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Mouth Rinses for Inactivation of COVID-19 (MOR)

Primary Purpose

Covid19, Coronavirus Infection, SARS-CoV-2 Infection

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Saline
1.5% w/v Hydrogen Peroxide
0.12% Chlorohexidine Gluconate
27% Ethanol plus essential oils
0.5% w/v Povidone-iodide
0.075% Cetylpyridinium Chloride
Sponsored by
University of North Carolina, Chapel Hill
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19 focused on measuring Inactivation of COVID SARS-2 Virus, Antiseptic Mouth Rinses

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Subjects must meet all of the following inclusion criteria to be eligible for enrollment in the study:

  • Diagnosed COVID+ status by physician. Either became symptomatic in the prior 7 days, or if not symptomatic, likely infected/exposed within the prior 7 days.
  • Individuals (all sex, all gender) at least 18 years of age and at most 65 years of age and in good oral health without any known allergies to commercial dental products or cosmetics. American Society of Anesthesiologists (ASA) class I or II prior to COVID infection
  • Evidence of a personally signed and dated informed consent document indicating the subject (or legally acceptable representative) has been informed of all pertinent aspects of the trial and all of their questions have been answered.
  • Able to comprehend and follow the requirements of the study (including availability on scheduled visit dates) based on research site personnel's assessment.
  • Females of childbearing potential will have a negative urine pregnancy test (on site) or be physically incapable of pregnancy (implants or injections, Intrauterine device, Bilateral tubal ligation, Hysterectomy, Ovariectomy, Women post-menopausal)

Exclusion Criteria: Subjects presenting with any of the following will not be included in the study:

  • Patients who have been eating or drinking within an hour of the study
  • Patients under 18 years old and older than 65 years old
  • Subjects presenting with and/or self-reporting any of the following will not be included in the study:

    • history of significant adverse effects following use of oral hygiene products such as toothpastes and mouthrinses. (self-reported)
    • Self-reported allergy to iodine, ethanol, essential oils (Eucalyptol, Menthol, Methyl salicylate, Thymol), hydrogen peroxide, chlorhexidine gluconate, peroxyl, listerine, betadine, peridex, cetylpyridinium chloride, and other components in the mouth rinses (methyl salicylate, ethanol, saccharin sodium, glycerin, propylene glycol, sorbitol, Federal Food, Drug, and Cosmetic (FD&C) blue no. 1, Poloxamer 407, Benzoic acid, Zinc chloride, Sodium benzoate, Sucralose, PolyEthylene Glycol - 40 (PEG-40) sorbitan diisostearate, potassium sorbate, citric acid).
    • History of serious medical conditions that, at the discretion of the Investigator, will disqualify the subject. (Self-reported)
    • A history of severe dry mouth (xerostomia), drug-induced xerostomia (antidepressants, anticonvulsants, antihypertensives), or Sjogren's syndrome
    • A history of recent (within the last 30 days) or current recent oral herpes flare up, candida (thrush) infection, apthous ulcer flare up, current/active severe periodontal disease, or other recent oral viral infection or flare up within the past 30 days (self-reported)
    • Current history of alcohol or drug abuse (self-reported).
    • History of drinking water or eating food within an hour of the study visit.
    • History of drinking alcohol within 12 hours of the study visit.
    • History of using a commercial mouthrinse within 24 hours of the study visit.
    • Participation in any study involving oral care products, concurrently or within the previous 30 days. (self-reported)
    • Positive pregnancy test, reported pregnancy or lactation (this criterion is due to oral tissue changes related to pregnancy and nursing which can affect interpretation of study results. Additionally, women are advised to check with their physician before using Povidone-iodine during pregnancy and lactation, which cannot occur in a blinded, randomized trial.)
    • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with trial participation or investigational product administration or may interfere with the interpretation of trial results and, in the judgment of the Investigator, would make the subject inappropriate for entry into this trial.
    • Patient with developmental/cognitive disability that cannot self-consent, comprehend and follow the requirements of the study based on research site personnel's assessment.
    • Patient who has or ever had a thyroid problem, including swelling (nodular colloid goitre, endemic goitre or Hashimoto's thyroiditis)
    • Patients currently having lithium therapy for depression
    • Patients with sizable mucosal tears, abrasions, growths or burns in the mouth

Sites / Locations

  • General and Oral Health Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Placebo Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Saline

27% Ethanol plus essential oils

0.075% Cetylpyridinium Chloride

1.5% w/v Hydrogen Peroxide

0.5% w/v Povidone-iodide

0.12% Chlorhexidine Gluconate

Arm Description

Subject participants will rinse mouth one time for 60 seconds with 10 mL of Isotonic Saline.

Subject participants will rinse mouth one time for 60 seconds with 10 mL 27% ethanol plus essential oils.

Subject participants will rinse mouth one time for 60 seconds with 10 mL 0.075% Cetylpyridinium Chloride.

Subject participants will rinse mouth one time for 60 seconds with 10 mL of 1.5% w/v hydrogen peroxide rinse.

Subject participants will rinse mouth one time for 60 seconds with 10 mL .5% w/v povidone-iodide.

Subject participants will rinse mouth one time for 60 seconds with 10 mL of 0.12% Chlorhexidine Gluconate.

Outcomes

Primary Outcome Measures

Change in Quantitative Polymerase Chain Reaction (qPCR) from Baseline to 30 Minutes
Determination of qPCR of inactivity of SARS-CoV-2 cellular infectivity in COVID+ patient saliva

Secondary Outcome Measures

Full Information

First Posted
October 9, 2020
Last Updated
September 26, 2022
Sponsor
University of North Carolina, Chapel Hill
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1. Study Identification

Unique Protocol Identification Number
NCT04584684
Brief Title
Mouth Rinses for Inactivation of COVID-19
Acronym
MOR
Official Title
Antiviral Efficacy and Acceptability of Therapeutic Antiseptic Mouth Rinses for Inactivation of COVID SARS-2 Virus
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Terminated
Why Stopped
The team decided to terminate the trial in order to start a new trial, unrelated to safety reasons
Study Start Date
December 18, 2020 (Actual)
Primary Completion Date
October 21, 2021 (Actual)
Study Completion Date
October 21, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of North Carolina, Chapel Hill

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Randomized, double-blind prospective trial to test the efficacy and acceptability of therapeutic, antiseptic mouth rinses to inactivate severe acute respiratory syndrome coronavirus (SARS-CoV-2) in saliva of COVID-19 positive patients aged 18-65 years old. All mouthrinses are commercially available and will be used according to on-label instructions. Patients will be randomized to a mouthrinse and will be asked to give a saliva sample immediately before and after a one minute mouthwash. Saliva samples will be collected from patients at 15 minute intervals thereafter up to an hour (15, 30, 45 and 60 minutes). The samples will be stored and used for real-time reverse transcription polymerase chain reaction (RT-PCR) detection of viral SARS-CoV-2 RNA and viral infectivity assays. Patients will also complete a short-survey on the taste and experience of using the mouthwash. This study involves 480 subject participants and one, 75-90 minute visit.
Detailed Description
Consenting Procedure Patients will be contacted first by phone and, if not available, then by email. Interested patients will make an appointment to visit the GO Health Clinical Research Unit at Adams School of Dentistry for this study. Study participation includes only one visit. For Spanish speaking patients and/or parents, Spanish forms will be provided and communication will occur through a Spanish translator. All patients are adults and over normal cognitive capacity, and therefore will be able to consent for themselves. Screening At the visit, a consented patient will answer screening questions regarding inclusion and exclusion criteria. Answers will be entered into the Carolina Data Acquisition and Reporting Tool (CDART) research database managed by UNC. Prior to finalizing these screening questions, women participants of childbearing potential will be asked to provide a urine sample in the restroom, to undergo a rapid pregnancy test by study personnel. Any pregnant or lactating patients will be excluded. Enrollment, Baseline, and/or Randomization Outpatient subjects will be recruited from patients seen in the UNC Respiratory Distress Clinic (RDC) who have tested positive for COVID+ and consented to be contacted for participation in COVID-related research studies. The subjects being approached by phone or email have signed a prior facility consent at the Respiratory Distress Clinic confirming willingness to share their name and contact information to be contacted for study participation in COVID related research. Investigators will not receive information on subjects that decline this internal consent. Subjects will be contacted for recruitment by phone and (if unreachable by phone) by secure email by study personnel; patients will have the study rationale and risks explained and will be provided time to ask questions and consider participation. If patients are interested in participating, a single appointment will be scheduled for them at the Adams School of Dentistry GO Health Clinical research core. Consent documentation will be signed in person and in private in the GO Health Clinical Research Core. A list of COVID+ subjects that have consented to be contacted for research, will be provided by the RDC clinic, sent via secure University of North Carolina (UNC) at Chapel Hill NC servers or secure UNC email to the research team's clinical coordinator, and this list will include names and contact details (PHI). This list is updated daily and provided to approved research sites.. Randomization The study statistician will create a block randomization schedule and perform these computations. The researcher in charge of collecting the salivary samples will be blinded to the mouthwash solution, as they will be given a pre-aliquoted mouthrinse in an unlabeled storage tube to provide to the patient for the rinse. Blinding Subjects will be provided with an unlabeled/blinded mouthrinse. The researcher in charge of collecting the salivary samples will be blinded to the mouthwash solution as well, as they will be given a pre-aliquoted mouthrinse in an unlabeled storage syringe to provide to the patient for the rinse. The study statistician will set up a block randomization schedule that the team will abide by for assignment of enrolled subjects. Follow-up Visits This study requires only one 70-90 minute, single visit appointment. No diagnostic tests will be run as part of this clinical trial. All participants will already have known COVID+ status, and therefore no follow-up reporting is needed. Completion/Final Evaluation This study requires only one 70-90 minute, single visit appointment. Subjects will be asked to rinse with an unlabeled/blinded antiviral mouth rinse for 60 seconds and provide 5 mL of saliva prior to the rinse and 2 mL of saliva immediately post-rinse, 15 minutes post-rinse, 30 minutes post-rinse, 45 minutes post-rinse, and 60 minutes post-rinse. Subjects will also be asked to complete a short survey about the rinsing experience. Subjects may withdraw from the trial at any time or they may be withdrawn at any time at the discretion of the Investigator or Sponsor for safety, behavioral or administrative reasons.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19, Coronavirus Infection, SARS-CoV-2 Infection
Keywords
Inactivation of COVID SARS-2 Virus, Antiseptic Mouth Rinses

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomized, placebo-controlled, double-blind prospective trial to test the efficacy and acceptability of 5 therapeutic, antiseptic mouth rinses to inactivate SARS-CoV-2 virus in saliva of COVID-19 positive patients.
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
129 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Saline
Arm Type
Placebo Comparator
Arm Description
Subject participants will rinse mouth one time for 60 seconds with 10 mL of Isotonic Saline.
Arm Title
27% Ethanol plus essential oils
Arm Type
Active Comparator
Arm Description
Subject participants will rinse mouth one time for 60 seconds with 10 mL 27% ethanol plus essential oils.
Arm Title
0.075% Cetylpyridinium Chloride
Arm Type
Active Comparator
Arm Description
Subject participants will rinse mouth one time for 60 seconds with 10 mL 0.075% Cetylpyridinium Chloride.
Arm Title
1.5% w/v Hydrogen Peroxide
Arm Type
Active Comparator
Arm Description
Subject participants will rinse mouth one time for 60 seconds with 10 mL of 1.5% w/v hydrogen peroxide rinse.
Arm Title
0.5% w/v Povidone-iodide
Arm Type
Active Comparator
Arm Description
Subject participants will rinse mouth one time for 60 seconds with 10 mL .5% w/v povidone-iodide.
Arm Title
0.12% Chlorhexidine Gluconate
Arm Type
Active Comparator
Arm Description
Subject participants will rinse mouth one time for 60 seconds with 10 mL of 0.12% Chlorhexidine Gluconate.
Intervention Type
Other
Intervention Name(s)
Saline
Other Intervention Name(s)
Isotonic Saline
Intervention Description
Saline placebo rinse
Intervention Type
Drug
Intervention Name(s)
1.5% w/v Hydrogen Peroxide
Intervention Description
Over-the-counter antiseptic mouth rinse
Intervention Type
Drug
Intervention Name(s)
0.12% Chlorohexidine Gluconate
Intervention Description
Dentist prescribed antimicrobial mouth rinse
Intervention Type
Drug
Intervention Name(s)
27% Ethanol plus essential oils
Intervention Description
Over-the-counter antiseptic mouth rinse
Intervention Type
Drug
Intervention Name(s)
0.5% w/v Povidone-iodide
Intervention Description
Over-the-counter antiseptic mouth rinse
Intervention Type
Drug
Intervention Name(s)
0.075% Cetylpyridinium Chloride
Intervention Description
Over-the-counter antiseptic mouth rinse
Primary Outcome Measure Information:
Title
Change in Quantitative Polymerase Chain Reaction (qPCR) from Baseline to 30 Minutes
Description
Determination of qPCR of inactivity of SARS-CoV-2 cellular infectivity in COVID+ patient saliva
Time Frame
Baseline, 30 Minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects must meet all of the following inclusion criteria to be eligible for enrollment in the study: Diagnosed COVID+ status by physician. Either became symptomatic in the prior 7 days, or if not symptomatic, likely infected/exposed within the prior 7 days. Individuals (all sex, all gender) at least 18 years of age and at most 65 years of age and in good oral health without any known allergies to commercial dental products or cosmetics. American Society of Anesthesiologists (ASA) class I or II prior to COVID infection Evidence of a personally signed and dated informed consent document indicating the subject (or legally acceptable representative) has been informed of all pertinent aspects of the trial and all of their questions have been answered. Able to comprehend and follow the requirements of the study (including availability on scheduled visit dates) based on research site personnel's assessment. Females of childbearing potential will have a negative urine pregnancy test (on site) or be physically incapable of pregnancy (implants or injections, Intrauterine device, Bilateral tubal ligation, Hysterectomy, Ovariectomy, Women post-menopausal) Exclusion Criteria: Subjects presenting with any of the following will not be included in the study: Patients who have been eating or drinking within an hour of the study Patients under 18 years old and older than 65 years old Subjects presenting with and/or self-reporting any of the following will not be included in the study: history of significant adverse effects following use of oral hygiene products such as toothpastes and mouthrinses. (self-reported) Self-reported allergy to iodine, ethanol, essential oils (Eucalyptol, Menthol, Methyl salicylate, Thymol), hydrogen peroxide, chlorhexidine gluconate, peroxyl, listerine, betadine, peridex, cetylpyridinium chloride, and other components in the mouth rinses (methyl salicylate, ethanol, saccharin sodium, glycerin, propylene glycol, sorbitol, Federal Food, Drug, and Cosmetic (FD&C) blue no. 1, Poloxamer 407, Benzoic acid, Zinc chloride, Sodium benzoate, Sucralose, PolyEthylene Glycol - 40 (PEG-40) sorbitan diisostearate, potassium sorbate, citric acid). History of serious medical conditions that, at the discretion of the Investigator, will disqualify the subject. (Self-reported) A history of severe dry mouth (xerostomia), drug-induced xerostomia (antidepressants, anticonvulsants, antihypertensives), or Sjogren's syndrome A history of recent (within the last 30 days) or current recent oral herpes flare up, candida (thrush) infection, apthous ulcer flare up, current/active severe periodontal disease, or other recent oral viral infection or flare up within the past 30 days (self-reported) Current history of alcohol or drug abuse (self-reported). History of drinking water or eating food within an hour of the study visit. History of drinking alcohol within 12 hours of the study visit. History of using a commercial mouthrinse within 24 hours of the study visit. Participation in any study involving oral care products, concurrently or within the previous 30 days. (self-reported) Positive pregnancy test, reported pregnancy or lactation (this criterion is due to oral tissue changes related to pregnancy and nursing which can affect interpretation of study results. Additionally, women are advised to check with their physician before using Povidone-iodine during pregnancy and lactation, which cannot occur in a blinded, randomized trial.) Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with trial participation or investigational product administration or may interfere with the interpretation of trial results and, in the judgment of the Investigator, would make the subject inappropriate for entry into this trial. Patient with developmental/cognitive disability that cannot self-consent, comprehend and follow the requirements of the study based on research site personnel's assessment. Patient who has or ever had a thyroid problem, including swelling (nodular colloid goitre, endemic goitre or Hashimoto's thyroiditis) Patients currently having lithium therapy for depression Patients with sizable mucosal tears, abrasions, growths or burns in the mouth
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Laura Jacox, DMD, PhD
Organizational Affiliation
University of North Carolina, Chapel Hill
Official's Role
Principal Investigator
Facility Information:
Facility Name
General and Oral Health Center
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Deidentified individual data that supports the results will be shared beginning following publication up to 1 year provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.
IPD Sharing Time Frame
following publication up to 1 year
IPD Sharing Access Criteria
Deidentified individual data that supports the results will be shared beginning following publication up to 1 year provided the investigator who proposes to use the data has approval from an IRB, IEC, or REB as applicable, and an executed data use/sharing agreement with UNC.
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Mouth Rinses for Inactivation of COVID-19

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