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Efficacy and Safety of Nitazoxanide in the Treatment of Colds Due to Enterovirus/Rhinovirus Infection

Primary Purpose

Enterovirus, Rhinovirus

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Nitazoxanide
Placebo
Sponsored by
Romark Laboratories L.C.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Enterovirus focused on measuring Enterovirus, Rhinovirus

Eligibility Criteria

12 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female subjects at least 12 years of age
  2. Presence of clinical signs and/or symptoms consistent with an acute illness compatible with EV/RV infection (each of the following is required):

    1. Presence of moderate or severe rhinorrhea defined as "attempting to relieve nasal symptoms by blowing, wiping, or sniffling at least twice per hour for any one hour within 12 hours preceding study entry," AND
    2. Presence of cough, sore throat or nasal obstruction.
  3. Negative rapid influenza diagnostic test (required only if the subject has an oral temperature >100°F in the clinic or if the latest CDC weekly influenza report shows influenza prevalence "Regional" or higher for the institution's state). A result from a rapid influenza diagnostic test performed on the same day that informed consent is obtained will be sufficient to meet this criterion if documentation of test results is available as part of medical history.
  4. Onset of illness no more than 40 hours before enrollment in the trial. Onset of illness is defined as the first time at which the subject experienced rhinorrhea, cough, sore throat or nasal obstruction.
  5. Willing and able to provide written informed consent (including assent by legal guardian if under 18 years of age) and comply with the requirements of the protocol, including completion of the subject diary

Exclusion Criteria:

  1. Persons requiring or anticipated to require in-hospital care
  2. Cystic fibrosis
  3. Cardiac arrhythmia
  4. Immunologic disorders or receiving immunosuppressive therapy (e.g., for organ or bone marrow transplants, immunomodulatory therapies for certain autoimmune diseases)
  5. Untreated HIV infection or treated HIV infection with a CD4 count below 350 cells/mm3 in the last 6 months
  6. Persons with sickle cell anemia or other hemoglobinopathies
  7. Poorly controlled insulin-dependent diabetes mellitus (HbA1C >8.0%)
  8. Concurrent infection at the screening examination that requires systemic antimicrobial therapy
  9. Females of childbearing potential who are either pregnant or sexually active without the use of birth control. Female subjects of child-bearing potential that are sexually active must have a negative baseline pregnancy test and must agree to continue an acceptable method of birth control for the duration of the study and for 1 month post-treatment. A double barrier method, oral birth control pills administered for at least 2 monthly cycles prior to study drug administration, an IUD, or medroxyprogesterone acetate administered intramuscularly for a minimum of one month prior to study drug administration are acceptable methods of birth control for inclusion into the study. Female subjects are considered of childbearing potential unless they are postmenopausal (absence of menstrual bleeding for 1 year - or 6 months if laboratory confirmation of hormonal status), or have had a hysterectomy, bilateral tubular ligation or bilateral oophorectomy.
  10. Females who are breastfeeding
  11. Receipt of any dose of NTZ within 30 days prior to screening
  12. Prior treatment with any investigational drug therapy within 30 days prior to screening
  13. Subjects with active respiratory allergies or subjects expected to require anti-allergy medications during the study period for respiratory allergies
  14. Known sensitivity to NTZ or any of the excipients comprising the NTZ tablets
  15. Subjects unable to take oral medications
  16. Subjects who, in the judgment of the Investigator, will be unlikely to comply with the requirements of this protocol including completion of the subject diary

Sites / Locations

  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site
  • Vanguard Study Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Nitazoxanide

Placebo

Arm Description

Two Nitazoxanide 300 mg tablets orally twice daily for 5 days

Two placebo tablets orally twice daily for 5 days

Outcomes

Primary Outcome Measures

Time From First Dose to Symptom Response Over 21 Days of Follow up Based Upon the FLU-PRO Instrument (Novel Endpoint)
Subjects used the FLU-PRO questionnaire once daily in the evening to score the severity of 32 FLU-PRO symptoms. Symptom response was deemed achieved when the rating for each of the 32 FLU-PRO symptoms was ≤ its assigned threshold for 2 consecutive daily diary periods without use of symptom relief medication. The symptom response thresholds were developed by applying an algorithm to blinded symptoms data to select the set of 32 symptom thresholds most closely associated with patient-reported usual health.

Secondary Outcome Measures

Time From First Dose to Ability to Perform All Normal Activities
Subjects completed a diary including rating ability to perform normal activities on a scale from 0 (able to perform no normal activities) to 10 (able to perform all normal activities) daily in the evening. The time from first dose to ability to perform all normal activities is the time in hours between the first dose of study medication and that time when the subject first reported a score of "10" (able to perform all normal activities) for two consecutive daily diary periods without use of symptom relief medication.
Proportions Experiencing Complications of EV/RV Infection
Complications of colds due to EV/RV infection include pneumonia, otitis media, bronchitis, sinusitis, exacerbations of asthma or COPD, worsening of pre-existing health conditions, secondary infections requiring systemic antibiotic use, hospitalization due to cold or complications of the cold, and death due to cold or complications of the cold. Proportions experiencing complications of EV/RV infection were compared across treatment groups.

Full Information

First Posted
July 18, 2018
Last Updated
April 13, 2022
Sponsor
Romark Laboratories L.C.
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1. Study Identification

Unique Protocol Identification Number
NCT03605862
Brief Title
Efficacy and Safety of Nitazoxanide in the Treatment of Colds Due to Enterovirus/Rhinovirus Infection
Official Title
A Phase III, Randomized, Double-Blind, Placebo Controlled Trial to Evaluate the Efficacy and Safety of Nitazoxanide in the Treatment of Colds Due to Enterovirus/Rhinovirus Infection
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
September 11, 2018 (Actual)
Primary Completion Date
February 4, 2019 (Actual)
Study Completion Date
February 4, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Romark Laboratories L.C.

4. Oversight

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

5. Study Description

Brief Summary
Trial to evaluate efficacy and safety of nitazoxanide in the treatment of colds due to Enterovirus/Rhinovirus infection
Detailed Description
Multicenter, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety of nitazoxanide in the treatment of colds due to Enterovirus/Rhinovirus infection

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Enterovirus, Rhinovirus
Keywords
Enterovirus, Rhinovirus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
1756 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Nitazoxanide
Arm Type
Active Comparator
Arm Description
Two Nitazoxanide 300 mg tablets orally twice daily for 5 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Two placebo tablets orally twice daily for 5 days
Intervention Type
Drug
Intervention Name(s)
Nitazoxanide
Other Intervention Name(s)
NTZ (nitazoxanide), NT-300
Intervention Description
Nitazoxanide 600 mg administered orally twice daily for five days
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo administered orally twice daily for five days
Primary Outcome Measure Information:
Title
Time From First Dose to Symptom Response Over 21 Days of Follow up Based Upon the FLU-PRO Instrument (Novel Endpoint)
Description
Subjects used the FLU-PRO questionnaire once daily in the evening to score the severity of 32 FLU-PRO symptoms. Symptom response was deemed achieved when the rating for each of the 32 FLU-PRO symptoms was ≤ its assigned threshold for 2 consecutive daily diary periods without use of symptom relief medication. The symptom response thresholds were developed by applying an algorithm to blinded symptoms data to select the set of 32 symptom thresholds most closely associated with patient-reported usual health.
Time Frame
Up to 21 days
Secondary Outcome Measure Information:
Title
Time From First Dose to Ability to Perform All Normal Activities
Description
Subjects completed a diary including rating ability to perform normal activities on a scale from 0 (able to perform no normal activities) to 10 (able to perform all normal activities) daily in the evening. The time from first dose to ability to perform all normal activities is the time in hours between the first dose of study medication and that time when the subject first reported a score of "10" (able to perform all normal activities) for two consecutive daily diary periods without use of symptom relief medication.
Time Frame
Up to 21 days
Title
Proportions Experiencing Complications of EV/RV Infection
Description
Complications of colds due to EV/RV infection include pneumonia, otitis media, bronchitis, sinusitis, exacerbations of asthma or COPD, worsening of pre-existing health conditions, secondary infections requiring systemic antibiotic use, hospitalization due to cold or complications of the cold, and death due to cold or complications of the cold. Proportions experiencing complications of EV/RV infection were compared across treatment groups.
Time Frame
28 days
Other Pre-specified Outcome Measures:
Title
Time to Return to Usual Health
Description
Subjects completed the FLU-PRO questionnaire including global assessment questions daily in the evening. The time from first dose to ability to return to usual health is the time in hours from the first dose of study medication to the first time when the subject answered "Have you returned to your usual health?" with "yes" for two consecutive daily diary periods without the use of symptom relief medication.
Time Frame
21 days
Title
Proportion Positive for EV/RV by RT-PCR at Days 2, 3 and 7
Description
Proportion of subjects with nasopharyngeal swab collected testing positive for Enterovirus/Rhinovirus (EV/RV) infection by RT-PCR at each time point.
Time Frame
Days 2, 3, and 7
Title
Analysis of Change From Baseline to Days 2, 3 and 7 in EV/RV Virus Titer
Description
Changes from baseline to day 2, baseline to day 3, and baseline to day 7 in EV/RV virus titer measured by quantitative RT-PCR. Samples negative for EV/RV were assigned the value of the limit of detection for the RT-PCR assay.
Time Frame
Days 2, 3, and 7
Title
Response Misclassification Rate Compared to Usual Health
Description
The proportion of patient diaries misclassified by the response definition used for the primary efficacy analysis compared to patient reported usual health. A diary was considered "misclassified" if the response definition predicted "responded" and the patient reported not being at usual health or if the response definition predicted "not responded" and the patient reported being at usual health.
Time Frame
21 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female subjects at least 12 years of age Presence of clinical signs and/or symptoms consistent with an acute illness compatible with EV/RV infection (each of the following is required): Presence of moderate or severe rhinorrhea defined as "attempting to relieve nasal symptoms by blowing, wiping, or sniffling at least twice per hour for any one hour within 12 hours preceding study entry," AND Presence of cough, sore throat or nasal obstruction. Negative rapid influenza diagnostic test (required only if the subject has an oral temperature >100°F in the clinic or if the latest CDC weekly influenza report shows influenza prevalence "Regional" or higher for the institution's state). A result from a rapid influenza diagnostic test performed on the same day that informed consent is obtained will be sufficient to meet this criterion if documentation of test results is available as part of medical history. Onset of illness no more than 40 hours before enrollment in the trial. Onset of illness is defined as the first time at which the subject experienced rhinorrhea, cough, sore throat or nasal obstruction. Willing and able to provide written informed consent (including assent by legal guardian if under 18 years of age) and comply with the requirements of the protocol, including completion of the subject diary Exclusion Criteria: Persons requiring or anticipated to require in-hospital care Cystic fibrosis Cardiac arrhythmia Immunologic disorders or receiving immunosuppressive therapy (e.g., for organ or bone marrow transplants, immunomodulatory therapies for certain autoimmune diseases) Untreated HIV infection or treated HIV infection with a CD4 count below 350 cells/mm3 in the last 6 months Persons with sickle cell anemia or other hemoglobinopathies Poorly controlled insulin-dependent diabetes mellitus (HbA1C >8.0%) Concurrent infection at the screening examination that requires systemic antimicrobial therapy Females of childbearing potential who are either pregnant or sexually active without the use of birth control. Female subjects of child-bearing potential that are sexually active must have a negative baseline pregnancy test and must agree to continue an acceptable method of birth control for the duration of the study and for 1 month post-treatment. A double barrier method, oral birth control pills administered for at least 2 monthly cycles prior to study drug administration, an IUD, or medroxyprogesterone acetate administered intramuscularly for a minimum of one month prior to study drug administration are acceptable methods of birth control for inclusion into the study. Female subjects are considered of childbearing potential unless they are postmenopausal (absence of menstrual bleeding for 1 year - or 6 months if laboratory confirmation of hormonal status), or have had a hysterectomy, bilateral tubular ligation or bilateral oophorectomy. Females who are breastfeeding Receipt of any dose of NTZ within 30 days prior to screening Prior treatment with any investigational drug therapy within 30 days prior to screening Subjects with active respiratory allergies or subjects expected to require anti-allergy medications during the study period for respiratory allergies Known sensitivity to NTZ or any of the excipients comprising the NTZ tablets Subjects unable to take oral medications Subjects who, in the judgment of the Investigator, will be unlikely to comply with the requirements of this protocol including completion of the subject diary
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Francois Rossignol, M.D., Ph.D
Organizational Affiliation
Romark Laboratories L.C.
Official's Role
Study Director
Facility Information:
Facility Name
Vanguard Study Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35235
Country
United States
Facility Name
Vanguard Study Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35242
Country
United States
Facility Name
Vanguard Study Site
City
Pelham
State/Province
Alabama
ZIP/Postal Code
35124
Country
United States
Facility Name
Vanguard Study Site
City
Hot Springs
State/Province
Arkansas
ZIP/Postal Code
71913
Country
United States
Facility Name
Vanguard Study Site
City
Anaheim
State/Province
California
ZIP/Postal Code
92805
Country
United States
Facility Name
Vanguard Study Site
City
Westminster
State/Province
California
ZIP/Postal Code
92683
Country
United States
Facility Name
Vanguard Study Site
City
Wilmington
State/Province
California
ZIP/Postal Code
90744
Country
United States
Facility Name
Vanguard Study Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33145
Country
United States
Facility Name
Vanguard Study Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Facility Name
Vanguard Study Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33174
Country
United States
Facility Name
Vanguard Study Site
City
Orlando
State/Province
Florida
ZIP/Postal Code
32819
Country
United States
Facility Name
Vanguard Study Site
City
Tampa
State/Province
Florida
ZIP/Postal Code
33609
Country
United States
Facility Name
Vanguard Study Site
City
Stockbridge
State/Province
Georgia
ZIP/Postal Code
30281
Country
United States
Facility Name
Vanguard Study Site
City
Blackfoot
State/Province
Idaho
ZIP/Postal Code
83221
Country
United States
Facility Name
Vanguard Study Site
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
Facility Name
Vanguard Study Site
City
Nampa
State/Province
Idaho
ZIP/Postal Code
83686
Country
United States
Facility Name
Vanguard Study Site
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60201
Country
United States
Facility Name
Vanguard Study Site
City
Valparaiso
State/Province
Indiana
ZIP/Postal Code
46383
Country
United States
Facility Name
Vanguard Study Site
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40207
Country
United States
Facility Name
Vanguard Study Site
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70115
Country
United States
Facility Name
Vanguard Study Site
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70124
Country
United States
Facility Name
Vanguard Study Site
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21236
Country
United States
Facility Name
Vanguard Study Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Vanguard Study Site
City
Missoula
State/Province
Montana
ZIP/Postal Code
59808
Country
United States
Facility Name
Vanguard Study Site
City
Bellevue
State/Province
Nebraska
ZIP/Postal Code
68005
Country
United States
Facility Name
Vanguard Study Site
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89104
Country
United States
Facility Name
Vanguard Study Site
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11229
Country
United States
Facility Name
Vanguard Study Site
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Vanguard Study Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45215
Country
United States
Facility Name
Vanguard Study Site
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44122
Country
United States
Facility Name
Vanguard Study Site
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Vanguard Study Site
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45424
Country
United States
Facility Name
Vanguard Study Site
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Vanguard Study Site
City
East Providence
State/Province
Rhode Island
ZIP/Postal Code
02914
Country
United States
Facility Name
Vanguard Study Site
City
Jackson
State/Province
Tennessee
ZIP/Postal Code
38305
Country
United States
Facility Name
Vanguard Study Site
City
Milan
State/Province
Tennessee
ZIP/Postal Code
38328
Country
United States
Facility Name
Vanguard Study Site
City
Austin
State/Province
Texas
ZIP/Postal Code
78735
Country
United States
Facility Name
Vanguard Study Site
City
Carrollton
State/Province
Texas
ZIP/Postal Code
75010
Country
United States
Facility Name
Vanguard Study Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77058
Country
United States
Facility Name
Vanguard Study Site
City
McAllen
State/Province
Texas
ZIP/Postal Code
78504
Country
United States
Facility Name
Vanguard Study Site
City
Plano
State/Province
Texas
ZIP/Postal Code
75024
Country
United States
Facility Name
Vanguard Study Site
City
Bountiful
State/Province
Utah
ZIP/Postal Code
84010
Country
United States
Facility Name
Vanguard Study Site
City
Saint George
State/Province
Utah
ZIP/Postal Code
84790
Country
United States
Facility Name
Vanguard Study Site
City
Ponce
ZIP/Postal Code
00780
Country
Puerto Rico
Facility Name
Vanguard Study Site
City
San Juan
ZIP/Postal Code
00926
Country
Puerto Rico

12. IPD Sharing Statement

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Efficacy and Safety of Nitazoxanide in the Treatment of Colds Due to Enterovirus/Rhinovirus Infection

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