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COVID-19 Outpatient Pragmatic Platform Study (COPPS) - Acebilustat Sub-Protocol (COPPS)

Primary Purpose

Covid19

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Acebilustat
Placebo
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19 focused on measuring Outpatient

Eligibility Criteria

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

Inclusion Criteria:

  1. Outpatient setting
  2. Age ≥ 18 years and ≤ 80 years at the time of the assessment
  3. Able and willing to understand the study, adhere to all study procedures, and provide written informed consent
  4. Initial diagnosis of COVID-19 disease as defined by an FDA-cleared molecular diagnostic assay positive for SARS-CoV-2 with no more than 72 hours from the initial swab used in the diagnosis to the time of commencing informed consent.
  5. At baseline, at least two symptoms should have mild or higher severity score, where at least one of the mild symptoms is not cough, fatigue, or loss of smell/taste OR at least one symptom has a moderate or higher severity score on the COVID Outpatient Symptom Scale (COSS).
  6. Participant's COVID-19 related symptom onset occurred within 7 days prior to time of randomization.
  7. Other inclusion criteria specific to the investigational product that may, in the eyes of the investigator, be deemed necessary.

Exclusion Criteria:

  1. At screening, the participant needs to be admitted to the hospital or is being evaluated for potential admission.
  2. Previous use of experimental drugs that may be active against COVID-19 in the eyes of the investigators.
  3. Participant yields a positive urine pregnancy test at screening.
  4. Participant is using adrenocorticosteroids (except topical or inhaled preparations or oral preparations equivalent to or less than 10 mg of oral prednisone) or immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer drugs, interleukins, interleukin antagonists or interleukin receptor blockers).

    NOTE: Treatment of study participants following institutional COVID-19 treatment policies or guidelines, including the use of immunomodulatory medications, is permitted. This excludes treatment with agents that have the potential for direct antiviral activity, including convalescent plasma and NO, and co-enrollment into other clinical studies that evaluate investigational agents for COVID-19.

  5. Participant has a serious chronic disease (e.g., uncontrolled human immunodeficiency virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or moderate or severe hepatic insufficiency).
  6. Has renal insufficiency including severe renal impairment and ESRD and/or requiring hemodialysis or continuous ambulatory peritoneal dialysis (CAPD).
  7. Has liver impairment greater than Child Pugh A.
  8. Has a history of alcohol or drug abuse in the previous 6 months.
  9. Has a psychiatric disease that is not well controlled where controlled is defined as: stable on a regimen for more than one year.
  10. Has taken another investigational drug within the past 30 days.
  11. Is deemed by the Investigator to be ineligible for any reason.

Additional exclusion criteria for acebilustat protocol:

  1. Patient has abnormal liver enzyme tests at screening, including AST or ALT ≥3 × the upper limit of normal (ULN) or total bilirubin >1.25 × ULN at Screening (patients with known Gilbert's syndrome can be included with bilirubin >1.25 × ULN).
  2. Patient is pregnant or breastfeeding.
  3. Patients with baseline ALT >1.5 × ULN.

Sites / Locations

  • Stanford University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Acebilustat

Matching Placebo

Arm Description

Participants are randomized to receive acebilustat for 28 days.

Participants are randomized to receive placebo to match acebilustat for 28 days.

Outcomes

Primary Outcome Measures

For Clinical Domain: Time-to-sustained-resolution
Time from randomization to sustained symptom resolution assessed over a 28-day period. Resolution is defined as the first day where no symptoms are self-reported on all succeeding days through and including day 28, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.

Secondary Outcome Measures

For the Viral Domain: Change in Viral Shedding
Change in shedding of SARS-CoV-2 virus through day 10 attained from self-collected nasal swab. Viral load (nucleic acid) was assessed by RT-PCR Ct over time, and is reported here as the average change in Ct values per day. Cycle threshold (Ct) denotes how many PCR cycles are required before the SARS-CoV-2 viral RNA reached a detectable level. Higher Ct values correspond to lower viral copy numbers. For reference, Ct values of 20 correspond to ~2.12 x 106 viral copies per milliliter, while a Ct value of 40 is undetectable and is considered the lower limit of detection of this RT-PCR test for SARS-CoV-2.
Time to Viral Cessation
Defined as the time in days from randomization to the first of two consecutive negative RT-PCR results of self-collected nasal swabs.
Time to First Resolution
Defined as the first study day where no symptoms are self-reported, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time to Full Resolution
Defined as the study day where no symptoms are first self-reported.
Number of Participants With SARS-CoV-2 Related Hospitalizations, Emergency Department (ED) Visits, or Death in Outpatients With COVID-19 Disease.
Number of Participants That Developed Antibodies to SARS-CoV-2

Full Information

First Posted
December 8, 2020
Last Updated
June 9, 2023
Sponsor
Stanford University
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1. Study Identification

Unique Protocol Identification Number
NCT04662060
Brief Title
COVID-19 Outpatient Pragmatic Platform Study (COPPS) - Acebilustat Sub-Protocol
Acronym
COPPS
Official Title
COVID-19 Outpatient Pragmatic Platform Study (COPPS): A Pragmatic Multi-arm, Adaptive, Phase 2, Blinded, Randomized Placebo-controlled Platform Trial to Assess the Efficacy of Different Investigational Therapeutics in Reducing Time to Disease Resolution or Viral Load Cessation, as Compared to Standard Supportive Care in Outpatients With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
April 23, 2021 (Actual)
Primary Completion Date
May 3, 2022 (Actual)
Study Completion Date
February 2, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stanford University

4. Oversight

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

5. Study Description

Brief Summary
The overall objective of this study is to efficiently evaluate the clinical efficacy and safety of different investigational therapeutics among adults who have COVID-19 but are not yet sick enough to require hospitalization. The overall hypothesis is that through an adaptive trial design, potential effective therapies (single and combination) may be identified for this group of patients. COVID-19 Outpatient Pragmatic Platform Study (COPPS) is a pragmatic platform protocol designed to evaluate COVID-19 treatments by assessing their ability to reduce viral shedding (Viral Domain) or improve clinical outcomes (Clinical Domain). To be included into the platform, every investigational product will collect data for both Domain primary endpoints. Individual treatments to be evaluated in the platform will be described in separate sub-protocols.
Detailed Description
The platform study allows investigational products with objectives either: evaluating viral shedding (Virology Domain); and COVID-19 related Clinical Outcomes (Clinical Domain). The primary objective for investigational products within the Viral Domain is: A. To evaluate the efficacy of each therapeutic intervention in addition to standard supportive care (SSC) compared with SSC in reducing viral shedding of SARS-CoV-2 virus in outpatients with COVID-19 disease. The primary objective for investigational products within for the Clinical Domain is: B. To evaluate the efficacy of each therapeutic intervention in addition to SSC as compared to SSC in improving sustained clinical outcomes in outpatients with COVID-19 disease. Secondary objectives are: The objective of the non-assigned domain an investigational product is under. If under Clinical Domain, reduction in viral shedding. If under Viral Domain, time to resolution of symptoms. To evaluate the efficacy of each therapeutic intervention in reducing SARS-CoV-2 related hospitalizations, ED visits, or death in outpatients with COVID-19 disease. To assess the development of antibodies against SARS-CoV-2 To evaluate the safety and tolerability of each therapeutic intervention compared with placebo (supportive care).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19
Keywords
Outpatient

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
120 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Acebilustat
Arm Type
Experimental
Arm Description
Participants are randomized to receive acebilustat for 28 days.
Arm Title
Matching Placebo
Arm Type
Placebo Comparator
Arm Description
Participants are randomized to receive placebo to match acebilustat for 28 days.
Intervention Type
Drug
Intervention Name(s)
Acebilustat
Intervention Description
100 mg capsule administered orally once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo to match acebilustat administered orally once daily
Primary Outcome Measure Information:
Title
For Clinical Domain: Time-to-sustained-resolution
Description
Time from randomization to sustained symptom resolution assessed over a 28-day period. Resolution is defined as the first day where no symptoms are self-reported on all succeeding days through and including day 28, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
For the Viral Domain: Change in Viral Shedding
Description
Change in shedding of SARS-CoV-2 virus through day 10 attained from self-collected nasal swab. Viral load (nucleic acid) was assessed by RT-PCR Ct over time, and is reported here as the average change in Ct values per day. Cycle threshold (Ct) denotes how many PCR cycles are required before the SARS-CoV-2 viral RNA reached a detectable level. Higher Ct values correspond to lower viral copy numbers. For reference, Ct values of 20 correspond to ~2.12 x 106 viral copies per milliliter, while a Ct value of 40 is undetectable and is considered the lower limit of detection of this RT-PCR test for SARS-CoV-2.
Time Frame
10 days
Title
Time to Viral Cessation
Description
Defined as the time in days from randomization to the first of two consecutive negative RT-PCR results of self-collected nasal swabs.
Time Frame
28 days
Title
Time to First Resolution
Description
Defined as the first study day where no symptoms are self-reported, not including sense of taste or smell, and defining recovery for fatigue and cough as mild or none.
Time Frame
28 days
Title
Time to Full Resolution
Description
Defined as the study day where no symptoms are first self-reported.
Time Frame
28 days
Title
Number of Participants With SARS-CoV-2 Related Hospitalizations, Emergency Department (ED) Visits, or Death in Outpatients With COVID-19 Disease.
Time Frame
28 days
Title
Number of Participants That Developed Antibodies to SARS-CoV-2
Time Frame
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: Outpatient setting Age ≥ 18 years and ≤ 80 years at the time of the assessment Able and willing to understand the study, adhere to all study procedures, and provide written informed consent Initial diagnosis of COVID-19 disease as defined by an FDA-cleared molecular diagnostic assay positive for SARS-CoV-2 with no more than 72 hours from the initial swab used in the diagnosis to the time of commencing informed consent. At baseline, at least two symptoms should have mild or higher severity score, where at least one of the mild symptoms is not cough, fatigue, or loss of smell/taste OR at least one symptom has a moderate or higher severity score on the COVID Outpatient Symptom Scale (COSS). Participant's COVID-19 related symptom onset occurred within 7 days prior to time of randomization. Other inclusion criteria specific to the investigational product that may, in the eyes of the investigator, be deemed necessary. Exclusion Criteria: At screening, the participant needs to be admitted to the hospital or is being evaluated for potential admission. Previous use of experimental drugs that may be active against COVID-19 in the eyes of the investigators. Participant yields a positive urine pregnancy test at screening. Participant is using adrenocorticosteroids (except topical or inhaled preparations or oral preparations equivalent to or less than 10 mg of oral prednisone) or immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer drugs, interleukins, interleukin antagonists or interleukin receptor blockers). NOTE: Treatment of study participants following institutional COVID-19 treatment policies or guidelines, including the use of immunomodulatory medications, is permitted. This excludes treatment with agents that have the potential for direct antiviral activity, including convalescent plasma and NO, and co-enrollment into other clinical studies that evaluate investigational agents for COVID-19. Participant has a serious chronic disease (e.g., uncontrolled human immunodeficiency virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or moderate or severe hepatic insufficiency). Has renal insufficiency including severe renal impairment and ESRD and/or requiring hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Has liver impairment greater than Child Pugh A. Has a history of alcohol or drug abuse in the previous 6 months. Has a psychiatric disease that is not well controlled where controlled is defined as: stable on a regimen for more than one year. Has taken another investigational drug within the past 30 days. Is deemed by the Investigator to be ineligible for any reason. Additional exclusion criteria for acebilustat protocol: Patient has abnormal liver enzyme tests at screening, including AST or ALT ≥3 × the upper limit of normal (ULN) or total bilirubin >1.25 × ULN at Screening (patients with known Gilbert's syndrome can be included with bilirubin >1.25 × ULN). Patient is pregnant or breastfeeding. Patients with baseline ALT >1.5 × ULN.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Angela Rogers, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Joseph Levitt, MD, MS
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34274494
Citation
Bunning B, Hedlin H, Purington N, Sundaram V, Kapphahn K, Weng Y, Cunanan K, Maldonado Y, Singh U, Khosla C, O'Hara R, Nicolls M, Springman E, Parsonnet J, Rogers A, Levitt J, Desai M. The COVID-19 Outpatient Pragmatic Platform Study (COPPS): Study design of a multi-center pragmatic platform trial. Contemp Clin Trials. 2021 Sep;108:106509. doi: 10.1016/j.cct.2021.106509. Epub 2021 Jul 16.
Results Reference
background
PubMed Identifier
36996150
Citation
Levitt JE, Hedlin H, Duong S, Lu D, Lee J, Bunning B, Elkarra N, Pinsky BA, Heffernan E, Springman E, Moss RB, Bonilla HF, Parsonnet J, Zamanian RT, Langguth JJ, Bollyky J, Khosla C, Nicolls MR, Desai M, Rogers AJ. Evaluation of Acebilustat, a Selective Inhibitor of Leukotriene B4 Biosynthesis, for Treatment of Outpatients With Mild-Moderate Coronavirus Disease 2019: A Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial. Clin Infect Dis. 2023 Jul 26;77(2):186-193. doi: 10.1093/cid/ciad187.
Results Reference
result

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COVID-19 Outpatient Pragmatic Platform Study (COPPS) - Acebilustat Sub-Protocol

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