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A Study to Evaluate the Efficacy and Safety of Itolizumab in Subjects Hospitalized With COVID-19 (EQUINOX)

Primary Purpose

Coronavirus

Status
Withdrawn
Phase
Phase 3
Locations
Colombia
Study Type
Interventional
Intervention
EQ001
EQ001 Placebo
Sponsored by
Equillium
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronavirus focused on measuring COVID-19, SARS-CoV-2

Eligibility Criteria

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

Inclusion Criteria:

  1. Is willing and able to, or has a legally acceptable representative who is willing and able to, provide informed consent to participate and to cooperate with all aspects of the protocol.
  2. Is male or female, age ≥18 years
  3. Is hospitalized with COVID-19 pneumonia with a diagnosis of SARS-CoV-2 infection confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) or equivalent local test within 14 days of randomization.
  4. Has PaO2/FiO2 ratio of ≤200 (or equivalent SpO2/FiO2 ratio ~235 within 24 hours before randomization. This ratio may be adjusted based on altitude.

Exclusion Criteria:

  1. Has known severe allergic reactions to mAbs.
  2. Has active TB or known history of inadequately treated latent or active TB.
  3. Has any known active systemic or pulmonary bacterial, fungal, or viral (other than SARS-CoV-2) infection at the time of randomization.
  4. Has known active, uncontrolled hepatitis B or hepatitis C or severe liver function impairment from any etiology, as defined by Child-Pugh Class C.
  5. Has human immunodeficiency virus (HIV) with known CD4 counts <0.2 × 10^9/L.
  6. Has a history of clinically significant cardiac abnormality within 6 months prior to randomization, such as myocardial infarction or stroke, New York Heart Association class III or IV, or clinically significant abnormalities of electrocardiogram (ECG) or cardiac function.
  7. Has been on mechanical ventilation for longer than 48 hours during their first continuous episode since admission, is on their second or greater episode of mechanical ventilation at the time of randomization during the concurrent hospitalization, or has received extracorporeal membrane oxygenation (ECMO).
  8. Has a declining clinical status with an expected survival <3 days in the opinion of the Investigator.
  9. Has received any systemic immunomodulatory or immunosuppressant agents for any condition within 3 months prior to randomization. (Note: a stable, oral, low dose of corticosteroids [prednisone or equivalent ≤10 mg/day] for a chronic condition or any dose of systemic corticosteroids for current COVID-19 treatment are permitted. Local/topical treatments are also permitted.)
  10. Has received any biologic treatment for any acute (eg, COVID-19) or chronic conditions (eg, TNFα inhibitors, anti-IL17A, tocilizumab, anti-cytokines, etc.) within 3 months prior to randomization.
  11. Is participating in another clinical study of an investigational product and/or received an investigational product within 30 days or within 5 half-lives (whichever is longer) prior to randomization.
  12. Is pregnant or breastfeeding, or has a positive pregnancy serum or urine test during Screening.
  13. Does not agree to use contraception in the event of sexual activity for 130 days (+90 days for male subjects) after the last dose of study drug if a female of childbearing potential or a male with a partner of childbearing potential. Note: this criterion does not apply to subjects in same-sex relationships.
  14. Has inadequate hematologic function during Screening defined as follows:

    • Absolute neutrophil count (ANC) <1.0 × 109/L.
    • ALC <0.5 × 109/L.
  15. Requires renal dialysis, either acute or chronic, at the time of randomization.
  16. Has a medical, psychiatric, or other condition or circumstance that, in the opinion of the Investigator, could affect the subject's safety, the subject's participation in the study, or the reliability of the study data.

Sites / Locations

  • Inv Site CO01

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

EQ001

EQ001 Placebo

Arm Description

EQ001 administered in a blinded fashion by intravenous infusion on Day 1 and Day 8 for a total of 2 doses.

Placebo administered in a blinded fashion by intravenous infusion on Day 1 and Day 8 for a total of 2 doses.

Outcomes

Primary Outcome Measures

Proportion of subjects who have recovered at Day 28.
Proportion of subjects who have recovered at Day 28.

Secondary Outcome Measures

Proportion of subjects deceased or requiring mechanical ventilation at Day 28.
Proportion of subjects deceased or requiring mechanical ventilation at Day 28.
Proportion of subjects deceased at Day 28.
Proportion of subjects deceased at Day 28.

Full Information

First Posted
October 21, 2020
Last Updated
January 25, 2021
Sponsor
Equillium
Collaborators
Biocon Limited
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1. Study Identification

Unique Protocol Identification Number
NCT04605926
Brief Title
A Study to Evaluate the Efficacy and Safety of Itolizumab in Subjects Hospitalized With COVID-19
Acronym
EQUINOX
Official Title
A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of Itolizumab in Subjects Hospitalized With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Withdrawn
Why Stopped
Sponsor has currently elected to withhold study initiation
Study Start Date
November 2020 (Anticipated)
Primary Completion Date
April 2021 (Anticipated)
Study Completion Date
June 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Equillium
Collaborators
Biocon Limited

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
This is a randomized controlled trial to evaluate the efficacy and safety of itolizumab in subjects hospitalized with COVID-19.
Detailed Description
This study will randomize up to 800 subjects in a 1:1 ratio; itolizumab vs. placebo. Subjects will receive either itolizumab or placebo administered intravenously on Day 1 and Day 8 with follow-up to Day 90. Two interim analyses of futility are planned. The first will take place when approximately 20% of the subjects have been evaluated for the primary endpoint, and the second will take place when approximately 50% of the subjects have been evaluated for the primary endpoint.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronavirus
Keywords
COVID-19, SARS-CoV-2

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
The study will be blinded to all study staff that has direct access to the subjects and the sponsor.
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
EQ001
Arm Type
Experimental
Arm Description
EQ001 administered in a blinded fashion by intravenous infusion on Day 1 and Day 8 for a total of 2 doses.
Arm Title
EQ001 Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo administered in a blinded fashion by intravenous infusion on Day 1 and Day 8 for a total of 2 doses.
Intervention Type
Biological
Intervention Name(s)
EQ001
Other Intervention Name(s)
itolizumab, Bmab600
Intervention Description
itolizumab [Bmab600]
Intervention Type
Biological
Intervention Name(s)
EQ001 Placebo
Intervention Description
EQ001 Placebo
Primary Outcome Measure Information:
Title
Proportion of subjects who have recovered at Day 28.
Description
Proportion of subjects who have recovered at Day 28.
Time Frame
Day 28
Secondary Outcome Measure Information:
Title
Proportion of subjects deceased or requiring mechanical ventilation at Day 28.
Description
Proportion of subjects deceased or requiring mechanical ventilation at Day 28.
Time Frame
Day 28
Title
Proportion of subjects deceased at Day 28.
Description
Proportion of subjects deceased at Day 28.
Time Frame
Day 28
Other Pre-specified Outcome Measures:
Title
Incidence of treatment-emergent adverse events (TEAEs).
Description
Number of participants with treatment-related adverse events as assessed by Common Terminology Criteria for Adverse Events (CTCAE)
Time Frame
Day 90
Title
Time to maximum itolizumab serum concentration, Tmax
Description
Time to maximum itolizumab serum concentration, Tmax
Time Frame
Day 28
Title
Maximum itolizumab serum drug concentration, Cmax
Description
Maximum itolizumab serum drug concentration, Cmax
Time Frame
Day 28
Title
Total itolizumab exposure across time, AUC (from zero to last)
Description
Total itolizumab exposure across time, AUC (from zero to last)
Time Frame
Day 28
Title
Inflammatory biomarkers
Description
Including but not limited to IL-1, IL-6, IL-17, TNF-α.
Time Frame
Day 28
Title
Pharmacodynamic markers
Description
sCD6, sALCAM
Time Frame
Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is willing and able to, or has a legally acceptable representative who is willing and able to, provide informed consent to participate and to cooperate with all aspects of the protocol. Is male or female, age ≥18 years Is hospitalized with COVID-19 pneumonia with a diagnosis of SARS-CoV-2 infection confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) or equivalent local test within 14 days of randomization. Has PaO2/FiO2 ratio of ≤200 (or equivalent SpO2/FiO2 ratio ~235 within 24 hours before randomization. This ratio may be adjusted based on altitude. Exclusion Criteria: Has known severe allergic reactions to mAbs. Has active TB or known history of inadequately treated latent or active TB. Has any known active systemic or pulmonary bacterial, fungal, or viral (other than SARS-CoV-2) infection at the time of randomization. Has known active, uncontrolled hepatitis B or hepatitis C or severe liver function impairment from any etiology, as defined by Child-Pugh Class C. Has human immunodeficiency virus (HIV) with known CD4 counts <0.2 × 10^9/L. Has a history of clinically significant cardiac abnormality within 6 months prior to randomization, such as myocardial infarction or stroke, New York Heart Association class III or IV, or clinically significant abnormalities of electrocardiogram (ECG) or cardiac function. Has been on mechanical ventilation for longer than 48 hours during their first continuous episode since admission, is on their second or greater episode of mechanical ventilation at the time of randomization during the concurrent hospitalization, or has received extracorporeal membrane oxygenation (ECMO). Has a declining clinical status with an expected survival <3 days in the opinion of the Investigator. Has received any systemic immunomodulatory or immunosuppressant agents for any condition within 3 months prior to randomization. (Note: a stable, oral, low dose of corticosteroids [prednisone or equivalent ≤10 mg/day] for a chronic condition or any dose of systemic corticosteroids for current COVID-19 treatment are permitted. Local/topical treatments are also permitted.) Has received any biologic treatment for any acute (eg, COVID-19) or chronic conditions (eg, TNFα inhibitors, anti-IL17A, tocilizumab, anti-cytokines, etc.) within 3 months prior to randomization. Is participating in another clinical study of an investigational product and/or received an investigational product within 30 days or within 5 half-lives (whichever is longer) prior to randomization. Is pregnant or breastfeeding, or has a positive pregnancy serum or urine test during Screening. Does not agree to use contraception in the event of sexual activity for 130 days (+90 days for male subjects) after the last dose of study drug if a female of childbearing potential or a male with a partner of childbearing potential. Note: this criterion does not apply to subjects in same-sex relationships. Has inadequate hematologic function during Screening defined as follows: Absolute neutrophil count (ANC) <1.0 × 109/L. ALC <0.5 × 109/L. Requires renal dialysis, either acute or chronic, at the time of randomization. Has a medical, psychiatric, or other condition or circumstance that, in the opinion of the Investigator, could affect the subject's safety, the subject's participation in the study, or the reliability of the study data.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maple Fung, MD
Organizational Affiliation
Equillium
Official's Role
Study Director
Facility Information:
Facility Name
Inv Site CO01
City
Medellín
Country
Colombia

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://equilliumbio.com/
Description
Company website

Learn more about this trial

A Study to Evaluate the Efficacy and Safety of Itolizumab in Subjects Hospitalized With COVID-19

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