An Adaptive Study of Favipiravir Compared to Standard of Care in Hospitalized Patients With COVID-19
COVID-19
About this trial
This is an interventional treatment trial for COVID-19 focused on measuring SARS-CoV-2, 2019-nCoV
Eligibility Criteria
Inclusion Criteria:
- Signed Patient Information Sheet and Informed Consent form to participate in the study.
- Men and women aged 18 years and older.
- Patients hospitalized with a diagnosis of COVID-19.
- The diagnosis of COVID-19 was confirmed by positive reverse transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2, performed no earlier than 7 days before hospitalization or at screening.
Moderate severity of COVID-19 with pneumonia with at least 1 of the following symptoms:
- Fever above 38 °C;
- Cough;
- Shortness of breath during physical exertion;
- C reactive protein (CRP) of blood serum > 10 mg/l;
- SpO2 < 95%
- The capability of oral drug administration.
- The patients' consent to use adequate contraception methods during the study (condom with spermicide) and for 3 months following completion.
Exclusion Criteria:
Severe type of disease, with at least one of the following criteria:
- Frequency of breath > 35 per minute, which does not decrease after the body temperature drops to normal or subfebrile values;
- Blood oxygen saturation (SpO2) < 90% at rest;
- Partial pressure of oxygen in arterial blood (PaO2) < 60 mm Hg;
- Oxygenation index (RaO2/FiO2) ≤ 200 mm Hg;
- Partial pressure of CO2 in arterial blood (PaCO2) < 60 mm Hg;
- Septic shock.
- Patients treated with lopinavir/ritonavir, ribavirin, arbidol, chloroquine, hydroxychloroquine, mefloquine, favipiravir within 7 days prior to screening.
- Severe cardiovascular diseases currently or 6 months prior to randomization, including: New York Heart Association (NYHA) Class III or IV chronic heart failure, clinically significant ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation), unstable angina, myocardial infarction, heart and coronary vessel surgery, significant valvular heart disease, uncontrolled arterial hypertension with systolic blood pressure > 180 mm Hg and diastolic blood pressure > 110 mm Hg, pulmonary embolism or deep vein thrombosis.
- Severe chronic renal impairment (GFR < 30 ml / min) or continuous renal replacement therapy, hemodialysis or peritoneal dialysis.
- A history of cirrhosis or an increase in alanine aminotransferase (ALT) and / or aspartate aminotransferase (AST) > 5 times × upper limit of normal (ULN).
- Severe diseases of the central nervous system, including seizures in history or conditions that may lead to their development; stroke or transient ischemic attack within 12 months prior to screening; head injuries or loss of consciousness within 12 months prior to screening; a brain tumor.
- Significant uncontrolled concomitant disease, e.g. neurological, renal, hepatic, endocrinological or gastrointestinal disorder which according to the Investigator, could prevent the patient from participating in the study
- Malignancies that require chemotherapy within 6 months prior to screening.
- Known HIV infection
- Hypersensitivity to any component of the study drug.
- Participation in other clinical studies or taking other study drugs within 28 days prior to screening.
- Pregnant or lactating women or women planning to get pregnant during the clinical study; women of child-bearing potential (including non-sterilized by surgical means and during the post-menopause period less than 2 years) who do not use adequate contraception methods.
- Inability to read or write, unwillingness to understand and follow procedures of study protocol, as well as any other concomitant medical or serious mental conditions that make the patient unfit to participate in the study, limit the legality of obtaining informed consent or can affect patient's ability to participate in the study.
Sites / Locations
- Republican Clinical Hospital
- "K+31" Clinic
- "Khaven" Llc
- Central Clinical Hospital with Polyclinic
- Central Research Institute of Epidemiology
- City Clinical Hospital n.a. O.M. Filatov
- City Clinical Hospital named after S.S. Yudin
- City Clinical Hospital No. 24
- City Clinical Hospital No. 51
- First Moscow State Medical University n.a. I.M. Sechenov
- Moscow State University n.a. M. V. Lomonosov
- National Medical and Surgical Center named after N.I. Pirogov
- City Hospital № 33 of the Leninsky region of Nizhny Novgorod
- Infectious clinical hospital No.2 of Nizhny Novgorod
- Ryazan State Medical University named after I.P. Pavlov
- Military Medical Academy named after S.M. Kirova
- Saratov State Medical University named after V.I. Razumovsky
- Clinical hospital No.1
- Regional Clinic Hospital
- Bashkir State Medical University
- Yakutsk City Clinical Hospital
- Yaroslavl Regional Clinical Hospital for War Veterans
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Experimental
Active Comparator
Experimental
Active Comparator
Favipiravir, lower dose (pilot stage)
Favipiravir, higher dose (pilot stage)
Standard of care (pilot stage)
Favipiravir, selected dose (pivotal stage)
Standard of care (pivotal stage)
1600mg BID on the 1st day followed by 600mg BID for 13 days
1800mg BID on the 1st day followed by 800mg BID for 13 days
Based on approved clinical recommendations for treatment of COVID-19 in the Russian Federation (but not Favipiravir). Might include hydroxychloroquine, chloroquine, lopinavir/ritonavir or other recommended schemes.
The dose will be selected based on pilot study results.
Based on approved clinical recommendations for treatment of COVID-19 in the Russian Federation (but not Favipiravir). Might include hydroxychloroquine, chloroquine, lopinavir/ritonavir or other recommended schemes.