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COVID-19 Long-Haulers Study

Primary Purpose

Coronavirus Disease 2019

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Placebos
Leronlimab (700mg)
Sponsored by
CytoDyn, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronavirus Disease 2019 focused on measuring COVID-19

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female adult ≥ 18 years of age at time of enrollment.
  2. Prior confirmed COVID-19 diagnosis by standard RT-PCR assay or equivalent testing
  3. Clinical Symptom Score of ≥6 AND at least two symptoms of moderate or higher severity as listed below at the time of Screening and currently experiencing two or more of the following symptoms consistent with COVID-19 infection for a prolonged period of time (>12 weeks).

    Clinical symptoms include the following:

    • Respiratory symptoms such as cough, sore throat, stuffy or runny nose, shortness of breath (difficulty breathing), tightness of chest.
    • Neurological symptoms such as difficulty in concentration (brain fog), sleep disturbance/insomnia, headache, dizziness, anxiety, tingling or numbness, loss of sense of smell or taste.
    • Cardiovascular and Gastrointestinal symptoms such as feeling of fast heartbeat, nausea, vomiting, diarrhea.
    • Musculoskeletal symptoms such as muscle aches/cramps, muscle weakness, joint pain/swelling.
    • General immune response symptoms such as fatigue (low energy or tiredness), chills or shivering, feeling hot or feverish, or exertional malaise (feeling of discomfort, illness, or lack of well-being after physical activity or mental stress).

    Note: Clinical Symptom Score is obtained from the patient diary (refer to Appendix 1 for scoring instructions).

  4. Electrocardiogram (ECG) with no clinically significant findings as assessed by the Investigator.

    Note: Below are the examples of clinically significant and non-clinically significant ECG abnormalities:

    • ECG findings indicative of acute myocardial infarction or acute ischemic changes would be considered clinically significant abnormalities.
    • ECG finding such as atrial fibrillation, atrial flutter, paced rhythms in individuals who have undergone permanent pacemaker placement, evidence of prior infarction, unchanged stable conduction abnormalities e.g. right bundle branch block, or any other finding which does not significantly impact mortality would be considered non-clinically significant findings and subjects with these abnormal findings would be allowed to enroll in the study.
  5. Subject (or legally authorized representative) provides written informed consent prior to initiation of any study procedures.
  6. Men and women of childbearing potential and their partner must agree to use two medically accepted methods of contraception (e.g., barrier contraceptives [male condom, female condom, or diaphragm with a spermicidal gel], hormonal contraceptives [implants, injectables, combination oral contraceptives, transdermal patches, or contraceptive rings], or one of the following methods of birth control (intrauterine devices, bilateral tubal occlusion, or vasectomy) or must practice complete sexual abstinence for the duration of the study (excluding women who are not of childbearing potential and men who have been sterilized).
  7. Females of child-bearing potential must have a negative urine pregnancy test at Screening Visit and prior to receiving the first dose of study drug; and Male participants must agree to use contraception and refrain from donating sperm for at least 90 days after the last dose of study intervention.
  8. Subject is willing and able to comply with scheduled visits, drug administration plan, laboratory tests, other study procedures and study restrictions

Exclusion Criteria:

  1. Exhibiting signs of moderate or severe pulmonary disease (such as COPD, asthma, or pulmonary fibrosis)
  2. Ongoing requirement of oxygen therapy
  3. Pulse oxygen saturation (SpO2) of <94% on room air at the time of screening
  4. History of splenectomy
  5. Liver cirrhosis or patient showing signs of clinical jaundice at the time of screening
  6. Chronic kidney disease stage 4 or requiring dialysis at the time of screening
  7. NYHA Class III or IV congestive heart failure (CHF)
  8. Exhibiting signs of uncontrolled hypo-or hyper- thyroidism at the time of Screening
  9. Uncontrolled rheumatologic disorders at the time of screening
  10. History of organ transplantation or are candidates for organ transplantation at the time of screening
  11. History of Chronic Fatigue Syndrome prior to COVID-19 infection
  12. History of fibromyalgia prior to COVID-19 infection
  13. History of major psychiatric disorder including bipolar disorders, schizophrenia, schizoaffective disorder, major depression. Patients with major depression can be enrolled if patient has had no episode within the past year or is considered in remission or controlled by treatment.
  14. Any malignancy within the past 5 years, excluding successfully treated basal cell carcinoma or squamous cell carcinoma without evidence of metastases.
  15. Any other clinically significant serious systemic diseases which would interfere with study conduct or study results interpretation per the Investigator.
  16. Treatment with immunosuppressive or immunomodulatory medications within 5 half-lives prior to screening. Patients on replacement therapy for adrenal insufficiency will be allowed. Patients on stable (> 3 months) low dose corticosteroid ≤ 5 mg Prednisone will be allowed.
  17. History of allergic reactions attributed to compounds of similar chemical or biologic composition to leronlimab (PRO 140) are not eligible
  18. Ongoing use of CCR5 antagonist
  19. Inability to provide informed consent or to comply with test requirements
  20. Consideration by the investigator, for safety reasons, that the subject is an unsuitable candidate to receive study treatment
  21. Pregnancy or breast feeding
  22. Participating in another study for an investigational treatment

Sites / Locations

  • Arthritis & Rheumatic Disease Specialties
  • Center for Advanced Research & Education (CARE)

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

700mg Leronlimab

Arm Description

Outcomes

Primary Outcome Measures

Changes from baseline in daily COVID-19-related symptom severity score through Day 56.
Note: A set of common COVID-19-related symptoms (see patient diary template) will be evaluated daily by the patient regardless of which symptoms a subject had at baseline, as new symptoms may appear following the baseline assessment.

Secondary Outcome Measures

Duration of COVID-19 associated symptoms from start of study treatment (Day 0) based on self-assessment using daily symptom diary.
Duration is defined as number of days when any symptoms scored as moderate or severe at baseline are still scored as moderate or severe (i.e., not mild or absent) through Day 56, or mild or absent at study entry are scored as mild or worse (i.e., not absent)through Day 56.
Number of symptom-free days of COVID-19 associated symptoms that were present at the start of study treatment (Day 0) based on self-assessment using daily symptom diary.
Symptom-free days are defined as number of days when any symptoms scored as mild, moderate or severe at baseline are scored as absent (or none) through Day 56.
Progression (or worsening) of COVID-19-associated symptoms through Day 56 compared to baseline.
Progression or symptom worsening is defined as number of days when any symptoms scored as moderate at baseline are scored as severe through Day 56. mild at baseline are scored as moderate or severe through Day 56. absent at baseline are scored as mild, moderate or worse through Day 56.
• Change from baseline in PROMIS® Fatigue Score at Days 28 and 56 and 56.
Change from baseline in PROMIS® Cognitive Function Score at Days 28 and 56
Change from baseline in PROMIS® Sleep Disturbance Score at Days 28 and 56.
Duration (days) of hospitalization during the treatment phase
Incidence of hospitalization during the treatment phase

Full Information

First Posted
December 14, 2020
Last Updated
July 30, 2021
Sponsor
CytoDyn, Inc.
Collaborators
Amarex Clinical Research
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1. Study Identification

Unique Protocol Identification Number
NCT04678830
Brief Title
COVID-19 Long-Haulers Study
Official Title
A Phase 2, Randomized, Double Blind, Placebo Controlled Study to Evaluate the Efficacy and Safety of Leronlimab in Patients Experiencing Prolonged Coronavirus Disease 2019 (COVID-19) Symptoms [Long-Haulers]
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
March 1, 2021 (Actual)
Primary Completion Date
June 5, 2021 (Actual)
Study Completion Date
July 8, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CytoDyn, Inc.
Collaborators
Amarex Clinical Research

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and efficacy of leronlimab (PRO 140) administered as weekly subcutaneous injections in subjects experiencing prolonged symptoms (> 12 weeks) of COVID-19.
Detailed Description
This is a Phase 2, two-arm, randomized, double blind, placebo controlled multicenter study to evaluate the safety and efficacy of leronlimab (PRO 140) in patients with prolonged symptoms caused by COVID-19. Patients will be randomized to receive weekly doses of 700 mg leronlimab (PRO 140), or placebo. Leronlimab (PRO 140) and placebo will be administered via subcutaneous injection. The study will have three phases: Screening Period, Treatment Period, and Follow-Up Period. Total study duration is 91 days. The study will be conducted at up to 5 centers in the United States and planned number of subjects are 50 subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronavirus Disease 2019
Keywords
COVID-19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
56 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Title
700mg Leronlimab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Placebos
Intervention Description
Placebos
Intervention Type
Drug
Intervention Name(s)
Leronlimab (700mg)
Intervention Description
Leronlimab (PRO) 140 is a humanized IgG4, monoclonal antibody (mAb) to the C-C chemokine receptor type 5 (CCR5)
Primary Outcome Measure Information:
Title
Changes from baseline in daily COVID-19-related symptom severity score through Day 56.
Description
Note: A set of common COVID-19-related symptoms (see patient diary template) will be evaluated daily by the patient regardless of which symptoms a subject had at baseline, as new symptoms may appear following the baseline assessment.
Time Frame
Day 56
Secondary Outcome Measure Information:
Title
Duration of COVID-19 associated symptoms from start of study treatment (Day 0) based on self-assessment using daily symptom diary.
Description
Duration is defined as number of days when any symptoms scored as moderate or severe at baseline are still scored as moderate or severe (i.e., not mild or absent) through Day 56, or mild or absent at study entry are scored as mild or worse (i.e., not absent)through Day 56.
Time Frame
56 days
Title
Number of symptom-free days of COVID-19 associated symptoms that were present at the start of study treatment (Day 0) based on self-assessment using daily symptom diary.
Description
Symptom-free days are defined as number of days when any symptoms scored as mild, moderate or severe at baseline are scored as absent (or none) through Day 56.
Time Frame
56 days
Title
Progression (or worsening) of COVID-19-associated symptoms through Day 56 compared to baseline.
Description
Progression or symptom worsening is defined as number of days when any symptoms scored as moderate at baseline are scored as severe through Day 56. mild at baseline are scored as moderate or severe through Day 56. absent at baseline are scored as mild, moderate or worse through Day 56.
Time Frame
56 days
Title
• Change from baseline in PROMIS® Fatigue Score at Days 28 and 56 and 56.
Time Frame
Days 42 and 56
Title
Change from baseline in PROMIS® Cognitive Function Score at Days 28 and 56
Time Frame
Days 42 and 56
Title
Change from baseline in PROMIS® Sleep Disturbance Score at Days 28 and 56.
Time Frame
Days 42 and 56
Title
Duration (days) of hospitalization during the treatment phase
Time Frame
56 days
Title
Incidence of hospitalization during the treatment phase
Time Frame
56 days
Other Pre-specified Outcome Measures:
Title
Change from baseline in pulse oxygen saturation (SpO2) at Day 7, 14, 21, 28, 35, 42, 49, and 56
Description
Exploratory Outcome
Time Frame
Day 7, 14, 21, 28, 35, 42, 49, and 56.
Title
Change from baseline in serum cytokine and chemokine levels on Days 28 and 56.
Description
Exploratory Outcome
Time Frame
Days 28 and 56
Title
Change from baseline in CD4+ and CD8+ T cell count on Days 28 and 56.
Description
Exploratory Outcome
Time Frame
Days 28 and 56
Title
Change from baseline in Transgrowth factor beta 1 (TGF beta1) on Days 28 and 56
Description
Exploratory Outcome
Time Frame
Days 28 and 56
Title
Change from baseline in CRP on Days 28 and 56
Description
Exploratory Outcome
Time Frame
Days 28 and 56
Title
Change from baseline in CCR5 receptor occupancy on Days 28 and 56.
Description
Exploratory Outcome
Time Frame
Days 28 and 56
Title
To explore biomarkers that may predict and/or act as pharmacodynamic indicators of pharmacologic activity of leronlimab.
Description
Exploratory Outcome
Time Frame
91 Days
Title
Incidence of treatment-related adverse events (TEAEs)
Description
Safety Measures
Time Frame
91 days
Title
Incidence and severity of treatment-emergent adverse events (TEAEs)
Description
Safety Measures
Time Frame
91 days
Title
Incidence of serious adverse events (SAEs)
Description
Safety Measures
Time Frame
91 days
Title
Incidence of TEAEs and SAEs leading to discontinuation of study medication.
Description
Safety Measures
Time Frame
56 days
Title
Changes in blood chemistry, hematology and coagulation parameter results
Description
Safety Measures
Time Frame
91 days
Title
Changes in vital signs including temperature, pulse, respiratory rate, systolic and diastolic blood pressure
Description
Safety Measures
Time Frame
91 days
Title
Changes in physical examination results
Description
Safety Measures
Time Frame
91 days
Title
Changes in electrocardiogram (ECG) results
Description
Safety Measures
Time Frame
91 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female adult ≥ 18 years of age at time of enrollment. Prior confirmed COVID-19 diagnosis by standard RT-PCR assay or equivalent testing Clinical Symptom Score of ≥6 AND at least two symptoms of moderate or higher severity as listed below at the time of Screening and currently experiencing two or more of the following symptoms consistent with COVID-19 infection for a prolonged period of time (>12 weeks). Clinical symptoms include the following: Respiratory symptoms such as cough, sore throat, stuffy or runny nose, shortness of breath (difficulty breathing), tightness of chest. Neurological symptoms such as difficulty in concentration (brain fog), sleep disturbance/insomnia, headache, dizziness, anxiety, tingling or numbness, loss of sense of smell or taste. Cardiovascular and Gastrointestinal symptoms such as feeling of fast heartbeat, nausea, vomiting, diarrhea. Musculoskeletal symptoms such as muscle aches/cramps, muscle weakness, joint pain/swelling. General immune response symptoms such as fatigue (low energy or tiredness), chills or shivering, feeling hot or feverish, or exertional malaise (feeling of discomfort, illness, or lack of well-being after physical activity or mental stress). Note: Clinical Symptom Score is obtained from the patient diary (refer to Appendix 1 for scoring instructions). Electrocardiogram (ECG) with no clinically significant findings as assessed by the Investigator. Note: Below are the examples of clinically significant and non-clinically significant ECG abnormalities: ECG findings indicative of acute myocardial infarction or acute ischemic changes would be considered clinically significant abnormalities. ECG finding such as atrial fibrillation, atrial flutter, paced rhythms in individuals who have undergone permanent pacemaker placement, evidence of prior infarction, unchanged stable conduction abnormalities e.g. right bundle branch block, or any other finding which does not significantly impact mortality would be considered non-clinically significant findings and subjects with these abnormal findings would be allowed to enroll in the study. Subject (or legally authorized representative) provides written informed consent prior to initiation of any study procedures. Men and women of childbearing potential and their partner must agree to use two medically accepted methods of contraception (e.g., barrier contraceptives [male condom, female condom, or diaphragm with a spermicidal gel], hormonal contraceptives [implants, injectables, combination oral contraceptives, transdermal patches, or contraceptive rings], or one of the following methods of birth control (intrauterine devices, bilateral tubal occlusion, or vasectomy) or must practice complete sexual abstinence for the duration of the study (excluding women who are not of childbearing potential and men who have been sterilized). Females of child-bearing potential must have a negative urine pregnancy test at Screening Visit and prior to receiving the first dose of study drug; and Male participants must agree to use contraception and refrain from donating sperm for at least 90 days after the last dose of study intervention. Subject is willing and able to comply with scheduled visits, drug administration plan, laboratory tests, other study procedures and study restrictions Exclusion Criteria: Exhibiting signs of moderate or severe pulmonary disease (such as COPD, asthma, or pulmonary fibrosis) Ongoing requirement of oxygen therapy Pulse oxygen saturation (SpO2) of <94% on room air at the time of screening History of splenectomy Liver cirrhosis or patient showing signs of clinical jaundice at the time of screening Chronic kidney disease stage 4 or requiring dialysis at the time of screening NYHA Class III or IV congestive heart failure (CHF) Exhibiting signs of uncontrolled hypo-or hyper- thyroidism at the time of Screening Uncontrolled rheumatologic disorders at the time of screening History of organ transplantation or are candidates for organ transplantation at the time of screening History of Chronic Fatigue Syndrome prior to COVID-19 infection History of fibromyalgia prior to COVID-19 infection History of major psychiatric disorder including bipolar disorders, schizophrenia, schizoaffective disorder, major depression. Patients with major depression can be enrolled if patient has had no episode within the past year or is considered in remission or controlled by treatment. Any malignancy within the past 5 years, excluding successfully treated basal cell carcinoma or squamous cell carcinoma without evidence of metastases. Any other clinically significant serious systemic diseases which would interfere with study conduct or study results interpretation per the Investigator. Treatment with immunosuppressive or immunomodulatory medications within 5 half-lives prior to screening. Patients on replacement therapy for adrenal insufficiency will be allowed. Patients on stable (> 3 months) low dose corticosteroid ≤ 5 mg Prednisone will be allowed. History of allergic reactions attributed to compounds of similar chemical or biologic composition to leronlimab (PRO 140) are not eligible Ongoing use of CCR5 antagonist Inability to provide informed consent or to comply with test requirements Consideration by the investigator, for safety reasons, that the subject is an unsuitable candidate to receive study treatment Pregnancy or breast feeding Participating in another study for an investigational treatment
Facility Information:
Facility Name
Arthritis & Rheumatic Disease Specialties
City
Aventura
State/Province
Florida
ZIP/Postal Code
33180
Country
United States
Facility Name
Center for Advanced Research & Education (CARE)
City
Gainesville
State/Province
Georgia
ZIP/Postal Code
30501
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
35452519
Citation
Gaylis NB, Ritter A, Kelly SA, Pourhassan NZ, Tiwary M, Sacha JB, Hansen SG, Recknor C, Yang OO. Reduced Cell Surface Levels of C-C Chemokine Receptor 5 and Immunosuppression in Long Coronavirus Disease 2019 Syndrome. Clin Infect Dis. 2022 Sep 30;75(7):1232-1234. doi: 10.1093/cid/ciac226.
Results Reference
derived
PubMed Identifier
34868084
Citation
Chang XL, Wu HL, Webb GM, Tiwary M, Hughes C, Reed JS, Hwang J, Waytashek C, Boyle C, Pessoa C, Sylwester AW, Morrow D, Belica K, Fischer M, Kelly S, Pourhassan N, Bochart RM, Smedley J, Recknor CP, Hansen SG, Sacha JB. CCR5 Receptor Occupancy Analysis Reveals Increased Peripheral Blood CCR5+CD4+ T Cells Following Treatment With the Anti-CCR5 Antibody Leronlimab. Front Immunol. 2021 Nov 19;12:794638. doi: 10.3389/fimmu.2021.794638. eCollection 2021.
Results Reference
derived

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COVID-19 Long-Haulers Study

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