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Clinical Trial for Assessment of Anti-SARS-CoV-2 Serum for Early Treatment of COVID-19 Cases (SOROCOV)

Primary Purpose

Immunosuppression, Cancer, COVID-19

Status
Unknown status
Phase
Phase 1
Locations
Brazil
Study Type
Interventional
Intervention
AntiSARS-CoV-2 Serum
Placebo
Sponsored by
Butantan Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Immunosuppression focused on measuring Anti-SARS-CoV-2 serum, safety, pharmacokinetic, efficacy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Adults 18 years of age or older;
  2. Diagnosis of SARS-CoV-2 infection confirmed by RT-PCR or antigen test no more than 5 days ago;
  3. Onset of clinical signs and symptoms of COVID-19 no more than 5 days manifested as:

    1. Presenting sudden onset of anosmia and/or ageusia without any other reasonable explanation and/or;
    2. Thoracic image by radiography, tomography or ultrasonography compatible with acute clinical symptoms findings of COVID-19 and/or;
    3. Acute onset of cough accompanied by fever and/or
    4. Acute onset of three or more of the following symptoms: fever, cough, fatigue or general weakness, headache, myalgia, sore throat, runny nose, dyspnea, anorexia or nausea or vomit, diarrhea and mental status change.
  4. Oxygen saturation by pulse oximetry ≥92%
  5. Agree to periodic contacts by phone, electronic means and home visits;
  6. Demonstrate intention to participate in the study, documented by Informed Consent Form signature on the part of the participant.

    For the very high risk group:

  7. Being on continuous drug immunosuppressant more than two weeks due to a basic medical condition (e.g. transplant or cancer);

    For the high risk group:

  8. To present at least two risk factors for developing serious COVID-19 (Over 60 years of age; diabetes mellitus; chronic obstructive pulmonary disease; kidney disease; cardiovascular diseases and body mass index ≥ 35).

Exclusion Criteria:

  1. Presenting COVID-9 in need of oxygen therapy on the moment of study inclusion, in other words, score 5 or higher in WHO COVID-19 progression scale;
  2. Behavioral, cognitive or psychiatric disease that, in principal investigator opinion or his/her medical representative, affect the participant capacity in understanding and collaborating with study protocol requirements;
  3. Any use considered alcohol or drugs abuse in the last 12 months prior to study inclusion that caused medical, professional or family problems, as indicated by clinical history;
  4. Severe allergic reaction history or anaphylaxis to heterologous serum or product components of the study;
  5. To have received heterologous serum or convalescent plasma in the last three months before of study inclusion, or planned administration of hemoderivatives or immunoglobulin on the next 28 days of study inclusion;
  6. The participant is a team member who is conducting the study or is in a dependent relationship with one of the study team members. Dependency relationships include close relatives (in other words, sons, partner/spouse, brothers, parents), as well as Researcher staff or staff from the location conducting the study;
  7. Any other condition that, in the principal investigator opinion or his/her medical representative, could threaten the safety or rights of a potential participant or which prevents him from fulfilling with this protocol.

    For female:

  8. Pregnancy (confirmed by positive β-hCG test), breastfeeding and/or expressing an intention to have sexual practices with reproductive potential without using a contraceptive method within four weeks of the product administration;

    For stages A and B:

  9. Previous immunization with vaccine against COVID-19

Sites / Locations

  • Hospital do Rim
  • Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

Experimental product group (Stage A)

Placebo group (Stage C)

Experimental product group (Stage B)

Experimental product group (Stage C)

Arm Description

Anti-SARS-CoV-2 Serum Dose: 5 mL/dose or 10 mL/dose Administration Route: Intravenous

Saline solution Administration Route: Intravenous

Anti-SARS-CoV-2 Serum Dose: 5 mL/dose or 10 mL/dose Administration Route: Intravenous

Anti-SARS-CoV-2 Serum Dose: 5 mL/dose or 10 mL/dose Administration Route: Intravenous

Outcomes

Primary Outcome Measures

Frequency of local and systemic adverse events
Frequency of local and systemic adverse events, solicited and unsolicited, during the infusion and within 12 hours after administration of the heterologous serum
Anti-SARS-CoV-2 serum average life
Anti-SARS-CoV-2 serum average life measured by equine antibodies levels
Proportion of patients with change in COVID-19 disease progression profile after administration of anti-SARS-CoV-2 serum
Proportion of patients with change in COVID-19 disease progression profile after administration of anti-SARS-CoV-2 serum, based on the WHO clinical progression scale (not progression to severe disease requiring mechanical ventilation or death - Score 7 or larger)

Secondary Outcome Measures

Frequency of local and systemic adverse events
Frequency of local and systemic adverse events, solicited and unsolicited, up to 28 days of serum heterologous administration
Frequency of severe adverse events
Frequency of severe adverse events and of the special interest up to 28 days after administration of serum heterologous
Clinical response
Clinical response according serum anti-SARS-CoV-2 dosage
Symptoms duration
Symptoms duration associated to COVID-19
Hospitalization time in Intensive Care Unit
Hospitalization time in Intensive Care Unit related to COVID-19
Deaths
Frequency of deaths by COVID-19

Full Information

First Posted
April 1, 2021
Last Updated
April 5, 2021
Sponsor
Butantan Institute
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1. Study Identification

Unique Protocol Identification Number
NCT04834089
Brief Title
Clinical Trial for Assessment of Anti-SARS-CoV-2 Serum for Early Treatment of COVID-19 Cases
Acronym
SOROCOV
Official Title
Phase I/II Clinical Trial for Dose Escalation and Safety Assessment and Clinical Response of Anti-SARS-CoV-2 Serum Produced by Instituto Butantan
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Unknown status
Study Start Date
May 2021 (Anticipated)
Primary Completion Date
May 2022 (Anticipated)
Study Completion Date
May 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Butantan Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Phase I/II Randomized Clinical Trial to evaluate the safety, pharmacokinetic and efficacy of Anti-SARS-CoV-2 hyperimmune serum. The study will include patients at early stage of COVID-19 with increased risk for severe disease due to underlying medical conditions to determine the utility of an equine heterologous serum anti-SARS-CoV-2 to avoid progression to a severe COVID-19
Detailed Description
Phase I/II Clinical Trial, randomized, multicentric, on three stages (A, B and C) to evaluate the safety, pharmacokinetic and efficacy of Anti-SARS-CoV-2 serum and dose escalation. The study will be in three stages: Stage A: 30 kidney transplanted participants (very high risk), where 15 will received 1 vial (5 mL) and 15 will received 2 vials (10 mL) of serum; Stage B: 30 immunocompetent participants with at least 2 risk factors for severe disease (high risk) who will receive the dose selected by stage A; Stage C: 558 participants, of very high risk and high risk, compared with placebo in allocation 2:1 (endpoint-driven design) Allocation type Open study without allocation of randomization on Stages A and B Randomized allocation with placebo comparator in Stage C. Recruitment Status: On planning Date of 1st recruitment Expected: April 2021 Target sample siz 618 (30/30/538) participants .

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immunosuppression, Cancer, COVID-19, Other Complication of Kidney Transplant, Chemotherapy, Renal Disease, Diabetes Mellitus, Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease
Keywords
Anti-SARS-CoV-2 serum, safety, pharmacokinetic, efficacy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Phase I/II Clinical Trial, randomized, multicentric, on three stages (A, B and C) to evaluate the safety, pharmacokinetic and efficacy of Anti-SARS-CoV-2 serum and dose escalation. The study will be in three stages: Stage A: 30 kidney transplanted participants (very high risk), where 15 will received 1 vial (5 mL) and 15 will received 2 vials (10 mL) of serum; Stage B: 30 immunocompetent participants with at least 2 risk factors for severe disease (high risk) who will receive the dose selected by stage A; Stage C: 558 participants, of very high risk and high risk, compared with placebo in allocation 2:1.
Masking
ParticipantInvestigator
Masking Description
Stage C of this study was designed as double-blind to avoid the bias introduction in the efficacy and adverse events evaluation. The clinical care team, the responsible professional for administering the serum and the participant will not know which product under investigation will be administered. Only the pharmacists or nurses responsible for the randomization of the study, separation and blinding of the product under investigation will have access to unblinded information. The allocation of the product under investigation will only be revealed after the completion of the participants' following up and database closing to guarantee a long-term safety evaluation of the product. The sponsor's operational team will also remain blind. If necessary, independent scientists not involved with the clinical or laboratory evaluation of the participants, who analyze the unblinded data of laboratory results.
Allocation
Randomized
Enrollment
618 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental product group (Stage A)
Arm Type
Experimental
Arm Description
Anti-SARS-CoV-2 Serum Dose: 5 mL/dose or 10 mL/dose Administration Route: Intravenous
Arm Title
Placebo group (Stage C)
Arm Type
Placebo Comparator
Arm Description
Saline solution Administration Route: Intravenous
Arm Title
Experimental product group (Stage B)
Arm Type
Experimental
Arm Description
Anti-SARS-CoV-2 Serum Dose: 5 mL/dose or 10 mL/dose Administration Route: Intravenous
Arm Title
Experimental product group (Stage C)
Arm Type
Experimental
Arm Description
Anti-SARS-CoV-2 Serum Dose: 5 mL/dose or 10 mL/dose Administration Route: Intravenous
Intervention Type
Biological
Intervention Name(s)
AntiSARS-CoV-2 Serum
Intervention Description
Stage A: 30 kidney transplanted participants (very high risk), where 15 will received 1 vial (5 mL) and 15 will received 2 vials (10 mL) of serum; Stage B: 30 immunocompetent participants with at least 2 risk factors for severe disease (high risk) who will receive the dose selected by stage A; Stage C: 558 participants, of very high risk and high risk, compared with placebo in allocation 2:1.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Saline solution Administration Route: Intravenous
Primary Outcome Measure Information:
Title
Frequency of local and systemic adverse events
Description
Frequency of local and systemic adverse events, solicited and unsolicited, during the infusion and within 12 hours after administration of the heterologous serum
Time Frame
12 hours after product administration
Title
Anti-SARS-CoV-2 serum average life
Description
Anti-SARS-CoV-2 serum average life measured by equine antibodies levels
Time Frame
28 days after product administration
Title
Proportion of patients with change in COVID-19 disease progression profile after administration of anti-SARS-CoV-2 serum
Description
Proportion of patients with change in COVID-19 disease progression profile after administration of anti-SARS-CoV-2 serum, based on the WHO clinical progression scale (not progression to severe disease requiring mechanical ventilation or death - Score 7 or larger)
Time Frame
14 days after product administration
Secondary Outcome Measure Information:
Title
Frequency of local and systemic adverse events
Description
Frequency of local and systemic adverse events, solicited and unsolicited, up to 28 days of serum heterologous administration
Time Frame
28 days after product administration
Title
Frequency of severe adverse events
Description
Frequency of severe adverse events and of the special interest up to 28 days after administration of serum heterologous
Time Frame
28 days after product administration
Title
Clinical response
Description
Clinical response according serum anti-SARS-CoV-2 dosage
Time Frame
14 days after product administration
Title
Symptoms duration
Description
Symptoms duration associated to COVID-19
Time Frame
28 days after product administration
Title
Hospitalization time in Intensive Care Unit
Description
Hospitalization time in Intensive Care Unit related to COVID-19
Time Frame
28 days after product administration
Title
Deaths
Description
Frequency of deaths by COVID-19
Time Frame
28 days after product administration
Other Pre-specified Outcome Measures:
Title
Frequency and magnitude of equine antibodies titers
Description
Frequency and magnitude of equine antibodies titers 14 and 28 days after administration of anti-SARS-CoV-2 serum
Time Frame
28 days after product administration
Title
Frequency and magnitude of neutralizing antibodies titers Against SARS-CoV-2
Description
Frequency and magnitude of neutralizing antibodies titers Against SARS-CoV-2 after administration of anti-SARS-CoV-2 serum
Time Frame
28 days after product administration
Title
Proportion of medical assistance
Description
Proportion of medical assistance related to COVID-19 (score ≥ 3 of WHO)
Time Frame
14 days after product administration
Title
Proportion of emergency service visit
Description
Proportion of emergency service visit related to COVID-19
Time Frame
14 days after product administration
Title
Proportion of hospitalization
Description
Proportion of hospitalization related to COVID-19 (defined as ≥24 hours of hospital care) (score ≥ 4 of WHO)
Time Frame
14 days after product administration
Title
Proportion of patients with change in COVID-19 disease progression
Description
Proportion of patients with change in COVID-19 disease progression profile after administration of anti-SARS-CoV-2 serum according to underlying medical conditions.
Time Frame
28 days after product administration

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Adults 18 years of age or older; Diagnosis of SARS-CoV-2 infection confirmed by RT-PCR or antigen test no more than 5 days ago; Onset of clinical signs and symptoms of COVID-19 no more than 5 days manifested as: Presenting sudden onset of anosmia and/or ageusia without any other reasonable explanation and/or; Thoracic image by radiography, tomography or ultrasonography compatible with acute clinical symptoms findings of COVID-19 and/or; Acute onset of cough accompanied by fever and/or Acute onset of three or more of the following symptoms: fever, cough, fatigue or general weakness, headache, myalgia, sore throat, runny nose, dyspnea, anorexia or nausea or vomit, diarrhea and mental status change. Oxygen saturation by pulse oximetry ≥92% Agree to periodic contacts by phone, electronic means and home visits; Demonstrate intention to participate in the study, documented by Informed Consent Form signature on the part of the participant. For the very high risk group: Being on continuous drug immunosuppressant more than two weeks due to a basic medical condition (e.g. transplant or cancer); For the high risk group: To present at least two risk factors for developing serious COVID-19 (Over 60 years of age; diabetes mellitus; chronic obstructive pulmonary disease; kidney disease; cardiovascular diseases and body mass index ≥ 35). Exclusion Criteria: Presenting COVID-9 in need of oxygen therapy on the moment of study inclusion, in other words, score 5 or higher in WHO COVID-19 progression scale; Behavioral, cognitive or psychiatric disease that, in principal investigator opinion or his/her medical representative, affect the participant capacity in understanding and collaborating with study protocol requirements; Any use considered alcohol or drugs abuse in the last 12 months prior to study inclusion that caused medical, professional or family problems, as indicated by clinical history; Severe allergic reaction history or anaphylaxis to heterologous serum or product components of the study; To have received heterologous serum or convalescent plasma in the last three months before of study inclusion, or planned administration of hemoderivatives or immunoglobulin on the next 28 days of study inclusion; The participant is a team member who is conducting the study or is in a dependent relationship with one of the study team members. Dependency relationships include close relatives (in other words, sons, partner/spouse, brothers, parents), as well as Researcher staff or staff from the location conducting the study; Any other condition that, in the principal investigator opinion or his/her medical representative, could threaten the safety or rights of a potential participant or which prevents him from fulfilling with this protocol. For female: Pregnancy (confirmed by positive β-hCG test), breastfeeding and/or expressing an intention to have sexual practices with reproductive potential without using a contraceptive method within four weeks of the product administration; For stages A and B: Previous immunization with vaccine against COVID-19
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ricardo Palacios, MD, PhD
Phone
+551137232121
Email
ricardo.palacios@butantan.gov.br
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ricardo Palacios, MD, PhD
Organizational Affiliation
Butantan Institute
Official's Role
Study Director
Facility Information:
Facility Name
Hospital do Rim
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
04038-002
Country
Brazil
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jose Osmar Medina Pestana, MD,PhD
First Name & Middle Initial & Last Name & Degree
Jose Osmar Medina Pestana, MD,PhD
Facility Name
Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
City
São Paulo
ZIP/Postal Code
05403-010
Country
Brazil

12. IPD Sharing Statement

Learn more about this trial

Clinical Trial for Assessment of Anti-SARS-CoV-2 Serum for Early Treatment of COVID-19 Cases

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