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COVID-19 Outpatient Pragmatic Platform Study (COPPS) - Camostat Sub-Protocol (COPPS)

Primary Purpose

Covid19

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Camostat
Placebo
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19 focused on measuring Outpatient

Eligibility Criteria

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

Inclusion Criteria:

  1. 1. Outpatient setting
  2. Age ≥ 18 years and ≤ 80 years at the time of the assessment
  3. Able and willing to understand the study, adhere to all study procedures, and provide written informed consent
  4. Initial diagnosis of COVID-19 disease as defined by an FDA-cleared molecular diagnostic assay positive for SARS-CoV-2 with no more than 72 hours from the initial swab used in the diagnosis to the time of commencing informed consent.
  5. At baseline, at least two symptoms should have mild or higher severity score, where at least one of the mild symptoms is not cough, fatigue, or loss of smell/taste OR at least one symptom has a moderate or higher severity score on the COVID Outpatient Symptom Scale (COSS).
  6. Participant's COVID-19 related symptom onset occurred within 7 days prior to time of randomization.
  7. Other inclusion criteria specific to the investigational product that may, in the eyes of the investigator, be deemed necessary.

Additional inclusion criteria for camostat protocol:

  1. If male, must be sterile, OR agree not to donate semen AND agree to strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication
  2. If female, must be unable to bear children, OR ensure that their male partner is incapable of fathering a child, OR, if of childbearing potential will strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication, and must agree to stop breast-feeding prior to first dose of study drug and through seven days after completing therapy.

Exclusion Criteria:

  1. At screening, the participant needs to be admitted to the hospital or is being evaluated for potential admission.
  2. Previous use of experimental drugs that may be active against COVID-19 in the eyes of the investigators.
  3. Participant yields a positive urine pregnancy test at screening.
  4. Participant is using adrenocorticosteroids (except topical or inhaled preparations or oral preparations equivalent to or less than 10 mg of oral prednisone) or immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer drugs, interleukins, interleukin antagonists or interleukin receptor blockers).

    NOTE: Treatment of study participants following institutional COVID-19 treatment policies or guidelines, including the use of immunomodulatory medications, is permitted. This excludes treatment with agents that have the potential for direct antiviral activity, including convalescent plasma and NO, and co-enrollment into other clinical studies that evaluate investigational agents for COVID-19.

  5. Participant has a serious chronic disease (e.g., uncontrolled human immunodeficiency virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or moderate or severe hepatic insufficiency).
  6. Has renal insufficiency including severe renal impairment and ESRD and/or requiring hemodialysis or continuous ambulatory peritoneal dialysis (CAPD).
  7. Has liver impairment greater than Child Pugh A.
  8. Has a history of alcohol or drug abuse in the previous 6 months.
  9. Has a psychiatric disease that is not well controlled where controlled is defined as: stable on a regimen for more than one year.
  10. Has taken another investigational drug within the past 30 days.
  11. Is deemed by the Investigator to be ineligible for any reason.

Additional exclusion criteria for camostat protocol:

  1. Participant has a history of gout and coagulation disorders.
  2. Participant has a concomitant bacterial respiratory infection as documented by a respiratory culture with microbiologic growth. NOTE: Participants on empirical antibiotic treatment for possible but unproven bacterial pneumonia, but who are positive for SARS-CoV-2, are allowed in the study.
  3. Has previously received camostat mesilate within the past 30 days.

Sites / Locations

  • ValleyCare Medical Center
  • Stanford University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Camostat

Matching Placebo

Arm Description

Participants are randomized to receive camostat for 10 days.

Participants are randomized to receive placebo to match camostat for 10 days.

Outcomes

Primary Outcome Measures

For the Viral Domain: Change in Viral Shedding
The number of participants who had viral shedding at Day 10 is reported. Change in shedding of SARS-CoV-2 virus through day 10 attained from self-collected nasal swab RT-PCR data after transformation using a referenced standard curve.

Secondary Outcome Measures

For Clinical Domain: Time-to-sustained-resolution
The number of participants with sustained resolution by Day 28 is reported. Resolution is defined as the first day where no symptoms are self-reported on all succeeding days through and including day 28, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time to Viral Cessation
Defined as the time in days from randomization to the first of two consecutive negative RT-PCR results of self-collected nasal swabs.
Time to First Resolution
The number of participants with first resolution by Day 28 is reported. First resolution is defined as the first study day where no symptoms are self-reported, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time to Full Resolution
The number of participants with full resolution by Day 28 is reported. Full resolution is defined as the study day where no symptoms are first self-reported.
Indicator of SARS-CoV-2 Related Hospitalizations, ED Visits, or Death in Outpatients With COVID-19 Disease.
Count (%) of participants that experienced SARS-CoV-2 a related hospitalization, emergency department (ED) visit, or death.
Indicator Participant Has Developed Antibodies to SARS-CoV-2
Indicator Participant Has a Negative SARS-CoV2 RT-PCR Test
Count (%) of participants with a negative SARS-CoV2 RT-PCR test at day 14
Indicator Participant Has a Negative SARS-CoV2 RT-PCR Test
Count (%) of participants with a negative SARS-CoV2 RT-PCR test at day 28

Full Information

First Posted
December 8, 2020
Last Updated
June 9, 2023
Sponsor
Stanford University
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1. Study Identification

Unique Protocol Identification Number
NCT04662073
Brief Title
COVID-19 Outpatient Pragmatic Platform Study (COPPS) - Camostat Sub-Protocol
Acronym
COPPS
Official Title
COVID-19 Outpatient Pragmatic Platform Study (COPPS): A Pragmatic Multi-arm, Adaptive, Phase 2, Blinded, Randomized Placebo-controlled Platform Trial to Assess the Efficacy of Different Investigational Therapeutics in Reducing Time to Disease Resolution or Viral Load Cessation, as Compared to Standard Supportive Care in Outpatients With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Terminated
Why Stopped
Enrollment into the camostat subprotocol was halted prematurely as a result of loss of equipoise due to external findings including those related to monoclonal antibodies.
Study Start Date
April 23, 2021 (Actual)
Primary Completion Date
June 8, 2021 (Actual)
Study Completion Date
March 4, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stanford University

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
Yes

5. Study Description

Brief Summary
The overall objective of this study is to efficiently evaluate the clinical efficacy and safety of different investigational therapeutics among adults who have COVID-19 but are not yet sick enough to require hospitalization. The overall hypothesis is that through an adaptive trial design, potential effective therapies (single and combination) may be identified for this group of patients. COVID-19 Outpatient Pragmatic Platform Study (COPPS) is a pragmatic platform protocol designed to evaluate COVID-19 treatments by assessing their ability to reduce viral shedding (Viral Domain) or improve clinical outcomes (Clinical Domain). To be included into the platform, every investigational product will collect data for both Domain primary endpoints. Individual treatments to be evaluated in the platform will be described in separate sub-protocols.
Detailed Description
The platform study allows investigational products with objectives either: evaluating viral shedding (Virology Domain); and COVID-19 related Clinical Outcomes (Clinical Domain). The primary objective for investigational products within the Viral Domain is: A. To evaluate the efficacy of each therapeutic intervention in addition to standard supportive care (SSC) compared with SSC in reducing viral shedding of SARS-CoV-2 virus in outpatients with COVID-19 disease. The primary objective for investigational products within for the Clinical Domain is: B. To evaluate the efficacy of each therapeutic intervention in addition to SSC as compared to SSC in improving sustained clinical outcomes in outpatients with COVID-19 disease. Secondary objectives are: The objective of the non-assigned domain an investigational product is under. If under Clinical Domain, reduction in viral shedding. If under Viral Domain, time to resolution of symptoms. To evaluate the efficacy of each therapeutic intervention in reducing SARS-CoV-2 related hospitalizations, ED visits, or death in outpatients with COVID-19 disease. To assess the development of antibodies against SARS-CoV-2 To evaluate the safety and tolerability of each therapeutic intervention compared with placebo (supportive care).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19
Keywords
Outpatient

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Camostat
Arm Type
Experimental
Arm Description
Participants are randomized to receive camostat for 10 days.
Arm Title
Matching Placebo
Arm Type
Placebo Comparator
Arm Description
Participants are randomized to receive placebo to match camostat for 10 days.
Intervention Type
Drug
Intervention Name(s)
Camostat
Intervention Description
200 mg (2 x 100 mg tablet) administered orally four times daily (800 mg total daily dose).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo to match camostat administered orally four times daily
Primary Outcome Measure Information:
Title
For the Viral Domain: Change in Viral Shedding
Description
The number of participants who had viral shedding at Day 10 is reported. Change in shedding of SARS-CoV-2 virus through day 10 attained from self-collected nasal swab RT-PCR data after transformation using a referenced standard curve.
Time Frame
10 days
Secondary Outcome Measure Information:
Title
For Clinical Domain: Time-to-sustained-resolution
Description
The number of participants with sustained resolution by Day 28 is reported. Resolution is defined as the first day where no symptoms are self-reported on all succeeding days through and including day 28, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time Frame
28 days
Title
Time to Viral Cessation
Description
Defined as the time in days from randomization to the first of two consecutive negative RT-PCR results of self-collected nasal swabs.
Time Frame
28 days
Title
Time to First Resolution
Description
The number of participants with first resolution by Day 28 is reported. First resolution is defined as the first study day where no symptoms are self-reported, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time Frame
28 days
Title
Time to Full Resolution
Description
The number of participants with full resolution by Day 28 is reported. Full resolution is defined as the study day where no symptoms are first self-reported.
Time Frame
28 days
Title
Indicator of SARS-CoV-2 Related Hospitalizations, ED Visits, or Death in Outpatients With COVID-19 Disease.
Description
Count (%) of participants that experienced SARS-CoV-2 a related hospitalization, emergency department (ED) visit, or death.
Time Frame
28 days
Title
Indicator Participant Has Developed Antibodies to SARS-CoV-2
Time Frame
28 days
Title
Indicator Participant Has a Negative SARS-CoV2 RT-PCR Test
Description
Count (%) of participants with a negative SARS-CoV2 RT-PCR test at day 14
Time Frame
day 14
Title
Indicator Participant Has a Negative SARS-CoV2 RT-PCR Test
Description
Count (%) of participants with a negative SARS-CoV2 RT-PCR test at day 28
Time Frame
day 28

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: 1. Outpatient setting Age ≥ 18 years and ≤ 80 years at the time of the assessment Able and willing to understand the study, adhere to all study procedures, and provide written informed consent Initial diagnosis of COVID-19 disease as defined by an FDA-cleared molecular diagnostic assay positive for SARS-CoV-2 with no more than 72 hours from the initial swab used in the diagnosis to the time of commencing informed consent. At baseline, at least two symptoms should have mild or higher severity score, where at least one of the mild symptoms is not cough, fatigue, or loss of smell/taste OR at least one symptom has a moderate or higher severity score on the COVID Outpatient Symptom Scale (COSS). Participant's COVID-19 related symptom onset occurred within 7 days prior to time of randomization. Other inclusion criteria specific to the investigational product that may, in the eyes of the investigator, be deemed necessary. Additional inclusion criteria for camostat protocol: If male, must be sterile, OR agree not to donate semen AND agree to strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication If female, must be unable to bear children, OR ensure that their male partner is incapable of fathering a child, OR, if of childbearing potential will strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication, and must agree to stop breast-feeding prior to first dose of study drug and through seven days after completing therapy. Exclusion Criteria: At screening, the participant needs to be admitted to the hospital or is being evaluated for potential admission. Previous use of experimental drugs that may be active against COVID-19 in the eyes of the investigators. Participant yields a positive urine pregnancy test at screening. Participant is using adrenocorticosteroids (except topical or inhaled preparations or oral preparations equivalent to or less than 10 mg of oral prednisone) or immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer drugs, interleukins, interleukin antagonists or interleukin receptor blockers). NOTE: Treatment of study participants following institutional COVID-19 treatment policies or guidelines, including the use of immunomodulatory medications, is permitted. This excludes treatment with agents that have the potential for direct antiviral activity, including convalescent plasma and NO, and co-enrollment into other clinical studies that evaluate investigational agents for COVID-19. Participant has a serious chronic disease (e.g., uncontrolled human immunodeficiency virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or moderate or severe hepatic insufficiency). Has renal insufficiency including severe renal impairment and ESRD and/or requiring hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Has liver impairment greater than Child Pugh A. Has a history of alcohol or drug abuse in the previous 6 months. Has a psychiatric disease that is not well controlled where controlled is defined as: stable on a regimen for more than one year. Has taken another investigational drug within the past 30 days. Is deemed by the Investigator to be ineligible for any reason. Additional exclusion criteria for camostat protocol: Participant has a history of gout and coagulation disorders. Participant has a concomitant bacterial respiratory infection as documented by a respiratory culture with microbiologic growth. NOTE: Participants on empirical antibiotic treatment for possible but unproven bacterial pneumonia, but who are positive for SARS-CoV-2, are allowed in the study. Has previously received camostat mesilate within the past 30 days.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Julie Parsonnet, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Chaitan Khosla, PhD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
ValleyCare Medical Center
City
Pleasanton
State/Province
California
ZIP/Postal Code
94588
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34274494
Citation
Bunning B, Hedlin H, Purington N, Sundaram V, Kapphahn K, Weng Y, Cunanan K, Maldonado Y, Singh U, Khosla C, O'Hara R, Nicolls M, Springman E, Parsonnet J, Rogers A, Levitt J, Desai M. The COVID-19 Outpatient Pragmatic Platform Study (COPPS): Study design of a multi-center pragmatic platform trial. Contemp Clin Trials. 2021 Sep;108:106509. doi: 10.1016/j.cct.2021.106509. Epub 2021 Jul 16.
Results Reference
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COVID-19 Outpatient Pragmatic Platform Study (COPPS) - Camostat Sub-Protocol

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