Reparixin as add-on Therapy to Standard of Care to Limit Disease Progression in Adult Patients With COVID-19 and Other Community-Acquired Pneumonia.
Infectious Pneumonia, Severe COVID-19
About this trial
This is an interventional treatment trial for Infectious Pneumonia focused on measuring COVID-19, SARS-CoV-2, Infectious pneumonia acquired in the community (CAP)
Eligibility Criteria
Inclusion Criteria:
- Informed consent signed
- Male and female ≥18 years old;
Patients hospitalized for clinically suspected CAP, defined as the occurrence of (within 48h from hospital admission):
- at least 1 of the following signs/symptoms: dyspnea, cough, purulent sputum, crackles (rales) and/or rhonchi
- body temperature > 38°C or <36°C (before or during admission) or leucocytosis (> local ULN)
- new/increased pulmonary infiltrate(s) by chest imaging
- Need for non-invasive supplemental oxygen (NIAID-OS 5-6; Appendix 14.4.1);
- SpO2 <92% at room air, or PaO2/FiO2 (or SpO2/FiO2) <300;
Females of child-bearing potential and with an active sexual life must not wish to get pregnant within 30 days after the end of the study and must be using at least one of the following reliable methods of contraception:
- Hormonal contraception, systemic, implantable, transdermal, or injectable contraceptives for at least 2 months before the screening visit until 30 days after the last IMP dose
- A non-hormonal intrauterine device [IUD] or female condom with spermicide or contraceptive sponge with spermicide or diaphragm with spermicide or cervical cap with spermicide for at least 2 months before the screening visit until 30 days after the last IMP dose
- A male sexual partner who agrees to use a male condom with spermicide
- A sterile sexual partner
Female participants of non-child-bearing potential or in post-menopausal status for at least 1 year will be admitted. For all female subjects, with child-bearing potential, pregnancy test result must be negative before first drug intake.
Exclusion Criteria:
- Treatment with IMV or ECMO (NIAID-OS 7);
- Hepatic dysfunction: ALT or AST > 5 ULN; history of chronic hepatic disease (defined with Child-Pugh score B or C);
- Renal dysfunction: estimated glomerular filtration rate (eGFR, MDRD) <50 mL/min/1.73 m2, or need for haemodialysis or hemofiltration;
- Current use of >2 immunosuppressive medications or immunosuppression status (AIDS, aplastic anaemia, asplenia, systemic chemotherapy within the past 3 months, neutropenia (ANC < local LLN), solid organ or bone marrow transplant recipients)
- Treatment with prohibited medication within 5 half-lives, and inability to stop during treatment period (see section 5.5.2);
- Anticipated discharge from the hospital or transfer to another hospital within 72 hours of screening
History of:
- intolerance or hypersensitivity to ibuprofen to more than one medication belonging to the class of sulfonamides, such as sulfamethazine, sulfamethoxazole, sulfasalazine, nimesulide or celecoxib (hypersensitivity to sulphanilamide antibiotics alone, e.g. sulfamethoxazole does not qualify for exclusion)
- lactase deficiency, galactosemia or glucose-galactose malabsorption
- gastrointestinal bleeding or perforation due to previous NSAIDs therapy or recurrent peptic ulcer/haemorrhage
- allergy to reparixin or any component of the IMP formulation
- Active bleeding or bleeding diathesis (excluding menses), prior intracranial haemorrhage
- Participation in other interventional clinical trials
- Clinical condition not compatible with oral administration of the study drug
Pregnancy:
- positive or missing pregnancy test before first drug intake or day 1;
- pregnant or lactating women;
- women of childbearing potential and fertile men who do not agree to use at least one primary form of contraception for the duration of the study
- Current hospital stay >72h
- Complicated CAP-associated conditions, such as fungal pulmonary infection, tuberculosis infection, abscess, empyema, significant bilateral pleural effusion, massive pulmonary embolism
Sites / Locations
- MD Banner University Medical Center /Arizona University
- Velocity Clinical Research, Chula Vista
- UC Davis Medical Center - UC Davis Medical Group - DavisRecruiting
- University of Southern California
- UCI HealthRecruiting
- Denver HealthRecruiting
- Nuvance Health
- MedStar Health Research Institute-Hyatteville, MarylandRecruiting
- Research Alliance Inc.
- University of Florida-Jacksonville
- University of South Florida
- Emory Johns Creek Hospital
- Augusta University Health - Augusta University Medical Center
- Northwestern University, Feinberg School of MedicineRecruiting
- Jesse Brown VA Medical Center
- Insight Hospital & Medical Center Chicago
- Northshore University HealthSystem
- Norton Healthcare
- Tulane Medical Center
- Ochsner Medical Center
- Tufts Medical CenterRecruiting
- Boston Medical Center
- Beth Israel Deaconess Medical Center
- Newton-Wellesley HospitalRecruiting
- NorthStar Anesthesia / Detroit Medical Center
- MidMichigan Medical Center - MidlandRecruiting
- William Beaumont Hospital
- University Hospital - MU HealthcareRecruiting
- Washington University, School of Medicine
- Mercy Research St Louis
- NYU Langone Hospital-BrooklynRecruiting
- New York University Langone HealthRecruiting
- NYU Langone Hospital--Long Island
- Duke University HospitalRecruiting
- University of Oklahoma Medical Center
- Oregon Health & Science University (OHSU) - Pulmonary ClinicRecruiting
- Jefferson University HospitalRecruiting
- UPMC Presbyterian
- University of Tennessee Medical Center
- Baptist Hospitals of Southeast TexasRecruiting
- Texoma Medical Center
- University of Utah Hospitals & Clinics
- University of Virginia Medical Center
- Virginia Commonwealth University HealthRecruiting
- Medical College of Wisconsin
- Hospital Interzonal General de Agudos Dr Jose Penna
- Hospital Cuenca Alta Nestor Kirchner
- Hospital Italiano de Buenos Aires
- Hospital Italiano de La Plata
- Instituto Medico Platense
- Clinica Independencia
- Hospital Aleman
- Hospital General de Agudos Dr. Ignacio Pirovano
- Sanatorio Finochietto
- Sanatorio Parque S.A. Privado
- Sanatorio de la Cañada
- Sanatorio Britanico S.A.
- Sanatorio Parque S.A.
- Clinica Mayo de Urgencias Medicas Cruz Blanca SRL
- Hospital Britanico de Buenos Aires
- Hospital General de Agudos Donacion Francisco Santojanni
- Hospital General de Agudos Dr. J. M. Ramos Mejia
- Clinica Adventista Belgrano
- CEMIC
- Clinica Chutro
- Nuevo Hospital San Roque
- Sanatorio Allende
- Sanatorio Privado de la Cañada - Cordoba
- Sanatorio Privado Duarte Quiroz De Clinica Colombo SA
- Campbelltown Hospital
- Westmead Hospital
- Royal Brisbane and Women's Hospital
- Mater Hospital Brisbane
- Gold Coast University Hospital
- Royal Adelaide Hospital
- Royal Melbourne Hospital
- Kepler Universitatsklinikum Med Campus III
- KH der Barmherzigen Brüder Linz
- Medizinische Universitaet Wien, Medizinische Klinik I, Abteilung für Infektionskrankheiten und TropenmedizinRecruiting
- Klinik Favoriten (Sozialmedizinisches Zentrum Sued - Kaiser-Franz-Josef-Spital mit Gottfried von Preyer'schem Kinderspital)Recruiting
- Universitaetsklinikum Freiburg
- Albeilung für Kardiologie und PneumologieRecruiting
- Medizinische HochschuleRecruiting
- Universitaetsklinikum Carl Gustav Carus TU Dresden
- Universitätsmedizin GöttingenRecruiting
- Universitaetsklinikum Jena
- UOC Malattie dell'Apparato Respiratorio, Policlinico di Bari
- ASST - Ospedale Papa Giovanni XXIII - UOC PneumologiaRecruiting
- Azienda Ospedaliera Universitaria di Bologna - Ospedale Sant'OrsolaRecruiting
- Campus Universitario "Salvatore Venuta", Complesso Clinico, Padiglione B, 8° livello, Pneumologia
- University Of Genoa - Ospedale Policlinico IRCCS San Martino di GenovaRecruiting
- Fondazione Ca' Granda Policlinico MilanoRecruiting
- IRCCS Istituto Clinico Humanitas U.O. Medicina D'UrgenzaRecruiting
- IRCCS Ospedale San Raffaele Centro di Ricerca Anestesia e RianimazioneRecruiting
- ASST SANTI PAOLO E CARLO Ospedale San Paolo Struttura Complessa Malattie InfettiveRecruiting
- Università degli Studi di Milano-Ospedale "L.Sacco" Polo Universitario - ASST Fatebenefratelli Sacco
- ASST Grande Ospedale Metropolitano Niguarda Dipartimento Malattie InfettiveRecruiting
- A.O.U. Federico II Malattie Infettive del Policlinico Federico IIRecruiting
- Università della Campania "Luigi Vanvitelli" Dipartimento di Malattie InfettiveRecruiting
- ASST-Monza Ospedale San Gerardo Malattie InfettiveRecruiting
- Clinica Pneumologica "L. Vanvitelli" - Osp MonaldiRecruiting
- Università degli studi di Padova, Unità Malattie Respiratorie
- AOUP "P.Giaccone" - UOC PneumologiaRecruiting
- Fondazione IRCCS Policlinico San Matteo - UOC Pneumologia, Dipartimento di Scienze Mediche e Malattie InfettiveRecruiting
- Struttura semplice di terapia demi-intensiva respiratoria S.C. di pneumologia AO IRCCS Santa Maria NuovaRecruiting
- Ankara City Hospital
- Dicle University, Medical Faculty
- Gaziantep Universitesi Sahinbey Arastirma Ve Uygulama Hastanesi
- Acibadem Atakent Hospital
- Ege University Medical Faculty
- Dokuz Eylul University Faculty of Medicine
- Kayseri State Hospital
- Kocaeli Universitesi Tip Fakultesi
- Inonu Uni.Med.Faculty
- Karadeniz Tecnical Uni. Med. Fac.
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Reparixin + standard of care
Placebo + standard of care
Reparixin will be administered orally at the dose of 1200 mg (2 x 600 mg tablets) TID (6 tablets daily) for up to 21 days. The three daily doses will be administered maintaining an interval between doses of about 8 hours.
Placebo tablets are identical in appearance to the active formulation. Placebo will be administered with the same treatment schedule.