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A Study to Evaluate the Safety and Effect of STC3141 Continuous Infusion in Subjects With Severe Corona Virus Disease 2019(COVID-19)Pneumonia

Primary Purpose

Severe COVID-19 Pneumonia

Status
Completed
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
STC3141
STC3141
Sponsored by
Grand Medical Pty Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Severe COVID-19 Pneumonia focused on measuring COVID-19

Eligibility Criteria

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

Inclusion Criteria:

  1. Males and non-pregnant females who are 18 years or older (inclusive).
  2. Signed informed consent. Subjects are to provide informed consent prior to any study procedures being performed. Consent can be oral if a written consent cannot be expressed. Where it is not practicable to approach a subject highly dependent on medical care, or the subject is not capable of making such a decision, consent will be sought from the legal representative of the subject. Subjects enrolled in the study based on consent by the legal representative will be given the opportunity to provide written confirmatory consent when and if they become able to do so. If the subject declines to confirm consent, they will be withdrawn from the study at the point where they decline consent.
  3. Virological diagnosis of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection (documentation of real-time polymerase chain reaction(PCR)or equivalent within the last 72h positive results is available before screening)
  4. Hospitalized due to clinical/chest image diagnosis of sever pneumonia. Severe pneumonia defined as dyspnea, hemoglobin oxygen saturation(SpO2)on room air at rest ≤93% or Partial pressure of oxygen(PaO2)/Fraction of inspired oxygen(FiO2)<300 mmHg.

Exclusion Criteria:

  1. Subjects who have renal impairment at screening, defined as an estimate glomerular filtration rate (eGFR) <55 ml/min/Body Surface area(BSA)
  2. Subjects requiring extracorporeal membrane oxygenation (ECMO) at screening
  3. Subjects who are on invasive mechanical ventilator more than 24 hours
  4. Female subjects of child-bearing potential (as judged by the Investigator) who do not agree to remain abstinent or use medically acceptable methods of contraception (e.g., implants, injectable, combined oral contraceptives, intra-uterine devices [Intrauterine devices(IUDs)], double-barrier protection) during the study. Male participants who do not agree to use a condom with spermicide during intercourse (if not surgically sterilized) during the study.
  5. Subjects who receive anticoagulants overall (except subtherapeutic doses of heparin which is ≤ 6000 International Unit(IU)twice a day Enoxaparin or equivalence) including but not limited to warfarin, rivaroxaban, apixaban, dabigatran acenocoumarol, fencoumarol, or other parenteral anticoagulants at randomization. Antiplatelets drugs are allowed
  6. Subjects who have International Normalized ratio or International normalized ratio(INR)>1.3 Upper limit of normal(ULN).
  7. Subjects who have Absolute Neutrophil Count (ANC) <1,000/μL.
  8. Subjects who have platelets count <80,000 /μL.
  9. Subjects who have activated Partial Thromboplastin Time (aPTT) >1.5 Upper limit of normal(ULN).
  10. Severe anaemia (haemoglobin < 7.0 g/dL).
  11. Bleeding in the past 24 hours requiring blood transfusion.
  12. Women who are pregnant or lactating at Screening or planning to conceive (self or partner) at any time during the study, including the follow-up period.
  13. Subjects who have the following chronic organ dysfunction or immunosuppression:

    1. Heart: New York heart association cardiac function IV.
    2. Lung: severe lung diseases other than COVID-19 lead to home oxygen therapy.
    3. Kidneys: renal impairment requiring chronic dialysis
    4. Liver: liver cirrhosis confirmed by biopsy and clear portal hypertension; the upper digestive tract hemorrhage caused by portal hypertension; or previous liver failure/hepatic encephalopathy/hepatic coma.
    5. Immune function: IV chemotherapy and radiotherapy within 4 weeks before screening or use of immunosuppressive medication within 2 weeks before screening including but not limited to: tacrolimus, cyclosporin, sirolimus, mycophenolate or azathioprine etc., or subjects with leukemia, lymphoma or acquired immunodeficiency syndrome [AIDS].
  14. Solid organ or bone marrow transplantation within 4 weeks.
  15. The following conditions occurring within 4 weeks prior to screening:

    1. Acute pulmonary embolism
    2. Acute coronary syndrome such as myocardial infarction, unstable angina pectoris etc.
  16. Known allergy to the active ingredient of STC3141 or its excipients (i.e., phosphate buffer).
  17. The investigator consider participation in the study is not in the best interests of the subjects.
  18. Prior or ongoing medical conditions, medical history, physical findings, or laboratory abnormality that, in the Investigator's (or delegate's) opinion, could adversely affect the safety of the subject; affect study endpoints or decrease the chance of obtaining satisfactory data required to achieve the objectives of the study.
  19. Any other severe or unstable medical condition that, in the opinion of the Investigator or Sponsor, could be expected to progress, recur, or change to such an extent that it could put the subject at special risk, or bias the assessment of the clinical or mental status of the subject to a significant degree.
  20. Simultaneous participation in other interventional trials which could interfere with this trial; simultaneous participation in registry and diagnostic trials is allowed.

Sites / Locations

  • Onze-Lieve-Vrouwziekenhuis Aalst, VZW
  • Universitair Ziekenhuis Brussel
  • Jan Yperman Ziekenhuis vzw
  • CHU Liège

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

No Intervention

Arm Label

Cohort 1: STC3141 58.3mg/hr

Cohort 2: STC3141 87.5mg/hr

Cohort 3: Comparator

Arm Description

Drug: STC3141 Continuous infusion of STC3141 at rate 58.3mg/hr up to 3 days (72 hours) N=10

Drug: STC3141 Continuous infusion of STC3141 at rate 87.5mg/hr up to 3 days (72 hours) N=10

Only to receive appropriate standard of care N=5

Outcomes

Primary Outcome Measures

The incidence of adverse event(AE), treatment emergent adverse event(TEAE), serious adverse event(SAE), adverse event of special interest(AESI)

Secondary Outcome Measures

Changes of C-reactive protein(CRP)(mg/dL, or nmol/L, or mg/L)
Changes of D-dimer(mg/L, or ng/mL, or μg/mL)
Changes of total bleeding time(TBL)(μmol/L)
Changes alanine transaminase(ALT)(IU/L, or U/L, or nkat/L)
Changes estimated glomerular filtration rate(eGFR)(ml/min)
Changes of activated partial thromboplastin time(aPTT)(seconds)
Changes of lactate dehydrogenase(LDH)(IU/L, or U/L, or nkat/L)
Changes of partial pressure of oxygen(PaO2)/fraction of inspired oxygen(FiO2) ratio
Changes of partial pressure of oxygen(PaO2)/fraction of inspired oxygen(FiO2) ratio for subjects who are on invasive or non-invasive ventilator
Changes of Sequential Organ Failure Assessment(SOFA)score
Specific score of 0, 1, 2, 3, 4. Higher score indicates worse prognosis.
Time to invasive mechanical ventilation
Time to independence from non-invasive mechanical ventilation
Time to independence from oxygen therapy
Duration of hospitalization
All-cause mortality rate
Subgroup analysis

Full Information

First Posted
April 25, 2021
Last Updated
April 6, 2022
Sponsor
Grand Medical Pty Ltd.
Collaborators
Trium Clinical Consulting
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1. Study Identification

Unique Protocol Identification Number
NCT04880694
Brief Title
A Study to Evaluate the Safety and Effect of STC3141 Continuous Infusion in Subjects With Severe Corona Virus Disease 2019(COVID-19)Pneumonia
Official Title
A Randomized, Open-Label, Multi-Centre, Phase 2a Study to Evaluate the Safety and Effect of STC3141 Continuous Infusion in Subjects With Severe Corona Virus Disease 2019(COVID-19)Pneumonia
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
May 20, 2021 (Actual)
Primary Completion Date
January 7, 2022 (Actual)
Study Completion Date
January 7, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Grand Medical Pty Ltd.
Collaborators
Trium Clinical Consulting

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
The study is a Randomized, Open-Label, Multi-Centre, Phase 2a Study to Evaluate the Safety and Effect of STC3141 Continuous Infusion in Subjects with Severe Corona Virus Disease 2019(COVID-19)Pneumonia.
Detailed Description
Pneumonia is the most frequent and serious complication of Corona Virus Disease 2019(COVID-19), a disease that results from severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection with a so-called "cytokine storm", characterized by the plasma increase of many cytokines that produce long-term damage and fibrosis of lung tissue. Therefore, the development of novel therapeutic strategies to target at neutrophils associated NETs/histones may reduce the overall disease mortality rate of COVID-19. STC3141 is a novel investigational product that can neutralize NETs/histone via charge-charge interaction. STC3141 was found to be well-tolerated in short infusions (2 hours) and continuous long-term infusions (72 hours) in healthy volunteers. A randomized, multi-centre, phase 2a study in 25 severe COVID-19 pneumonia subjects who require hospitalization, is designed to evaluate the safety and the preliminary effect of STC3141 in this population where the treatment will be tested for the first time. Subjects will be randomized to three cohorts in a 2:2:1 ratio to receive continuous infusion of STC3141 either at rate 58.3mg/hr or 87.5mg/hr up to 3 days (72hours), or to receive appropriate standard of care. All subjects in STC3141 treatment groups will also receive standard of care for their conditions as background treatment. The primary objective of the study is to evaluate the safety of STC3141 in subjects with severe COVID-19 pneumonia.The secondary objective is to evaluate the preliminary effects of STC3141 in the treatment of subjects with severe COVID-19 pneumonia.As an exploratory objective, the change in biomarkers from baseline following STC3141 treatment in subjects with severe COVID-19 pneumonia will be evaluated.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subjects will be randomized to three cohorts in a 2:2:1 ratio to receive continuous infusion of STC3141 either at rate 58.3mg/hr or 87.5mg/hr up to 3 days (72hours), or to receive appropriate standard of care. All subjects in STC3141 treatment groups will also receive standard of care for their conditions as background treatment.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1: STC3141 58.3mg/hr
Arm Type
Experimental
Arm Description
Drug: STC3141 Continuous infusion of STC3141 at rate 58.3mg/hr up to 3 days (72 hours) N=10
Arm Title
Cohort 2: STC3141 87.5mg/hr
Arm Type
Experimental
Arm Description
Drug: STC3141 Continuous infusion of STC3141 at rate 87.5mg/hr up to 3 days (72 hours) N=10
Arm Title
Cohort 3: Comparator
Arm Type
No Intervention
Arm Description
Only to receive appropriate standard of care N=5
Intervention Type
Drug
Intervention Name(s)
STC3141
Intervention Description
To receive continuous infusion of STC3141 at rate 58.3mg/hr up to 3 days (72hours). Also to receive appropriate standard of care.
Intervention Type
Drug
Intervention Name(s)
STC3141
Intervention Description
To receive continuous infusion of STC3141 at rate 87.5mg/hr up to 3 days (72hours). Also to receive appropriate standard of care.
Primary Outcome Measure Information:
Title
The incidence of adverse event(AE), treatment emergent adverse event(TEAE), serious adverse event(SAE), adverse event of special interest(AESI)
Time Frame
up to 30 days
Secondary Outcome Measure Information:
Title
Changes of C-reactive protein(CRP)(mg/dL, or nmol/L, or mg/L)
Time Frame
through study completion, an average of 30 days.
Title
Changes of D-dimer(mg/L, or ng/mL, or μg/mL)
Time Frame
through study completion, an average of 30 days.
Title
Changes of total bleeding time(TBL)(μmol/L)
Time Frame
through study completion, an average of 30 days.
Title
Changes alanine transaminase(ALT)(IU/L, or U/L, or nkat/L)
Time Frame
through study completion, an average of 30 days.
Title
Changes estimated glomerular filtration rate(eGFR)(ml/min)
Time Frame
through study completion, an average of 30 days.
Title
Changes of activated partial thromboplastin time(aPTT)(seconds)
Time Frame
through study completion, an average of 30 days.
Title
Changes of lactate dehydrogenase(LDH)(IU/L, or U/L, or nkat/L)
Time Frame
through study completion, an average of 30 days.
Title
Changes of partial pressure of oxygen(PaO2)/fraction of inspired oxygen(FiO2) ratio
Time Frame
through study completion, an average of 30 days.
Title
Changes of partial pressure of oxygen(PaO2)/fraction of inspired oxygen(FiO2) ratio for subjects who are on invasive or non-invasive ventilator
Time Frame
through study completion, an average of 30 days.
Title
Changes of Sequential Organ Failure Assessment(SOFA)score
Description
Specific score of 0, 1, 2, 3, 4. Higher score indicates worse prognosis.
Time Frame
through study completion, an average of 30 days.
Title
Time to invasive mechanical ventilation
Time Frame
through study completion, an average of 30 days.
Title
Time to independence from non-invasive mechanical ventilation
Time Frame
through study completion, an average of 30 days.
Title
Time to independence from oxygen therapy
Time Frame
through study completion, an average of 30 days.
Title
Duration of hospitalization
Time Frame
through study completion, an average of 30 days.
Title
All-cause mortality rate
Time Frame
On Day 30.
Title
Subgroup analysis
Time Frame
through study completion, an average of 30 days.
Other Pre-specified Outcome Measures:
Title
Changes from baseline in MPO(neutrophil-derived extracellular traps (NETs))(ng/ml)and citrullinated histone (H3 in plasma)(ng/ml)
Description
As an exploratory objective, the change in biomarkers from baseline following STC3141 treatment in subjects with severe COVID-19 pneumonia will be evaluated.
Time Frame
up to 7 days
Title
Changes from baseline in interleukin(IL)-1b, interleukin(IL)-2, interleukin(IL)-6, interleukin(IL)-8/CXCL8, interleukin(IL)-10, Interferon(IFN)-γ, tumor necrosis factor(TNF)-α, interleukin(IL)-12/P70(pg/ml)
Description
As an exploratory objective, the change in biomarkers from baseline following STC3141 treatment in subjects with severe COVID-19 pneumonia will be evaluated.
Time Frame
up to 7 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and non-pregnant females who are 18 years or older (inclusive). Signed informed consent. Subjects are to provide informed consent prior to any study procedures being performed. Consent can be oral if a written consent cannot be expressed. Where it is not practicable to approach a subject highly dependent on medical care, or the subject is not capable of making such a decision, consent will be sought from the legal representative of the subject. Subjects enrolled in the study based on consent by the legal representative will be given the opportunity to provide written confirmatory consent when and if they become able to do so. If the subject declines to confirm consent, they will be withdrawn from the study at the point where they decline consent. Virological diagnosis of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection (documentation of real-time polymerase chain reaction(PCR)or equivalent within the last 72h positive results is available before screening) Hospitalized due to clinical/chest image diagnosis of sever pneumonia. Severe pneumonia defined as dyspnea, hemoglobin oxygen saturation(SpO2)on room air at rest ≤93% or Partial pressure of oxygen(PaO2)/Fraction of inspired oxygen(FiO2)<300 mmHg. Exclusion Criteria: Subjects who have renal impairment at screening, defined as an estimate glomerular filtration rate (eGFR) <55 ml/min/Body Surface area(BSA) Subjects requiring extracorporeal membrane oxygenation (ECMO) at screening Subjects who are on invasive mechanical ventilator more than 24 hours Female subjects of child-bearing potential (as judged by the Investigator) who do not agree to remain abstinent or use medically acceptable methods of contraception (e.g., implants, injectable, combined oral contraceptives, intra-uterine devices [Intrauterine devices(IUDs)], double-barrier protection) during the study. Male participants who do not agree to use a condom with spermicide during intercourse (if not surgically sterilized) during the study. Subjects who receive anticoagulants overall (except subtherapeutic doses of heparin which is ≤ 6000 International Unit(IU)twice a day Enoxaparin or equivalence) including but not limited to warfarin, rivaroxaban, apixaban, dabigatran acenocoumarol, fencoumarol, or other parenteral anticoagulants at randomization. Antiplatelets drugs are allowed Subjects who have International Normalized ratio or International normalized ratio(INR)>1.3 Upper limit of normal(ULN). Subjects who have Absolute Neutrophil Count (ANC) <1,000/μL. Subjects who have platelets count <80,000 /μL. Subjects who have activated Partial Thromboplastin Time (aPTT) >1.5 Upper limit of normal(ULN). Severe anaemia (haemoglobin < 7.0 g/dL). Bleeding in the past 24 hours requiring blood transfusion. Women who are pregnant or lactating at Screening or planning to conceive (self or partner) at any time during the study, including the follow-up period. Subjects who have the following chronic organ dysfunction or immunosuppression: Heart: New York heart association cardiac function IV. Lung: severe lung diseases other than COVID-19 lead to home oxygen therapy. Kidneys: renal impairment requiring chronic dialysis Liver: liver cirrhosis confirmed by biopsy and clear portal hypertension; the upper digestive tract hemorrhage caused by portal hypertension; or previous liver failure/hepatic encephalopathy/hepatic coma. Immune function: IV chemotherapy and radiotherapy within 4 weeks before screening or use of immunosuppressive medication within 2 weeks before screening including but not limited to: tacrolimus, cyclosporin, sirolimus, mycophenolate or azathioprine etc., or subjects with leukemia, lymphoma or acquired immunodeficiency syndrome [AIDS]. Solid organ or bone marrow transplantation within 4 weeks. The following conditions occurring within 4 weeks prior to screening: Acute pulmonary embolism Acute coronary syndrome such as myocardial infarction, unstable angina pectoris etc. Known allergy to the active ingredient of STC3141 or its excipients (i.e., phosphate buffer). The investigator consider participation in the study is not in the best interests of the subjects. Prior or ongoing medical conditions, medical history, physical findings, or laboratory abnormality that, in the Investigator's (or delegate's) opinion, could adversely affect the safety of the subject; affect study endpoints or decrease the chance of obtaining satisfactory data required to achieve the objectives of the study. Any other severe or unstable medical condition that, in the opinion of the Investigator or Sponsor, could be expected to progress, recur, or change to such an extent that it could put the subject at special risk, or bias the assessment of the clinical or mental status of the subject to a significant degree. Simultaneous participation in other interventional trials which could interfere with this trial; simultaneous participation in registry and diagnostic trials is allowed.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Pang, PhD
Organizational Affiliation
Grand Medical Pty Ltd.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Onze-Lieve-Vrouwziekenhuis Aalst, VZW
City
Aalst
ZIP/Postal Code
Moorselbaan 164, 9300 Aalst
Country
Belgium
Facility Name
Universitair Ziekenhuis Brussel
City
Brussel
ZIP/Postal Code
Laarbeeklaan 101, 1090 Brussel
Country
Belgium
Facility Name
Jan Yperman Ziekenhuis vzw
City
Ieper
ZIP/Postal Code
Briekestraat 12, 8900 Ieper
Country
Belgium
Facility Name
CHU Liège
City
Liège
ZIP/Postal Code
Avenue de l'hôpital 1, 4000
Country
Belgium

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Evaluate the Safety and Effect of STC3141 Continuous Infusion in Subjects With Severe Corona Virus Disease 2019(COVID-19)Pneumonia

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