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Study of Favipiravir Compared to Standard of Care in Hospitalized Patients With COVID-19

Primary Purpose

COVID-19

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
Favipiravir
Standard of care
Sponsored by
Promomed, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring Favipiravir, Areplivir, COVID-19, SARS-CoV-2, 2019-nCoV

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signing and dating of the Informed Consent Form of the Patient Information Leaflet (PIL) by patients.
  2. Men and women aged 18 to 80 years inclusive at the time of signing the Informed Consent Form in PIL.
  3. No difficulty with oral medication (e.g. swallowing disorder).
  4. Patient diagnosed with "Coronavirus infection caused by SARS-CoV-2 (confirmed)1, moderate severity form*" established in accordance with the Interim Guidelines of the Russian Ministry of Health for the prevention, diagnosis and treatment of a new coronavirus infection (COVID-19), (revision 6 of 28.04.2020).

    *Moderate severity form: fever above 38 °C, BR above 22/min, dyspnea during exercise, pneumonia (confirmed by lung CT), SpO2 < 95%, C reactive protein (CRP) serum level above 10 mg/l.

  5. Patient should be hospitalized no more than 48 hours before the start of the study therapy.
  6. Positive PCR result for presence of SARS-CoV-2 RNA at screening phase (results obtained within 7 days prior to screening are appropriate).
  7. Patient's consent to use reliable contraceptive methods throughout the study and within 1 month for women and 3 months for men after its completion. Persons eligible for participation in the study: - Women who have a negative pregnancy test and use the following contraceptives: barrier method (condom or occlusive cap (diaphragm or cervical/vaulted cap)) or double barrier method of contraception (condom or occlusive cap (diaphragm or cervical/vaulted cap) plus spermicide (foam/gel/film/cream/suppository)). Women incapable of childbearing may also participate in the study (with past history of: hysterectomy, tubal ligation, infertility, menopause more than 1 year) or men with preserved reproductive function who use barrier contraceptives, as well as men with infertility or vasectomy in the past medical history.

Exclusion Criteria:

  1. Hypersensitivity to favipiravir and/or other components of the study drug.
  2. Impossibility of CT procedure (for example, gypsum dressing or metal structures in the field of imaging).
  3. The need to use drugs from the list of prohibited therapy.
  4. Need for treatment in the intensive care unit.
  5. Impaired liver function (AST and/or ALT ≥ 2 UNL and/or total bilirubin ≥ 1.5 UNL) at the time of screening.
  6. Impaired kidney function (creatinine clearance according to Cockcroft-Gault formula less than 45 ml/min) at the time of screening.
  7. Positive testing for HIV, syphilis, hepatitis B and/or C.
  8. Chronic heart failure FC III-IV according to New York Heart Association (NYHA) functional classification.
  9. Malabsorption syndrome or other clinically significant gastrointestinal disease that may affect absorption of the study drug (non-correctable vomiting, diarrhea, ulcerative colitis, and others).
  10. Malignancies in the past medical history.
  11. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening.
  12. Schizophrenia, schizoaffective disorder, bipolar disorder, or other history of mental pathology or suspicion of their presence at the time of screening.
  13. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten the patient's life or impair the patient's prognosis, and also make it impossible for him/her to participate in the clinical study).
  14. Any history data that the investigating physician believes could lead to complication in the interpretation of the study results or create an additional risk to the patient as a result of his/her participation in the study.
  15. Patient's unwillingness or inability to comply with procedures of the Study Protocol (in the opinion of physician investigator).
  16. Pregnant or nursing women or women planning pregnancy.
  17. Participation in another clinical study for 3 months prior to inclusion in the study.
  18. Other conditions that, according to the physician investigator, prevent the patient from being included in the study.

Sites / Locations

  • State Clinical Hospital №50
  • Regional Clinic Hospital of Ryazan
  • City Hospital N40 of Kurortny District
  • Medical institute Ogarev Mordovia State university
  • Smolensk clinical hospital №1

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Favipiravir (Areplivir)

Standard of care

Arm Description

Arm 1 (n=100) receives the study drug Areplivir film-coated tablets: on day 1 of therapy - 1600 mg (8 tablets) 2 times a day; on days 2-14 of treatment - 600 mg (3 tablets) 2 times a day. The drug is taken orally every 12 hours, swallowing whole tablet without chewing and washing down with a glass of water. The course of treatment is 14 days. The test drug is administered in hospital setting under supervision of a clinical investigator. The test drug is not handed over to the patient.

Arm 2 (n=100) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the Interim Guidelines for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19) approved by the Russian Ministry of Health (but not Favipiravir) by decision of the investigator and taking into account the availability of drugs at the study site. Might include hydroxychloroquine (with or without azithromycin), chloroquine, lopinavir/ritonavir or other recommended schemes. Standard therapy is administered in hospital setting. Discharge of patients from a hospital is carried out in accordance with the local practice of the study site in compliance with the current sanitary and epidemiological regime.

Outcomes

Primary Outcome Measures

Rate of Clinical Status Improvement
Rate of clinical status improvement by categorical ordinal scale of clinical status improvement by 2 or more categories by Day 10 WHO Ordinal Scale for Clinical Improvement (WHO-OSCI), 0 - uninfected (There are no clinical and virological signs of infection), 8 - dead, higher scores mean a worse outcome
Time to Clinical Improvement
Time (in days) to improvement in clinical status by WHO categorical ordinal scale of clinical status improvement.

Secondary Outcome Measures

Rate of Viral Elimination by Day 10
Percentage of patients with elimination (clearance) of COVID-19 according to PCR data by day 10 (negative PCR results).
Time Before the End of Fever
Time (in days) before the end of fever (body temperature < 37.2 ° C for 3 consecutive days without antipyretic medication).
Change in the Level of Lung Damage According to CT
Assessment of lung injury (degree of damage by "empirical" visual scale and % of patients) according to CT data comparing to baseline. The number of patients in whom by the end of therapy there was an improvement in the condition of the lungs (a decrease in the volume of the lesion according to CT)
Rate of Transfer to the Intensive Care Unit
Percentage of patients transferred to intensive care unit (% of patients).
Rate of the Use of Non-invasive Lung Ventilation
Percentage of cases with non-invasive lung ventilation (% of patients).
Rate of the Use of Mechanical Ventilation
Percentage of cases with mechanical lung ventilation (% of patients)
Mortality
Incidence of fatal cases (% of patients)

Full Information

First Posted
September 4, 2020
Last Updated
November 3, 2020
Sponsor
Promomed, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04542694
Brief Title
Study of Favipiravir Compared to Standard of Care in Hospitalized Patients With COVID-19
Official Title
Open-label Randomized Multicenter Comparative Study on the Efficacy and Safety of Areplivir Film-coated Tablets (PROMOMED RUS LLC, Russia) in Patients Hospitalized With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
May 21, 2020 (Actual)
Primary Completion Date
August 10, 2020 (Actual)
Study Completion Date
August 20, 2020 (Actual)

3. Sponsor/Collaborators

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

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 open-labe randomized multicenter comparative Phase III study conducted in 5 medical facilities. The objective of the study is to assess the efficacy and safety of Favipiravir compared with the Standard of care (SOC) in hospitalized patients with moderate COVID-19 pneumonia.
Detailed Description
Upon signing the informed consent form and screening, 200 eligible patients with polymerase chain reaction (PCR) confirmed COVID-19 are randomized at a 1:1 ratio to receive either Favipiravir 1600 mg twice a day (BID) on Day 1 followed by 600 mg BID on Days 2-14 (1600/600 mg), or SOC. The course of treatment by Favipiravir is 14 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
Favipiravir, Areplivir, COVID-19, SARS-CoV-2, 2019-nCoV

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Favipiravir (Areplivir)
Arm Type
Experimental
Arm Description
Arm 1 (n=100) receives the study drug Areplivir film-coated tablets: on day 1 of therapy - 1600 mg (8 tablets) 2 times a day; on days 2-14 of treatment - 600 mg (3 tablets) 2 times a day. The drug is taken orally every 12 hours, swallowing whole tablet without chewing and washing down with a glass of water. The course of treatment is 14 days. The test drug is administered in hospital setting under supervision of a clinical investigator. The test drug is not handed over to the patient.
Arm Title
Standard of care
Arm Type
Active Comparator
Arm Description
Arm 2 (n=100) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the Interim Guidelines for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19) approved by the Russian Ministry of Health (but not Favipiravir) by decision of the investigator and taking into account the availability of drugs at the study site. Might include hydroxychloroquine (with or without azithromycin), chloroquine, lopinavir/ritonavir or other recommended schemes. Standard therapy is administered in hospital setting. Discharge of patients from a hospital is carried out in accordance with the local practice of the study site in compliance with the current sanitary and epidemiological regime.
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Other Intervention Name(s)
AREPLIVIR
Intervention Description
200 mg coated tablets
Intervention Type
Drug
Intervention Name(s)
Standard of care
Intervention Description
Drug: Standard of Care Standard of Care will be prescribed in accordance with the recommended treatment regimens presented in the Russian guidelines for the prevention, diagnosis and treatment of COVID-19 according to the decision of the Investigator. Other Name: Hydroxychloroquine, chloroquine, lopinavir/ritonavir, etc.
Primary Outcome Measure Information:
Title
Rate of Clinical Status Improvement
Description
Rate of clinical status improvement by categorical ordinal scale of clinical status improvement by 2 or more categories by Day 10 WHO Ordinal Scale for Clinical Improvement (WHO-OSCI), 0 - uninfected (There are no clinical and virological signs of infection), 8 - dead, higher scores mean a worse outcome
Time Frame
By Visit 3, approximately 10 days
Title
Time to Clinical Improvement
Description
Time (in days) to improvement in clinical status by WHO categorical ordinal scale of clinical status improvement.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Rate of Viral Elimination by Day 10
Description
Percentage of patients with elimination (clearance) of COVID-19 according to PCR data by day 10 (negative PCR results).
Time Frame
10 days
Title
Time Before the End of Fever
Description
Time (in days) before the end of fever (body temperature < 37.2 ° C for 3 consecutive days without antipyretic medication).
Time Frame
28 days
Title
Change in the Level of Lung Damage According to CT
Description
Assessment of lung injury (degree of damage by "empirical" visual scale and % of patients) according to CT data comparing to baseline. The number of patients in whom by the end of therapy there was an improvement in the condition of the lungs (a decrease in the volume of the lesion according to CT)
Time Frame
Days 15, 21, 28
Title
Rate of Transfer to the Intensive Care Unit
Description
Percentage of patients transferred to intensive care unit (% of patients).
Time Frame
28 Days
Title
Rate of the Use of Non-invasive Lung Ventilation
Description
Percentage of cases with non-invasive lung ventilation (% of patients).
Time Frame
28 Days
Title
Rate of the Use of Mechanical Ventilation
Description
Percentage of cases with mechanical lung ventilation (% of patients)
Time Frame
28 Days
Title
Mortality
Description
Incidence of fatal cases (% of patients)
Time Frame
28 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signing and dating of the Informed Consent Form of the Patient Information Leaflet (PIL) by patients. Men and women aged 18 to 80 years inclusive at the time of signing the Informed Consent Form in PIL. No difficulty with oral medication (e.g. swallowing disorder). Patient diagnosed with "Coronavirus infection caused by SARS-CoV-2 (confirmed)1, moderate severity form*" established in accordance with the Interim Guidelines of the Russian Ministry of Health for the prevention, diagnosis and treatment of a new coronavirus infection (COVID-19), (revision 6 of 28.04.2020). *Moderate severity form: fever above 38 °C, BR above 22/min, dyspnea during exercise, pneumonia (confirmed by lung CT), SpO2 < 95%, C reactive protein (CRP) serum level above 10 mg/l. Patient should be hospitalized no more than 48 hours before the start of the study therapy. Positive PCR result for presence of SARS-CoV-2 RNA at screening phase (results obtained within 7 days prior to screening are appropriate). Patient's consent to use reliable contraceptive methods throughout the study and within 1 month for women and 3 months for men after its completion. Persons eligible for participation in the study: - Women who have a negative pregnancy test and use the following contraceptives: barrier method (condom or occlusive cap (diaphragm or cervical/vaulted cap)) or double barrier method of contraception (condom or occlusive cap (diaphragm or cervical/vaulted cap) plus spermicide (foam/gel/film/cream/suppository)). Women incapable of childbearing may also participate in the study (with past history of: hysterectomy, tubal ligation, infertility, menopause more than 1 year) or men with preserved reproductive function who use barrier contraceptives, as well as men with infertility or vasectomy in the past medical history. Exclusion Criteria: Hypersensitivity to favipiravir and/or other components of the study drug. Impossibility of CT procedure (for example, gypsum dressing or metal structures in the field of imaging). The need to use drugs from the list of prohibited therapy. Need for treatment in the intensive care unit. Impaired liver function (AST and/or ALT ≥ 2 UNL and/or total bilirubin ≥ 1.5 UNL) at the time of screening. Impaired kidney function (creatinine clearance according to Cockcroft-Gault formula less than 45 ml/min) at the time of screening. Positive testing for HIV, syphilis, hepatitis B and/or C. Chronic heart failure FC III-IV according to New York Heart Association (NYHA) functional classification. Malabsorption syndrome or other clinically significant gastrointestinal disease that may affect absorption of the study drug (non-correctable vomiting, diarrhea, ulcerative colitis, and others). Malignancies in the past medical history. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening. Schizophrenia, schizoaffective disorder, bipolar disorder, or other history of mental pathology or suspicion of their presence at the time of screening. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten the patient's life or impair the patient's prognosis, and also make it impossible for him/her to participate in the clinical study). Any history data that the investigating physician believes could lead to complication in the interpretation of the study results or create an additional risk to the patient as a result of his/her participation in the study. Patient's unwillingness or inability to comply with procedures of the Study Protocol (in the opinion of physician investigator). Pregnant or nursing women or women planning pregnancy. Participation in another clinical study for 3 months prior to inclusion in the study. Other conditions that, according to the physician investigator, prevent the patient from being included in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dmitriy Pushkar
Organizational Affiliation
Moscow State Clinical Hospital №50
Official's Role
Principal Investigator
Facility Information:
Facility Name
State Clinical Hospital №50
City
Moscow
Country
Russian Federation
Facility Name
Regional Clinic Hospital of Ryazan
City
Ryazan'
Country
Russian Federation
Facility Name
City Hospital N40 of Kurortny District
City
Saint Petersburg
Country
Russian Federation
Facility Name
Medical institute Ogarev Mordovia State university
City
Saransk
Country
Russian Federation
Facility Name
Smolensk clinical hospital №1
City
Smolensk
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of Favipiravir Compared to Standard of Care in Hospitalized Patients With COVID-19

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