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Evaluating Safety, Pharmacokinetics and Clinical Benefit of Silmitasertib (CX-4945) in Subjects With Moderate COVID-19

Primary Purpose

Covid19

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Silmitasertib
SOC
Sponsored by
Chris Recknor, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or non-pregnant female adult ≥ 18 years of age
  2. Diagnosed with COVID-19 by standard RT-PCR assay or equivalent testing
  3. Outpatient subjects with moderate illness caused by SARS-CoV-2 infection as defined below,

    • Symptoms of moderate systemic illness/infection with COVID-19:

    At least two of the key COVID-19-related symptoms with score 2 or higher (0=none, 1=mild, 2=moderate, and 3=severe): cough, sore throat, malaise, headache, muscle pain, fever, neurological symptoms such as brain fog/concentration challenges, gastrointestinal symptoms or shortness of breath with exertion

    AND

    • Clinical signs indicative of moderate systemic illness/infection with COVID-19 At least 1 of the following: respiratory rate ≥ 20 breaths per minute, heart rate ≥ 90 beats per minute

    AND

    • No clinical signs indicative of Severe or Critical Illness Severity required hospitalization (see exclusion criterion #1)
  4. Patient (or legally authorized representative) provides written informed consent prior to initiation of any study procedures.
  5. Adequate hematopoietic capacity, as defined by the following:

    1. Hemoglobin ≥ 9.0 g/dL and not transfusion dependent
    2. Platelets ≥ 100,000/mm3
    3. Absolute neutrophil count ≥ 1500 cells/mm3
  6. Adequate hepatic function, as defined by the following:

    1. AST and ALT ≤ 2.5 times upper limit of normal (ULN)
    2. Total bilirubin ≤ 1.5 x ULN
    3. Albumin ≥ 3.0 g/dL
  7. Adequate renal function, as defined by the following:

    a. Renal: calculated creatinine clearance >45 mL/min for patients with abnormal, increased creatinine levels (Cockcroft-Gault formula).

  8. Ability to take oral medication and be willing to adhere to drug administration and premedication requirements (see Section 6.3) throughout study duration.

Exclusion Criteria:

  1. Any signs indicative of Severe or Critical Illness Severity required hospitalization as defined below:

    • Severe COVID-19: Shortness of breath in rest, or respiratory distress, respiratory rate (RR) >/= 30 per minute, heart rate (HR) >/=125 bpm, SpO2</=93% on room air at sea level or PaO2/FiO2<300
    • Critical COVID-19: respiratory failure required mechanical ventilation, oxygen delivered by high-flow nasal cannula, ESMO; shock or multi-organ dysfunction/failure
  2. Pregnant or nursing women. (NOTE: Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) prior to study entry and for the duration of study participation. Should a man father a child, or a woman become pregnant or suspect she is pregnant while participating in this study, he or she should inform the treating physician immediately.)
  3. Active or uncontrolled infections other than COVID-19 or with serious illnesses or medical conditions which would not permit the patient to receive study treatment
  4. Chronic diarrhea (excess of 2-3 stools/day above normal frequency)
  5. Concomitant treatment with another investigational drug from Day 1 through Day 28.
  6. Current use or anticipated need for drugs that are known strong inhibitors or inducers of major CYP enzymes.

Sites / Locations

  • Center for Advanced Research and Education

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Group A

Group B

Arm Description

Group A will receive the best supportive care and/or recommended standard of care (at this point no standard of care drugs are recommended by CDC for patients with moderate COVID-19) in combination with the study drug Silmitasertib

Group B (control) that will receive the same care as the Group A but without Silmitasertib

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]) within the CX-4945 Treatment Group assessed by CTCAE v5.0
To assess adverse events associated with the administration of CX-4945 orally, twice daily to patients with moderate COVID-19.

Secondary Outcome Measures

Clinical Recovery associated with COVID-19 within the CX-4945 Treatment Group
To compare the number of days to clinical recovery specifically associated with COVID-19 in the CX-4945 treatment group as compared to the control arm by Day 14 of the study.
Anti-Viral Activity of CX-4945
To evaluate preliminary evidence of anti-viral activity of CX-4945 as compared to the control arm.
Maximum Plasma Concentration [Cmax] of CX-4945
To evaluate the maximum plasma concentration of CX-4945 when given at 1000 mg BID PO (Experimental Arm taking CX-4945 only i.e. Group A).
Clinical Benefit of CX-4945 i.e. All-Cause Mortality
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of all-cause mortality. Mortality status and cause will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The data collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in all-cause mortality between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Clinical Benefit of CX-4945 i.e. Number of Respiratory Failures
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of the number of respiratory failures. Respiratory failures will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in number of respiratory failures between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Clinical Benefit of CX-4945 i.e. Number of Hospitalized Days
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of the number of hospitalized days. The number of hospitalized days will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in number of hospitalized days between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Clinical Benefit of CX-4945 i.e. Changes in Pulse Oxygen Saturation
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of changes in pulse oxygen saturation. The levels of oxygen saturation will be assessed by study staff measuring the subject's oxygen saturation level, non-invasively and recording the oxygen saturation reading on a Clinical Recovery log. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in pulse oxygen saturation between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Clinical Benefit of CX-4945 i.e. Changes in Clinical Status
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of changes in clinical status. Clinical status (ranging from deceased to not hospitalized/no limitations on activities) will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in clinical status between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Clinical Benefit of CX-4945 i.e. Self-Reported Quality of Life
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of subject reported quality of life. Quality of life will be assessed by the subject in relation to Covid-19 related symptoms. The information will be documented on a Clinical Symptom questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in self-reported quality of life between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
CX-4945 Inflammatory Marker Outcomes i.e. Plasma IL-6
Labs to evaluate changes in plasma IL-6 (interleukin-6 in pg/mL) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma IL-6 levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
CX-4945 Inflammatory Marker Outcomes i.e. Plasma CRP
Labs to evaluate changes in plasma CRP (C-reactive protein in mg/DL) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma CRP levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
CX-4945 Inflammatory Marker Outcomes i.e. Plasma LDH
Labs to evaluate changes in plasma LDH (lactic acid dehydrogenase in U/L) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma LDH levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
CX-4945 Inflammatory Marker Outcomes i.e. Plasma CPK
Labs to evaluate changes in plasma CPK (creatine phosphokinase in mcg/L) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma CPK levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
CX-4945 Inflammatory Marker Outcomes i.e. Plasma Ferritin
Labs to evaluate changes in plasma ferritin (mcg/L) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma ferritin levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
CX-4945 Inflammatory Marker Outcomes i.e. Plasma D-Dimer
Labs to evaluate changes in plasma D-dimer (ng/mL) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma D-dimer levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.

Full Information

First Posted
December 1, 2020
Last Updated
May 5, 2022
Sponsor
Chris Recknor, MD
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1. Study Identification

Unique Protocol Identification Number
NCT04663737
Brief Title
Evaluating Safety, Pharmacokinetics and Clinical Benefit of Silmitasertib (CX-4945) in Subjects With Moderate COVID-19
Official Title
A Phase II, Randomized and Controlled Investigator Initiated Trial Evaluating Safety, Pharmacokinetics and Clinical Benefit of Silmitasertib (CX-4945) in Outpatient Adult Subjects With Moderate Coronavirus Disease 2019 (COVID-19)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
December 3, 2020 (Actual)
Primary Completion Date
August 16, 2021 (Actual)
Study Completion Date
September 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Chris Recknor, MD

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
This single-center, open-label, 2 arm parallel-group, randomized, interventional prospective exploratory study in 20 subjects aimed to evaluate safety and explore putative clinical benefits of Silmitasertib 1000 mg BID dose in patients with moderate COVID-19. Two-arm trial comparing the SOC/supportive care alone to the SOC/supportive care with addition of Silmitasertib (allocation ratio 1:1).
Detailed Description
Silmitasertib is a first-in-class small molecule drug that targets Casein Kinase 2 (CK2). Protein kinase CK2 phosphorylates key proteins required to trigger mechanisms vital for viral replication and also is involved in development of host anti-viral immune response. SARS-CoV-2 viral proteins interacting with many human host proteins affect multiple innate immune pathways. One of these key proteins dysregulated by SARS-CoV-2 is the protein kinase CK2. SARS-COV-2 upregulates CK2 to support viral replication, avoid innate immune response and spread virus to nearby cells. Overactivation of CK2 indirectly contribute to successful viral replication and development of cytokine storm.SARs-Cov-2-induced overexpression of CK2, while pharmacological inhibition of CK2 suppresses virus proliferation. CK2 signaling appears to be an important pathway hijacked by SARS-CoV-2. Emerging pre-clinical and clinical data and results of independent efficacy evaluation conducted by Utah State University and UCSF COVID-19 research group and Senhwa Biosciences hypothesize that Silmitasertib (CX-4945) could potentially quell virus-provoked aberrant hyperactivation of the innate immune system by inhibition of upregulated CK2 protein kinase, preferentially restoring normal host cell cytokine regulation, and attenuating viral replication in patients with moderate to severe COVID-19, thereby preventing disease progression and improving clinical outcomes. Intended target patient population for treatment with Silmitasertib (CX-4945) are SARS-COV-2 positive patients with moderate to severe COVID-19, since in the moderate to severe stage of the disease infected cells actively produce viral proteins that dysregulate signaling pathways to allow viruses to manipulate host immune responses to create an environment more favorable for infection, that may not be observed in the initial or mild stage of the disease. CX-4945 demonstrated remarkable clinical benefits under emergency IND authorization in a patient with COVID-19 pneumonia not responsive to remdesivir, dexamethasone and antibiotics and requiring supplemental oxygen. The patient recovered and was discharged from the hospital in five days of treatment with CX-4945. The purpose of this open-label, randomized, 2 arm parallel-group controlled, interventional prospective exploratory study in 20 subjects is to evaluate safety, tolerability and pharmacokinetics of Silmitasertib (CX-4945) 1000 mg BID dose, to compare time to clinical recovery, and putative clinical benefit across treatment groups, and to evaluate anti-viral activities in COVID-19 patients. Silmitasertib is a generally well-tolerated medication. Most adverse events reported were mild to moderate in severity. The most common toxicities associated with CX-4945 were gastrointestinal disorders, manageable with drug discontinuation or use of anti-diarrheal medication. Based on the currently available data, the identified or potential risks of the product do not outweigh its identified or potential benefits.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A
Arm Type
Experimental
Arm Description
Group A will receive the best supportive care and/or recommended standard of care (at this point no standard of care drugs are recommended by CDC for patients with moderate COVID-19) in combination with the study drug Silmitasertib
Arm Title
Group B
Arm Type
Active Comparator
Arm Description
Group B (control) that will receive the same care as the Group A but without Silmitasertib
Intervention Type
Drug
Intervention Name(s)
Silmitasertib
Other Intervention Name(s)
CX-4945
Intervention Description
Capsules
Intervention Type
Drug
Intervention Name(s)
SOC
Other Intervention Name(s)
SOC/ Best Supportive Care
Intervention Description
Some therapeutics for COVID-19 are available through EUA. SOC treatment availability is expected to change during the course of this trial.
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]) within the CX-4945 Treatment Group assessed by CTCAE v5.0
Description
To assess adverse events associated with the administration of CX-4945 orally, twice daily to patients with moderate COVID-19.
Time Frame
From the first day that CX-4945 is taken until the end of the study i.e. 60 days or 46 days after the last dose of CX-4945 is taken.
Secondary Outcome Measure Information:
Title
Clinical Recovery associated with COVID-19 within the CX-4945 Treatment Group
Description
To compare the number of days to clinical recovery specifically associated with COVID-19 in the CX-4945 treatment group as compared to the control arm by Day 14 of the study.
Time Frame
First 14 days of the study.
Title
Anti-Viral Activity of CX-4945
Description
To evaluate preliminary evidence of anti-viral activity of CX-4945 as compared to the control arm.
Time Frame
Quantitative changes in viral load from Day 1 to Day 28.
Title
Maximum Plasma Concentration [Cmax] of CX-4945
Description
To evaluate the maximum plasma concentration of CX-4945 when given at 1000 mg BID PO (Experimental Arm taking CX-4945 only i.e. Group A).
Time Frame
Plasma sample of CX-4945 are collected at the following timepoints: Day 1 pre-dose, 0.5, 1, 2, 3, 6 and 24 hours post Day 1 morning dose and Day 14: pre-dose, 0.5, 1, 2, 3, 6, 24, 48 and 72 hours post Day 14 morning dose.
Title
Clinical Benefit of CX-4945 i.e. All-Cause Mortality
Description
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of all-cause mortality. Mortality status and cause will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The data collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in all-cause mortality between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Day 1, Day 4, Day 8, Day 11, Day 14, Day 15, Day 16, Da y17, Day 28, Day 45 and Day 60.
Title
Clinical Benefit of CX-4945 i.e. Number of Respiratory Failures
Description
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of the number of respiratory failures. Respiratory failures will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in number of respiratory failures between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
Clinical Benefit of CX-4945 i.e. Number of Hospitalized Days
Description
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of the number of hospitalized days. The number of hospitalized days will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in number of hospitalized days between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
Clinical Benefit of CX-4945 i.e. Changes in Pulse Oxygen Saturation
Description
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of changes in pulse oxygen saturation. The levels of oxygen saturation will be assessed by study staff measuring the subject's oxygen saturation level, non-invasively and recording the oxygen saturation reading on a Clinical Recovery log. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in pulse oxygen saturation between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
Clinical Benefit of CX-4945 i.e. Changes in Clinical Status
Description
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of changes in clinical status. Clinical status (ranging from deceased to not hospitalized/no limitations on activities) will be assessed by study staff and the information will be documented on a Clinical Status questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in clinical status between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
Clinical Benefit of CX-4945 i.e. Self-Reported Quality of Life
Description
Between the experimental arm with CX-4945 and the control arm, moderate COVID-19 patients' health status will be evaluated in terms of subject reported quality of life. Quality of life will be assessed by the subject in relation to Covid-19 related symptoms. The information will be documented on a Clinical Symptom questionnaire. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in self-reported quality of life between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1 - Day 14, Day 28 and Day 45.
Title
CX-4945 Inflammatory Marker Outcomes i.e. Plasma IL-6
Description
Labs to evaluate changes in plasma IL-6 (interleukin-6 in pg/mL) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma IL-6 levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Day 1, Day 4, Day 8, Day 11 and Day 14.
Title
CX-4945 Inflammatory Marker Outcomes i.e. Plasma CRP
Description
Labs to evaluate changes in plasma CRP (C-reactive protein in mg/DL) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma CRP levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
CX-4945 Inflammatory Marker Outcomes i.e. Plasma LDH
Description
Labs to evaluate changes in plasma LDH (lactic acid dehydrogenase in U/L) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma LDH levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
CX-4945 Inflammatory Marker Outcomes i.e. Plasma CPK
Description
Labs to evaluate changes in plasma CPK (creatine phosphokinase in mcg/L) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma CPK levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
CX-4945 Inflammatory Marker Outcomes i.e. Plasma Ferritin
Description
Labs to evaluate changes in plasma ferritin (mcg/L) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma ferritin levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.
Title
CX-4945 Inflammatory Marker Outcomes i.e. Plasma D-Dimer
Description
Labs to evaluate changes in plasma D-dimer (ng/mL) levels between the patients within the experimental arm with CX-4945 and the control arm, of patients with moderate COVID-19. The information collected will be analyzed at the conclusion of the study to determine if there is a statistically significant difference in plasma D-dimer levels between those whose treatment included CX-4945 and those whose treatment did not include CX-4945.
Time Frame
Various time points i.e. Screening, Day 1, Day 4, Day 8, Day 11, Day 14, Day 28 and Day 45.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant female adult ≥ 18 years of age Diagnosed with COVID-19 by standard RT-PCR assay or equivalent testing Outpatient subjects with moderate illness caused by SARS-CoV-2 infection as defined below, Symptoms of moderate systemic illness/infection with COVID-19: At least two of the key COVID-19-related symptoms with score 2 or higher (0=none, 1=mild, 2=moderate, and 3=severe): cough, sore throat, malaise, headache, muscle pain, fever, neurological symptoms such as brain fog/concentration challenges, gastrointestinal symptoms or shortness of breath with exertion AND Clinical signs indicative of moderate systemic illness/infection with COVID-19 At least 1 of the following: respiratory rate ≥ 20 breaths per minute, heart rate ≥ 90 beats per minute AND No clinical signs indicative of Severe or Critical Illness Severity required hospitalization (see exclusion criterion #1) Patient (or legally authorized representative) provides written informed consent prior to initiation of any study procedures. Adequate hematopoietic capacity, as defined by the following: Hemoglobin ≥ 9.0 g/dL and not transfusion dependent Platelets ≥ 100,000/mm3 Absolute neutrophil count ≥ 1500 cells/mm3 Adequate hepatic function, as defined by the following: AST and ALT ≤ 2.5 times upper limit of normal (ULN) Total bilirubin ≤ 1.5 x ULN Albumin ≥ 3.0 g/dL Adequate renal function, as defined by the following: a. Renal: calculated creatinine clearance >45 mL/min for patients with abnormal, increased creatinine levels (Cockcroft-Gault formula). Ability to take oral medication and be willing to adhere to drug administration and premedication requirements (see Section 6.3) throughout study duration. Exclusion Criteria: Any signs indicative of Severe or Critical Illness Severity required hospitalization as defined below: Severe COVID-19: Shortness of breath in rest, or respiratory distress, respiratory rate (RR) >/= 30 per minute, heart rate (HR) >/=125 bpm, SpO2</=93% on room air at sea level or PaO2/FiO2<300 Critical COVID-19: respiratory failure required mechanical ventilation, oxygen delivered by high-flow nasal cannula, ESMO; shock or multi-organ dysfunction/failure Pregnant or nursing women. (NOTE: Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) prior to study entry and for the duration of study participation. Should a man father a child, or a woman become pregnant or suspect she is pregnant while participating in this study, he or she should inform the treating physician immediately.) Active or uncontrolled infections other than COVID-19 or with serious illnesses or medical conditions which would not permit the patient to receive study treatment Chronic diarrhea (excess of 2-3 stools/day above normal frequency) Concomitant treatment with another investigational drug from Day 1 through Day 28. Current use or anticipated need for drugs that are known strong inhibitors or inducers of major CYP enzymes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chris P. Recknor, MD
Organizational Affiliation
Center for Advanced Research and Education
Official's Role
Principal Investigator
Facility Information:
Facility Name
Center for Advanced Research and Education
City
Gainesville
State/Province
Georgia
ZIP/Postal Code
30501
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Evaluating Safety, Pharmacokinetics and Clinical Benefit of Silmitasertib (CX-4945) in Subjects With Moderate COVID-19

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