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Efficacy and Safety of Ambervin® and Standard Therapy in Hospitalized Patients With COVID-19

Primary Purpose

COVID-19

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate intramuscularly
Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate inhaled
Standard of care
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, Ambervin

Eligibility Criteria

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

Inclusion Criteria: Availability of the Informed Consent Form of thePatient Information Leaflet (PIL) signed and dated bypatient. Men and women aged 18 to 80 years inclusive at thetime of signing the Informed Consent Form in PIL. Confirmed case of COVID-19 at the time ofscreening based on SARS-CoV-2 RNA test usingnucleic acid amplification (NAA) method. It isacceptable to include a patient with a presumptiveCOVID-19 diagnosis prior to receiving the results ofSARS-CoV-2 RNA test made at the screening stage. Hospital admission due to COVID-19. Moderate severity infection with SARS-CoV-2: Clinical signs (the presence of at least 2 of the following criteria): body temperature > 38 °C; RR > 22/min; CT pattern typical of a viral lesion shortness of breath on exertion; SpO2 < 95%; Serum CRP > 10 mg/L. Lesion volume is minimal or moderate; CT 1-2. Patient's consent to use reliable contraceptive methods through out the study and within 1 month for women and 3 months for men after its completion. Reliable means of contraception are: sexualabstinence, use of condom in combination withspermicide. Women incapable of childbearing may also participate inthe study (with past history of: hysterectomy, tubal ligation,infertility, menopause for more than 2 years), as well asmen with infertility or a history of vasectomy Exclusion Criteria: Hypersensitivity to components of the study drug. Impossibility of CT procedure (for example, gypsumdressing or metal structures in the field of imaging). Obstacles or inability to perform intramuscular injections and / or inhalations Arterial hypotension (a decrease in blood pressure (BP) below 100/60 mm Hg) at the time of screening and / or a history of hypotensive crises. The need for the use of drugs from the list of prohibited therapies. Availability of criteria for severe and extremely severe disease at the time of screening Presence within 6 months prior to screening of a probable or confirmed case of moderate COVID-19 History of presumptive or confirmed COVID-19 caseof moderate, severe and extremely severe course ofthe disease. Vaccination less than 4 weeks prior to screening. The need for treatment in the intensive care unit at the time of screening. Impaired liver function (AST and/or ALT ≥ 2 UNLand/or total bilirubin ≥ 1.5 UNL) at the time ofscreening. Renal impairment (GFR < 60 ml/min) at the time of screening. 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. Malignancies in the past medical history. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening. Epilepsy in history. Schizophrenia, schizoaffective disorder, bipolardisorder, or other history of mental pathology orsuspicion of their presence at the time of screening. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten thepatient'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 monthsprior to inclusion in the study. Other conditions that, according to the physicianinvestigator, prevent the patient from being includedin the study.

Sites / Locations

  • Budgetary institution of the Chuvash Republic "Emergency Hospital"
  • City clinical Hospital №24
  • Infectious Clinical Hospital No.1
  • State Budgetary Healthcare Institution City Clinical Hospital named after S. I. Spasokukotskiy of Moscow Healthcare Department
  • Regional Clinical Hospital
  • Ryazan State Medical University named after academician I.P. Pavlov of Ministry of Health of the Russian Federation
  • Ogarev Mordova State University of Ministry of Health of the Russian Federation
  • City Hospital No. 40 Kurortny District
  • Regional State Budget Healthcare Institution "Clinical hospital No. 1"
  • Voronezh Regional Clinical Hospital No.1

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Ambervin intramuscularly

Ambervin inhaled

Standard of care

Arm Description

Arm 1 (n=104) receives the study drug Ambervin for intramuscularly administration 1 mg 1 time per day. The course of treatment is 10 days.

Arm 2 (n=105) receives the study drug Ambervin for inhalation administration 10 mg 1 time per day. The course of treatment is 10 days.

Arm 3 (n=104) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the InterimGuidelines 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

Outcomes

Primary Outcome Measures

Prevalence of patients with category 0-1 as per categorical ordinal clinical improvement WHO scale
The proportion of patients with category 0-1 as per the categorical ordinal clinical improvement scale

Secondary Outcome Measures

Prevalence of patients with clinical status less than 4 points on the categorical ordinal WHO scale of clinical improvement
The proportion of patients with clinical status less than 4 points on the categorical ordinal WHO scale of clinical improvement
Frequency of improvement in clinical status on a categorical ordinal WHO scale of clinical improvement of 2 or more categories
The proportion of patients with clinical status on a categorical ordinal WHO scale of clinical improvement of 2 or more categories
Time to improve clinical status on a categorical ordinal scale of clinical improvement by ≥ 1 point.
Number of days to improve clinical status on a categorical ordinal scale of clinical improvement by ≥ 1 point.
Prevalence of patients eligible for discharge to continue outpatient treatment according to BMR
The proportion of patients eligible for discharge to continue outpatient treatment according to current Cuidelines
Prevalence of patients with RR < 22/min
The proportion of patients with RR < 22/min
Prevalence of patients with CRP level < 10 mg/l
The proportion of patients with CRP level < 10 mg/l
Prevalence of patients with blood lymphocytes > 1.2 x 10(9)/L
The proportion of patients with blood lymphocytes > 1.2 x 10(9)/L
Assessment of the degree of lung damage according to CT
The degree of lung damage according to CT
Prevalence of patients with SpO2 ≥ 95% on 2 consecutive days
The proportion of patients with SpO2 ≥ 95% on 2 consecutive days
The frequency of transfer of patients to the intensive care unit and intensive care
The proportion of patients transferred to the intensive care unit and intensive care
The frequency of cases of the use of high flow oxygen therapy, non-invasive and invasive ventilation of lung, ECMO
The proportion of patients who used high flow oxygen therapy, non-invasive and invasive ventilation of lung, ECMO
The frequency of cases of ARDS
The proportion of patients with ARDS
The frequency of patients with a fatal outcome
The proportion of patients with a fatal outcome

Full Information

First Posted
December 15, 2022
Last Updated
April 4, 2023
Sponsor
Promomed, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05656495
Brief Title
Efficacy and Safety of Ambervin® and Standard Therapy in Hospitalized Patients With COVID-19
Official Title
An Open Randomized Multicenter Comparative Study to Evaluate the Efficacy, Safety and Tolerability of the Use of Ambervin® for Intramuscular Administration and for Inhalation in Patients Hospitalized With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
February 28, 2022 (Actual)
Primary Completion Date
November 22, 2022 (Actual)
Study Completion Date
November 22, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Promomed, LLC

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 8 medical facilities. The objective of the study is to assess the efficacy, safety and tolerability of Ambervin for intramuscular and inhaled administration in complex therapy COVID-19 compared with the Standard of care (SOC) in hospitalized patients with moderate COVID-19.
Detailed Description
Upon signing the informed consent form and screening, 313 eligible patients hospitalized with COVID-19 were randomized at a 1:1:1 ratio to receive either Ambervin intramuscular 1mg 1 times a day for 10 days or Ambervin inhaled 10mg 1 times a day for 10 days or SOC.

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, Ambervin

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ambervin intramuscularly
Arm Type
Experimental
Arm Description
Arm 1 (n=104) receives the study drug Ambervin for intramuscularly administration 1 mg 1 time per day. The course of treatment is 10 days.
Arm Title
Ambervin inhaled
Arm Type
Experimental
Arm Description
Arm 2 (n=105) receives the study drug Ambervin for inhalation administration 10 mg 1 time per day. The course of treatment is 10 days.
Arm Title
Standard of care
Arm Type
Active Comparator
Arm Description
Arm 3 (n=104) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the InterimGuidelines 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
Intervention Type
Drug
Intervention Name(s)
Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate intramuscularly
Other Intervention Name(s)
Ambervin intramuscularly
Intervention Description
lyophilizate for preparation of solution for intramuscular administration 1 mg 1 time per day for 10 days
Intervention Type
Drug
Intervention Name(s)
Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate inhaled
Other Intervention Name(s)
Ambervin inhaled
Intervention Description
lyophilizate for preparation of solution for inhalation administration 10 mg 1 time per day for 10 days
Intervention Type
Drug
Intervention Name(s)
Standard of care
Intervention Description
The administration of 'StandardTherapy' drugs was done according to the regimen recommended in the 'COVID-19TreatmentGuidelines'(current version)
Primary Outcome Measure Information:
Title
Prevalence of patients with category 0-1 as per categorical ordinal clinical improvement WHO scale
Description
The proportion of patients with category 0-1 as per the categorical ordinal clinical improvement scale
Time Frame
From baseline to Visit 4 (days 14-15)
Secondary Outcome Measure Information:
Title
Prevalence of patients with clinical status less than 4 points on the categorical ordinal WHO scale of clinical improvement
Description
The proportion of patients with clinical status less than 4 points on the categorical ordinal WHO scale of clinical improvement
Time Frame
From baseline to Visit 3 (days 11-12) and 4 (days 14-15)
Title
Frequency of improvement in clinical status on a categorical ordinal WHO scale of clinical improvement of 2 or more categories
Description
The proportion of patients with clinical status on a categorical ordinal WHO scale of clinical improvement of 2 or more categories
Time Frame
From baseline to Visit 3 (days 11-12) and 4 (days 14-15)
Title
Time to improve clinical status on a categorical ordinal scale of clinical improvement by ≥ 1 point.
Description
Number of days to improve clinical status on a categorical ordinal scale of clinical improvement by ≥ 1 point.
Time Frame
From baseline to Visit 6 (study completion, day 28±1)
Title
Prevalence of patients eligible for discharge to continue outpatient treatment according to BMR
Description
The proportion of patients eligible for discharge to continue outpatient treatment according to current Cuidelines
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12)
Title
Prevalence of patients with RR < 22/min
Description
The proportion of patients with RR < 22/min
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12)
Title
Prevalence of patients with CRP level < 10 mg/l
Description
The proportion of patients with CRP level < 10 mg/l
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12)
Title
Prevalence of patients with blood lymphocytes > 1.2 x 10(9)/L
Description
The proportion of patients with blood lymphocytes > 1.2 x 10(9)/L
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12)
Title
Assessment of the degree of lung damage according to CT
Description
The degree of lung damage according to CT
Time Frame
From baseline to Visit 4 (days 14-15)
Title
Prevalence of patients with SpO2 ≥ 95% on 2 consecutive days
Description
The proportion of patients with SpO2 ≥ 95% on 2 consecutive days
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15)
Title
The frequency of transfer of patients to the intensive care unit and intensive care
Description
The proportion of patients transferred to the intensive care unit and intensive care
Time Frame
From baseline to Visit 6 (study completion, day 28±1)
Title
The frequency of cases of the use of high flow oxygen therapy, non-invasive and invasive ventilation of lung, ECMO
Description
The proportion of patients who used high flow oxygen therapy, non-invasive and invasive ventilation of lung, ECMO
Time Frame
From baseline to Visit 6 (study completion, day 28±1)
Title
The frequency of cases of ARDS
Description
The proportion of patients with ARDS
Time Frame
From baseline to Visit 6 (study completion, day 28±1)
Title
The frequency of patients with a fatal outcome
Description
The proportion of patients with a fatal outcome
Time Frame
From baseline to Visit 6 (study completion, day 28±1)

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 thePatient Information Leaflet (PIL) signed and dated bypatient. Men and women aged 18 to 80 years inclusive at thetime of signing the Informed Consent Form in PIL. Confirmed case of COVID-19 at the time ofscreening based on SARS-CoV-2 RNA test usingnucleic acid amplification (NAA) method. It isacceptable to include a patient with a presumptiveCOVID-19 diagnosis prior to receiving the results ofSARS-CoV-2 RNA test made at the screening stage. Hospital admission due to COVID-19. Moderate severity infection with SARS-CoV-2: Clinical signs (the presence of at least 2 of the following criteria): body temperature > 38 °C; RR > 22/min; CT pattern typical of a viral lesion shortness of breath on exertion; SpO2 < 95%; Serum CRP > 10 mg/L. Lesion volume is minimal or moderate; CT 1-2. Patient's consent to use reliable contraceptive methods through out the study and within 1 month for women and 3 months for men after its completion. Reliable means of contraception are: sexualabstinence, use of condom in combination withspermicide. Women incapable of childbearing may also participate inthe study (with past history of: hysterectomy, tubal ligation,infertility, menopause for more than 2 years), as well asmen with infertility or a history of vasectomy Exclusion Criteria: Hypersensitivity to components of the study drug. Impossibility of CT procedure (for example, gypsumdressing or metal structures in the field of imaging). Obstacles or inability to perform intramuscular injections and / or inhalations Arterial hypotension (a decrease in blood pressure (BP) below 100/60 mm Hg) at the time of screening and / or a history of hypotensive crises. The need for the use of drugs from the list of prohibited therapies. Availability of criteria for severe and extremely severe disease at the time of screening Presence within 6 months prior to screening of a probable or confirmed case of moderate COVID-19 History of presumptive or confirmed COVID-19 caseof moderate, severe and extremely severe course ofthe disease. Vaccination less than 4 weeks prior to screening. The need for treatment in the intensive care unit at the time of screening. Impaired liver function (AST and/or ALT ≥ 2 UNLand/or total bilirubin ≥ 1.5 UNL) at the time ofscreening. Renal impairment (GFR < 60 ml/min) at the time of screening. 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. Malignancies in the past medical history. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening. Epilepsy in history. Schizophrenia, schizoaffective disorder, bipolardisorder, or other history of mental pathology orsuspicion of their presence at the time of screening. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten thepatient'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 monthsprior to inclusion in the study. Other conditions that, according to the physicianinvestigator, prevent the patient from being includedin the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dmitriy Pushkar
Organizational Affiliation
Moscow State Clinical Hospital №50
Official's Role
Principal Investigator
Facility Information:
Facility Name
Budgetary institution of the Chuvash Republic "Emergency Hospital"
City
Cheboksary
Country
Russian Federation
Facility Name
City clinical Hospital №24
City
Moscow
Country
Russian Federation
Facility Name
Infectious Clinical Hospital No.1
City
Moscow
Country
Russian Federation
Facility Name
State Budgetary Healthcare Institution City Clinical Hospital named after S. I. Spasokukotskiy of Moscow Healthcare Department
City
Moscow
Country
Russian Federation
Facility Name
Regional Clinical Hospital
City
Ryazan
Country
Russian Federation
Facility Name
Ryazan State Medical University named after academician I.P. Pavlov of Ministry of Health of the Russian Federation
City
Ryazan
Country
Russian Federation
Facility Name
Ogarev Mordova State University of Ministry of Health of the Russian Federation
City
Saransk
Country
Russian Federation
Facility Name
City Hospital No. 40 Kurortny District
City
Sestroretsk
Country
Russian Federation
Facility Name
Regional State Budget Healthcare Institution "Clinical hospital No. 1"
City
Smolensk
Country
Russian Federation
Facility Name
Voronezh Regional Clinical Hospital No.1
City
Voronezh
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
Citation
L.A. Balykova, O.A. Radaeva, K.Ya. Zaslavskaya, P.A. Bely, V.F. Pavelkina, N.A. Pyataev, A.Yu. Ivanova, G.V. Rodoman, N.E. Kostina, V.B. Filimonov, E.N. Simakina, D.A. Bystritsky, A.S. Agafina, K.N. Koryanova, D.Yu. Pushkar. Efficacy and safety of original drug based on hexapeptide succinate in complex COVID-19 therapy in adults hospitalized patients. Pharmacy & Pharmacology. 2022;10(6):573-588. DOI: 10.19163/2307-9266-2022-10-6-573-588
Results Reference
background
Links:
URL
https://cyberleninka.ru/article/n/effektivnost-i-bezopasnost-originalnogo-preparata-na-osnove-suktsinata-geksapeptida-v-kompleksnoy-terapii-covid-19-u-vzroslyh
Description
Cyberleninka is an open access scientific electronic library

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Efficacy and Safety of Ambervin® and Standard Therapy in Hospitalized Patients With COVID-19

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