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The Potential Use of Nebulized Hydroxychloroquine for the Treatment of COVID-19

Primary Purpose

2019 Novel Coronavirus

Status
Recruiting
Phase
Phase 2
Locations
Jordan
Study Type
Interventional
Intervention
HCQ01
standard of care (SOC) for COVID-19
Sponsored by
Ministry of Health Jordan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for 2019 Novel Coronavirus focused on measuring COVID-19, Inhaled/nebulized Hydroxychloroquine

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Pregnant (positive β-human chorionic gonadotropin test, β-HCG) or lactating female at screening.
  2. Patients with a history of retinopathy, sickle cell disease or trait, psoriasis, porphyria, history of splenectomy, mental illness or uncontrolled seizures disorder, known active tuberculosis or history of incompletely treated tuberculosis, patients on chronic immunosuppression for other medical conditions such as rheumatological disorders, inflammatory bowel disease, or in patients with organ transplants.
  3. Patients admitted in ICU.
  4. Taking medications which may lead to interactions with hydroxychloroquine, including penicillamine, telbivudine, botulinum toxin, fluconazole, digoxin, propafenone , cimetidine, statins, warfarin, and cyclosporine within 2 weeks of dosing start, and during the duration of the study.
  5. History of Glucose-6-phosphate dehydrogenase deficiency.
  6. Pre-treatment corrected QT interval (QTc) ≥450 milliseconds.

Exclusion Criteria:

  1. Pregnant (positive β-human chorionic gonadotropin test, β-HCG) or lactating female at screening.
  2. Patients with a history of retinopathy, sickle cell disease or trait, psoriasis, porphyria, history of splenectomy, mental illness or uncontrolled seizures disorder, known active tuberculosis or history of incompletely treated tuberculosis, patients on chronic immunosuppression for other medical conditions such as rheumatological disorders, inflammatory bowel disease, or in patients with organ transplants.
  3. Patients admitted in ICU.
  4. Taking medications which may lead to interactions with hydroxychloroquine, including penicillamine, telbivudine, botulinum toxin, fluconazole, digoxin, propafenone , cimetidine, statins, warfarin, and cyclosporine within 2 weeks of dosing start, and during the duration of the study.
  5. History of Glucose-6-phosphate dehydrogenase deficiency.
  6. Pre-treatment corrected QT interval (QTc) ≥450 milliseconds.
  7. Acute or chronic kidney disease (stage-4 or -5 renal impairment; eGFR<30 mL/min/1.73 m2 or hemodialysis).
  8. Liver Child-Pugh grade C.
  9. Patients with Hypokalemia (<3.5mmol/L), Hypocalcemia (<2.2mmol/L), Hypomagnesemia (<0.66mmol/L). Will be included after correction.
  10. Need for mechanical ventilation.
  11. History of hypersensitivity to hydroxychloroquine.
  12. History of Chronic Hepatitis B or hepatitis C infections.
  13. History of Human Immunodeficiency Virus (HIV) infection.
  14. Concurrent serious illness including, but not limited to, any of the following:

    • Clinically significant cardiovascular disease (e.g., uncontrolled hypertension, myocardial infarction, or unstable angina).
    • New York Heart Association class II-IV congestive heart failure.
    • Serious cardiac arrhythmia requiring medication. -Peripheral vascular disease ≥ grade 2 within the past year. -
    • Psychiatric illness/social situation that would limit compliance with study requirements. -COPD, Lung cancer, and moderate to severe asthma.
  15. Any other significant finding based on the judgment of the PI would increase the risk of having an adverse outcome from participating in this study.
  16. Any other concomitant treatment based on the judgment of the PI would increase the risk of having an adverse outcome from participating in this study.
  17. Is currently participating in or has participated in an interventional clinical trial with an investigational compound or device within 80 days of signing the informed consent/assent for this current trial.

Sites / Locations

  • Prince Hamza Hospital/ Amman Field HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

First Arm (Hydroxychloroquine sulfate, 5 days)

Second Arm (Continued Standard of Care (SOC) Therapy)

Arm Description

Participants will receive continued standard of care therapy (SOC) for COVID-19 together with 2 ml HCQ01 (12.5 mg/ml) twice a day for 5 consecutive days.

Participants will receive continued standard of care therapy for COVID-19

Outcomes

Primary Outcome Measures

WHO Ordinal Scale for for Clinical Improvement
Change in condition measured using the Ordinal Scale for Clinical Improvement. Patients are scored on a scale of 0-10 with 0 being uninfected and 10 being dead

Secondary Outcome Measures

Proportion of participants who improve by at least one level lower on the 11-point WHO-OSCI
All-cause mortality
HCQ concentration in plasma versus time profiles
Change from Baseline Oxygenation as determined by the SpO2/FiO2 ratio
Rate of Transfer to the Intensive Care Unit
Time to Hospital Discharge or NEWS2 (National Early Warning Score 2) of ≤ 2
Treatment-related adverse events of HCQ
Cardiac Arrhythmia - Polymorphic Ventricular Tachycardia [Time Frame
Cardiologist Diagnostic Documentation
Cardiac Arrhythmia - Ventricular Tachycardia
Cardiologist Diagnostic Documentation
Cardiac Arrhythmia - Lengthening QTc
Cardiologist Diagnostic Documentation

Full Information

First Posted
November 6, 2021
Last Updated
March 2, 2022
Sponsor
Ministry of Health Jordan
Collaborators
King Hussein Cancer Center, ACDIMA Biocenter, Amman Pharmaceutical Industries, Sana Pharmaceutical Industry
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1. Study Identification

Unique Protocol Identification Number
NCT05113810
Brief Title
The Potential Use of Nebulized Hydroxychloroquine for the Treatment of COVID-19
Official Title
A Pilot, Randomized, Open-label Trial to Determine the Feasibility, Safety, Efficacy, and Pharmacokinetics of Nebulized HCQ01for the Treatment of Patients With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 20, 2022 (Anticipated)
Primary Completion Date
July 20, 2022 (Anticipated)
Study Completion Date
July 20, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ministry of Health Jordan
Collaborators
King Hussein Cancer Center, ACDIMA Biocenter, Amman Pharmaceutical Industries, Sana Pharmaceutical Industry

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
This is a pilot, randomized, single-center, parallel group, open-label controlled study to evaluate the feasibility, safety, efficacy, and pharmacokinetics of nebulized HCQ01 plus Standard of Care (SOC) versus SOC alone in hospitalized COVID-19 patients. The Jordanian Ministry of Health (MOH) is the study sponsor, and the study will be conducted at MOH COVID-19 hospitals. Approximately 110 patients, ≥18 years of age with a confirmed SARS-CoV-2 infection, will be enrolled and randomized 1:1 to the treatment and control arms where they will receive ten doses of Hydroxychloroquine solution via nebulizer in addition to SOC or the control arm where treatment will follow the MOH SOC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
2019 Novel Coronavirus
Keywords
COVID-19, Inhaled/nebulized Hydroxychloroquine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
110 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
First Arm (Hydroxychloroquine sulfate, 5 days)
Arm Type
Experimental
Arm Description
Participants will receive continued standard of care therapy (SOC) for COVID-19 together with 2 ml HCQ01 (12.5 mg/ml) twice a day for 5 consecutive days.
Arm Title
Second Arm (Continued Standard of Care (SOC) Therapy)
Arm Type
Active Comparator
Arm Description
Participants will receive continued standard of care therapy for COVID-19
Intervention Type
Drug
Intervention Name(s)
HCQ01
Intervention Description
HCQ01 is a sterile, clear and colorless, ready-to-use aqueous nebulizer solution. Hydroxychloroquine sulfate administered via nebulization
Intervention Type
Other
Intervention Name(s)
standard of care (SOC) for COVID-19
Intervention Description
Standard of care (SOC) for COVID-19
Primary Outcome Measure Information:
Title
WHO Ordinal Scale for for Clinical Improvement
Description
Change in condition measured using the Ordinal Scale for Clinical Improvement. Patients are scored on a scale of 0-10 with 0 being uninfected and 10 being dead
Time Frame
[ Day -1 (screening) to Days 3,6, and 14 ]
Secondary Outcome Measure Information:
Title
Proportion of participants who improve by at least one level lower on the 11-point WHO-OSCI
Time Frame
Day 28
Title
All-cause mortality
Time Frame
Day 28
Title
HCQ concentration in plasma versus time profiles
Time Frame
Day 1 pre-dose (within 1-hour prior dosing) and +2, +5, +10, +15, +20, +25, and +30 minutes after dose, and also +1, +2, +3, +4 and +6 hours post-dose completion
Title
Change from Baseline Oxygenation as determined by the SpO2/FiO2 ratio
Time Frame
Days 3 & 6
Title
Rate of Transfer to the Intensive Care Unit
Time Frame
Up to day 28
Title
Time to Hospital Discharge or NEWS2 (National Early Warning Score 2) of ≤ 2
Time Frame
Up to day 28
Title
Treatment-related adverse events of HCQ
Time Frame
Up to day 28
Title
Cardiac Arrhythmia - Polymorphic Ventricular Tachycardia [Time Frame
Description
Cardiologist Diagnostic Documentation
Time Frame
Up to day 6
Title
Cardiac Arrhythmia - Ventricular Tachycardia
Description
Cardiologist Diagnostic Documentation
Time Frame
Up to day 6
Title
Cardiac Arrhythmia - Lengthening QTc
Description
Cardiologist Diagnostic Documentation
Time Frame
Up to day 6

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Pregnant (positive β-human chorionic gonadotropin test, β-HCG) or lactating female at screening. Patients with a history of retinopathy, sickle cell disease or trait, psoriasis, porphyria, history of splenectomy, mental illness or uncontrolled seizures disorder, known active tuberculosis or history of incompletely treated tuberculosis, patients on chronic immunosuppression for other medical conditions such as rheumatological disorders, inflammatory bowel disease, or in patients with organ transplants. Patients admitted in ICU. Taking medications which may lead to interactions with hydroxychloroquine, including penicillamine, telbivudine, botulinum toxin, fluconazole, digoxin, propafenone , cimetidine, statins, warfarin, and cyclosporine within 2 weeks of dosing start, and during the duration of the study. History of Glucose-6-phosphate dehydrogenase deficiency. Pre-treatment corrected QT interval (QTc) ≥450 milliseconds. Exclusion Criteria: Pregnant (positive β-human chorionic gonadotropin test, β-HCG) or lactating female at screening. Patients with a history of retinopathy, sickle cell disease or trait, psoriasis, porphyria, history of splenectomy, mental illness or uncontrolled seizures disorder, known active tuberculosis or history of incompletely treated tuberculosis, patients on chronic immunosuppression for other medical conditions such as rheumatological disorders, inflammatory bowel disease, or in patients with organ transplants. Patients admitted in ICU. Taking medications which may lead to interactions with hydroxychloroquine, including penicillamine, telbivudine, botulinum toxin, fluconazole, digoxin, propafenone , cimetidine, statins, warfarin, and cyclosporine within 2 weeks of dosing start, and during the duration of the study. History of Glucose-6-phosphate dehydrogenase deficiency. Pre-treatment corrected QT interval (QTc) ≥450 milliseconds. Acute or chronic kidney disease (stage-4 or -5 renal impairment; eGFR<30 mL/min/1.73 m2 or hemodialysis). Liver Child-Pugh grade C. Patients with Hypokalemia (<3.5mmol/L), Hypocalcemia (<2.2mmol/L), Hypomagnesemia (<0.66mmol/L). Will be included after correction. Need for mechanical ventilation. History of hypersensitivity to hydroxychloroquine. History of Chronic Hepatitis B or hepatitis C infections. History of Human Immunodeficiency Virus (HIV) infection. Concurrent serious illness including, but not limited to, any of the following: Clinically significant cardiovascular disease (e.g., uncontrolled hypertension, myocardial infarction, or unstable angina). New York Heart Association class II-IV congestive heart failure. Serious cardiac arrhythmia requiring medication. -Peripheral vascular disease ≥ grade 2 within the past year. - Psychiatric illness/social situation that would limit compliance with study requirements. -COPD, Lung cancer, and moderate to severe asthma. Any other significant finding based on the judgment of the PI would increase the risk of having an adverse outcome from participating in this study. Any other concomitant treatment based on the judgment of the PI would increase the risk of having an adverse outcome from participating in this study. Is currently participating in or has participated in an interventional clinical trial with an investigational compound or device within 80 days of signing the informed consent/assent for this current trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yasmeen Dodin, MSc
Phone
00962798950958
Email
YD.14502@KHCC.JO
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Feras Hawari, MD
Organizational Affiliation
The Jordanian Ministry of Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Prince Hamza Hospital/ Amman Field Hospital
City
Amman
ZIP/Postal Code
00962
Country
Jordan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Khaldoun Khader, MD
First Name & Middle Initial & Last Name & Degree
Mohammed Shakeeb, MSc
Phone
0781633832
Email
mshakeeb95@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Potential Use of Nebulized Hydroxychloroquine for the Treatment of COVID-19

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