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NanoMn®_COVID-19 A Prospective, Multicenter, Randomized, Placebo-controlled, Parallel-group, Double-blind Trial to Evaluate the Clinical Efficacy of NanoManganese® on Top of Standard of Care, in Adult Patients With Moderate to Severe Coronavirus Disease 2019 (COVID-19)

Primary Purpose

COVID-19 Pandemic

Status
Recruiting
Phase
Phase 1
Locations
Brazil
Study Type
Interventional
Intervention
Placebo
Experimental drug
Sponsored by
Medesis Pharma SA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 Pandemic

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female patient aged ≥ 18 years
  • Patient hospitalized with positive COVID-19, confirmed by a Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) or an antigen test done ≤ 7 days before study entry
  • Patient with at least 1 of the National Institutes of Health COVID- 19 clinical symptoms (Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea) that appeared ≤ 15 days before study entry
  • Patient with a peripheral capillary oxygen saturation (SpO2) < 96%, or with an arterial oxygen partial pressure (PaO2) ≤65 mmHg, at study entry
  • Female patient of childbearing potential must be willing to use an efficient birth control method during the study and until 3 months after IMP administration.

A woman is considered to be of childbearing potential if she is post menarche, has not reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus, tubal ligation). The following are acceptable contraceptive methods: - Established use of oral, injected, or implanted hormonal methods of contraception - Intrauterine system or placement of an intrauterine device - Double barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam, gel, film, cream, or suppository - True abstinence [periodic abstinence (e.g., calendar, ovulation, symptothermal, post ovulation methods) and withdrawal are not acceptable methods of contraception]

  • Male patient must be willing to use male contraception (condom) during the study, avoid donating semen during study and until 3 months after last dose of IMP administration.
  • Patient must sign the informed consent form
  • Patient who have or have not been vaccinated for COVID-19 (1, 2, 3 or 4 shots) can enter the study

Exclusion Criteria:

  • Refusal to participate expressed by patient
  • Pregnancy or breast-feeding
  • Anticipated transfer to another hospital, which is not a study site within 72 hours
  • Contraindication to Manganese supplementation
  • Patient under Long-term oxygen therapy or invasive ventilation prior to COVID-19 infection
  • Patient requiring Continuous Positive Airway Pressure (CPAP), high flow, or Non-Invasive Ventilation (NIV) and a SpO2 <92%
  • Patient on invasive mechanical ventilation
  • Patient with homozygotic sickle cell disease or methemoglobin.
  • Patient receiving a biotherapy as a SoC for COVID-19
  • Patient participating in another drug trial
  • Patient under guardianship or prisoner
  • Patient with a written order for restricted care
  • Patient allergic to peanut or soja
  • Patient under parenteral nutrition (with Mn in composition)

Sites / Locations

  • Santa Casa BHRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo + SoC (N=30)

NanoManganese® + SoC (N=90)

Arm Description

This arm is composed by 30 patients. Placebo: administration of 2 mL twice a day (morning and evening) by depositing 1 mL in the gingivo-jugal groove of each cheek with the graduated pipette. Standard of care

This arm is composed by 90 patients. NanoManganese® + standard of care group: NanoManganese®: administration of 2 mL twice a day (morning and evening) by depositing 1 mL in the gingivo-jugal groove of each cheek with the graduated pipette. Standard of care

Outcomes

Primary Outcome Measures

Change of the PaO2/FiO2 ratio
Change from baseline to D10 of the PaO2/FiO2 ratio in the NanoManganese® + SoC group and in the placebo+ SoC group.

Secondary Outcome Measures

Proportion of patients with PaO2 > 65 mmHg
Proportion of patients with PaO2 > 65 mmHg at D3, at D5 and at D10, measured preferable after IP administration in the morning.
Change of PaO2
Change between baseline and D10 of PaO2
Evolution of respiratory rate over time
Evolution of respiratory rate over time
Proportion of patients with SpO2 ≥ 95%
Proportion of patients with SpO2 ≥ 95% at D3, D5 and at D10,
Change of SpO2
Change between baseline and D10 of SpO2,
Incidence of oxygen use
Duration of oxygen use
Oxygen free days at D15-22 after inclusion
Incidence of noninvasive support (high flow, CPAP, NIV) use
Duration of noninvasive support (high flow, CPAP, NIV) use
Noninvasive support (high flow, CPAP, NIV) free days during follow- up (between D15 and D22 after inclusion
Incidence of invasive mechanical ventilation use,
Duration of invasive mechanical ventilation use
Invasive mechanical ventilation free days during follow-up (between D15 and D22 after inclusion)
Time to improvement of 1 level on seven point ordinal scale
Higher scores indicate a worse outcome - Not hospitalized, no limitation of activities - Not hospitalized, limitation of activities - Hospitalized, not requiring supplemental oxygen - Hospitalized, requiring supplemental oxygen - Hospitalized, on non-invasive ventilation or high flow oxygen devices - Hospitalized, on invasive mechanical ventilation or ECMO - Death
Clinical status assessed by ordinal scale
Proportion of patient transferred in ICU
Description of ICU-free days during follow-up (between D15 and D22 after inclusion)
Overall survival at day 22 and cause of death

Full Information

First Posted
July 7, 2022
Last Updated
July 12, 2022
Sponsor
Medesis Pharma SA
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1. Study Identification

Unique Protocol Identification Number
NCT05451654
Brief Title
NanoMn®_COVID-19 A Prospective, Multicenter, Randomized, Placebo-controlled, Parallel-group, Double-blind Trial to Evaluate the Clinical Efficacy of NanoManganese® on Top of Standard of Care, in Adult Patients With Moderate to Severe Coronavirus Disease 2019 (COVID-19)
Official Title
A Prospective, Multicenter, Randomized, Placebo-controlled, Parallel-group, Double-blind Trial to Evaluate the Clinical Efficacy of NanoManganese® on Top of Standard of Care, in Adult Patients With Moderate to Severe Coronavirus Disease 2019 (COVID-19)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
February 4, 2022 (Actual)
Primary Completion Date
November 2022 (Anticipated)
Study Completion Date
December 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medesis Pharma SA

4. Oversight

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

5. Study Description

Brief Summary
This is a prospective, multicenter, randomized (3:1), placebo- controlled, parallel-group, double-blind trial. Patients will be randomized into two arms of treatment: Placebo + SoC (N=30) NanoManganese® + SoC (N=90) Patients will be treated and followed-up for 10 days: Arterial oxygen partial pressure (PaO2) will be measured at baseline and at days 3, 5 and 10, Oxygen saturation, vital signs including respiration rate, pulse rate, blood pressure and body temperature, disease severity (7-point ordinal scale and NEWS2 score) will be measured at baseline and daily, Hematology and biochemistry measurements will be done at baseline and at day 3, 5 and 10, Pharmacokinetic (Blood Mn concentration) measurements will be done at baseline and at day 3, 5 and 10, Biomarkers will be measured at baseline and at day 3, 5 and 10. At the end of the 10-day treatment period, a follow-up visit will be planned between day 15 and day 22. The following. assessments/examinations will be performed: oxygen saturation, vital signs including respiration rate and body temperature, disease severity (7-point ordinal scale and NEWS2 score), electrocardiogram (ECG), hematology, biochemistry, concomitant therapies, and adverse events.
Detailed Description
120 patients will be enrolled in this study, they will be randomly assigned in 2 arms on a 3:1 ratio, 90 patients in the NanoManganese® + Standard of Care group and 30 patients in the placebo + Standard of Care group. This study will be conducted in Brazil and will be conducted in around 8 investigational sites The investigational products are : Manganese sulfate monohydrate, MnSO4, H2O (NanoManganese®) will be administered using the microemulsion AONYS® technology. The product is mucoadhesive, it sticks to the mucosa of the cheeks on which it will be deposited and will not be swallowed. The placebo (Pharmacopoeia soybean oil) will be administered using the same protocol and the same bottle. Treatments : NanoManganese® + standard of care group: NanoManganese®: administration of 2 mL twice a day (morning and evening) by depositing 1 mL in the gingivo-jugal groove of each cheek with the graduated pipette. Standard of care Placebo + standard of care group: Placebo: administration of 2 mL twice a day (morning and evening) by depositing 1 mL in the gingivo-jugal groove of each cheek with the graduated pipette. Standard of care The treatments will be administered by the nurse. Duration of treatment: 10 days or until hospital discharge or until death.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19 Pandemic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo + SoC (N=30)
Arm Type
Placebo Comparator
Arm Description
This arm is composed by 30 patients. Placebo: administration of 2 mL twice a day (morning and evening) by depositing 1 mL in the gingivo-jugal groove of each cheek with the graduated pipette. Standard of care
Arm Title
NanoManganese® + SoC (N=90)
Arm Type
Experimental
Arm Description
This arm is composed by 90 patients. NanoManganese® + standard of care group: NanoManganese®: administration of 2 mL twice a day (morning and evening) by depositing 1 mL in the gingivo-jugal groove of each cheek with the graduated pipette. Standard of care
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The administration of the treatment consists in a deposit in the gingivo-jugal groove of each cheek with a graduated pipette
Intervention Type
Drug
Intervention Name(s)
Experimental drug
Intervention Description
The administration of the treatment consists in a deposit in the gingivo-jugal groove of each cheek with a graduated pipette
Primary Outcome Measure Information:
Title
Change of the PaO2/FiO2 ratio
Description
Change from baseline to D10 of the PaO2/FiO2 ratio in the NanoManganese® + SoC group and in the placebo+ SoC group.
Time Frame
10 days
Secondary Outcome Measure Information:
Title
Proportion of patients with PaO2 > 65 mmHg
Description
Proportion of patients with PaO2 > 65 mmHg at D3, at D5 and at D10, measured preferable after IP administration in the morning.
Time Frame
10 days
Title
Change of PaO2
Description
Change between baseline and D10 of PaO2
Time Frame
10 days
Title
Evolution of respiratory rate over time
Description
Evolution of respiratory rate over time
Time Frame
10 days
Title
Proportion of patients with SpO2 ≥ 95%
Description
Proportion of patients with SpO2 ≥ 95% at D3, D5 and at D10,
Time Frame
10 days
Title
Change of SpO2
Description
Change between baseline and D10 of SpO2,
Time Frame
10 days
Title
Incidence of oxygen use
Time Frame
10 days
Title
Duration of oxygen use
Time Frame
10 days
Title
Oxygen free days at D15-22 after inclusion
Time Frame
10 days
Title
Incidence of noninvasive support (high flow, CPAP, NIV) use
Time Frame
10 days
Title
Duration of noninvasive support (high flow, CPAP, NIV) use
Time Frame
10 days
Title
Noninvasive support (high flow, CPAP, NIV) free days during follow- up (between D15 and D22 after inclusion
Time Frame
10 days
Title
Incidence of invasive mechanical ventilation use,
Time Frame
10 days
Title
Duration of invasive mechanical ventilation use
Time Frame
10 days
Title
Invasive mechanical ventilation free days during follow-up (between D15 and D22 after inclusion)
Time Frame
10 days
Title
Time to improvement of 1 level on seven point ordinal scale
Description
Higher scores indicate a worse outcome - Not hospitalized, no limitation of activities - Not hospitalized, limitation of activities - Hospitalized, not requiring supplemental oxygen - Hospitalized, requiring supplemental oxygen - Hospitalized, on non-invasive ventilation or high flow oxygen devices - Hospitalized, on invasive mechanical ventilation or ECMO - Death
Time Frame
10 days
Title
Clinical status assessed by ordinal scale
Time Frame
10 days
Title
Proportion of patient transferred in ICU
Time Frame
10 days
Title
Description of ICU-free days during follow-up (between D15 and D22 after inclusion)
Time Frame
10 days
Title
Overall survival at day 22 and cause of death
Time Frame
10 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patient aged ≥ 18 years Patient hospitalized with positive COVID-19, confirmed by a Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) or an antigen test done ≤ 7 days before study entry Patient with at least 1 of the National Institutes of Health COVID- 19 clinical symptoms (Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea) that appeared ≤ 15 days before study entry Patient with a peripheral capillary oxygen saturation (SpO2) < 96%, or with an arterial oxygen partial pressure (PaO2) ≤65 mmHg, at study entry Female patient of childbearing potential must be willing to use an efficient birth control method during the study and until 3 months after IMP administration. A woman is considered to be of childbearing potential if she is post menarche, has not reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus, tubal ligation). The following are acceptable contraceptive methods: - Established use of oral, injected, or implanted hormonal methods of contraception - Intrauterine system or placement of an intrauterine device - Double barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam, gel, film, cream, or suppository - True abstinence [periodic abstinence (e.g., calendar, ovulation, symptothermal, post ovulation methods) and withdrawal are not acceptable methods of contraception] Male patient must be willing to use male contraception (condom) during the study, avoid donating semen during study and until 3 months after last dose of IMP administration. Patient must sign the informed consent form Patient who have or have not been vaccinated for COVID-19 (1, 2, 3 or 4 shots) can enter the study Exclusion Criteria: Refusal to participate expressed by patient Pregnancy or breast-feeding Anticipated transfer to another hospital, which is not a study site within 72 hours Contraindication to Manganese supplementation Patient under Long-term oxygen therapy or invasive ventilation prior to COVID-19 infection Patient requiring Continuous Positive Airway Pressure (CPAP), high flow, or Non-Invasive Ventilation (NIV) and a SpO2 <92% Patient on invasive mechanical ventilation Patient with homozygotic sickle cell disease or methemoglobin. Patient receiving a biotherapy as a SoC for COVID-19 Patient participating in another drug trial Patient under guardianship or prisoner Patient with a written order for restricted care Patient allergic to peanut or soja Patient under parenteral nutrition (with Mn in composition)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Solène Guilliot
Phone
+33 6 19 50 48 01
Email
solene.guilliot@medesispharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Guilliot
Facility Information:
Facility Name
Santa Casa BH
City
Belo Horizonte
State/Province
Santa Efigenia
ZIP/Postal Code
30150-221
Country
Brazil
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Claudio Dornas, Doctor
Phone
+55 31 3238-8975

12. IPD Sharing Statement

Learn more about this trial

NanoMn®_COVID-19 A Prospective, Multicenter, Randomized, Placebo-controlled, Parallel-group, Double-blind Trial to Evaluate the Clinical Efficacy of NanoManganese® on Top of Standard of Care, in Adult Patients With Moderate to Severe Coronavirus Disease 2019 (COVID-19)

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