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Randomized Multicenter Study on the Efficacy and Safety of Favipiravir for Parenteral Administration Compared to Standard of Care in Hospitalized Patients With COVID-19

Primary Purpose

COVID-19

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
Favipiravir
Favipiravir
Remdesivir
Sponsored by
Promomed, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring SARS-CoV-2, Areplivir, 2019-nCoV, Favipiravir, Pneumonia, Coronavirus Infections

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Availability of the Informed Consent Form of the Patient Information Leaflet (PIL) signed and dated by patient.
  2. Men and women aged 18 to 80 years inclusive at the time of signing the Informed Consent Form in PIL.
  3. Confirmed case of COVID-19 at the time of screening based on SARS-CoV-2 RNA test using nucleic acid amplification (NAA) method. It is acceptable to include a patient with a presumptive COVID-19 diagnosis prior to receiving the results of SARS-CoV-2 RNA test made at the screening stage.
  4. Hospital admission due to COVID-19.
  5. Moderate severity infection with SARS-CoV-2:

    • Clinical signs:
    • Mandatory: CT pattern typical of a viral lesion (lesion volume is minimal or moderate; CT 1-2).
    • Additional (at least 1 of the following criteria):
    • body temperature > 38 °C;
    • RR > 22/min;
    • shortness of breath on exertion;
    • SpO2 < 95%;
    • Serum CRP > 10 mg/L.
  6. Patient's consent to use reliable contraceptive methods throughout the study and within 1 month for women and 3 months for men after its completion. Reliable means of contraception are: sexual abstinence, use of condom in combination with spermicide.

For men (optional): Consent to avoid sexual contact with pregnant women for the duration of the study and for 3 months after its completion.

Women incapable of childbearing may also participate in the study (with past history of: hysterectomy, tubal ligation, infertility, menopause for more than 2 years), as well as men with infertility or a history of vasectomy.

Exclusion Criteria:

  1. Hypersensitivity to favipiravir, remdesivir and/or other components of the study drug.
  2. Impossibility of CT procedure (for example, gypsum dressing or metal structures in the field of imaging).
  3. History of vaccination against COVID-19.
  4. History of presumptive or confirmed COVID-19 case of moderate, severe and extremely severe course of the disease.
  5. Use of favipiravir or remdesivir within 10 days prior to screening.
  6. The need to use drugs from the list of prohibited therapy.
  7. Meeting the criteria for severe and extremely severe course of the disease.
  8. Need for treatment in the intensive care unit.
  9. Impaired liver function (AST and/or ALT ≥ 2 UNL and/or total bilirubin ≥ 1.5 UNL) at the time of screening.
  10. Renal impairment (GFR < 60 ml/min) at the time of screening.
  11. History of gout.
  12. Positive testing for HIV, syphilis, hepatitis B and/or C.
  13. Chronic heart failure FC III-IV according to New York Heart Association (NYHA) functional classification (see Appendix 2).
  14. Malignancies in the past medical history.
  15. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening.
  16. Schizophrenia, schizoaffective disorder, bipolar disorder, or other history of mental pathology or suspicion of their presence at the time of screening.
  17. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten the patient's life or impair the patient's prognosis, and also make it impossible for him/her to participate in the clinical study).
  18. Any history data that the investigating physician believes could lead to complication in the interpretation of the study results or create an additional risk to the patient as a result of his/her participation in the study.
  19. Patient's unwillingness or inability to comply with procedures of the Study Protocol (in the opinion of physician investigator).
  20. Pregnant or nursing women or women planning pregnancy.
  21. Participation in another clinical study for 3 months prior to inclusion in the study.
  22. Other conditions that, according to the physician investigator, prevent the patient from being included in the study.

Sites / Locations

  • Regional budgetary health care institution "Ivanovo Clinical Hospital named after Kuvaevs"
  • State Budgetary Institution of Healthcare of the City of Moscow "City Clinical Hospital No. 24 of the Department of Healthcare of the City of Moscow"
  • State Clinical Hospital №50
  • Regional Clinic Hospital of Ryazan
  • Medical institute Ogarev Mordovia State university
  • Smolensk clinical hospital №1

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Favipiravir (Areplivir)

Standard of care

Arm Description

Arm 1 (n=106) receives the study drug Areplivir for parenteral administration as follows: Day 1 1600 mg 2 times a day, Day 2-10 800 mg 2 times a day. Administration will be done intravenously by drip infusion for 2 hours. The course of treatment is 10 days. The test drug is administered in hospital setting under supervision of a clinical investigator. The test drug is not handed over to the patient.

Arm 2 (n=108) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the Interim Guidelines for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19) approved by the Russian Ministry of Health by decision of the investigator and taking into account the availability of drugs at the study site. Might include Favipiravir tab, Remdesivir or other recommended schemes. Standard therapy is administered in hospital setting. Discharge of patients from a hospital is carried out in accordance with the local practice of the study site in compliance with the current sanitary and epidemiological regime.

Outcomes

Primary Outcome Measures

Rate of Clinical Status Improvement
Rate of clinical status improvement by WHO categorical ordinal scale of clinical status improvement by 2 or more categories by Day 10. WHO Ordinal Scale for Clinical Improvement (WHO-OSCI), 0 - uninfected (There are no clinical and virological signs of infection), 8 - dead, higher scores mean a worse outcome
Time to Clinical Improvement
Time (in days) to improvement in clinical status by WHO categorical ordinal scale of clinical status improvement

Secondary Outcome Measures

Rate of Clinical Status Improvement
Rate of clinical status improvement by WHO categorical ordinal scale of clinical status improvement by 2 or more categories at Visits 2 (Day 5) and 4 (Day 14)
Rate of Clinical Status Improvement
Percentage of patients with clinical status of 0 and 1 point according to the WHO categorical ordinal scale of clinical improvement on Days 5, 10 and 14.
End of Fever on Days of study
Percentage of patients with fever disappearance (body temperature < 37,2 °C in 3 consecutive measurements without antipyretic medication) an Days 5, 10 and 14.
Change in the Level of Lung Damage According to CT
Assessment of lung injury (degree of damage by "empirical" visual scale and % of patients) according to CT data comparing to baseline. The number of patients in whom by the end of therapy there was an improvement in the condition of the lungs (a decrease in the volume of the lesion according to CT)
Rate of Viral Elimination
Percentage of patients with SARS-CoV-2 elimination (negative test for SARS-CoV-2 by NAA method) on Days 5, 10, and 14.
Rate of Transfer to the Intensive Care Unit
Percentage of patients transferred to intensive care unit
Rate of the Use of Non-invasive Lung Ventilation
Percentage of cases with non-invasive lung ventilation
Rate of the Use of Mechanical Ventilation
Percentage of cases with mechanical lung ventilation (% of patients)
Mortality
Incidence of fatal cases (% of patients)

Full Information

First Posted
January 7, 2022
Last Updated
January 7, 2022
Sponsor
Promomed, LLC
Collaborators
Solyur Pharmaceuticals Group
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1. Study Identification

Unique Protocol Identification Number
NCT05185284
Brief Title
Randomized Multicenter Study on the Efficacy and Safety of Favipiravir for Parenteral Administration Compared to Standard of Care in Hospitalized Patients With COVID-19
Official Title
Open-label Randomized Multicenter Comparative Study on the Efficacy and Safety of AREPLIVIR® (Favipiravir) for Parenteral Administration (PROMOMED RUS LLC, Russia) in Hospitalized Patients With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
August 11, 2021 (Actual)
Primary Completion Date
December 30, 2021 (Actual)
Study Completion Date
December 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Promomed, LLC
Collaborators
Solyur Pharmaceuticals Group

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is open-labe randomized multicenter comparative Phase III study conducted in 7 medical facilities. The objective of the study is to assess the efficacy and safety of Favipiravir for parenteral administration compared with the Standard of care (SOC) in hospitalized patients with moderate COVID-19 pneumonia.
Detailed Description
Upon signing the informed consent form and screening, 217 eligible patients hospitalized with COVID-19 pneumonia were randomized at a 1:1 ratio to receive either Favipiravir intravenously by drip infusion for 2 hours 1600 mg twice a day (BID) on Day 1 followed by 800 mg BID on Days 2-14 (1600/800 mg), or SOC. The course of treatment by Favipiravir is 10 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
SARS-CoV-2, Areplivir, 2019-nCoV, Favipiravir, Pneumonia, Coronavirus Infections

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
217 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Favipiravir (Areplivir)
Arm Type
Experimental
Arm Description
Arm 1 (n=106) receives the study drug Areplivir for parenteral administration as follows: Day 1 1600 mg 2 times a day, Day 2-10 800 mg 2 times a day. Administration will be done intravenously by drip infusion for 2 hours. The course of treatment is 10 days. The test drug is administered in hospital setting under supervision of a clinical investigator. The test drug is not handed over to the patient.
Arm Title
Standard of care
Arm Type
Active Comparator
Arm Description
Arm 2 (n=108) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the Interim Guidelines for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19) approved by the Russian Ministry of Health by decision of the investigator and taking into account the availability of drugs at the study site. Might include Favipiravir tab, Remdesivir or other recommended schemes. Standard therapy is administered in hospital setting. Discharge of patients from a hospital is carried out in accordance with the local practice of the study site in compliance with the current sanitary and epidemiological regime.
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Other Intervention Name(s)
Areplivir
Intervention Description
400 mg, lyophilizate for preparation of concentrate for solution for infusion
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Intervention Description
200 mg coated tablets
Intervention Type
Drug
Intervention Name(s)
Remdesivir
Intervention Description
100 mg, lyophilizate for preparation of concentrate for solution for infusion
Primary Outcome Measure Information:
Title
Rate of Clinical Status Improvement
Description
Rate of clinical status improvement by WHO categorical ordinal scale of clinical status improvement by 2 or more categories by Day 10. WHO Ordinal Scale for Clinical Improvement (WHO-OSCI), 0 - uninfected (There are no clinical and virological signs of infection), 8 - dead, higher scores mean a worse outcome
Time Frame
By Visit 3, approximately 10 days
Title
Time to Clinical Improvement
Description
Time (in days) to improvement in clinical status by WHO categorical ordinal scale of clinical status improvement
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Rate of Clinical Status Improvement
Description
Rate of clinical status improvement by WHO categorical ordinal scale of clinical status improvement by 2 or more categories at Visits 2 (Day 5) and 4 (Day 14)
Time Frame
14 days
Title
Rate of Clinical Status Improvement
Description
Percentage of patients with clinical status of 0 and 1 point according to the WHO categorical ordinal scale of clinical improvement on Days 5, 10 and 14.
Time Frame
14 Days
Title
End of Fever on Days of study
Description
Percentage of patients with fever disappearance (body temperature < 37,2 °C in 3 consecutive measurements without antipyretic medication) an Days 5, 10 and 14.
Time Frame
14 Days
Title
Change in the Level of Lung Damage According to CT
Description
Assessment of lung injury (degree of damage by "empirical" visual scale and % of patients) according to CT data comparing to baseline. The number of patients in whom by the end of therapy there was an improvement in the condition of the lungs (a decrease in the volume of the lesion according to CT)
Time Frame
14 Days
Title
Rate of Viral Elimination
Description
Percentage of patients with SARS-CoV-2 elimination (negative test for SARS-CoV-2 by NAA method) on Days 5, 10, and 14.
Time Frame
14 days
Title
Rate of Transfer to the Intensive Care Unit
Description
Percentage of patients transferred to intensive care unit
Time Frame
28 days
Title
Rate of the Use of Non-invasive Lung Ventilation
Description
Percentage of cases with non-invasive lung ventilation
Time Frame
28 Days
Title
Rate of the Use of Mechanical Ventilation
Description
Percentage of cases with mechanical lung ventilation (% of patients)
Time Frame
28 Days
Title
Mortality
Description
Incidence of fatal cases (% of patients)
Time Frame
28 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Availability of the Informed Consent Form of the Patient Information Leaflet (PIL) signed and dated by patient. Men and women aged 18 to 80 years inclusive at the time of signing the Informed Consent Form in PIL. Confirmed case of COVID-19 at the time of screening based on SARS-CoV-2 RNA test using nucleic acid amplification (NAA) method. It is acceptable to include a patient with a presumptive COVID-19 diagnosis prior to receiving the results of SARS-CoV-2 RNA test made at the screening stage. Hospital admission due to COVID-19. Moderate severity infection with SARS-CoV-2: Clinical signs: Mandatory: CT pattern typical of a viral lesion (lesion volume is minimal or moderate; CT 1-2). Additional (at least 1 of the following criteria): body temperature > 38 °C; RR > 22/min; shortness of breath on exertion; SpO2 < 95%; Serum CRP > 10 mg/L. Patient's consent to use reliable contraceptive methods throughout the study and within 1 month for women and 3 months for men after its completion. Reliable means of contraception are: sexual abstinence, use of condom in combination with spermicide. For men (optional): Consent to avoid sexual contact with pregnant women for the duration of the study and for 3 months after its completion. Women incapable of childbearing may also participate in the study (with past history of: hysterectomy, tubal ligation, infertility, menopause for more than 2 years), as well as men with infertility or a history of vasectomy. Exclusion Criteria: Hypersensitivity to favipiravir, remdesivir and/or other components of the study drug. Impossibility of CT procedure (for example, gypsum dressing or metal structures in the field of imaging). History of vaccination against COVID-19. History of presumptive or confirmed COVID-19 case of moderate, severe and extremely severe course of the disease. Use of favipiravir or remdesivir within 10 days prior to screening. The need to use drugs from the list of prohibited therapy. Meeting the criteria for severe and extremely severe course of the disease. Need for treatment in the intensive care unit. Impaired liver function (AST and/or ALT ≥ 2 UNL and/or total bilirubin ≥ 1.5 UNL) at the time of screening. Renal impairment (GFR < 60 ml/min) at the time of screening. History of gout. Positive testing for HIV, syphilis, hepatitis B and/or C. Chronic heart failure FC III-IV according to New York Heart Association (NYHA) functional classification (see Appendix 2). Malignancies in the past medical history. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening. Schizophrenia, schizoaffective disorder, bipolar disorder, or other history of mental pathology or suspicion of their presence at the time of screening. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten the patient's life or impair the patient's prognosis, and also make it impossible for him/her to participate in the clinical study). Any history data that the investigating physician believes could lead to complication in the interpretation of the study results or create an additional risk to the patient as a result of his/her participation in the study. Patient's unwillingness or inability to comply with procedures of the Study Protocol (in the opinion of physician investigator). Pregnant or nursing women or women planning pregnancy. Participation in another clinical study for 3 months prior to inclusion in the study. Other conditions that, according to the physician investigator, prevent the patient from being included in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dmitriy Pushkar, MD, Academic
Organizational Affiliation
Moscow State Clinical Hospital №50
Official's Role
Principal Investigator
Facility Information:
Facility Name
Regional budgetary health care institution "Ivanovo Clinical Hospital named after Kuvaevs"
City
Ivanovo
ZIP/Postal Code
153025
Country
Russian Federation
Facility Name
State Budgetary Institution of Healthcare of the City of Moscow "City Clinical Hospital No. 24 of the Department of Healthcare of the City of Moscow"
City
Moscow
ZIP/Postal Code
127015
Country
Russian Federation
Facility Name
State Clinical Hospital №50
City
Moscow
Country
Russian Federation
Facility Name
Regional Clinic Hospital of Ryazan
City
Ryazan'
Country
Russian Federation
Facility Name
Medical institute Ogarev Mordovia State university
City
Saransk
Country
Russian Federation
Facility Name
Smolensk clinical hospital №1
City
Smolensk
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Time Frame
January 2022

Learn more about this trial

Randomized Multicenter Study on the Efficacy and Safety of Favipiravir for Parenteral Administration Compared to Standard of Care in Hospitalized Patients With COVID-19

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