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Open Multicentre Study of the Safety and Efficacy Against COVID-19 of Nirmatrelvir/Ritonavir in the Adult Population

Primary Purpose

COVID-19

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
nirmatrelvir/ritonavir
Standard of care
Sponsored by
Promomed, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring Nirmatrelvir/ritonavir, Skayvira, SARS-CoV-2

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Availability of PIS Informed Consent Form signed and dated by a patient. Male and female subjects aged 18 to 80 inclusive as of the time of signing the PIS Informed Consent Form. Confirmed COVID-19 at screening stage: positive for SARS-CoV-2 RNA laboratory test with nucleic acid amplification techniques (NAAT) or SARS-CoV-2 antigen with immunochromatographic assay. SARS-CoV-2 test results obtained up to 5 days prior to randomization may be taken into account upon availability of supporting documentation. Mild or moderate SARS-CoV-2 induced infection. At least one of the following COVID-19 symptoms as of the time of screening and randomization: nasal congestion or rhinitis; sore throat; dyspnoea or respiratory distress on exertion; cough; tiredness; pain in muscles or throughout the body; headache; chills; fever (body temperature > 38 ⁰С); nausea; vomiting; diarrhoea; anosmia; ageusia. Disease onset (first symptom) within not more than 5 days prior to randomization The patient agrees and is able to take oral drug products. Patient's consent to use reliable contraception methods during the entire study and for 3 weeks after the end of the study. Reliable contraception methods are: sexual abstinence, the use of a condom combined with a spermicidal agent. Female subjects incapable of bearing children (history: hysterectomy, tubal ligation, infertility, menopause for more than 2 years), as well as male subjects with infertility or a history of vasectomy may participate in the study. Exclusion Criteria: Hypersensitivity to the study drug components. Lactase deficiency, lactose intolerance, glucose-galactose malabsorption. Use of direct-acting antiviral drugs within 10 days prior to screening. The use of drugs at the time of screening whose clearance is highly dependent on the CYP3A isoenzyme, or which are strong inducers of CYP3A (for more information, see the section "Unauthorized pharmaceuticals"). Necessity to use unauthorized pharmaceuticals. The need for oxygen therapy at the time of screening. Hospitalization required at time of screening, or hospitalization expected to be required for COVID-19 within 48 hours of randomization, excluding hospitalization to the observation facility for social reasons (e. g., living in a hostel, cohabiting with people, including those with risk factors for aggravated COVID-19, who, after contact with the patient, have a negative result for the SARS-CoV-2 RNA/antigen, etc.). Severe and extremely severe disease signs as of the time of screening. Vaccination within less than 4 weeks prior to screening. Possible or confirmed moderate COVID-19 within 6 months prior to screening. Possible or confirmed history of severe or very severe COVID-19. Patients with moderate to severe renal insufficiency (estimated glomerular filtration rate (GFR) < 60 ml/min/1.73 m2 per CKD-EPI formula) or receiving renal replacement therapy at the time of screening. Severe liver failure (class C per Child-Pugh) at the time of screening or elevated ALT and/or AST levels of ≥ 2.5 UNL and/or elevated total bilirubin levels of ≥ 2 UNL (≥ 3 UNL with Gilbert's syndrome) in past medical history (within 6 months prior to screening). Positive test result for HIV, syphilis, hepatitis B and/or C at the time of screening. Alcohol, pharmacological and/or drug dependence (history and/or at the time of screening). Schizophrenia, schizoaffective disorder, bipolar disorder, or other psychiatric disorder (history or suspected) at the time of screening. Any history data that may complicate, in the opinion of the investigator, interpretation of the study results or create additional risk for the patient due to his/her participation in the study. Unwillingness or inability of a patient to comply with the Protocol procedures (in the opinion of the investigator). Pregnant or lactating women, or women planning a pregnancy. Participation in another clinical study within 3 months prior to enrolment in the present study. Other conditions that prevent the patient from inclusion in the study.

Sites / Locations

  • Regional Budgetary Healthcare Institution "Ivanovo Clinical Hospital"
  • Kirov State Medical University of Ministry of Health of the Russian Federation
  • State Budgetary Healthcare Institution City Clinical Hospital named after S. I. Spasokukotskiy of Moscow Healthcare Department
  • Regional Clinic Hospital of Ryazan
  • Ryazan State Medical University named after academician I.P. Pavlov of Ministry of Health of the Russian Federation
  • Avrora MedFort, LLC
  • OrCli Hospital, LLC
  • Ogarev Mordova State University of Ministry of Health of the Russian Federation
  • Regional State Budgetary Healthcare Institution "Clinical Hospital No. 1"
  • Smolensk State Medical University of Ministry of Health of the Russian Federation
  • State Budgetary Healthcare Institution of the Yaroslavl Oblast "Clinical Hospital No.3"

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

JTBC00201 (nirmatrelvir/ritonavir, Skayvira)

Standard of care

Arm Description

Group 1 (n=132) received the study drug nirmatrelvir/ritonavir, tablets 300/100 mg, 2 times a day with 12 ±2 hours interval for 5 days in the setting of pathogenetic and symptomatic therapy provided by Interim Guidelines for the prevention, diagnosis and treatment of COVID-19 validated of the time of the study

Group 2 (n=132) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the Interim Guidelines for the prevention, diagnosis and treatment of COVID-19 validated of the time of the study

Outcomes

Primary Outcome Measures

Prevalence of patients with COVID-19 severity increase as compared from baseline to Visit 4
Patient severity score at screening and during treatment was determined as per сurrent clinical Guidelines

Secondary Outcome Measures

Clinical status changes according to the WHO Ordinal Scale ranges from 0 (uninfected) to 8 (dead)
The score as per the categorical ordinal clinical improvement WHO scale
Clinical status deterioration incidence according to the WHO Ordinal Scale ranges from 0 (uninfected) to 8 (dead) by ≥ 1 category
The proportion of patients with clinical status deterioration as per the categorical ordinal clinical improvement on the WHO scale of ≥1 category
Achievement of clinical status 0 according to the WHO Ordinal Scale ranges from 0 (uninfected) to 8 (dead)
The proportion of patients with category 0 as per the categorical ordinal clinical improvement on the WHO scale
Prevalence of patients with negative SARS-CoV-2 RNA test
The proportion of patients with negative SARS-CoV-2 RNA test
Symptoms intensity score as per COVID-19 Related Symptom Scale
The proportion of patients with Symptoms intensity score as per COVID-19 Major Symptom Rating Scale. Ranges for each symptom: 0 points (no symptoms) - 3 points (severe)

Full Information

First Posted
October 31, 2022
Last Updated
April 6, 2023
Sponsor
Promomed, LLC
Collaborators
Sponsor GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT05601167
Brief Title
Open Multicentre Study of the Safety and Efficacy Against COVID-19 of Nirmatrelvir/Ritonavir in the Adult Population
Official Title
Open Multicentre Study for Assessment of the Safety and Efficacy Against COVID-19 of the Drug JTBC00201 (PROMOMED RUS LLC, Russia) in the Adult Population
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
February 17, 2021 (Actual)
Primary Completion Date
June 1, 2022 (Actual)
Study Completion Date
June 1, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Promomed, LLC
Collaborators
Sponsor GmbH

4. Oversight

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

5. Study Description

Brief Summary
This is open-labe randomized multicenter comparative Phase III study conducted in 11 medical facilities. The objective of the study is to evaluate efficacy and safety of the drug JTBC00201, tablets in the setting of pathogenetic and symptomatic therapy as compared to standard therapy in outpatients with COVID-19.
Detailed Description
Upon signing the informed consent form and screening, 264 eligible outpatients with mild or moderate COVID-19 were randomized at a 1:1 ratio to receive either nirmatrelvir/ritonavir tablets, 300/100 mg, 2 times a day with 12 ±2 hours interval for 5 days, or SOC

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
Nirmatrelvir/ritonavir, Skayvira, SARS-CoV-2

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
264 (Actual)

8. Arms, Groups, and Interventions

Arm Title
JTBC00201 (nirmatrelvir/ritonavir, Skayvira)
Arm Type
Experimental
Arm Description
Group 1 (n=132) received the study drug nirmatrelvir/ritonavir, tablets 300/100 mg, 2 times a day with 12 ±2 hours interval for 5 days in the setting of pathogenetic and symptomatic therapy provided by Interim Guidelines for the prevention, diagnosis and treatment of COVID-19 validated of the time of the study
Arm Title
Standard of care
Arm Type
Active Comparator
Arm Description
Group 2 (n=132) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the Interim Guidelines for the prevention, diagnosis and treatment of COVID-19 validated of the time of the study
Intervention Type
Drug
Intervention Name(s)
nirmatrelvir/ritonavir
Other Intervention Name(s)
JTBC00201
Intervention Description
Tablets 300/100mg, 2 times a day with 12 ±2 hours interval for 5 days
Intervention Type
Drug
Intervention Name(s)
Standard of care
Intervention Description
The administration of 'Standard of care' drugs was done according to the regimen recommended in the 'COVID-19 TreatmentGuidelines' validated at the time of the study
Primary Outcome Measure Information:
Title
Prevalence of patients with COVID-19 severity increase as compared from baseline to Visit 4
Description
Patient severity score at screening and during treatment was determined as per сurrent clinical Guidelines
Time Frame
From baseline to Visit 4 (days 14-15)
Secondary Outcome Measure Information:
Title
Clinical status changes according to the WHO Ordinal Scale ranges from 0 (uninfected) to 8 (dead)
Description
The score as per the categorical ordinal clinical improvement WHO scale
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15), 5 (days 21±1), 6 (study completion, day 28±1)
Title
Clinical status deterioration incidence according to the WHO Ordinal Scale ranges from 0 (uninfected) to 8 (dead) by ≥ 1 category
Description
The proportion of patients with clinical status deterioration as per the categorical ordinal clinical improvement on the WHO scale of ≥1 category
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15)
Title
Achievement of clinical status 0 according to the WHO Ordinal Scale ranges from 0 (uninfected) to 8 (dead)
Description
The proportion of patients with category 0 as per the categorical ordinal clinical improvement on the WHO scale
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15)
Title
Prevalence of patients with negative SARS-CoV-2 RNA test
Description
The proportion of patients with negative SARS-CoV-2 RNA test
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15)
Title
Symptoms intensity score as per COVID-19 Related Symptom Scale
Description
The proportion of patients with Symptoms intensity score as per COVID-19 Major Symptom Rating Scale. Ranges for each symptom: 0 points (no symptoms) - 3 points (severe)
Time Frame
From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15), 5 (days 21±1), 6 (study completion, day 28±1)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Availability of PIS Informed Consent Form signed and dated by a patient. Male and female subjects aged 18 to 80 inclusive as of the time of signing the PIS Informed Consent Form. Confirmed COVID-19 at screening stage: positive for SARS-CoV-2 RNA laboratory test with nucleic acid amplification techniques (NAAT) or SARS-CoV-2 antigen with immunochromatographic assay. SARS-CoV-2 test results obtained up to 5 days prior to randomization may be taken into account upon availability of supporting documentation. Mild or moderate SARS-CoV-2 induced infection. At least one of the following COVID-19 symptoms as of the time of screening and randomization: nasal congestion or rhinitis; sore throat; dyspnoea or respiratory distress on exertion; cough; tiredness; pain in muscles or throughout the body; headache; chills; fever (body temperature > 38 ⁰С); nausea; vomiting; diarrhoea; anosmia; ageusia. Disease onset (first symptom) within not more than 5 days prior to randomization The patient agrees and is able to take oral drug products. Patient's consent to use reliable contraception methods during the entire study and for 3 weeks after the end of the study. Reliable contraception methods are: sexual abstinence, the use of a condom combined with a spermicidal agent. Female subjects incapable of bearing children (history: hysterectomy, tubal ligation, infertility, menopause for more than 2 years), as well as male subjects with infertility or a history of vasectomy may participate in the study. Exclusion Criteria: Hypersensitivity to the study drug components. Lactase deficiency, lactose intolerance, glucose-galactose malabsorption. Use of direct-acting antiviral drugs within 10 days prior to screening. The use of drugs at the time of screening whose clearance is highly dependent on the CYP3A isoenzyme, or which are strong inducers of CYP3A (for more information, see the section "Unauthorized pharmaceuticals"). Necessity to use unauthorized pharmaceuticals. The need for oxygen therapy at the time of screening. Hospitalization required at time of screening, or hospitalization expected to be required for COVID-19 within 48 hours of randomization, excluding hospitalization to the observation facility for social reasons (e. g., living in a hostel, cohabiting with people, including those with risk factors for aggravated COVID-19, who, after contact with the patient, have a negative result for the SARS-CoV-2 RNA/antigen, etc.). Severe and extremely severe disease signs as of the time of screening. Vaccination within less than 4 weeks prior to screening. Possible or confirmed moderate COVID-19 within 6 months prior to screening. Possible or confirmed history of severe or very severe COVID-19. Patients with moderate to severe renal insufficiency (estimated glomerular filtration rate (GFR) < 60 ml/min/1.73 m2 per CKD-EPI formula) or receiving renal replacement therapy at the time of screening. Severe liver failure (class C per Child-Pugh) at the time of screening or elevated ALT and/or AST levels of ≥ 2.5 UNL and/or elevated total bilirubin levels of ≥ 2 UNL (≥ 3 UNL with Gilbert's syndrome) in past medical history (within 6 months prior to screening). Positive test result for HIV, syphilis, hepatitis B and/or C at the time of screening. Alcohol, pharmacological and/or drug dependence (history and/or at the time of screening). Schizophrenia, schizoaffective disorder, bipolar disorder, or other psychiatric disorder (history or suspected) at the time of screening. Any history data that may complicate, in the opinion of the investigator, interpretation of the study results or create additional risk for the patient due to his/her participation in the study. Unwillingness or inability of a patient to comply with the Protocol procedures (in the opinion of the investigator). Pregnant or lactating women, or women planning a pregnancy. Participation in another clinical study within 3 months prior to enrolment in the present study. Other conditions that prevent the patient from inclusion in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dmitriy Pushkar, Academician
Organizational Affiliation
Moscow State Clinical Hospital №50
Official's Role
Principal Investigator
Facility Information:
Facility Name
Regional Budgetary Healthcare Institution "Ivanovo Clinical Hospital"
City
Ivanovo
Country
Russian Federation
Facility Name
Kirov State Medical University of Ministry of Health of the Russian Federation
City
Kirov
Country
Russian Federation
Facility Name
State Budgetary Healthcare Institution City Clinical Hospital named after S. I. Spasokukotskiy of Moscow Healthcare Department
City
Moscow
Country
Russian Federation
Facility Name
Regional Clinic Hospital of Ryazan
City
Ryazan'
Country
Russian Federation
Facility Name
Ryazan State Medical University named after academician I.P. Pavlov of Ministry of Health of the Russian Federation
City
Ryazan'
Country
Russian Federation
Facility Name
Avrora MedFort, LLC
City
Saint Petersburg
Country
Russian Federation
Facility Name
OrCli Hospital, LLC
City
Saint Petersburg
Country
Russian Federation
Facility Name
Ogarev Mordova State University of Ministry of Health of the Russian Federation
City
Saransk
Country
Russian Federation
Facility Name
Regional State Budgetary Healthcare Institution "Clinical Hospital No. 1"
City
Smolensk
Country
Russian Federation
Facility Name
Smolensk State Medical University of Ministry of Health of the Russian Federation
City
Smolensk
Country
Russian Federation
Facility Name
State Budgetary Healthcare Institution of the Yaroslavl Oblast "Clinical Hospital No.3"
City
Yaroslavl
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
Citation
L.A. Balykova, N.M. Selezneva, E.I. Gorshenina, O.I. Shepeleva, N.V. Kirichenko, E.N. Simakina, K.B. Kolontarev, D.Yu. Pushkar, D.N. Zemskov, K.Ya. Zaslavskaya, S.M. Noskov, A.V. Taganov, P.A. Bely. modern directed antiviral COVID-19 therapy: results of multicenter clinical effectiveness and safety study of fixed nirmatrelvir+ritonavir combination. Pharmacy & Pharmacology. 2022;10(4):. DOI: 10.19163/2307-9266- 2022-10-4-
Results Reference
background
Links:
URL
https://cyberleninka.ru/article/n/sovremennaya-napravlennaya-protivovirusnaya-terapiya-covid-19-rezultaty-mnogotsentrovogo-klinicheskogo-issledovaniya-effektivnosti
Description
Cyberleninka is an open access scientific electronic library

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Open Multicentre Study of the Safety and Efficacy Against COVID-19 of Nirmatrelvir/Ritonavir in the Adult Population

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