frame
    14 days
    Title
    Incidence of mechanical ventilation
    Description
    If the patient required mechanical ventilation during hospitalization
    Time Frame
    14 days
    Title
    Incidence of ICU admission
    Description
    If the patient was admitted to ICU
    Time Frame
    14 days
    Title
    Time to hospital discharge
    Description
    Length of time in hospital prior to being discharged
    Time Frame
    29 days
    Title
    Changes in serum C reactive protein levels (CRP)
    Description
    Changes in serum CRP levels
    Time Frame
    29 days
    Title
    Changes in D-dimer levels
    Description
    Changes in D-dimer levels
    Time Frame
    29 days
    Title
    Changes in soluble low-density lipoprotein receptor (sLDLR) expression and proprotein convertase subtilisin/kexin type 9 (PCSK9) and soluble angiotensin converting enzyme 2 (sACE2) levels
    Description
    Changes in sLDLR expression, and PCSK9 and sACE2 levels
    Time Frame
    29 days
    Title
    Changes in LDL-cholesterol
    Description
    Changes in LDL-cholesterol
    Time Frame
    29 days
    Title
    Changes in creatinine
    Description
    Changes in creatinine
    Time Frame
    29 days
    Title
    Changes in liver enzymes
    Description
    Changes in liver enzymes
    Time Frame
    29 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients must exhibit symptoms of COVID-19 disease at screening; Patients must be 18 years of age or older, of either gender; Patients must have a documented SARS-CoV-2 RNA-positive test virus within 3 days prior to randomization; Patients must be admitted (or under observation to be admitted) to a controlled facility or hospital to receive standard-of-care for COVID-19 disease; Patient's health status must be 3 (if hospitalized for comorbidities), 4, or 5 on the WHO clinical progression scale defined as hospitalized moderate disease (no oxygen therapy or oxygen by mask or nasal prongs); If female, must be either post-menopausal (one year or greater without menses), surgically sterile, or, for female subjects of child-bearing potential who are capable of conception, must be: practicing a highly effective method of birth control during the study and through 30 days after the last dose of the study medication. Patients must have the ability to understand and give informed consent, which can be verbal with a witness, according to local requirements; Patients deemed capable of adequate compliance including attending scheduled visits for the duration of the study; Patients must be able to swallow the study drug capsules Exclusion Criteria: Patients with a history of allergy or anaphylaxis to ingredients in Isoquercetin (IQC-950AN) including known intolerance of niacin or ascorbic acid or known glucose-6-phosphate dehydrogenase (G6PD) deficiency; Patients with known chronic kidney disease with estimated creatinine clearance < 50 mL/minute or need for dialysis; Patients receiving an intensified dose regimen of low molecular weight heparin (LMWH) or unfractionated heparin (defined as doses of LMWH or unfractionated heparin greater than those approved for thromboprophylaxis) or dual antiplatelet therapy; Patients who are severely hypotensive defined as needing hemodynamic pressors to maintain blood pressure; Patients with moderate or severe thrombocytopenia (platelet count <100 × 10⁹/L); Patients who are breast-feeding an infant or child; Patients who are pregnant or unwilling to use an appropriate form of contraception, except for heterosexual celibacy Any other condition that, in the opinion of the investigator, may adversely affect the patient's ability to complete this study or its measures, or pose a significant risk to the patient; Any reason the investigator suspects that data collected from this patient would be incomplete or of poor quality
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Michel Chrétien, FRS MD FRCP©
    Phone
    1-833-705-0648
    Email
    michel.chretien@ircm.qc.ca
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Michel Chrétien, FRS MD FRCP©
    Organizational Affiliation
    Montreal Clinical Research Institute
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    32539990
    Citation
    WHO Working Group on the Clinical Characterisation and Management of COVID-19 infection. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis. 2020 Aug;20(8):e192-e197. doi: 10.1016/S1473-3099(20)30483-7. Epub 2020 Jun 12. Erratum In: Lancet Infect Dis. 2020 Oct;20(10):e250.
    Results Reference
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    Study of Isoquercetin (IQC-950AN) Plus Standard of Care Versus Standard of Care Only for the Treatment of COVID-19

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