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Clinical Study in the Treatment of Patients With COVID-19

Primary Purpose

COVID-19

Status
Unknown status
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
Molixan
Placebo
Sponsored by
Pharma VAM
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring COVID-19, METABOLIC DRUG, Severe course of COVID-19

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Hospitalized male and female patients aged 18 to 75 and weighing no more than 120 kg inclusively with a diagnosis of the severe course of COVID-19 confirmed by the result of a laboratory study for the presence of SARS-CoV-2 RNA using nucleic acid amplification methods (to be performed on Screening, or results with sampling 72 hours prior to Screening may be accepted);
  2. Changes in the lungs on CT (X-ray) typical for viral damage (the damage size is significant or subtotal; CT 3-4);
  3. One or more criteria for a severe course:

    • RR > 30/min
    • SpO2 ≤ 93%
    • PaO2 /FiO2 ≤ 300 mm Hg
    • Decreased consciousness, agitation
    • Unstable hemodynamics (systolic blood pressure less than 90 mm Hg or diastolic blood pressure less than 60 mm Hg, urine output less than 20 ml/hour)
    • Arterial blood lactate > 2 mmol/l
    • qSOFA > 2 points
  4. Signed informed consent of the patient to participate in the study*;
  5. The patient's ability to adequately cooperate (the ability to understand the information provided about the clinical study, the willingness to comply with the requirements of the study protocol)*;

    *In case of impossibility of the criteria No. 4 and 5 fulfilling the decision on including the patient shall be taken by a medical council. After the normalization of the status the patient shall compulsorily be proposed to acquaint themselves with the Patient Information Leaflet and take a decision on further participation in the study (Informed Consent Form signing) or withdrawal.

  6. For women with preserved reproductive function - a negative pregnancy test and consent to use adequate methods of contraception from the moment of inclusion in the study until the end of the study;
  7. For men - consent to use adequate methods of contraception from the moment of inclusion in the study to the end of the study.

Non-inclusion criteria:

Patients cannot be included in the study if at least one of the following criteria is met:

Associated with the underlying disease:

  1. Mild, moderate and extremely severe COVID-19 disease upon admission to the hospital;
  2. A condition requiring invasive oxygen support;
  3. Failure to meet the criteria for inclusion and severity of the condition in terms of the main parameters;

    Related to the investigational drug, prior and concomitant therapy:

  4. Hypersensitivity or individual intolerance to the components of the investigational drug according to the history;
  5. Taking any antiviral or immunomodulatory drugs after the manifestation of COVID-19 (except for those planned for appointment as part of the study);

    Associated with concomitant pathology:

    According to the history and physical examination:

  6. A history of active tuberculosis;
  7. Impossibility of intravenous administration of the drug;
  8. Severe, decompensated or unstable somatic diseases according to the history and outpatient card/medical history:

    • Child-Pugh class B and C cirrhosis;
    • Myocardial infarction, CVA/TIA, PE less than 3 months before the start of the study, large aortic aneurysm (more than 6 cm);
    • Type 1 diabetes mellitus. Diseases of the thyroid gland with decompensation.
    • The presence of signs of severe damage to the central nervous system (history of severe TBI, meningitis, consequences of CVA, encephalopathy of various origin, epilepsy, etc.);
    • Current severe blood disorders or history of such diseases (i.e. baseline anemia Hb<80, myeloid leukemia, myelodysplastic syndrome, etc.);
    • No less than 3 months after the surgery for coronary artery bypass grafting/stenting before inclusion in the study;
    • Malignant neoplasm of any localization at present or within 5 years prior to inclusion in the study, with the exception of completely healed carcinoma in situ;
  9. Any other comorbidities or conditions that, in the opinion of the investigator, make it difficult to interpret the results of treatment or may limit the patient's participation in the study;

    According to laboratory tests at screening:

  10. A positive result for HIV, syphilis, hepatitis B and C at screening;

    Associated with the patient compliance in the study:

  11. A history of alcohol abuse, drug dependence or drug addiction;
  12. Patients who, in the opinion of the investigator, are obviously or likely to be unable to understand and evaluate the information on this study as part of the informed consent signing process, in particular regarding the expected risks and possible discomfort;
  13. Patient's inability or unwillingness to follow the rules for conducting and participating in the clinical study;
  14. Severe visual and/or hearing impairments, severe speech impairments and/or other abnormalities that may prevent the patient from adequately cooperating during the study;
  15. A history of mental illness;

    Other:

  16. Pregnancy;
  17. Breast-feeding;
  18. Participation in other clinical studies within 3 months prior to enrollment in this study.

Exclusion Criteria:

  1. Erroneous inclusion (violation of inclusion/non-inclusion criteria).
  2. Individual intolerance to the investigational drug.
  3. Refusal of the patient to continue participating in the study/withdrawal of informed consent by the patient.
  4. Termination of the study.

Sites / Locations

  • Yaroslavl Regional Clinical Hospital for War Veterans - The International Center for the Elderly "Healthy Longevity"Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Molixan

Placebo

Arm Description

30 mg/ml solution for intravenous and intramuscular injection. Pharmacotherapeutic group: Metabolic agent. ATC code: V03AX - other medicinal products

Sol. of NaCl (Sodium chloride) - 0.9% Pharmacotherapeutic group: Regulators of water-electrolytic balance and acid-base balance. ATC: B05CB01 Sodium chloride

Outcomes

Primary Outcome Measures

WHO Ordinal Scale for Clinical Improvement
The median time to reach the clinical improvement on the WHO Ordinal Scale for Clinical Improvement (follow-up period 28 days after initiation of treatment) using hazard ratio estimates.

Secondary Outcome Measures

Mortality
All-cause mortality (follow-up period of 28 days after the start of treatment)
Duration of hospitalization
Duration of hospitalization from the start of therapy, days (observation period of 28 days after the start of treatment)
Mechanical ventilation
The need for mechanical ventilation, extracorporeal membrane oxygenation, non-invasive ventilation or high-flow oxygen delivery by nasal cannula (observation period of 28 days after the start of treatment).
Time to cancellation of oxygen support
Time to cancellation of oxygen support, if available, days (observation period of 28 days after the start of treatment)
Invasive mechanical ventilation
The need for invasive mechanical ventilation of the lungs (observation period of 28 days after the start of treatment)
Stay in the intensive care unit
The need to stay in the intensive care unit (observation period of 28 days after the start of treatment).
The transition of the disease to an extremely severe course
The frequency of the transition of the disease to an extremely severe course (observation period of 28 days after the start of treatment).
Fever
Duration of fever (≥38оC), days (observation period of 28 days after the start of treatment)
The dynamics of the National Early Warning Score (NEWS)
The dynamics of the National Early Warning Score (NEWS) decrease in comparison with the baseline value (observation period of 10 days). NEWS uses six physiological measurements: respiratory rate; oxygen saturation; temperature; systolic blood pressure; heart rate and level of consciousness. Each scores 0-3 and individual scores are added together for an overall score. An additional one points are added if the patient is receiving oxygen therapy. Higher scores mean a worse outcome.
The dynamics of changes in the level of C-reactive protein
The dynamics of changes in the level of C-reactive protein compared with the baseline value (observation period of 10 days).
The dynamics of residual symptoms
The dynamics of residual symptoms compared to baseline values (observation period of 10 days).
The dynamics of residual symptoms
The dynamics of residual symptoms on the 28th day after the start of treatment.
The dynamics of blood biochemical parameters
The dynamics of blood biochemical parameters in comparison with the initial value (observation period of 10 days) Any clinically significant deviations from laboratory parameters detected at visits after the first dosing of the drugs. Biochemical blood assay: urea, creatinine, glucose, alanine aminotransferase, aspartate aminotransferase, bilirubin, albumin, lactate, lactate dehydrogenase, troponin, ferritin. Local laboratories of research centers will be used for laboratory tests and assessments. After collecting and verification 100% values of laboratory parameters according to the Protocol from all local laboratories, the units of measurement will be unified before Statistical process control by valid formulas for transitions.
The dynamics of CT signs
The dynamics of CT signs on the 14th day after the start of therapy compared with the baseline value. In the conclusion CT study, a probabilistic assessment of the relationship of the detected changes with COVID 19 according to international recommendations and the approximate volume of lung damage according to the "empirical" scale of assessment shall be given. The scale is based on a visual assessment of the approximate volume of compacted lung tissue in both lungs: 1. Absence of characteristic manifestations (CT-0) 2. Minimum volume/site < 25% of lung volume (CT-1) 3. Average volume/site 25 - 50% of lung volume (CT-2) 4. Significant volume/site 50 - 75% of lung volume (CT-3) 5. Critical volume/site > 75% of lung volume (CT-4).

Full Information

First Posted
February 25, 2021
Last Updated
October 8, 2021
Sponsor
Pharma VAM
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1. Study Identification

Unique Protocol Identification Number
NCT04780672
Brief Title
Clinical Study in the Treatment of Patients With COVID-19
Official Title
Clinical Study to Analyze the Safety and Efficacy of Molixan® as Part of Standard Therapy in the Treatment of Patients With the Severe Course of New Coronavirus Infection (COVID-19)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Unknown status
Study Start Date
March 9, 2021 (Actual)
Primary Completion Date
May 31, 2022 (Anticipated)
Study Completion Date
September 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharma VAM

4. Oversight

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

5. Study Description

Brief Summary
Multicenter, prospective, double-blind, placebo-controlled, randomized, parallel-group phase III study. The study is designed for 2 treatment groups: Group 1 of the investigational drug - Patients receive standard therapy and the investigational drug. Group 2 of comparison - Patients receive standard therapy and placebo.
Detailed Description
Patients with the severe course of COVID-19 infection confirmed by PCR laboratory test will be involved in the study on a voluntary basis. In accordance with regulatory enactments, these patients receive specialized medical care in specialized medical institutions, where the conduct of the study is planned. The study is planned as a double-blind, which will be achieved by using Molixan and placebo (0.9% NaCl solution) in the same packaging with the same labeling, indistinguishable in color and smell. Patients will be randomized in an unpredictable manner using the IWRS system. It is planned to divide patients into 2 parallel groups: Group 1. Standard therapy + Molixan; Group 2. Standard therapy + placebo. The regimen (1 or 2) assigned to each study subject will not be known to either the Investigator or the patient.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
COVID-19, METABOLIC DRUG, Severe course of COVID-19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
330 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Molixan
Arm Type
Active Comparator
Arm Description
30 mg/ml solution for intravenous and intramuscular injection. Pharmacotherapeutic group: Metabolic agent. ATC code: V03AX - other medicinal products
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Sol. of NaCl (Sodium chloride) - 0.9% Pharmacotherapeutic group: Regulators of water-electrolytic balance and acid-base balance. ATC: B05CB01 Sodium chloride
Intervention Type
Drug
Intervention Name(s)
Molixan
Other Intervention Name(s)
Inosine glycyl-cysteinyl-glutamate disodium
Intervention Description
The investigational drug in this study is Molixan in the dosage form of 30 mg/ml solution for intravenous and intramuscular injection. Against the background of standard therapy: Molixan® at a dose of 3.0 mg/kg per day is administered once intravenously (stream injection) with 0.9% sodium chloride solution at a volume ratio of 1:1 for 10 days.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Sodium chloride
Intervention Description
Placebo will be used as a comparator drug and will be an analogue of the investigational drug without active substance. Against the background of standard therapy: Placebo at a dose of 3.0 mg/kg per day is administered once intravenously (stream injection) with 0.9% sodium chloride solution at a volume ratio of 1:1 for 10 days.
Primary Outcome Measure Information:
Title
WHO Ordinal Scale for Clinical Improvement
Description
The median time to reach the clinical improvement on the WHO Ordinal Scale for Clinical Improvement (follow-up period 28 days after initiation of treatment) using hazard ratio estimates.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Mortality
Description
All-cause mortality (follow-up period of 28 days after the start of treatment)
Time Frame
28 days
Title
Duration of hospitalization
Description
Duration of hospitalization from the start of therapy, days (observation period of 28 days after the start of treatment)
Time Frame
28 days
Title
Mechanical ventilation
Description
The need for mechanical ventilation, extracorporeal membrane oxygenation, non-invasive ventilation or high-flow oxygen delivery by nasal cannula (observation period of 28 days after the start of treatment).
Time Frame
28 days
Title
Time to cancellation of oxygen support
Description
Time to cancellation of oxygen support, if available, days (observation period of 28 days after the start of treatment)
Time Frame
28 days
Title
Invasive mechanical ventilation
Description
The need for invasive mechanical ventilation of the lungs (observation period of 28 days after the start of treatment)
Time Frame
28 days
Title
Stay in the intensive care unit
Description
The need to stay in the intensive care unit (observation period of 28 days after the start of treatment).
Time Frame
28 days
Title
The transition of the disease to an extremely severe course
Description
The frequency of the transition of the disease to an extremely severe course (observation period of 28 days after the start of treatment).
Time Frame
28 days
Title
Fever
Description
Duration of fever (≥38оC), days (observation period of 28 days after the start of treatment)
Time Frame
28 days
Title
The dynamics of the National Early Warning Score (NEWS)
Description
The dynamics of the National Early Warning Score (NEWS) decrease in comparison with the baseline value (observation period of 10 days). NEWS uses six physiological measurements: respiratory rate; oxygen saturation; temperature; systolic blood pressure; heart rate and level of consciousness. Each scores 0-3 and individual scores are added together for an overall score. An additional one points are added if the patient is receiving oxygen therapy. Higher scores mean a worse outcome.
Time Frame
10 days
Title
The dynamics of changes in the level of C-reactive protein
Description
The dynamics of changes in the level of C-reactive protein compared with the baseline value (observation period of 10 days).
Time Frame
10 days
Title
The dynamics of residual symptoms
Description
The dynamics of residual symptoms compared to baseline values (observation period of 10 days).
Time Frame
10 days
Title
The dynamics of residual symptoms
Description
The dynamics of residual symptoms on the 28th day after the start of treatment.
Time Frame
28 days
Title
The dynamics of blood biochemical parameters
Description
The dynamics of blood biochemical parameters in comparison with the initial value (observation period of 10 days) Any clinically significant deviations from laboratory parameters detected at visits after the first dosing of the drugs. Biochemical blood assay: urea, creatinine, glucose, alanine aminotransferase, aspartate aminotransferase, bilirubin, albumin, lactate, lactate dehydrogenase, troponin, ferritin. Local laboratories of research centers will be used for laboratory tests and assessments. After collecting and verification 100% values of laboratory parameters according to the Protocol from all local laboratories, the units of measurement will be unified before Statistical process control by valid formulas for transitions.
Time Frame
10 days
Title
The dynamics of CT signs
Description
The dynamics of CT signs on the 14th day after the start of therapy compared with the baseline value. In the conclusion CT study, a probabilistic assessment of the relationship of the detected changes with COVID 19 according to international recommendations and the approximate volume of lung damage according to the "empirical" scale of assessment shall be given. The scale is based on a visual assessment of the approximate volume of compacted lung tissue in both lungs: 1. Absence of characteristic manifestations (CT-0) 2. Minimum volume/site < 25% of lung volume (CT-1) 3. Average volume/site 25 - 50% of lung volume (CT-2) 4. Significant volume/site 50 - 75% of lung volume (CT-3) 5. Critical volume/site > 75% of lung volume (CT-4).
Time Frame
14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Hospitalized male and female patients aged 18 to 75 and weighing no more than 120 kg inclusively with a diagnosis of the severe course of COVID-19 confirmed by the result of a laboratory study for the presence of SARS-CoV-2 RNA using nucleic acid amplification methods (to be performed on Screening, or results with sampling 72 hours prior to Screening may be accepted); Changes in the lungs on CT (X-ray) typical for viral damage (the damage size is significant or subtotal; CT 3-4); One or more criteria for a severe course: RR > 30/min SpO2 ≤ 93% PaO2 /FiO2 ≤ 300 mm Hg Decreased consciousness, agitation Unstable hemodynamics (systolic blood pressure less than 90 mm Hg or diastolic blood pressure less than 60 mm Hg, urine output less than 20 ml/hour) Arterial blood lactate > 2 mmol/l qSOFA > 2 points Signed informed consent of the patient to participate in the study*; The patient's ability to adequately cooperate (the ability to understand the information provided about the clinical study, the willingness to comply with the requirements of the study protocol)*; *In case of impossibility of the criteria No. 4 and 5 fulfilling the decision on including the patient shall be taken by a medical council. After the normalization of the status the patient shall compulsorily be proposed to acquaint themselves with the Patient Information Leaflet and take a decision on further participation in the study (Informed Consent Form signing) or withdrawal. For women with preserved reproductive function - a negative pregnancy test and consent to use adequate methods of contraception from the moment of inclusion in the study until the end of the study; For men - consent to use adequate methods of contraception from the moment of inclusion in the study to the end of the study. Non-inclusion criteria: Patients cannot be included in the study if at least one of the following criteria is met: Associated with the underlying disease: Mild, moderate and extremely severe COVID-19 disease upon admission to the hospital; A condition requiring invasive oxygen support; Failure to meet the criteria for inclusion and severity of the condition in terms of the main parameters; Related to the investigational drug, prior and concomitant therapy: Hypersensitivity or individual intolerance to the components of the investigational drug according to the history; Taking any antiviral or immunomodulatory drugs after the manifestation of COVID-19 (except for those planned for appointment as part of the study); Associated with concomitant pathology: According to the history and physical examination: A history of active tuberculosis; Impossibility of intravenous administration of the drug; Severe, decompensated or unstable somatic diseases according to the history and outpatient card/medical history: Child-Pugh class B and C cirrhosis; Myocardial infarction, CVA/TIA, PE less than 3 months before the start of the study, large aortic aneurysm (more than 6 cm); Type 1 diabetes mellitus. Diseases of the thyroid gland with decompensation. The presence of signs of severe damage to the central nervous system (history of severe TBI, meningitis, consequences of CVA, encephalopathy of various origin, epilepsy, etc.); Current severe blood disorders or history of such diseases (i.e. baseline anemia Hb<80, myeloid leukemia, myelodysplastic syndrome, etc.); No less than 3 months after the surgery for coronary artery bypass grafting/stenting before inclusion in the study; Malignant neoplasm of any localization at present or within 5 years prior to inclusion in the study, with the exception of completely healed carcinoma in situ; Any other comorbidities or conditions that, in the opinion of the investigator, make it difficult to interpret the results of treatment or may limit the patient's participation in the study; According to laboratory tests at screening: A positive result for HIV, syphilis, hepatitis B and C at screening; Associated with the patient compliance in the study: A history of alcohol abuse, drug dependence or drug addiction; Patients who, in the opinion of the investigator, are obviously or likely to be unable to understand and evaluate the information on this study as part of the informed consent signing process, in particular regarding the expected risks and possible discomfort; Patient's inability or unwillingness to follow the rules for conducting and participating in the clinical study; Severe visual and/or hearing impairments, severe speech impairments and/or other abnormalities that may prevent the patient from adequately cooperating during the study; A history of mental illness; Other: Pregnancy; Breast-feeding; Participation in other clinical studies within 3 months prior to enrollment in this study. Exclusion Criteria: Erroneous inclusion (violation of inclusion/non-inclusion criteria). Individual intolerance to the investigational drug. Refusal of the patient to continue participating in the study/withdrawal of informed consent by the patient. Termination of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mark Borisovich Balazovskij
Phone
+7 (812) 714-10-10
Email
vam@glutoxim.ru
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Viktor Borisovich Filimonov
Organizational Affiliation
Federal State Budgetary Educational Institution of Higher Education
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Tamara Valerievna Gaigolnik
Organizational Affiliation
Federal Siberian Scientific and Clinical Center of the Federal Medical and Biological Agency, Krasnoyarsk
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Halida Hanafievna Ganceva
Organizational Affiliation
Federal State Budgetary Educational Institution of Higher Education "Bashkir State Medical University" of the Ministry of Healthcare of the Russian Federation
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Elena Petrovna Dmitrikova
Organizational Affiliation
State Budgetary Institution of Healthcare of Moscow Region "Zhukovskaya City Clinical Hospital", Zhukovskiy, Moscow Region, Russian Federation
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mariya Evgen'evna Mozhejko
Organizational Affiliation
Yaroslavl Regional Clinical Hospital for War Veterans - The International Center for the Elderly "Healthy Longevity"
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Halit Saubanovich Haertynv
Organizational Affiliation
Republican Clinical Infectious Diseases Hospital named after professor Agafonov
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Zoya Gennad'evna Tatarinceva
Organizational Affiliation
State Budgetary Healthcare Institution "Research Institute - Regional Clinical Hospital No. 1 named after Professor S. V. Ochapovsky" of the Ministry of Health of the Krasnodar Territory
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Aleksandr Alekseevich Punin
Organizational Affiliation
Regional State Budgetary Healthcare Institution "Smolensk Regional Clinical Hospital"
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dmitrij YUr'evich Konstantinov
Organizational Affiliation
Federal State Budgetary Educational Institution of Higher Education "Samara State Medical University" of the Ministry of Healthcare of the Russian Federation
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yaroslavl Regional Clinical Hospital for War Veterans - The International Center for the Elderly "Healthy Longevity"
City
Yaroslavl
ZIP/Postal Code
150047
Country
Russian Federation
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mariya Evgen'evna Mozhejko
Phone
89056391139
Email
mmozheiko@yandex.ru

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
All of the individual participant data collected during the trial, after deidentification
IPD Sharing Time Frame
Immediately following publication. No end date
IPD Sharing Access Criteria
Anyone who wishes to access the data.

Learn more about this trial

Clinical Study in the Treatment of Patients With COVID-19

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