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Phase 2a MIB-626 vs. Placebo COVID-19

Primary Purpose

Covid19, Stage 1 Acute Kidney Injury

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MIB-626
Placebo
Home Treatment
Sponsored by
Metro International Biotech, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19 focused on measuring MIB-626, Covid19, Early Acute Kidney Injury, NAD-boosting drug

Eligibility Criteria

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

Inclusion Criteria:

  • A man or a woman, 18 years or older
  • Willing and able to provide informed consent, or with a legal representative who can provide informed consent with participant's assent
  • Has Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection confirmed by an approved diagnostic test before randomization
  • Currently hospitalized
  • Documented increase in serum creatinine of 0.3 mg/dL or 50%-99% over baseline (baseline either based on admission serum creatinine or known pre-admission baseline, defined as most recent previous measurement)
  • Participant or legal representative has read and signed the Informed Consent Form (ICF) after the nature of the study has been fully explained
  • Is willing and able to provide authorization for the use and disclosure of personal health information in accordance with Health Insurance Portability and Accountability Act (HIPAA)
  • Patients who are receiving remdesivir as a part of their clinical care or are in clinical trials of remdesivir or other antiviral drugs may be allowed if they meet other eligibility criteria
  • Patients, who are participating in observational studies or studies of nonpharmacological interventions, will be allowed to participate
  • Not be pregnant and not planning to become pregnant over the next 6 months

Exclusion Criteria:

  • In the intensive care unit at the time of screening or prior to randomization
  • Requiring mechanical ventilation at the time of screening or prior to randomization
  • Has baseline estimated glomerular filtration rate < 30 ml/min/1.73m2
  • Has a history of kidney transplantation or hemodialysis treatment or receiving or expected to receive hemodialysis or peritoneal dialysis at screening and prior to randomization
  • Is on mechanical ventilation
  • Has a contraindication for MIB-626 or its inert ingredients
  • Has a diagnosis of lupus nephritis, polycystic kidney disease, other glomerular disease (other than diabetes)
  • Has AST or ALT > 3 times the upper limit of normal
  • Has other medical condition which, in the opinion of the Principal Investigator, would jeopardize the safety of the study subject or impact the validity of the study results
  • Will exclude patients, who are receiving or are enrolled in placebo-controlled intervention trials of anti-inflammatory or immunomodulatory agents, such as tocilizumab. Occasional use of acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen, for fever or headache is permitted.

Sites / Locations

  • The Brigham and Women's HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Other

Arm Label

MIB-626

Placebo Tablet

Home Treatment

Arm Description

Oral administration of MIB-626 substantially raises the intracellular NAD+ levels and activates signaling mechanisms that regulate inflammation and cell survival, downregulates the NLRP3 inflammasome, and attenuates the inflammatory response in a number of experimental models, and protects against tissue damage induced by pro-inflammatory cytokines.

A placebo control will be supplied. Participants randomized to placebo will receive matching tablet. Matching placebo tablets will be provided by the study's Sponsor, Metro International Biotech, LLC.

Participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.

Outcomes

Primary Outcome Measures

Change from baseline in serum cystatin C levels
Change from baseline in serum cystatin C levels

Secondary Outcome Measures

Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)
Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)
Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)
Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)
The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury
The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury
Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization
Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization
Change from baseline in oxygen saturation
Change from baseline in oxygen saturation
Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)
Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)
Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants
Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants
Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period
Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period

Full Information

First Posted
March 18, 2021
Last Updated
March 1, 2023
Sponsor
Metro International Biotech, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05038488
Brief Title
Phase 2a MIB-626 vs. Placebo COVID-19
Official Title
A Phase 2a Randomized Controlled Trial of MIB-626 (NAD-boosting Drug) vs. Placebo in Adults With COVID-19 Infection and Early Acute Kidney Injury
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 26, 2021 (Actual)
Primary Completion Date
July 31, 2023 (Anticipated)
Study Completion Date
August 28, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Metro International Biotech, LLC

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 proposed phase 2a trial will determine whether MIB-626 treatment in adults with COVID-19 infection and stage 1 acute kidney injury is more efficacious than placebo in preventing worsening of kidney function, as assessed by longitudinal changes in serum creatinine concentration, and in attenuating the inflammatory response to the infection.
Detailed Description
This is a two-center, randomized, double-blind, placebo-controlled, parallel-group, phase 2a study that will determine the efficacy and safety of MIB-626 treatment relative to placebo in adult patients with COVID-19 infection and stage 1 acute kidney injury. Hospitalized adult patients with a confirmed or suspected diagnosis of COVID-19 infection will be screened for conformity to inclusion and exclusion criteria and those meeting eligibility criteria on screening will be offered participation in the study. Fifty participants, who meet all the eligibility criteria, and are able and willing to provide informed consent, will be randomized, stratified by sex, remdesivir use, and trial site, in a 3:2 ratio to receive either MIB-626 1.0 g orally or matching placebo twice daily for 14 days. The participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19, Stage 1 Acute Kidney Injury
Keywords
MIB-626, Covid19, Early Acute Kidney Injury, NAD-boosting drug

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This will be a two center, randomized, double-blind, placebo- controlled, parallel group, efficacy trial to determine the efficacy of MIB-626 treatment relative to placebo in adult patients with COVID-19 infection and stage 1 acute kidney injury. Participants will be screened for eligibility and those meeting eligibility criteria will be offered participation in the study. The subjects will be randomized by minimization to receive MIB-626 or placebo twice daily for up to 14 days. The participants will be followed for 28 days after the administration of the last dose of the investigational product. Kidney function will be ascertained by daily measurements of serum creatinine, which is the standard of care in hospitalized patients with COVID-19.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double blind
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
MIB-626
Arm Type
Experimental
Arm Description
Oral administration of MIB-626 substantially raises the intracellular NAD+ levels and activates signaling mechanisms that regulate inflammation and cell survival, downregulates the NLRP3 inflammasome, and attenuates the inflammatory response in a number of experimental models, and protects against tissue damage induced by pro-inflammatory cytokines.
Arm Title
Placebo Tablet
Arm Type
Placebo Comparator
Arm Description
A placebo control will be supplied. Participants randomized to placebo will receive matching tablet. Matching placebo tablets will be provided by the study's Sponsor, Metro International Biotech, LLC.
Arm Title
Home Treatment
Arm Type
Other
Arm Description
Participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.
Intervention Type
Drug
Intervention Name(s)
MIB-626
Other Intervention Name(s)
NAD-boosting drug
Intervention Description
Fifty participants will be randomized, stratified by sex, remdesivir use, and trial site, in a 3:2 ratio to receive either MIB-626 1.0 g orally or matching placebo twice daily for 14 days.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Subjects will be randomized to receive either the placebo or 1000-mg MIB-626 twice daily orally.
Intervention Type
Other
Intervention Name(s)
Home Treatment
Intervention Description
Participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.
Primary Outcome Measure Information:
Title
Change from baseline in serum cystatin C levels
Description
Change from baseline in serum cystatin C levels
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Secondary Outcome Measure Information:
Title
Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Description
Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Description
The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)
Description
Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)
Description
Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury
Description
The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization
Description
Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change from baseline in oxygen saturation
Description
Change from baseline in oxygen saturation
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)
Description
Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants
Description
Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period
Description
Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Other Pre-specified Outcome Measures:
Title
Progression in the stage of acute kidney injury increase in serum creatinine OR serum creatinine > 4.0 mg/dL OR need
Description
Progression in the stage of acute kidney injury
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The WHO 8-point Ordinal Scale of Clinical Status
Description
The WHO 8-point Ordinal Scale of Clinical Status
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
Change from baseline in Modified Sequential Organ Failure Assessment (SOFA) Score (SOFA) Score
Description
Change from baseline in Modified Sequential Organ Failure Assessment (SOFA) Score
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The number and proportion of patients requiring mechanical ventilation, hemodialysis, or transferred to ICU
Description
The number and proportion of patients requiring mechanical ventilation, hemodialysis, or transferred to ICU
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The number and proportion of patients requiring hemodialysis
Description
The number and proportion of patients requiring hemodialysis
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The number and proportion of patients who die
Description
The number and proportion of patients who die
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The number of days it takes for the temperature to return to normal (<99F)
Description
The number of days it takes for the temperature to return to normal (<99F)
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first
Title
The length of hospital stay
Description
The length of hospital stay
Time Frame
enrollment to 14 days or hospital discharge, or death, whichever comes first

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A man or a woman, 18 years or older Willing and able to provide informed consent, or with a legal representative who can provide informed consent with participant's assent Has Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection confirmed by an approved diagnostic test before randomization Currently hospitalized Documented increase in serum creatinine of 0.3 mg/dL or 50%-99% over baseline (baseline either based on admission serum creatinine or known pre-admission baseline, defined as most recent previous measurement) Participant or legal representative has read and signed the Informed Consent Form (ICF) after the nature of the study has been fully explained Is willing and able to provide authorization for the use and disclosure of personal health information in accordance with Health Insurance Portability and Accountability Act (HIPAA) Patients who are receiving remdesivir as a part of their clinical care or are in clinical trials of remdesivir or other antiviral drugs may be allowed if they meet other eligibility criteria Patients, who are participating in observational studies or studies of nonpharmacological interventions, will be allowed to participate Not be pregnant and not planning to become pregnant over the next 6 months Exclusion Criteria: In the intensive care unit at the time of screening or prior to randomization Requiring mechanical ventilation at the time of screening or prior to randomization Has baseline estimated glomerular filtration rate < 30 ml/min/1.73m2 Has a history of kidney transplantation or hemodialysis treatment or receiving or expected to receive hemodialysis or peritoneal dialysis at screening and prior to randomization Is on mechanical ventilation Has a contraindication for MIB-626 or its inert ingredients Has a diagnosis of lupus nephritis, polycystic kidney disease, other glomerular disease (other than diabetes) Has AST or ALT > 3 times the upper limit of normal Has other medical condition which, in the opinion of the Principal Investigator, would jeopardize the safety of the study subject or impact the validity of the study results Will exclude patients, who are receiving or are enrolled in placebo-controlled intervention trials of anti-inflammatory or immunomodulatory agents, such as tocilizumab. Occasional use of acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen, for fever or headache is permitted.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shalender Bhasin, MD
Phone
617 525 9150
Email
sbhasin@bwh.harvard.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Deatrice S Moore
Phone
617 872 6096
Email
dsmoore@bwh.harvard.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shalender Bhasin, MD
Organizational Affiliation
Brigham and Women's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shalendar Bhasin, MD
Phone
617-525-9150
Email
sbhasin@partners.org
First Name & Middle Initial & Last Name & Degree
Catherine Ghattas
Phone
617-525-9198
Email
CGHATTAS@BWH.HARVARD.EDU

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Individual participant data will not be shared

Learn more about this trial

Phase 2a MIB-626 vs. Placebo COVID-19

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