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A Study to Evaluate the Safety and Efficacy of OT-101+Artemisinin in Hospitalized COVID-19 Subjects

Primary Purpose

COVID-19

Status
Unknown status
Phase
Phase 2
Locations
Brazil
Study Type
Interventional
Intervention
OT-101
Artemisinin
Placebo
Sponsored by
Oncotelic Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19

Eligibility Criteria

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

Inclusion Criteria:

  1. Hospitalized adult male or non-pregnant, non-lactating female subjects (between 18 and 80 years), with SARS-CoV-2 (previously known as 2019-nCoV) infection that is documented by authorized diagnostic PCR test. A rapid PCR test could also be used. Confirmation that subject has COVID-19 within the last 2 weeks prior to randomization.
  2. Meeting WHO COVID 19 Clinical Improvement Ordinal Scale Criteria 5 (non-invasive mechanical ventilation or high-flow oxygen) or Criteria 6 (intubation and mechanical ventilation).
  3. O2 sat <= 93%
  4. Male subjects and female subjects of childbearing potential must agree to use protocol specified methods of contraception.
  5. Female subjects of childbearing potential and women of non childbearing potential (defined as at least 2 years postmenopausal or permanently sterilized women [bilateral tubal ligation, bilateral ovariectomy, or hysterectomy]) must have a negative serum pregnancy test at screening or pretreatment on Day 1.
  6. The subject or a LAR has provided written informed consent.
  7. The subject or the LAR is aware of the investigational nature of this study and willing to comply with protocol treatments, and other evaluations listed in the ICF.

Exclusion Criteria:

  1. Participation in any other clinical trial of an experimental treatment for COVID-19 or participation in another interventional clinical trial, including an expanded access trial.
  2. Concurrent treatment with other agents with actual or possible direct acting antiviral activity against SARS CoV 2 infection <24 hours prior to study drug dosing except for remdesivir.
  3. Uncontrolled hypertension (systolic blood pressure >150 mmHg and/or diastolic blood pressure >100 mmHg), unstable angina, congestive heart failure of any New York Respiratory Association classification, serious cardiac arrhythmia requiring treatment (exceptions: atrial fibrillation, paroxysmal supraventricular tachycardia), or history of myocardial infarction within 12 months of enrollment.
  4. Hypotension requiring vasoactive peptides, such as dopamine, norepinephrine, epinephrine, or dobutamine.
  5. Renal function impairment (creatinine clearance [Cr. Cl.] <50 mL/min, based on Modification of Diet in Renal Disease calculation).
  6. Liver function impairment

    1. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >5 × upper limit of normal (ULN), or ALT/AST >3 × ULN plus total bilirubin >2 × ULN.
    2. Total bilirubin >1.5 × ULN, unless the subject has known Gilbert's syndrome.
  7. Platelet count <50 000/µL
  8. Multi-organ failure.
  9. Document active infection with a bacterial pathogen requiring parenteral systemic antibiotics.
  10. Bacterial or fungal sepsis.
  11. History of live vaccination within the last 4 weeks prior to study enrollment; subjects must not receive live, attenuated influenza vaccine (eg, FluMist) within 4 weeks before enrolment or at any time during the study.
  12. History of an allergic reaction or hypersensitivity to the study drug or any component of the study drug formulation.
  13. Anti-inflammatory treatments other than steroids (eg, complement inhibitor, anti-GM-CSF antibody, anti-IL6 antibody) ARE PROHIBITED. However, antiviral drugs (eg, remdesivir,), systemic corticosteroids, and non steroidal anti inflammatory drugs (NSAIDs) ARE ALLOWED.
  14. Presence of any uncontrolled concomitant illness, serious illness, medical conditions, or other medical history, including laboratory results, which, in the Investigator's opinion, would be likely to interfere with their participation in the study.
  15. Major surgical procedure within 4 weeks prior to screening or anticipation of need for major surgical procedure during the course of the study.
  16. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to screening
  17. History of organ allograft.

Sites / Locations

  • Praxis Pesquisa Medica S / S Ltda

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

OT-101 + Artemisinin + Standard of Care

Placebo + Artemisinin + Standard of Care

Arm Description

OT-101 - Days 1 to 7: 140 mg/m2 daily intravenous (i.v.) infusion for 7 continuous days. Artemisinin: Days 1 to 5: 500 mg per day for 5 days by oral

Artemisinin: Days 1 to 5: 500 mg per day for 5 days by oral

Outcomes

Primary Outcome Measures

The proportion of subjects with clinical improvement score measured by an 8-point WHO COVID-19 Clinical Improvement Ordinal Scale as assessed by the odds ratio (OR) at Day 14.
Clinical improvement is defined as • A score decrease to categories 1, 2, 3, or 4.

Secondary Outcome Measures

The OR at Days 7, 21, and 28 based on the clinical improvement score (as measured by an 8 point WHO COVID 19 Clinical Improvement Ordinal Scale).
Clinical improvement defined as per primary endpoint.
The OR at Days 7, 14, 21, and 28 of a decrease of at least 1, 2, 3, and 4 points in subjects with severe COVID 19.
Time to at least 2 point improvement from baseline on Days 7, 14, 21, and 28 in subjects with severe COVID 19.
Worsening (increase in clinical improvement score) of at least '1' score on Days 7, 14, 21, and 28.
Mortality by Days 7, 14, 21, and 28.
Duration of supplemental oxygen/ventilator support by Days 7, 14, 21, and 28.
Duration of intensive care unit stay by Days 7, 14, 21, and 28.
Duration of hospitalization by Days 7, 14, 21, and 28.
Ventilator free days by Day 14 and Day 28.
Days on ventilation.

Full Information

First Posted
March 1, 2021
Last Updated
March 15, 2021
Sponsor
Oncotelic Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04801017
Brief Title
A Study to Evaluate the Safety and Efficacy of OT-101+Artemisinin in Hospitalized COVID-19 Subjects
Official Title
A Double Blind, Randomized, Placebo Controlled, Multi Center Study of OT-101 in Hospitalized COVID-19 Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Unknown status
Study Start Date
April 2021 (Anticipated)
Primary Completion Date
August 2021 (Anticipated)
Study Completion Date
October 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Oncotelic Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
Primary Objective is to evaluate the safety and efficacy of OT-101+Artemisinin when used in combination with standard of care (SoC) in hospitalized COVID 19 subjects versus SoC+ Artemisinin+Placebo.
Detailed Description
This is a randomized, double blind, placebo controlled study to evaluate the efficacy, safety and tolerability of OT-101+Artemisinin when used in combination with SoC in hospitalized subjects with severe COVID 19. Written informed consent must be obtained from all subjects or their legally authorized representative (LAR) during screening (up to Day 3 prior to dosing) and prior to study related procedures being performed. Following completion of all screening assessments and meeting of eligibility criteria, subjects will be enrolled and randomized on Day 1 to either receive OT-101+Artemisinin or placebo+Artemisinin in a 2:1 ratio for 7 days in combination with SoC therapy per local SoC policies, followed to Day 28. Subjects: includes subjects with severe COVID 19 (WHO COVID 19 Clinical Improvement Ordinal Scale 5 - non-invasive ventilation or high flow oxygen, or 6 - intubation and mechanical ventilation) at screening. Subjects will undergo assessment during hospitalization or could discontinue their treatment with OT 101 or placebo during the 7 day infusion period or any time later during the study. All subjects will be closely monitored for adverse events (AEs) from signing the informed consent form (ICF) for at least 21 days after the final dose of study treatment (until Day 28). Standard of care treatment may continue as clinically indicated (after the 7 day dosing completion) as per local institutional guidelines. If subjects are discharged after Day 7 (after completing dosing), post discharge assessments can be done either at home (home health visit) or at the site. For subjects who are discharged before Day 28 or who withdraw from the study early will have follow up phone calls or will be followed up at site or a home visit to collect safety data until End of Study on Day 28. On days of laboratory assessments, discharged subjects may have a home visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
OT-101 + Artemisinin + Standard of Care
Arm Type
Experimental
Arm Description
OT-101 - Days 1 to 7: 140 mg/m2 daily intravenous (i.v.) infusion for 7 continuous days. Artemisinin: Days 1 to 5: 500 mg per day for 5 days by oral
Arm Title
Placebo + Artemisinin + Standard of Care
Arm Type
Placebo Comparator
Arm Description
Artemisinin: Days 1 to 5: 500 mg per day for 5 days by oral
Intervention Type
Drug
Intervention Name(s)
OT-101
Other Intervention Name(s)
Trabedersen
Intervention Description
TGF β2 specific synthetic 18 mer phosphorothioate antisense oligodeoxynucleotide
Intervention Type
Drug
Intervention Name(s)
Artemisinin
Other Intervention Name(s)
ArtiVeda
Intervention Description
Herbal Supplement/ Purified extract from Artemisia
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Normal saline
Intervention Description
0.9% sodium chloride injection
Primary Outcome Measure Information:
Title
The proportion of subjects with clinical improvement score measured by an 8-point WHO COVID-19 Clinical Improvement Ordinal Scale as assessed by the odds ratio (OR) at Day 14.
Description
Clinical improvement is defined as • A score decrease to categories 1, 2, 3, or 4.
Time Frame
at Day 14
Secondary Outcome Measure Information:
Title
The OR at Days 7, 21, and 28 based on the clinical improvement score (as measured by an 8 point WHO COVID 19 Clinical Improvement Ordinal Scale).
Description
Clinical improvement defined as per primary endpoint.
Time Frame
at Day 7, 21, 28
Title
The OR at Days 7, 14, 21, and 28 of a decrease of at least 1, 2, 3, and 4 points in subjects with severe COVID 19.
Time Frame
at Day 7, 14, 21, 28
Title
Time to at least 2 point improvement from baseline on Days 7, 14, 21, and 28 in subjects with severe COVID 19.
Time Frame
at Day 7, 14, 21, 28
Title
Worsening (increase in clinical improvement score) of at least '1' score on Days 7, 14, 21, and 28.
Time Frame
at Day 7, 14, 21, 28
Title
Mortality by Days 7, 14, 21, and 28.
Time Frame
up to Day 28
Title
Duration of supplemental oxygen/ventilator support by Days 7, 14, 21, and 28.
Time Frame
up to Day 28
Title
Duration of intensive care unit stay by Days 7, 14, 21, and 28.
Time Frame
up to Day 28
Title
Duration of hospitalization by Days 7, 14, 21, and 28.
Time Frame
up to Day 28
Title
Ventilator free days by Day 14 and Day 28.
Time Frame
up to Day 28
Title
Days on ventilation.
Time Frame
up to Day 28
Other Pre-specified Outcome Measures:
Title
Incidence of AEs and treatment-emergent AEs (TEAEs).
Time Frame
up to 28 days
Title
Adverse events leading to premature discontinuation of the study treatment.
Time Frame
up to 28 days
Title
Changes in radiology tests (chest X-ray or chest computed tomography [CT]) from baseline.
Time Frame
up to 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: Hospitalized adult male or non-pregnant, non-lactating female subjects (between 18 and 80 years), with SARS-CoV-2 (previously known as 2019-nCoV) infection that is documented by authorized diagnostic PCR test. A rapid PCR test could also be used. Confirmation that subject has COVID-19 within the last 2 weeks prior to randomization. Meeting WHO COVID 19 Clinical Improvement Ordinal Scale Criteria 5 (non-invasive mechanical ventilation or high-flow oxygen) or Criteria 6 (intubation and mechanical ventilation). O2 sat <= 93% Male subjects and female subjects of childbearing potential must agree to use protocol specified methods of contraception. Female subjects of childbearing potential and women of non childbearing potential (defined as at least 2 years postmenopausal or permanently sterilized women [bilateral tubal ligation, bilateral ovariectomy, or hysterectomy]) must have a negative serum pregnancy test at screening or pretreatment on Day 1. The subject or a LAR has provided written informed consent. The subject or the LAR is aware of the investigational nature of this study and willing to comply with protocol treatments, and other evaluations listed in the ICF. Exclusion Criteria: Participation in any other clinical trial of an experimental treatment for COVID-19 or participation in another interventional clinical trial, including an expanded access trial. Concurrent treatment with other agents with actual or possible direct acting antiviral activity against SARS CoV 2 infection <24 hours prior to study drug dosing except for remdesivir. Uncontrolled hypertension (systolic blood pressure >150 mmHg and/or diastolic blood pressure >100 mmHg), unstable angina, congestive heart failure of any New York Respiratory Association classification, serious cardiac arrhythmia requiring treatment (exceptions: atrial fibrillation, paroxysmal supraventricular tachycardia), or history of myocardial infarction within 12 months of enrollment. Hypotension requiring vasoactive peptides, such as dopamine, norepinephrine, epinephrine, or dobutamine. Renal function impairment (creatinine clearance [Cr. Cl.] <50 mL/min, based on Modification of Diet in Renal Disease calculation). Liver function impairment Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >5 × upper limit of normal (ULN), or ALT/AST >3 × ULN plus total bilirubin >2 × ULN. Total bilirubin >1.5 × ULN, unless the subject has known Gilbert's syndrome. Platelet count <50 000/µL Multi-organ failure. Document active infection with a bacterial pathogen requiring parenteral systemic antibiotics. Bacterial or fungal sepsis. History of live vaccination within the last 4 weeks prior to study enrollment; subjects must not receive live, attenuated influenza vaccine (eg, FluMist) within 4 weeks before enrolment or at any time during the study. History of an allergic reaction or hypersensitivity to the study drug or any component of the study drug formulation. Anti-inflammatory treatments other than steroids (eg, complement inhibitor, anti-GM-CSF antibody, anti-IL6 antibody) ARE PROHIBITED. However, antiviral drugs (eg, remdesivir,), systemic corticosteroids, and non steroidal anti inflammatory drugs (NSAIDs) ARE ALLOWED. Presence of any uncontrolled concomitant illness, serious illness, medical conditions, or other medical history, including laboratory results, which, in the Investigator's opinion, would be likely to interfere with their participation in the study. Major surgical procedure within 4 weeks prior to screening or anticipation of need for major surgical procedure during the course of the study. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to screening History of organ allograft.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Federico Lerner, MD
Phone
54 (911) 2852.0457
Email
federico@latinaba.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Vuong Trieu, PhD
Organizational Affiliation
Oncotelic Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Praxis Pesquisa Medica S / S Ltda
City
Jardim
Country
Brazil
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marcelo Bacci, MD
Phone
+55 11 2759-8377
Email
mrbacci@yahoo.com

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study to Evaluate the Safety and Efficacy of OT-101+Artemisinin in Hospitalized COVID-19 Subjects

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