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Leidos-Enabled Adaptive Protocol for Clinical Trials (LEAP-CT) in Hospitalized Patients With COVID-19 (Addendum 1)

Primary Purpose

2019 Novel Coronavirus Disease, 2019 Novel Coronavirus Infection, 2019-nCoV Disease

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Famotidine
Celecoxib
Placebo
Sponsored by
Leidos Life Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for 2019 Novel Coronavirus Disease focused on measuring COVID-19, COVID, COVID19, SARS-CoV-2

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female participants must be at least 18 years of age, inclusive, at the time of signing the informed consent form.
  • Confirmed COVID-19 or symptom onset within 7 days of hospitalization, as shown by medical history, physical exam, and laboratory tests (PCR), and who have been hospitalized for COVID-19 at WHO Grade 4-5.
  • Contraceptive use by men or women should be consistent with Appendix 4 of the Master Protocol (LDOS-21-001).
  • Capable of understanding and providing a signed informed consent form.
  • Reliable access to the internet.

Exclusion Criteria:

Participants are excluded from the study if any of the following criteria apply:

  • Pregnant or breastfeeding
  • History of HIV
  • Ongoing treatment that cannot be temporarily discontinued during the study: anti-inflammatory treatment (nonsteroidal anti-inflammatory drugs [NSAIDS]);corticosteroids; antimalarials; antiarrhythmics; tricyclic antidepressants; natalizumab; quinolones; macrolides; and agalsidase alfa and beta

    1. drugs dependent on gastric pH for absorption, e.g., dasatinib, delavirdine, mesylate, cefditoren, and fosamprenavir;
    2. tizanidine (CYP1A2) substrate;
    3. drugs that interfere with hemostasis (e.g., warfarin, aspirin, selective serotonin reuptake inhibitors [SSRIs]/serotonin norepinephrine reuptake inhibitors [SNRIs]);
    4. angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), or beta-blockers;
    5. diuretics;
    6. digoxin
  • Ongoing famotidine, celecoxib, or other COVID-19 clinical investigational treatment(s) within the past 30 days or current participation in another investigational clinical trial
  • History of immunosuppression
  • History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
  • Rejection of participation at the discretion of the Principal Investigator or Sponsor
  • Any contraindication for famotidine or celecoxib treatment:

    a. Famotidine or celecoxib hypersensitivity; b. Retinopathy, visual field or visual acuity disturbances; c. History of cardiovascular disease, such as congestive heart failure, QT prolongation, bradycardia (<50 bpm), ventricular tachycardia, other arrhythmias, as determined at screening electrocardiogram (ECG) or medical history; d. Potassium <3 mEq/L (milliequivalent/liter) as determined at Visit 1; e. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >5 upper normal limit, as determined at Visit 1; f. Previous myocardial infarction; e. Myasthenia gravis; h. Psoriasis or porphyria; i. Glomerular clearance, 60 mL/min; j. Previous history of severe hypoglycemia; k. Known or suspected to be poor CYP2C9 metabolizers based on genotype or previous history or experience with other CYP2C9 substrates, such as warfarin and phenytoin; l. Moderate or severe hepatic impairment, e.g., Child-Pugh Class B or C.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Group 1 (Study Product)

    Group 2 (Reference Therapy)

    Arm Description

    Subjects will receive 80 mg famotidine (PO) QID and 400 mg celecoxib as a first dose, followed by 200 mg (PO) BID celecoxib, for 5 days. Following this 5-day period, subjects will continue their famotidine treatment for an additional 9 days.

    Subjects will receive matching placebos QID and BID, for 5 days. Following this 5-day period, subjects will continue to receive matching famotidine placebo, QID, for an additional 9 days.

    Outcomes

    Primary Outcome Measures

    Time-to-event to achieve WHO level ≤3
    Evaluation of the time-to-event to achieve a WHO level score ≤3
    Death rate
    Evaluation of the time-to-event where all-cause mortality occurs

    Secondary Outcome Measures

    Hospital discharge to chronic palliative care
    Measured incidence of hospital discharge to chronic palliative care
    Hospital discharge with no additional medical care
    Measured incidence of hospital discharge with no additional medical care required
    Related adverse events (AEs) and serious adverse events (SAEs)
    Measured incidence of related AEs and SAEs
    Study discontinuation due to related AEs or SAEs
    Measured incidence of study discontinuation due to related AEs or SAEs

    Full Information

    First Posted
    October 7, 2021
    Last Updated
    October 5, 2023
    Sponsor
    Leidos Life Sciences
    Collaborators
    United States Department of Defense
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05085574
    Brief Title
    Leidos-Enabled Adaptive Protocol for Clinical Trials (LEAP-CT) in Hospitalized Patients With COVID-19 (Addendum 1)
    Official Title
    A Phase 2 Randomized, Single-blind, Placebo-controlled Study to Evaluate the Safety and Efficacy of the Combination of Famotidine and Celecoxib as a Treatment in Moderate-to-severe Patients Hospitalized for COVID-19
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2023
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    COVID environment, lack of site confidence to enroll subjects, sites not suited to study procedures, decline of potential inpatient subjects at site
    Study Start Date
    February 7, 2023 (Actual)
    Primary Completion Date
    February 7, 2023 (Actual)
    Study Completion Date
    February 7, 2023 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Leidos Life Sciences
    Collaborators
    United States Department of Defense

    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
    This study is designed to test the efficacy and safety of combinations of two well-understood agents - famotidine and celecoxib in patients hospitalized with moderate-to-severe COVID-19 (based on World Health Organization [WHO] Ordinal Scale for Clinical Improvement). Both famotidine and celecoxib separately demonstrate clinical activity in mitigating COVID-19 disease symptoms or severity, and appear to have separate and complementary mechanisms of action.
    Detailed Description
    Participants will be randomly assigned, in a 1:1 ratio, to one of two regimens, with 202 subjects per group as follows: Group 1 (study product) subjects will receive 80 mg famotidine by mouth (PO) 4 times per day (QID) + 400 mg celecoxib as a first dose, followed by 200 mg celecoxib PO, 2 times per day (BID), for 5 days. Following this 5-day period, subjects will continue their famotidine treatment for an additional 9 days. Group 2 (reference therapy) subjects will receive matching placebos QID and BID, for 5 days. Following this 5-day period, subjects will continue to receive matching famotidine placebo, QID, for an additional 9 days. Safety, efficacy and pharmacokinetics of famotidine and celecoxib will be evaluated. All participants will receive the standard of care (SOC), which typically consists of remdesivir, decadron (dexamethasone), lovenox, tociluzimab, and convalescent plasma. At the discretion of the investigator, study treatment can be stopped and dexamethasone initiated in study participants who require supplemental oxygen (WHO 5) as outlined in the NIH COVID-19 Treatment Guidelines. Investigators are required to stop study treatment and initiate dexamethasone, as indicated in participants who require high-flow oxygen (WHO 6), non-invasive ventilation (NIV; WHO 6), invasive mechanical ventilation (WHO 7-8) or extracorporeal membrane oxygenation (ECMO; WHO 9), in accordance with the NIH COVID-19 Treatment Guidelines. The NIH COVID-19 Treatment Guidelines recommend against the use of dexamethasone only in hospitalized patients not requiring supplemental oxygen (WHO 4).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    2019 Novel Coronavirus Disease, 2019 Novel Coronavirus Infection, 2019-nCoV Disease, 2019-nCoV Infection, COVID-19 Pandemic, COVID-19 Virus Disease, COVID-19 Virus Infection, Covid19, Coronavirus Disease 2019, SARS-CoV-2 Infection, SARS-CoV-2 Acute Respiratory Disease, COVID-19
    Keywords
    COVID-19, COVID, COVID19, SARS-CoV-2

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    Subjects randomized 1:1, study drug:placebo
    Masking
    Participant
    Masking Description
    Single-blind
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Group 1 (Study Product)
    Arm Type
    Experimental
    Arm Description
    Subjects will receive 80 mg famotidine (PO) QID and 400 mg celecoxib as a first dose, followed by 200 mg (PO) BID celecoxib, for 5 days. Following this 5-day period, subjects will continue their famotidine treatment for an additional 9 days.
    Arm Title
    Group 2 (Reference Therapy)
    Arm Type
    Placebo Comparator
    Arm Description
    Subjects will receive matching placebos QID and BID, for 5 days. Following this 5-day period, subjects will continue to receive matching famotidine placebo, QID, for an additional 9 days.
    Intervention Type
    Drug
    Intervention Name(s)
    Famotidine
    Other Intervention Name(s)
    Pepcid
    Intervention Description
    80 mg tablet, QID for 14 days
    Intervention Type
    Drug
    Intervention Name(s)
    Celecoxib
    Other Intervention Name(s)
    Celebrex
    Intervention Description
    400 mg (initial dose), then 200 mg capsule, BID for 5 days
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    tablet, QID for 14 days; capsule, BID for 5 days
    Primary Outcome Measure Information:
    Title
    Time-to-event to achieve WHO level ≤3
    Description
    Evaluation of the time-to-event to achieve a WHO level score ≤3
    Time Frame
    30 days
    Title
    Death rate
    Description
    Evaluation of the time-to-event where all-cause mortality occurs
    Time Frame
    30 days
    Secondary Outcome Measure Information:
    Title
    Hospital discharge to chronic palliative care
    Description
    Measured incidence of hospital discharge to chronic palliative care
    Time Frame
    30 days
    Title
    Hospital discharge with no additional medical care
    Description
    Measured incidence of hospital discharge with no additional medical care required
    Time Frame
    30 days
    Title
    Related adverse events (AEs) and serious adverse events (SAEs)
    Description
    Measured incidence of related AEs and SAEs
    Time Frame
    90 days
    Title
    Study discontinuation due to related AEs or SAEs
    Description
    Measured incidence of study discontinuation due to related AEs or SAEs
    Time Frame
    90 days
    Other Pre-specified Outcome Measures:
    Title
    Pharmacokinetic (PK) endpoint-Assess area under the curve
    Description
    Measure area under the curve (AUC) for famotidine and celecoxib combination in 10 patients per group
    Time Frame
    14 days
    Title
    Pharmacokinetic (PK) endpoint-Assess time to maximum plasma concentration
    Description
    Measure time to maximum plasma concentration (tmax) for famotidine and celecoxib combination in 10 patients per group
    Time Frame
    14 days
    Title
    Pharmacokinetic (PK) endpoint-Assess maximum serum concentration
    Description
    Measure maximum serum concentration (Cmax) for famotidine and celecoxib combination in 10 patients per group
    Time Frame
    14 days
    Title
    Exploratory endpoint-Incidence of symptom reduction
    Description
    Cumulative incidence of clinically significant symptom reduction (severity and duration) using COVID-19 Symptom Score
    Time Frame
    14 days
    Title
    Exploratory endpoint-Incidence of clinical improvement
    Description
    Cumulative incidence of clinically significant symptom reduction (severity and duration) using WHO Ordinal Scale for Clinical Improvement
    Time Frame
    14 days
    Title
    Special Assessment - High-resolution computed tomography (HRCT), 20 patients/group, change from baseline
    Description
    HRCT scan of the chest
    Time Frame
    Study Day 1 (baseline), Day 16 (discharge), 30 days after first dose, and 90 days after first dose
    Title
    Special Assessment - Total lung capacity (TLC), 20 patients/group, change from baseline
    Description
    TLC
    Time Frame
    Study Day 1 (baseline), 16 (discharge), 30 days after first dose, and 90 days after first dose
    Title
    Special Assessment - Prostaglandin E2 (PGE2), 20 patients/group, change from baseline
    Description
    PGE2 testing
    Time Frame
    Study Day 1 (baseline), 16 (discharge), 30 days after first dose, and 90 days after first dose
    Title
    Special Assessments - Urinalysis, 20 patients/group, change from baseline
    Description
    Urinalysis
    Time Frame
    Study Day 1 (baseline) and 16 (discharge)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female participants must be at least 18 years of age, inclusive, at the time of signing the informed consent form. Confirmed COVID-19 or symptom onset within 7 days of hospitalization, as shown by medical history, physical exam, and laboratory tests (PCR), and who have been hospitalized for COVID-19 at WHO Grade 4-5. Contraceptive use by men or women should be consistent with Appendix 4 of the Master Protocol (LDOS-21-001). Capable of understanding and providing a signed informed consent form. Reliable access to the internet. Exclusion Criteria: Participants are excluded from the study if any of the following criteria apply: Pregnant or breastfeeding History of HIV Ongoing treatment that cannot be temporarily discontinued during the study: anti-inflammatory treatment (nonsteroidal anti-inflammatory drugs [NSAIDS]);corticosteroids; antimalarials; antiarrhythmics; tricyclic antidepressants; natalizumab; quinolones; macrolides; and agalsidase alfa and beta drugs dependent on gastric pH for absorption, e.g., dasatinib, delavirdine, mesylate, cefditoren, and fosamprenavir; tizanidine (CYP1A2) substrate; drugs that interfere with hemostasis (e.g., warfarin, aspirin, selective serotonin reuptake inhibitors [SSRIs]/serotonin norepinephrine reuptake inhibitors [SNRIs]); angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), or beta-blockers; diuretics; digoxin Ongoing famotidine, celecoxib, or other COVID-19 clinical investigational treatment(s) within the past 30 days or current participation in another investigational clinical trial History of immunosuppression History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs Rejection of participation at the discretion of the Principal Investigator or Sponsor Any contraindication for famotidine or celecoxib treatment: a. Famotidine or celecoxib hypersensitivity; b. Retinopathy, visual field or visual acuity disturbances; c. History of cardiovascular disease, such as congestive heart failure, QT prolongation, bradycardia (<50 bpm), ventricular tachycardia, other arrhythmias, as determined at screening electrocardiogram (ECG) or medical history; d. Potassium <3 mEq/L (milliequivalent/liter) as determined at Visit 1; e. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >5 upper normal limit, as determined at Visit 1; f. Previous myocardial infarction; e. Myasthenia gravis; h. Psoriasis or porphyria; i. Glomerular clearance, 60 mL/min; j. Previous history of severe hypoglycemia; k. Known or suspected to be poor CYP2C9 metabolizers based on genotype or previous history or experience with other CYP2C9 substrates, such as warfarin and phenytoin; l. Moderate or severe hepatic impairment, e.g., Child-Pugh Class B or C.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Tilly Lawrence, BSN, RN
    Organizational Affiliation
    Leidos, Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    IPD Sharing Plan Description
    It is not yet known if there will be a plan to make individual participant data (IPD) available.

    Learn more about this trial

    Leidos-Enabled Adaptive Protocol for Clinical Trials (LEAP-CT) in Hospitalized Patients With COVID-19 (Addendum 1)

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