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Clinical Trial of Favipiravir Treatment of Patients With COVID-19

Primary Purpose

SARS-CoV-2 Infection

Status
Completed
Phase
Phase 3
Locations
Hungary
Study Type
Interventional
Intervention
Favipiravir
Sponsored by
University of Pecs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for SARS-CoV-2 Infection

Eligibility Criteria

18 Years - 74 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18 to 74 years (at the time of informed consent)
  2. Male or female
  3. Patients who meet all of the following three criteria at the time of enrolment:

    1. SARS-CoV-2-positive patients as measured by rtPCR by nasopharyngeal sampling
    2. Moderate patients with radiological evidence of pneumonia in the lung at the time of enrolment (RTG, CT, or UH), clearly described by the radiologist following the imaging examination. (The diagnosis of the finding should clearly include the presence of pneumonia to any extent, localization, and extent)
    3. Body temperature 37,5°C or more
    4. Patient requires hospitalization during the treatment period (obligation to stay in the hospital for whole treatment period, 14 days)
  4. For premenopausal females, patients who have been confirmed to be negative on a pregnancy test before administration of the study drug
  5. Signed informed consent by the patient or by the legal representative -

Exclusion Criteria:

  1. Body temperature of 37.5 °C or higher for more than 10 days after the onset of elevated body temperature
  2. Patients with SpO2 less than 95%
  3. Patient requires supportive oxygen therapy
  4. Patients who show increased procalcitonin levels before the start of the study drug administration and are suspected to have concurrent bacterial infection
  5. Patients with proven concomitant systematic fungal infection prior to initiation of study drug.
  6. Patients with concurrent congestive heart failure (NYHA III-IV)
  7. Patients with severe hepatic impairment equivalent to Grade C on Child-Pugh classification
  8. Patient with renal impairment requiring dialysis.
  9. Patients with disturbed consciousness such as disturbed orientation.
  10. Pregnant or possibly pregnant patients.
  11. Female patients who are woman of childbearing potential and unable to consent to the use of dual contraception from the start of favipiravir administration to 30 days after the end of favipiravir administration. Dual contraception is a combination of two of the following: Barrier method of contraception: condoms (male or female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide; IUD; Hormone-based contraceptive; Tubal ligation
  12. Male patients whose are unable to consent to the use of the barrier method of contraception (condom) from the start of favipiravir administration to 90 days after the end of favipiravir administration. Male patients who are planning to donate sperm from the start up until 90 days after the end of favipiravir administration.
  13. Female patients who intend to breastfeed from the start of favipiravir administration until 14 days after discontinuation of favipiravir administration
  14. Patients with herditary xanthinuria
  15. Patients who have hyperuricemia (> 1 mg/dL) or xanthine urinary calculi
  16. Patients with a history of gout or on treatment for gout or hyperuricemia
  17. Patients receiving immunosuppressants
  18. Patients who received interferon-alpha or drugs with reported antiviral activity against SARS-CoV-2 (hydroxychloroquine sulfate, chloroquine phosphate, lopinavir-ritonavir combination, ciclesonide, nafamostat mesylate, camostat mesylate, remdesivir, etc.) within 9 days after fever onset (37.5°C or more)
  19. Patients in whom this episode of infection is a recurrence or a reinfection with the SARS-CoV-2 infection
  20. Patients who have previously been treated with favipiravir (T-705a)
  21. Other patients judged ineligible by the investigator, sub-investigator, or assigned physician.

    -

Sites / Locations

  • Department of Pulmonology Semmelweis University
  • National Korányi Institute for Pulmonology
  • Institute of Infectology, University of Debrecen
  • 1st Department of Medicine, University of Pécs
  • First Department of Internal Medicine, University of Szeged

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Group Avigan

Group Control

Arm Description

Favipiravir from Day1 + Supportive care (symptomatic therapy) a regimen of 3600 mg (1800 mg twice a day orally) loading dose on Day1 followed by 1600 mg maintenance dose (800 mg twice a day orally) on Day2 to Day14.

Supportive care (symptomatic therapy)

Outcomes

Primary Outcome Measures

Time to improvement in body temperature
Time to improvement in SpO2
Time to improvement in chest imaging findings
Time to improvement in negative SARS-CoV-2

Secondary Outcome Measures

(1) Changes in patient status on a 5-point scale
Name of the scale is: Patient Status Score. 1:A condition in which the patient can be discharged; 5:A condition requiring ECMO or invasive oxygen therapy and ICU management
(2) Changes in the level of SARS-CoV-2 viral genome
(3) SARS-CoV-2 virus genome clearance rate
(4) Duration of pyrexia
(5) Changes in clinical symptoms
Changes in clinical symptoms, including: Patient's condition; Coughing, Sore throat, Headache, Muscle or joint pain, Nasal congestion or Nasal discharge, Chills or sweating, Malaise or fatigue, Chest pain, dehydration, cyanosis, pleural effusion, Thoracic rales, Conscious state.
(6) Changes in NEWS (National Early Warning Score)
Changes in NEWS (unabbreviated scale title: National Early Warning Score). Calculate the total value from the clinical symptoms and findings (consciousness) and vital signs (SpO2, body temperature, blood pressure, pulse rate, respiratory rate). 0 is normal
(7) Changes in chest imaging findings on Days 4,7,10,13,16,19,22,25,28.
(8) Percentage of patients requiring adjuvant oxygen therapy
(8) Adjuvant oxygen therapy average duration
(9) Percentage of patients requiring mechanical ventilation therapy
(9)Adjuvant oxygen therapy average durationduration

Full Information

First Posted
October 8, 2020
Last Updated
October 30, 2022
Sponsor
University of Pecs
Collaborators
HECRIN Consortium, Hungarian Ministry of Innovation and Technology
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1. Study Identification

Unique Protocol Identification Number
NCT04600999
Brief Title
Clinical Trial of Favipiravir Treatment of Patients With COVID-19
Official Title
An Investigation of the Efficacy and Safety of Favipiravir in COVID-19 Patients With Mild Pneumonia - An Open-label Randomized Controlled Study -
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
October 7, 2020 (Actual)
Primary Completion Date
December 28, 2020 (Actual)
Study Completion Date
December 28, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Pecs
Collaborators
HECRIN Consortium, Hungarian Ministry of Innovation and Technology

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
To verify that the efficacy of favipiravir exceeds that of the actual supportive care (symptomatic therapy) in SARS-CoV-2 infected patients (COVID-19 patients) with mild pneumonia, using the time required to improve clinical symptoms as the primary endpoint.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
SARS-CoV-2 Infection

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Group Avigan
Arm Type
Experimental
Arm Description
Favipiravir from Day1 + Supportive care (symptomatic therapy) a regimen of 3600 mg (1800 mg twice a day orally) loading dose on Day1 followed by 1600 mg maintenance dose (800 mg twice a day orally) on Day2 to Day14.
Arm Title
Group Control
Arm Type
No Intervention
Arm Description
Supportive care (symptomatic therapy)
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Intervention Description
Name: AVIGAN Generic name: Favipiravir Content: T-705a tablets [200]
Primary Outcome Measure Information:
Title
Time to improvement in body temperature
Time Frame
9 month
Title
Time to improvement in SpO2
Time Frame
9 month
Title
Time to improvement in chest imaging findings
Time Frame
9 month
Title
Time to improvement in negative SARS-CoV-2
Time Frame
9 month
Secondary Outcome Measure Information:
Title
(1) Changes in patient status on a 5-point scale
Description
Name of the scale is: Patient Status Score. 1:A condition in which the patient can be discharged; 5:A condition requiring ECMO or invasive oxygen therapy and ICU management
Time Frame
9 month
Title
(2) Changes in the level of SARS-CoV-2 viral genome
Time Frame
9 month
Title
(3) SARS-CoV-2 virus genome clearance rate
Time Frame
9 month
Title
(4) Duration of pyrexia
Time Frame
9 month
Title
(5) Changes in clinical symptoms
Description
Changes in clinical symptoms, including: Patient's condition; Coughing, Sore throat, Headache, Muscle or joint pain, Nasal congestion or Nasal discharge, Chills or sweating, Malaise or fatigue, Chest pain, dehydration, cyanosis, pleural effusion, Thoracic rales, Conscious state.
Time Frame
9 month
Title
(6) Changes in NEWS (National Early Warning Score)
Description
Changes in NEWS (unabbreviated scale title: National Early Warning Score). Calculate the total value from the clinical symptoms and findings (consciousness) and vital signs (SpO2, body temperature, blood pressure, pulse rate, respiratory rate). 0 is normal
Time Frame
9 month
Title
(7) Changes in chest imaging findings on Days 4,7,10,13,16,19,22,25,28.
Time Frame
Changes in chest imaging findings will be collected and checked on Days 4,7,10,13,16,19,22,25,28, the data will be analyzied at 9. month.
Title
(8) Percentage of patients requiring adjuvant oxygen therapy
Time Frame
9 month
Title
(8) Adjuvant oxygen therapy average duration
Time Frame
9 month
Title
(9) Percentage of patients requiring mechanical ventilation therapy
Time Frame
9 month
Title
(9)Adjuvant oxygen therapy average durationduration
Time Frame
9 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 to 74 years (at the time of informed consent) Male or female Patients who meet all of the following three criteria at the time of enrolment: SARS-CoV-2-positive patients as measured by rtPCR by nasopharyngeal sampling Moderate patients with radiological evidence of pneumonia in the lung at the time of enrolment (RTG, CT, or UH), clearly described by the radiologist following the imaging examination. (The diagnosis of the finding should clearly include the presence of pneumonia to any extent, localization, and extent) Body temperature 37,5°C or more Patient requires hospitalization during the treatment period (obligation to stay in the hospital for whole treatment period, 14 days) For premenopausal females, patients who have been confirmed to be negative on a pregnancy test before administration of the study drug Signed informed consent by the patient or by the legal representative - Exclusion Criteria: Body temperature of 37.5 °C or higher for more than 10 days after the onset of elevated body temperature Patients with SpO2 less than 95% Patient requires supportive oxygen therapy Patients who show increased procalcitonin levels before the start of the study drug administration and are suspected to have concurrent bacterial infection Patients with proven concomitant systematic fungal infection prior to initiation of study drug. Patients with concurrent congestive heart failure (NYHA III-IV) Patients with severe hepatic impairment equivalent to Grade C on Child-Pugh classification Patient with renal impairment requiring dialysis. Patients with disturbed consciousness such as disturbed orientation. Pregnant or possibly pregnant patients. Female patients who are woman of childbearing potential and unable to consent to the use of dual contraception from the start of favipiravir administration to 30 days after the end of favipiravir administration. Dual contraception is a combination of two of the following: Barrier method of contraception: condoms (male or female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide; IUD; Hormone-based contraceptive; Tubal ligation Male patients whose are unable to consent to the use of the barrier method of contraception (condom) from the start of favipiravir administration to 90 days after the end of favipiravir administration. Male patients who are planning to donate sperm from the start up until 90 days after the end of favipiravir administration. Female patients who intend to breastfeed from the start of favipiravir administration until 14 days after discontinuation of favipiravir administration Patients with herditary xanthinuria Patients who have hyperuricemia (> 1 mg/dL) or xanthine urinary calculi Patients with a history of gout or on treatment for gout or hyperuricemia Patients receiving immunosuppressants Patients who received interferon-alpha or drugs with reported antiviral activity against SARS-CoV-2 (hydroxychloroquine sulfate, chloroquine phosphate, lopinavir-ritonavir combination, ciclesonide, nafamostat mesylate, camostat mesylate, remdesivir, etc.) within 9 days after fever onset (37.5°C or more) Patients in whom this episode of infection is a recurrence or a reinfection with the SARS-CoV-2 infection Patients who have previously been treated with favipiravir (T-705a) Other patients judged ineligible by the investigator, sub-investigator, or assigned physician. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
István Várkonyi
Organizational Affiliation
Institute of Infectology University of Debrecen
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Pulmonology Semmelweis University
City
Budapest
ZIP/Postal Code
1083
Country
Hungary
Facility Name
National Korányi Institute for Pulmonology
City
Budapest
ZIP/Postal Code
1121
Country
Hungary
Facility Name
Institute of Infectology, University of Debrecen
City
Debrecen
ZIP/Postal Code
4031
Country
Hungary
Facility Name
1st Department of Medicine, University of Pécs
City
Pécs
ZIP/Postal Code
7624
Country
Hungary
Facility Name
First Department of Internal Medicine, University of Szeged
City
Szeged
ZIP/Postal Code
6720
Country
Hungary

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
17606691
Citation
Gowen BB, Wong MH, Jung KH, Sanders AB, Mendenhall M, Bailey KW, Furuta Y, Sidwell RW. In vitro and in vivo activities of T-705 against arenavirus and bunyavirus infections. Antimicrob Agents Chemother. 2007 Sep;51(9):3168-76. doi: 10.1128/AAC.00356-07. Epub 2007 Jul 2.
Results Reference
background
PubMed Identifier
22022624
Citation
Mendenhall M, Russell A, Smee DF, Hall JO, Skirpstunas R, Furuta Y, Gowen BB. Effective oral favipiravir (T-705) therapy initiated after the onset of clinical disease in a model of arenavirus hemorrhagic Fever. PLoS Negl Trop Dis. 2011 Oct;5(10):e1342. doi: 10.1371/journal.pntd.0001342. Epub 2011 Oct 11.
Results Reference
background
PubMed Identifier
24583123
Citation
Oestereich L, Ludtke A, Wurr S, Rieger T, Munoz-Fontela C, Gunther S. Successful treatment of advanced Ebola virus infection with T-705 (favipiravir) in a small animal model. Antiviral Res. 2014 May;105:17-21. doi: 10.1016/j.antiviral.2014.02.014. Epub 2014 Feb 26.
Results Reference
background
PubMed Identifier
32020029
Citation
Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020 Mar;30(3):269-271. doi: 10.1038/s41422-020-0282-0. Epub 2020 Feb 4. No abstract available.
Results Reference
background
PubMed Identifier
27553371
Citation
Bai CQ, Mu JS, Kargbo D, Song YB, Niu WK, Nie WM, Kanu A, Liu WW, Wang YP, Dafae F, Yan T, Hu Y, Deng YQ, Lu HJ, Yang F, Zhang XG, Sun Y, Cao YX, Su HX, Sun Y, Liu WS, Wang CY, Qian J, Liu L, Wang H, Tong YG, Liu ZY, Chen YS, Wang HQ, Kargbo B, Gao GF, Jiang JF. Clinical and Virological Characteristics of Ebola Virus Disease Patients Treated With Favipiravir (T-705)-Sierra Leone, 2014. Clin Infect Dis. 2016 Nov 15;63(10):1288-1294. doi: 10.1093/cid/ciw571. Epub 2016 Aug 23.
Results Reference
background
Links:
URL
http://www.kansensho.or.jp/uploads/files/topics/2019ncov/covid19casereport_200225.pdf
Description
Report of Clinical Course of 4 Patients with Coronavirus Disease 2019 (COVID-19) Who Required Oxygen Administration

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Clinical Trial of Favipiravir Treatment of Patients With COVID-19

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