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Multicenter Double Blind, Parallel-group Phase 2/3 Trial, to Study Raloxifene in Adult COVID-19 Patients.

Primary Purpose

SARS CoV 2 Infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Raloxifene
Placebo
Sponsored by
Dompé Farmaceutici S.p.A
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for SARS CoV 2 Infection focused on measuring COVID-19, SARS-CoV-2, severe pneumonia, pneumonia

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject autonomously provides informed consent prior to initiation of any study procedures
  2. Males and females > 40 years old at time of enrolment
  3. Understands and agrees to comply with planned study procedures, has the availability of an email address as well as an Internet connection at domicile location
  4. Agrees to the collection of nasopharyngeal swabs and venous blood samples per protocol
  5. Has laboratory-confirmed SARS-CoV-2 infection as determined by an approved molecular test (PCR) in Europe within 10 days at the screening time
  6. Patient paucisymptomatic who complains at the screening time at least one of the following symptoms mild to moderate: fever, dyspnea, headache, cough, dysgeusia, conjunctivitis, vomiting, diarrhea, anosmia, muscle or body aches or other symptoms which in the opinion of the Investigator are part of the COVID-19 clinical picture
  7. No need of supplemental oxygen therapy, mechanical ventilation
  8. Females of child-bearing potential and with an active sexual life must not wish to get pregnant within 30 days after the end of the study and must be using at least one of the following reliable methods of contraception:

    1. Hormonal contraception, systemic, implantable, transdermal, or injectable contraceptives for at least 2 months before the screening visit until 30 days after final visit
    2. A non-hormonal intrauterine device [IUD] or female condom with spermicide or contraceptive sponge with spermicide or diaphragm with spermicide or cervical cap with spermicide for at least 2 months before the screening visit until 30 days after final visit
    3. A male sexual partner who agrees to use a male condom with spermicide
    4. A sterile sexual partner

Female participants of non-child-bearing potential or in post-menopausal status for at least 1 year will be admitted. For all female subjects, with child-bearing potential, pregnancy test result must be negative before first drug intake on T7 and T14.

Exclusion Criteria:

  1. Being totally asymptomatic at the screening time
  2. Requires supplemental oxygen therapy or mechanical ventilation
  3. Being already under raloxifene or other SERM treatment for another medical condition at the time of randomization
  4. Being concurrently involved in another trial with IP or participation in any clinical trial with IP for 1 months before this study. The 1-month interval is calculated as the time between the last visit of the previous study and the first day of the present study (date of the informed consent signature)
  5. Clinically significant abnormal physical findings which could interfere with the objectives of the study
  6. Diseases:

    1. history of stroke and/or venous thromboembolism;
    2. known moderate / severe renal impairment: Chronic Kidney Disease (CKD) stage 3 or higher;
    3. known liver disease (Child-Pugh Class A or higher);
    4. presence of known hypoalbuminemia;
    5. endometrial bleeding;
    6. signs or symptoms of endometrial cancer
  7. Autoimmune diseases receiving therapy at the time of randomization
  8. Risk of venous thrombosis or any condition/disease that could bring to an extended period of immobilization
  9. Ascertained or presumptive hypersensitivity to the active principles (raloxifene) and/or excipients or allergic reactions in general, which the Investigator considers may affect the outcome of the study
  10. Medications: in particular cholestyramine (or any ion exchange resin), medications used in treatment of early or advanced breast cancer (including adjuvant therapy), warfarin, any drug that cannot be coadministered with the experimental compound
  11. Pregnancy:

    1. positive or missing pregnancy test before first drug intake or day 1;
    2. pregnant or lactating women;
  12. Women of childbearing potential and fertile men who does not agree to use at least one primary form of contraception for the duration of the study.

Sites / Locations

  • CHU Amiens
  • Clinique de l'infirmerie protestante de Lyon
  • CH Emile Roux le Puy en Velay
  • Centre Hospitalier de Troyes
  • Humanitas Gavazzeni
  • Ospedale San Salvatore
  • AO dei Colli (Ospedale Monaldi)
  • INMI Lazzaro Spallanzani
  • Istituto Clinico Humanitas
  • A.O.U. Città della Salute e della Scienza
  • Hospital Universitario Virgen de la Victoria

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Group 1: Raloxifene 60 mg

Group 2: Raloxifene 120 mg

Group 3: Placebo.

Arm Description

After an administration of two oral doses in the first day of treatment (one dose in the morning and one dose in the evening, each dose administered with 2 capsules containing 60 mg of the active substance or placebo), a single daily oral dose of raloxifene 60 mg was administered; the treatment was taken by the patients for two weeks.

After an administration of two oral doses in the first day of treatment (one dose in the morning and one dose in the evening, each dose administered with 2 capsules containing 60 mg of the active substance or placebo), a single daily oral dose of raloxifene 120 mg was administered; the treatment was taken by the patients for two weeks.

After an administration of two oral doses in the first day of treatment (one dose in the morning and one dose in the evening, each dose administered with 2 capsules containing placebo), a single daily oral dose of placebo (2 capsules guarantee the blinding design) was administered; the treatment was taken by the patients for two weeks.

Outcomes

Primary Outcome Measures

Proportion of participants with undetectable SARS-CoV-2 at PCR randomization
Number of participants who, after a PCR test, were not detected as SARS-CoV2 positive
Proportion of participants not requiring oxygen therapy and/or mechanical ventilation
Proportion of participants who does not require supplemental oxygen therapy (NEWS ≤ 2) and/or mechanical ventilation

Secondary Outcome Measures

Proportion of participants with undetectable SARS-CoV-2 at PCR
Proportion of participants with undetectable SARS-CoV-2 at PCR at day 14 after randomization, and at day 28 after randomization
Proportion of participants not requiring oxygen therapy and/or mechanical ventilation
Proportion of participants who does not require supplemental oxygen therapy (NEWS ≤ 2) and/or mechanical ventilation after randomization;
Proportion of patients in each National Early Warning Score (NEWS) category
Proportion of patients in each National Early Warning Score (NEWS) category after randomization. NEWS is a system for scoring the physiological measurements that are routinely recorded at the patient's bedside. The score can range from 0 to 19. The higher the score, the worse the outcome.
Mean value of National Early Warning Score (NEWS) category
Mean value of National Early Warning Score (NEWS) category after randomization. NEWS is a system for scoring the physiological measurements that are routinely recorded at the patient's bedside. The score can range from 0 to 19. The higher the score, the worse the outcome.
Proportion of participants with any adverse event with grade ≤ 2 after randomization.
Proportion of participants with any adverse event with grade ≤ 2 according to Common Terminology Criteria for Adverse Events (CTCAE).
Proportion of participants with any severe adverse events (grade ≥ 3 according to CTCAE) after randomization
Proportion of participants with any severe adverse events (grade ≥ 3 according to CTCAE)
Proportion of hospitalized participants who at the beginning of the study were at domicile isolation after randomization.
Proportion of hospitalized patients who at the beginning of the study were at domicile isolation.
Proportion of participants admitted to intensive care after randomization.
Proportion of participants admitted to intensive care. Intensive care is a special medical treatment in which a patient who is dangerously ill is kept under constant observation, typically in a dedicated department of a hospital.
Proportion of survivors
Proportion of survivors after randomization.
Mean change from baseline to day 7, 14, 21 and 28 after randomization of value for biomarker parameters
biomarker parameters assessed have been: Complete blood cell counts; Hepatic function (alanine aminotransferase or ALT, aspartate aminotransferase or AST and bilirubin); Coagulation (prothrombin time or PT, activated partial thromboplastin time or aPTT and INR or PT); Other markers including (D-dimer, creatine phosphokinase or CPK, lactate dehydrogenase or LDH); Please note that multiple measurements will be aggregated to arrive at one reported value (e.g., weight and height will be combined to report BMI in kg/m^2).
Quality of life questionnaire
Quality of life questionnaire 3 months after the randomization. No specifications on the questionnaire structure are reported in the protocol.

Full Information

First Posted
December 23, 2021
Last Updated
January 10, 2022
Sponsor
Dompé Farmaceutici S.p.A
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1. Study Identification

Unique Protocol Identification Number
NCT05172050
Brief Title
Multicenter Double Blind, Parallel-group Phase 2/3 Trial, to Study Raloxifene in Adult COVID-19 Patients.
Official Title
Multicenter, Adaptive, Randomized, Placebo-controlled, Double Blind, Parallel-group Phase 2/3 Trial, to Study Efficacy and Safety of Two Doses of Raloxifene in Adult Paucisymptomatic COVID-19 Patients.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
January 22, 2021 (Actual)
Primary Completion Date
June 12, 2021 (Actual)
Study Completion Date
June 12, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Dompé Farmaceutici S.p.A

4. Oversight

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

5. Study Description

Brief Summary
The objective of the study is to evaluate the efficacy and safety of two different doses of raloxifene orally administered compared to placebo in patients with early diagnosis of paucisymptomatic COVID-19. Primary objectives: Evaluation of the effectiveness of therapy in reducing the proportion of subjects who still have viruses in the upper airways after 7 days of therapy Evaluation of the effectiveness of therapy in reducing the proportion of subjects who requires supplemental oxygen therapy and/or mechanical ventilation within 14 days of starting therapy Secondary objectives: Evaluation of the effectiveness of therapy in reducing the proportion of subjects who still have viruses in the upper airways after 14 and 28 days of therapy Evaluation of the effectiveness of therapy in reducing the proportion of subject patients who requires supplemental oxygen therapy and/or mechanical ventilation within 7 or 28 days of starting therapy 7, 14 and 28 days drug safety and tolerability profile Assessment of body temperature, blood and biochemical parameters between T0 and T28
Detailed Description
The study is a phase 2/3, multicenter, adaptive, randomized, placebo-controlled, double blind, parallel-group study to evaluate efficacy and safety of two doses of raloxifene in adult paucisymptomatic COVID-19 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
SARS CoV 2 Infection
Keywords
COVID-19, SARS-CoV-2, severe pneumonia, pneumonia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Multicenter, adaptive, double-blind, randomized, placebo controlled, double blind, parallelgroup, to study efficacy and safety, with the following adaptive components: Parallel multi-arms (2 interventional arms and 1 placebo control arm); A 2-stage sequential design (1 interim analysis + 1 final analysis); Sample size re-calculation at interim stage; Stopping rule for efficacy or futility at interim stage.
Masking
ParticipantInvestigator
Masking Description
Appearance, including packaging and labelling, of the investigational medicinal product (IMP, capsules, packaging) will not allow to recognize actual treatment (either raloxifene or placebo).
Allocation
Randomized
Enrollment
68 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1: Raloxifene 60 mg
Arm Type
Experimental
Arm Description
After an administration of two oral doses in the first day of treatment (one dose in the morning and one dose in the evening, each dose administered with 2 capsules containing 60 mg of the active substance or placebo), a single daily oral dose of raloxifene 60 mg was administered; the treatment was taken by the patients for two weeks.
Arm Title
Group 2: Raloxifene 120 mg
Arm Type
Experimental
Arm Description
After an administration of two oral doses in the first day of treatment (one dose in the morning and one dose in the evening, each dose administered with 2 capsules containing 60 mg of the active substance or placebo), a single daily oral dose of raloxifene 120 mg was administered; the treatment was taken by the patients for two weeks.
Arm Title
Group 3: Placebo.
Arm Type
Placebo Comparator
Arm Description
After an administration of two oral doses in the first day of treatment (one dose in the morning and one dose in the evening, each dose administered with 2 capsules containing placebo), a single daily oral dose of placebo (2 capsules guarantee the blinding design) was administered; the treatment was taken by the patients for two weeks.
Intervention Type
Drug
Intervention Name(s)
Raloxifene
Intervention Description
Raloxifene was administered as 60 mg hard gelatine capsule(s) once a day. Starting from day 2 of treatment: one single capsule (plus one of placebo to guarantee the blinding) containing 60 mg raloxifene was administered in Group 1, and 2 capsules 60 mg each for a total of 120 mg in Group 2.
Intervention Type
Other
Intervention Name(s)
Placebo
Other Intervention Name(s)
control
Intervention Description
Placebo was administered orally once a day as 2 capsules (for maintaining the blinding design)
Primary Outcome Measure Information:
Title
Proportion of participants with undetectable SARS-CoV-2 at PCR randomization
Description
Number of participants who, after a PCR test, were not detected as SARS-CoV2 positive
Time Frame
At Day 7
Title
Proportion of participants not requiring oxygen therapy and/or mechanical ventilation
Description
Proportion of participants who does not require supplemental oxygen therapy (NEWS ≤ 2) and/or mechanical ventilation
Time Frame
At Day 14
Secondary Outcome Measure Information:
Title
Proportion of participants with undetectable SARS-CoV-2 at PCR
Description
Proportion of participants with undetectable SARS-CoV-2 at PCR at day 14 after randomization, and at day 28 after randomization
Time Frame
At days 14 and 28
Title
Proportion of participants not requiring oxygen therapy and/or mechanical ventilation
Description
Proportion of participants who does not require supplemental oxygen therapy (NEWS ≤ 2) and/or mechanical ventilation after randomization;
Time Frame
At days 7 and 28
Title
Proportion of patients in each National Early Warning Score (NEWS) category
Description
Proportion of patients in each National Early Warning Score (NEWS) category after randomization. NEWS is a system for scoring the physiological measurements that are routinely recorded at the patient's bedside. The score can range from 0 to 19. The higher the score, the worse the outcome.
Time Frame
At days 7, 14, 28
Title
Mean value of National Early Warning Score (NEWS) category
Description
Mean value of National Early Warning Score (NEWS) category after randomization. NEWS is a system for scoring the physiological measurements that are routinely recorded at the patient's bedside. The score can range from 0 to 19. The higher the score, the worse the outcome.
Time Frame
At days 7, 14, 28
Title
Proportion of participants with any adverse event with grade ≤ 2 after randomization.
Description
Proportion of participants with any adverse event with grade ≤ 2 according to Common Terminology Criteria for Adverse Events (CTCAE).
Time Frame
At days 7, 14, 28
Title
Proportion of participants with any severe adverse events (grade ≥ 3 according to CTCAE) after randomization
Description
Proportion of participants with any severe adverse events (grade ≥ 3 according to CTCAE)
Time Frame
At days 7, 14, 28
Title
Proportion of hospitalized participants who at the beginning of the study were at domicile isolation after randomization.
Description
Proportion of hospitalized patients who at the beginning of the study were at domicile isolation.
Time Frame
At days 7, 14, 28
Title
Proportion of participants admitted to intensive care after randomization.
Description
Proportion of participants admitted to intensive care. Intensive care is a special medical treatment in which a patient who is dangerously ill is kept under constant observation, typically in a dedicated department of a hospital.
Time Frame
At days 7,14 ,28
Title
Proportion of survivors
Description
Proportion of survivors after randomization.
Time Frame
At days 7, 14, 28
Title
Mean change from baseline to day 7, 14, 21 and 28 after randomization of value for biomarker parameters
Description
biomarker parameters assessed have been: Complete blood cell counts; Hepatic function (alanine aminotransferase or ALT, aspartate aminotransferase or AST and bilirubin); Coagulation (prothrombin time or PT, activated partial thromboplastin time or aPTT and INR or PT); Other markers including (D-dimer, creatine phosphokinase or CPK, lactate dehydrogenase or LDH); Please note that multiple measurements will be aggregated to arrive at one reported value (e.g., weight and height will be combined to report BMI in kg/m^2).
Time Frame
At days 7, 14, 21 and 28
Title
Quality of life questionnaire
Description
Quality of life questionnaire 3 months after the randomization. No specifications on the questionnaire structure are reported in the protocol.
Time Frame
At month 3

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject autonomously provides informed consent prior to initiation of any study procedures Males and females > 40 years old at time of enrolment Understands and agrees to comply with planned study procedures, has the availability of an email address as well as an Internet connection at domicile location Agrees to the collection of nasopharyngeal swabs and venous blood samples per protocol Has laboratory-confirmed SARS-CoV-2 infection as determined by an approved molecular test (PCR) in Europe within 10 days at the screening time Patient paucisymptomatic who complains at the screening time at least one of the following symptoms mild to moderate: fever, dyspnea, headache, cough, dysgeusia, conjunctivitis, vomiting, diarrhea, anosmia, muscle or body aches or other symptoms which in the opinion of the Investigator are part of the COVID-19 clinical picture No need of supplemental oxygen therapy, mechanical ventilation Females of child-bearing potential and with an active sexual life must not wish to get pregnant within 30 days after the end of the study and must be using at least one of the following reliable methods of contraception: Hormonal contraception, systemic, implantable, transdermal, or injectable contraceptives for at least 2 months before the screening visit until 30 days after final visit A non-hormonal intrauterine device [IUD] or female condom with spermicide or contraceptive sponge with spermicide or diaphragm with spermicide or cervical cap with spermicide for at least 2 months before the screening visit until 30 days after final visit A male sexual partner who agrees to use a male condom with spermicide A sterile sexual partner Female participants of non-child-bearing potential or in post-menopausal status for at least 1 year will be admitted. For all female subjects, with child-bearing potential, pregnancy test result must be negative before first drug intake on T7 and T14. Exclusion Criteria: Being totally asymptomatic at the screening time Requires supplemental oxygen therapy or mechanical ventilation Being already under raloxifene or other SERM treatment for another medical condition at the time of randomization Being concurrently involved in another trial with IP or participation in any clinical trial with IP for 1 months before this study. The 1-month interval is calculated as the time between the last visit of the previous study and the first day of the present study (date of the informed consent signature) Clinically significant abnormal physical findings which could interfere with the objectives of the study Diseases: history of stroke and/or venous thromboembolism; known moderate / severe renal impairment: Chronic Kidney Disease (CKD) stage 3 or higher; known liver disease (Child-Pugh Class A or higher); presence of known hypoalbuminemia; endometrial bleeding; signs or symptoms of endometrial cancer Autoimmune diseases receiving therapy at the time of randomization Risk of venous thrombosis or any condition/disease that could bring to an extended period of immobilization Ascertained or presumptive hypersensitivity to the active principles (raloxifene) and/or excipients or allergic reactions in general, which the Investigator considers may affect the outcome of the study Medications: in particular cholestyramine (or any ion exchange resin), medications used in treatment of early or advanced breast cancer (including adjuvant therapy), warfarin, any drug that cannot be coadministered with the experimental compound Pregnancy: positive or missing pregnancy test before first drug intake or day 1; pregnant or lactating women; Women of childbearing potential and fertile men who does not agree to use at least one primary form of contraception for the duration of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Francesco Sergio, MD, PhD
Organizational Affiliation
Dompé Farmaceutici
Official's Role
Study Director
Facility Information:
Facility Name
CHU Amiens
City
Amiens
Country
France
Facility Name
Clinique de l'infirmerie protestante de Lyon
City
Caluire-et-Cuire
Country
France
Facility Name
CH Emile Roux le Puy en Velay
City
Le Puy-en-Velay
Country
France
Facility Name
Centre Hospitalier de Troyes
City
Troyes
Country
France
Facility Name
Humanitas Gavazzeni
City
Bergamo
Country
Italy
Facility Name
Ospedale San Salvatore
City
L'Aquila
Country
Italy
Facility Name
AO dei Colli (Ospedale Monaldi)
City
Napoli
Country
Italy
Facility Name
INMI Lazzaro Spallanzani
City
Roma
Country
Italy
Facility Name
Istituto Clinico Humanitas
City
Rozzano
Country
Italy
Facility Name
A.O.U. Città della Salute e della Scienza
City
Torino
Country
Italy
Facility Name
Hospital Universitario Virgen de la Victoria
City
Málaga
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35582123
Citation
Nicastri E, Marinangeli F, Pivetta E, Torri E, Reggiani F, Fiorentino G, Scorzolini L, Vettori S, Marsiglia C, Gavioli EM, Beccari AR, Terpolilli G, De Pizzol M, Goisis G, Mantelli F, Vaia F, Allegretti M; Raloxifene Territorial Health COVID19 STUDY GROUP. A phase 2 randomized, double-blinded, placebo-controlled, multicenter trial evaluating the efficacy and safety of raloxifene for patients with mild to moderate COVID-19. EClinicalMedicine. 2022 Jun;48:101450. doi: 10.1016/j.eclinm.2022.101450. Epub 2022 May 12.
Results Reference
derived

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Multicenter Double Blind, Parallel-group Phase 2/3 Trial, to Study Raloxifene in Adult COVID-19 Patients.

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