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Study Evaluating Safety and Tolerability of Allocetra-OTS in Patients With COVID-19

Primary Purpose

Covid19

Status
Unknown status
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Allocetra-OTS
Sponsored by
Enlivex Therapeutics Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19 focused on measuring Cell therapy, Allocetra-OTS

Eligibility Criteria

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

Inclusion Criteria:

  1. Male and female > 18 and < 80 years of age.
  2. Laboratory confirmation of SARS-CoV-2 infection by RT-PCR from any diagnostic sampling source.
  3. Patient hospitalized due to COVID-19 in the last 24 hours.
  4. Hospitalized patients meeting the criteria for moderate COVID-19, as set forth by the May 2020 FDA Guidance for Industry: COVID-19: Developing Drugs and Biological Products for Treatment or Prevention, Patients with symptoms of moderate illness with COVID-19, which could include any symptom of mild illness (such as fever, cough, sore throat, malaise, headache, muscle pain, gastrointestinal symptoms, without shortness of breath or dyspnea) or shortness of breath with exertion with at least one of the following clinical signs:

    1. Respiratory rate: ≥ 20 breaths/minute;
    2. SpO2: > 93% on room air at sea level;
    3. Heart rate: ≥ 90 beats/minute;
  5. Signed written informed consent by the patient.
  6. Women and men who are of childbearing potential, willing to use acceptable contraceptive measures during 4 weeks from enrolment .

Exclusion Criteria:

  1. Any signs indicative of Severe or Critical Illness Severity requiring hospitalization as defined below:

    Severe COVID-19: Shortness of breath in rest, or respiratory distress, or respiratory rate (RR≥30 per minute , or heart rate (HR) ≥125 bpm, or SpO2≤93% on room air at sea level or PaO2/FiO2<300

    Critical COVID-19- at least one of the following:

    • Respiratory failure required at least one of the following: mechanical ventilation, oxygen delivered by high-flow nasal cannula, noninvasive positive pressure ventilation, ECMO.
    • Shock
    • Multi-organ dysfunction/failure.
  2. Women who are pregnant or breast feeding.
  3. Weight <50 kg or >110 kg.
  4. Stage 4 and 5 severe chronic kidney disease or requiring dialysis with eGFR < 30 ml/min.
  5. Patients with active malignant tumor.
  6. Patients who are participating in other concurrent investigational clinical trials or have been treated with any experimental agents within 30 days prior to enrollment.
  7. Known active chronic viral infections including, but not limited to, active HBV, HCV, or HIV/AIDS or other chronic infections.

    Based on medical history and concomitant therapies that would suggest infection, have suspected clinical diagnosis of current active TB or, if known, latent TB treated for less than 4 weeks with appropriate anti-TB therapy per institutional guidelines; Based on medical history and concomitant therapies that would suggest infection, suspected serious, active bacterial, fungal, viral (including, but not limited to, active HBV, HCV, or HIV/AIDS).

  8. Known immunocompromised state or immunosuppressing medications taken for indications other than SARS-CoV-2 (i.e., agents including chronic corticosteroids > 10 mg/day, azathioprine, cyclosporine, cyclophosphamide).
  9. Known New York Heart Association (NYHA) class III and IV heart failure or unstable angina, ventricular arrhythmias, active ischemic heart disease , or myocardial infarction within six months prior to diagnosis of COVID-19.
  10. Known active upper gastrointestinal (GI) tract ulceration or hepatic dysfunction including but not limited to biopsy-proven cirrhosis; end-stage cirrhosis (Child Pugh Class C); portal hypertension; episodes of past upper GI bleeding attributed to portal hypertension; or prior episodes of hepatic failure, encephalopathy, or coma.
  11. Patients with Glasgow Coma Scale (GCS) <13 with verbal score <5.
  12. Estimated GFR < 25 ml/min.
  13. Hemoglobin < 8 gr%.
  14. Patients with history of chronic liver disease, evidence of acute cholangitis or cholecystitis. Patients with at least one of the following:

    • ALT or AST > 5X ULN (upper limit of normal range)
    • Bilirubin > 3 X ULN
    • Combination of ALT/AST > 3 X ULN and elevated direct bilirubin>ULN
  15. Known history of transfusion reactions, hemolytic anemia, or allergic reaction.
  16. Organ allograft or previous history of stem cell transplantation.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Active Comparator

    Active Comparator

    Active Comparator

    Arm Label

    Cohort 1

    Cohort 2

    Cohort 3

    Arm Description

    Single Intravenous (IV) dose of Allocetra-OTS with 5x10^9 cells

    Single Intravenous (IV) dose of Allocetra-OTS with 10x10^9 cells

    Two IV doses of Allocetra-OTS with 10x10^9 cells in each dose

    Outcomes

    Primary Outcome Measures

    Safety - Adverse Events
    Number and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs).
    Maximum Tolerated Dose (MTD)
    The highest dose of Allocetra-OTS that did not cause a Dose-Limiting Toxicity (DLT) in 2/6 cohort patientsor maximally administered dose if no DLT is seen.

    Secondary Outcome Measures

    Efficacy - PaO2 or SO2/FiO2 Ratio
    Change in PaO2 or SO2/FiO2 Ratio
    Efficacy - mortality
    All-cause mortality
    Efficacy - organ function / support measurements
    Oxygen free days, vasopressors free days, cumulative days in ICU or IMU
    Efficacy - NEWS2 Score
    Change from baseline in National Early Warning Score 2 (NEWS2)

    Full Information

    First Posted
    December 7, 2020
    Last Updated
    August 17, 2021
    Sponsor
    Enlivex Therapeutics Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04659304
    Brief Title
    Study Evaluating Safety and Tolerability of Allocetra-OTS in Patients With COVID-19
    Official Title
    A Multi-Center , Sequential Dose Escalation Study, Evaluating Safety and Tolerability of Allocetra-OTS in Patients With COVID-19
    Study Type
    Interventional

    2. Study Status

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

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Enlivex Therapeutics Ltd.

    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
    Phase 1b, multi-center, open label, sequential dose escalation trial assessing 3 dose cohorts using a 3+3 design to evaluate safety and tolerability of Allocetra-OTS in adult patients with moderate COVID-19. The sample size for this trial is anticipated to range from 9 to 18 patients.
    Detailed Description
    Potential patients, who will be identified as suffering from moderate COVID-19 (as set forth in the FDA guidance for industry dated May 2020) will be recruited. After the patient has signed the Informed Consent Form (ICF), and after confirmation that the patient meets all eligibility criteria, the patient will be enrolled to the relevant dose group according to the following sequential design: Single Intravenous (IV) dose of Allocetra-OTS with 5x10^9 cells, Single Intravenous (IV) dose of Allocetra-OTS with 10x10^9 cells, Two IV doses of Allocetra-OTS with10x10^9 cells each dose (separated by 72 hours). Each dose cohort will consist of 3 and up to 6 patients. In each dose cohort, starting with dose cohort 1, a single patient will be enrolled and dosed. If no dose limiting toxicity (DLT) is observed after at least 1 week and following review of relevant safety data of the first patient in that cohort by the DMC, 2 additional patients will be enrolled. If no DLT is seen in the initial 3 dosed patients within a certain cohort and following DMC review, the first patient in the next dose cohort can be enrolled, repeating the same sequence of enrollment as described above. If 1 DLT is seen in the initial 3 dosed patients within a certain cohort, the cohort will be expanded to a total of 6 patients. If >2/6 patients experience a DLT, the MTD will be reached. If no more than 1 patient out of 6 experiences a DLT, the next sequence of enrollment will be continued. DMC will review and assess safety data at the predefined timepoints to recommend on cohort expansion or cohort escalation. Investigational Product (IP) administration will occur on Day 1 within 12±4 hours from the time of eligibility. Following IP administration (Day 1), patients will be followed for safety and efficacy assessments through 6 months.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Covid19
    Keywords
    Cell therapy, Allocetra-OTS

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Sequential Assignment
    Model Description
    sequential dose escalation using a 3+3 design
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    18 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Cohort 1
    Arm Type
    Active Comparator
    Arm Description
    Single Intravenous (IV) dose of Allocetra-OTS with 5x10^9 cells
    Arm Title
    Cohort 2
    Arm Type
    Active Comparator
    Arm Description
    Single Intravenous (IV) dose of Allocetra-OTS with 10x10^9 cells
    Arm Title
    Cohort 3
    Arm Type
    Active Comparator
    Arm Description
    Two IV doses of Allocetra-OTS with 10x10^9 cells in each dose
    Intervention Type
    Drug
    Intervention Name(s)
    Allocetra-OTS
    Intervention Description
    Cell-based therapy comprised of allogeneic non-HLA matched peripheral blood mononuclear cells induced to an early apoptotic state.
    Primary Outcome Measure Information:
    Title
    Safety - Adverse Events
    Description
    Number and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs).
    Time Frame
    28 days
    Title
    Maximum Tolerated Dose (MTD)
    Description
    The highest dose of Allocetra-OTS that did not cause a Dose-Limiting Toxicity (DLT) in 2/6 cohort patientsor maximally administered dose if no DLT is seen.
    Time Frame
    28 days
    Secondary Outcome Measure Information:
    Title
    Efficacy - PaO2 or SO2/FiO2 Ratio
    Description
    Change in PaO2 or SO2/FiO2 Ratio
    Time Frame
    28 days
    Title
    Efficacy - mortality
    Description
    All-cause mortality
    Time Frame
    28 days
    Title
    Efficacy - organ function / support measurements
    Description
    Oxygen free days, vasopressors free days, cumulative days in ICU or IMU
    Time Frame
    28 days
    Title
    Efficacy - NEWS2 Score
    Description
    Change from baseline in National Early Warning Score 2 (NEWS2)
    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: Male and female > 18 and < 80 years of age. Laboratory confirmation of SARS-CoV-2 infection by RT-PCR from any diagnostic sampling source. Patient hospitalized due to COVID-19 in the last 24 hours. Hospitalized patients meeting the criteria for moderate COVID-19, as set forth by the May 2020 FDA Guidance for Industry: COVID-19: Developing Drugs and Biological Products for Treatment or Prevention, Patients with symptoms of moderate illness with COVID-19, which could include any symptom of mild illness (such as fever, cough, sore throat, malaise, headache, muscle pain, gastrointestinal symptoms, without shortness of breath or dyspnea) or shortness of breath with exertion with at least one of the following clinical signs: Respiratory rate: ≥ 20 breaths/minute; SpO2: > 93% on room air at sea level; Heart rate: ≥ 90 beats/minute; Signed written informed consent by the patient. Women and men who are of childbearing potential, willing to use acceptable contraceptive measures during 4 weeks from enrolment . Exclusion Criteria: Any signs indicative of Severe or Critical Illness Severity requiring hospitalization as defined below: Severe COVID-19: Shortness of breath in rest, or respiratory distress, or respiratory rate (RR≥30 per minute , or heart rate (HR) ≥125 bpm, or SpO2≤93% on room air at sea level or PaO2/FiO2<300 Critical COVID-19- at least one of the following: Respiratory failure required at least one of the following: mechanical ventilation, oxygen delivered by high-flow nasal cannula, noninvasive positive pressure ventilation, ECMO. Shock Multi-organ dysfunction/failure. Women who are pregnant or breast feeding. Weight <50 kg or >110 kg. Stage 4 and 5 severe chronic kidney disease or requiring dialysis with eGFR < 30 ml/min. Patients with active malignant tumor. Patients who are participating in other concurrent investigational clinical trials or have been treated with any experimental agents within 30 days prior to enrollment. Known active chronic viral infections including, but not limited to, active HBV, HCV, or HIV/AIDS or other chronic infections. Based on medical history and concomitant therapies that would suggest infection, have suspected clinical diagnosis of current active TB or, if known, latent TB treated for less than 4 weeks with appropriate anti-TB therapy per institutional guidelines; Based on medical history and concomitant therapies that would suggest infection, suspected serious, active bacterial, fungal, viral (including, but not limited to, active HBV, HCV, or HIV/AIDS). Known immunocompromised state or immunosuppressing medications taken for indications other than SARS-CoV-2 (i.e., agents including chronic corticosteroids > 10 mg/day, azathioprine, cyclosporine, cyclophosphamide). Known New York Heart Association (NYHA) class III and IV heart failure or unstable angina, ventricular arrhythmias, active ischemic heart disease , or myocardial infarction within six months prior to diagnosis of COVID-19. Known active upper gastrointestinal (GI) tract ulceration or hepatic dysfunction including but not limited to biopsy-proven cirrhosis; end-stage cirrhosis (Child Pugh Class C); portal hypertension; episodes of past upper GI bleeding attributed to portal hypertension; or prior episodes of hepatic failure, encephalopathy, or coma. Patients with Glasgow Coma Scale (GCS) <13 with verbal score <5. Estimated GFR < 25 ml/min. Hemoglobin < 8 gr%. Patients with history of chronic liver disease, evidence of acute cholangitis or cholecystitis. Patients with at least one of the following: ALT or AST > 5X ULN (upper limit of normal range) Bilirubin > 3 X ULN Combination of ALT/AST > 3 X ULN and elevated direct bilirubin>ULN Known history of transfusion reactions, hemolytic anemia, or allergic reaction. Organ allograft or previous history of stem cell transplantation.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Odelia Ben Shitrit, MBA
    Phone
    972-548887609
    Email
    odelia@enlivexpharm.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Lior Binder
    Phone
    972-548054899
    Email
    lior@enlivexpharm.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Oren Hershkovitz, PhD
    Organizational Affiliation
    Enlivex Therapeutics R&D
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    IPD Sharing Plan Description
    Patient data will not contain any information which would make the patient identifiable. Data will be processes and shared using patient study number only.

    Learn more about this trial

    Study Evaluating Safety and Tolerability of Allocetra-OTS in Patients With COVID-19

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