COVID-19 and Anti-CD14 Treatment Trial (CaTT)
Coronavirus Disease 2019 (COVID-19), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
About this trial
This is an interventional treatment trial for Coronavirus Disease 2019 (COVID-19) focused on measuring anti-CD14 (anti-CD14 chimeric monoclonal antibody), randomized double-blind placebo-controlled clinical trial, hospitalized patients
Eligibility Criteria
Inclusion Criteria:
Patients included in the study must meet all the following criteria:
- Patient or legally authorized representative able to provide informed consent
- Presence of SARS-CoV-2 infection documented by positive RT-PCR testing or history of positive RT-PCR test for SARS-CoV-2 within 7 days of screening
- Radiologic findings compatible with diagnosis of SARS-CoV-2 pulmonary infection
Hypoxemia as defined by any of the following:
- SpO2 ≤94% on room air, or
- Requirement for ≥2L/m O2 per standard nasal cannula to maintain SpO2≥94%, but not requiring high-flow nasal cannula (defined as ≥30 L/m), and
- Negative pregnancy test for women of childbearing potential and, must be willing to use birth control for the duration of the study.
Exclusion Criteria:
An individual fulfilling any of the following criteria should be excluded from enrollment in the study:
- Receiving non-invasive positive-pressure ventilation through nasal mask, face mask, or nasal plugs
- Receiving invasive mechanical ventilation
Patient, surrogate, or physician not committed to full support
--Exception: a participant will not be excluded if he/she would receive all supportive care other than attempts at resuscitation from cardiac arrest)
- Anticipated survival <48 hours
- Underlying malignancy, or other condition, with estimated life expectancy of less than two months
Significant pre-existing organ dysfunction prior to randomization
- Lung: Currently receiving home oxygen therapy as documented in medical record
- Heart: Pre-existing congestive heart failure defined as an ejection fraction <20% as documented in the medical record
- Renal: End-stage renal disease requiring renal replacement therapy or eGFR <30 mL/min
- Liver: Severe chronic liver disease defined as Child-Pugh Class C or AST or ALT >5x upper limit of normal
- Hematologic: Baseline platelet count <50,000/mm^3
Presence of co-existing infection, including, but not limited to:
- HIV infection not virally suppressed and with pre-hospitalization CD4 counts ≤ 500 cell/mm^3
- Active tuberculosis or a history of inadequately treated tuberculosis
- Active hepatitis B or hepatitis C viral infection
Ongoing immunosuppression
- Solid organ transplant recipient
- High-dose corticosteroids (equivalent to >20 mg/prednisone/day) within the past 28 days, except for dexamethasone except for dexamethasone or equivalent treatment for COVID-19 illness
- Oncolytic drug therapy within the past 14 days
- Current treatment, or treatment within 30 days or five half-lives (whichever is longer) with etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), certolizumab (Cimzia®), golimumab (Simponi®), anakinra (Kineret®), rilonacept (Arcalyst®), tocilizumab (Actemra®), sarilumab (Kevzara®), siltuximab (Sylvant®), or other potent immunosuppressant or immunomodulatory drugs or treatments
- Current treatment with an anti-viral medication for COVID-19 (e.g. hydroxychloroquine, lopinavir/ritonavir), other than remdesivir
- Current enrollment in an interventional trial for COVID-19
- History of hypersensitivity or idiosyncratic reaction to IC14
- Women who are currently breastfeeding
- Received a live-attenuated vaccine within 30 days prior to enrollment
- Received five or more doses of remdesivir, including the loading dose, outside of the study as treatment for COVID-19, or
- Any condition that in the opinion of the treating physician will increase the risk for the participant.
Sites / Locations
- Sarasota Memorial Health Care System
- Virginia Mason Medical Center
- Harborview Medical Center
- Swedish Medical Center
- University of Washington Medical Center-Montlake
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
anti-CD14 + SOC
Placebo + SOC
Anti-CD14: Anticipated 150 participants randomized to 4 mg/kg on Day 1, 2 mg/kg on Days 2-4 intravenously. Standard of Care (SOC): All participants will receive remdesivir (antiviral) according to current approved dosing for COVID-19 illness.
Anticipated 150 participants randomized to Placebo diluent on Days 1-4 intravenously. Standard of Care (SOC): All participants will receive remdesivir (antiviral) according to current approved dosing for COVID-19 illness.