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Hydroxychloroquine Monotherapy and in Combination With Azithromycin in Patients With Moderate and Severe COVID-19 Disease

Primary Purpose

Covid-19

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
HCQ
HCQ+AZT
Placebo
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid-19 focused on measuring covid19, covid 19, covid-19, coronavirus, SARS-CoV, SARS-CoV-2, novel coronavirus, adult, JWT629, acute respiratory syndrome coronavirus

Eligibility Criteria

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

Inclusion Criteria:

  1. Informed consent must be obtained prior to participation in the study
  2. Adult patient ≥ 18 years old
  3. Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection confirmed by polymerase chain reaction (PCR) test from respiratory tract specimen (e.g nasopharyngeal swab)
  4. Onset of signs and symptoms of COVID19 illness ≤ 7 days prior to randomization (including but not limited to fever, cough, myalgias, fatigue, abnormal chest imaging)
  5. Currently hospitalized or requiring hospitalization due to COVID-19 disease

Exclusion Criteria:

  1. Use of other investigational drugs or newly approved COVID-19 treatments within 5-half lives or 30 days of enrolment
  2. History of hypersensitivity to any of the study treatments or its excipients or to drugs of similar chemical classes
  3. Participation in any other clinical trial of an experimental treatment for COVID-19
  4. Expectation of concurrent treatment with any other agents or potential direct acting antiviral activity against SARS-Co V-2 during study drug dosing
  5. Requires, in the judgement of the investigator, admission to the intensive care unit (ICU) or mechanical ventilatory support (invasive or non-invasive) prior to first dose of study drug (There might be a patient who cannot be admitted to the ICU, even if the patient's condition is severe enough, due to administrative reasons under the current circumstances. This case is also considered under admission to the ICU judged by the investigator)
  6. Evidence of cytokine storm syndrome or multi-organ system failure
  7. Confirmed co-infection with influenza
  8. Creatinine clearance < 45 mL/min or requiring acute renal replacement therapy
  9. History or current diagnosis of ECG abnormalities indicating significant risk of safety for participants participating in the study
  10. Any other condition which in the opinion of the investigator, would put the safety of the participant at risk, impede compliance or hinder completion of the study
  11. Pregnant or nursing (lactating) women
  12. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they agree to use basic methods of contraception during dosing of study treatment.

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Arm 1: hydroxychloroquine + aithromycin placebo

Arm 2: hydroxychloroquine + azithromycin

Arm 3: hydroxychloroquine placebo + azithromycin placebo

Arm Description

Hydroxychloroquine 600mg o.d. as loading dose (Day 1) +followed by 200mg t.i.d was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin (AZT) placebo o.d.

Hydroxychloroquine 600 mg o.d. as a loading dose (Day 1) followed by 200 mg t.i.d. was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin: 500 mg as a loading dose (Day 1) followed by 250 mg o.d. Day 2 - Day 5

Hydroxychloroquine placebo o.d. (day 1) followed by hydroxychloroquine placebo t.i.d Azythromycin placebo o.d.

Outcomes

Primary Outcome Measures

Number of Participants Who Achieved Clinical Response by Day 15
Clinical response was defined as a) discharged alive; or b) No need for mechanical ventilation in any participants and no need for supplemental oxygen requirement (SpO2) in participants without pre-morbid O2 requirement.

Secondary Outcome Measures

Number of Participants Who Achieved Viral Clearance
Number and percentage of participants with negative or below LLOQ SARS-COV-2 based on polymerase chain reaction (PCR) test
Number of Participants Discharged or Ready for Discharge
Number of participants who received hydrochloroquine plus azithromycin relative to placebo who were discharged from hospital
Time to Return to Pre-morbid Supplemental Oxygen Requirement in Participants Receiving Hydrochloroquine or Hydrochloroquine Plus Azithromycin Relative to Placebo
Number of participants requiring supplemental oxygen at the time of randomization who returned to pre-morbid supplemental oxygen

Full Information

First Posted
April 8, 2020
Last Updated
October 7, 2021
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04358081
Brief Title
Hydroxychloroquine Monotherapy and in Combination With Azithromycin in Patients With Moderate and Severe COVID-19 Disease
Official Title
A Multi-center, Randomized, Double-blinded, Placebo-controlled Study to Evaluate the Safety and Efficacy of Hydroxychloroquine Monotherapy and in Combination With Azithromycin in Patients With Moderate and Severe COVID-19 Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
May 1, 2020 (Actual)
Primary Completion Date
July 27, 2020 (Actual)
Study Completion Date
July 27, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
Two recent studies have suggested that in patients with Covid19, treatment with hydroxychloroquine may shorten the duration of symptoms and improve viral clearance, an effect that appears most pronounced when combined with azithromycin. Hydroxychloroquine treatment may inhibit viral nucleic acid-mediated activation of various innate immune pathways, as well as blockade of lysosomal functions in cell types relevant for viral entry and antigen presentation. The purpose of the study was to determine if oral hydroxychloroquine monotherapy, or in combination with azithromycin results in clinical benefit in patients hospitalized with COVID19 pneumonia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid-19
Keywords
covid19, covid 19, covid-19, coronavirus, SARS-CoV, SARS-CoV-2, novel coronavirus, adult, JWT629, acute respiratory syndrome coronavirus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1: hydroxychloroquine + aithromycin placebo
Arm Type
Experimental
Arm Description
Hydroxychloroquine 600mg o.d. as loading dose (Day 1) +followed by 200mg t.i.d was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin (AZT) placebo o.d.
Arm Title
Arm 2: hydroxychloroquine + azithromycin
Arm Type
Experimental
Arm Description
Hydroxychloroquine 600 mg o.d. as a loading dose (Day 1) followed by 200 mg t.i.d. was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin: 500 mg as a loading dose (Day 1) followed by 250 mg o.d. Day 2 - Day 5
Arm Title
Arm 3: hydroxychloroquine placebo + azithromycin placebo
Arm Type
Placebo Comparator
Arm Description
Hydroxychloroquine placebo o.d. (day 1) followed by hydroxychloroquine placebo t.i.d Azythromycin placebo o.d.
Intervention Type
Drug
Intervention Name(s)
HCQ
Other Intervention Name(s)
JWT629
Intervention Description
Hydroxychloroquine Monotherapy
Intervention Type
Drug
Intervention Name(s)
HCQ+AZT
Other Intervention Name(s)
JWT629 + AZT
Intervention Description
Hydroxychloroquine with azithromycin
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Number of Participants Who Achieved Clinical Response by Day 15
Description
Clinical response was defined as a) discharged alive; or b) No need for mechanical ventilation in any participants and no need for supplemental oxygen requirement (SpO2) in participants without pre-morbid O2 requirement.
Time Frame
15 days
Secondary Outcome Measure Information:
Title
Number of Participants Who Achieved Viral Clearance
Description
Number and percentage of participants with negative or below LLOQ SARS-COV-2 based on polymerase chain reaction (PCR) test
Time Frame
6 days and 10 Days
Title
Number of Participants Discharged or Ready for Discharge
Description
Number of participants who received hydrochloroquine plus azithromycin relative to placebo who were discharged from hospital
Time Frame
15 days
Title
Time to Return to Pre-morbid Supplemental Oxygen Requirement in Participants Receiving Hydrochloroquine or Hydrochloroquine Plus Azithromycin Relative to Placebo
Description
Number of participants requiring supplemental oxygen at the time of randomization who returned to pre-morbid supplemental oxygen
Time Frame
15 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Informed consent must be obtained prior to participation in the study Adult patient ≥ 18 years old Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection confirmed by polymerase chain reaction (PCR) test from respiratory tract specimen (e.g nasopharyngeal swab) Onset of signs and symptoms of COVID19 illness ≤ 7 days prior to randomization (including but not limited to fever, cough, myalgias, fatigue, abnormal chest imaging) Currently hospitalized or requiring hospitalization due to COVID-19 disease Exclusion Criteria: Use of other investigational drugs or newly approved COVID-19 treatments within 5-half lives or 30 days of enrolment History of hypersensitivity to any of the study treatments or its excipients or to drugs of similar chemical classes Participation in any other clinical trial of an experimental treatment for COVID-19 Expectation of concurrent treatment with any other agents or potential direct acting antiviral activity against SARS-Co V-2 during study drug dosing Requires, in the judgement of the investigator, admission to the intensive care unit (ICU) or mechanical ventilatory support (invasive or non-invasive) prior to first dose of study drug (There might be a patient who cannot be admitted to the ICU, even if the patient's condition is severe enough, due to administrative reasons under the current circumstances. This case is also considered under admission to the ICU judged by the investigator) Evidence of cytokine storm syndrome or multi-organ system failure Confirmed co-infection with influenza Creatinine clearance < 45 mL/min or requiring acute renal replacement therapy History or current diagnosis of ECG abnormalities indicating significant risk of safety for participants participating in the study Any other condition which in the opinion of the investigator, would put the safety of the participant at risk, impede compliance or hinder completion of the study Pregnant or nursing (lactating) women Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they agree to use basic methods of contraception during dosing of study treatment.
Facility Information:
Facility Name
Novartis Investigative Site
City
Fullerton
State/Province
California
ZIP/Postal Code
92835
Country
United States
Facility Name
Novartis Investigative Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1793
Country
United States
Facility Name
Novartis Investigative Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Novartis Investigative Site
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70809
Country
United States
Facility Name
Novartis Investigative Site
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Novartis Investigative Site
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Novartis Investigative Site
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Links:
URL
https://www.novctrd.com/ctrdweb/patientsummary/patientsummaries?patientSummaryId=859
Description
A Plain Language Trial Summary is available on novartisclinicaltrials.com

Learn more about this trial

Hydroxychloroquine Monotherapy and in Combination With Azithromycin in Patients With Moderate and Severe COVID-19 Disease

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