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Oral Favipiravir Compared to Placebo in Subjects With Mild COVID-19

Primary Purpose

Sars-CoV2, COVID-19

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Favipiravir
Placebo
Standard of care treatment
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sars-CoV2

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of COVID-19 disease:

    • If symptomatic, presence of mild to moderate symptoms without signs of respiratory distress, with positive for SARS-CoV-2 diagnostic assay within 72 hours prior to.informed consent.
    • If asymptomatic, initial diagnosis obtained no more than 72 hours prior to informed consent
  • Subject agrees to maintain home or other quarantine as recommended by the study physician, except to visit the study site as required by the protocol
  • Members of the same household may participate in the study as long as the inclusion and exclusion criteria are met
  • Males must be sterile, OR agree not to donate semen AND agree to strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication
  • Females must be unable to bear children, OR ensure that their male partner is incapable of fathering a child, OR, if of childbearing potential will strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication
  • Females must agree to stop breast-feeding prior to first dose of study drug and through seven days after completing therapy
  • Females must have a negative pregnancy test at screening
  • Participant agrees to maintain home or other quarantine as recommended by the study physician, except to visit the study site as required by the protocol

Exclusion Criteria:

  • Concomitant bacterial respiratory infection documented by respiratory culture. NOTE: Subjects on empirical antibiotic treatment for possible but unproven bacterial pneumonia, but who are positive for SARS-CoV-2, are allowed in the study (will be randomized to the same treatment to maintain blinding).
  • History of abnormal uric acid metabolism.
  • History of hypersensitivity to an anti-viral nucleoside-analog drug targeting a viral RNA polymerase.
  • Abnormal laboratory test results at screening:
  • Use of adrenocorticosteroids (except topical or inhaled preparations or oral preparations equivalent to or less than 10 mg of oral prednisone) or immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer drugs, interleukins, interleukin antagonists or interleukin receptor blockers). NOTE: Treatment of study participants following institutional COVID-19 treatment policies or guidelines, including the use of immunomodulatory medications, is permitted. This excludes treatment with agents that have the potential for direct antiviral activity, including convalescent plasma and NO, and co-enrollment into other clinical studies that evaluate investigational agents for COVID-19.
  • Serious chronic disease (e.g., human immunodeficiency virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or moderate or severe hepatic insufficiency).
  • Previously received favipiravir within the past 30 days.
  • Advanced kidney disease
  • Advanced liver disease
  • History of alcohol or drug abuse in the previous two years.
  • Psychiatric illness that is not well controlled (defined as stable on a regimen for more than one year).
  • Taken another investigational drug within the past 30 days.
  • Seemed by the Investigator to be ineligible for any reason.

Sites / Locations

  • Stanford University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Favipiravir

Placebo

Arm Description

In addition to SOC, participants will receive favipiravir for 10 days, and be evaluated for health outcomes through day 28.

In addition to SOC, participants will receive placebo to match favipiravir for 10 days, and be evaluated for health outcomes through day 28.

Outcomes

Primary Outcome Measures

Time Until Cessation of Oral Shedding of SARS-CoV-2 Virus
Time in days from randomization to the first two negative results of nasal and/or oropharyngeal swab.

Secondary Outcome Measures

Sars-CoV-2 Viral Load
Viral load (nucleic acid) will be assessed by RT-PCR Ct over time. Cycle threshold (Ct) denotes how many PCR cycles are required before the SARS-CoV-2 viral RNA reached a detectable level. Higher Ct values correspond to lower viral copy numbers. For reference, Ct values of 20 correspond to ~2.12 x 106 viral copies per milliliter, while a Ct value of 40 is undetectable and is considered the lower limit of detection of this RT-PCR test for SARS-CoV-2.
Count of Participants With Clinical Worsening of COVID-19 Disease
Clinical worsening is reported as the number of participants with hospitalization or emergency department (ED) visits.
Count of Participants With Development of SARS-CoV-2 Antibodies
Time Until Cessation of Symptoms
Time until cessation of symptoms is reported as days until initial resolution and sustained resolution of symptoms.
Count of Participant With Absence of Development of Any Symptoms
This outcome will be assessed in patient who are asymptomatic of COVID-19 infection at the time of enrollment
Cmax of Favipiravir
Cmax is a pharmacokinetic parameter that measures the maximum concentration of drug in plasma.
Cmin of Favipiravir
Cmin is a pharmacokinetic parameter that measures the minimum concentration of drug in plasma.

Full Information

First Posted
April 10, 2020
Last Updated
July 6, 2022
Sponsor
Stanford University
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1. Study Identification

Unique Protocol Identification Number
NCT04346628
Brief Title
Oral Favipiravir Compared to Placebo in Subjects With Mild COVID-19
Official Title
A Phase 2 Randomized, Double Blinded, Placebo Controlled Study of Oral Favipiravir Compared to Standard Supportive Care in Subjects With Mild or Asymptomatic COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
July 12, 2020 (Actual)
Primary Completion Date
April 16, 2021 (Actual)
Study Completion Date
April 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stanford University

4. Oversight

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

5. Study Description

Brief Summary
The objective of this study is to evaluate the efficacy of oral favipiravir plus standard of care treatment (SOC) compared with placebo plus SOC in reducing the duration of shedding of SARS-CoV2 virus in patients with mild or asymptomatic COVID-19.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sars-CoV2, COVID-19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
149 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Favipiravir
Arm Type
Experimental
Arm Description
In addition to SOC, participants will receive favipiravir for 10 days, and be evaluated for health outcomes through day 28.
Arm Title
Placebo
Arm Type
Active Comparator
Arm Description
In addition to SOC, participants will receive placebo to match favipiravir for 10 days, and be evaluated for health outcomes through day 28.
Intervention Type
Drug
Intervention Name(s)
Favipiravir
Intervention Description
Favipiravir administered orally, 1800 mg on the first dose (day 1) followed by 800 mg twice daily for the next 9 days (days 2-10).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo to match favipiravir administered orally through day 10.
Intervention Type
Other
Intervention Name(s)
Standard of care treatment
Intervention Description
Standard of care treatment for COVID-19 infection
Primary Outcome Measure Information:
Title
Time Until Cessation of Oral Shedding of SARS-CoV-2 Virus
Description
Time in days from randomization to the first two negative results of nasal and/or oropharyngeal swab.
Time Frame
Up to 28 days
Secondary Outcome Measure Information:
Title
Sars-CoV-2 Viral Load
Description
Viral load (nucleic acid) will be assessed by RT-PCR Ct over time. Cycle threshold (Ct) denotes how many PCR cycles are required before the SARS-CoV-2 viral RNA reached a detectable level. Higher Ct values correspond to lower viral copy numbers. For reference, Ct values of 20 correspond to ~2.12 x 106 viral copies per milliliter, while a Ct value of 40 is undetectable and is considered the lower limit of detection of this RT-PCR test for SARS-CoV-2.
Time Frame
Up to 28 days
Title
Count of Participants With Clinical Worsening of COVID-19 Disease
Description
Clinical worsening is reported as the number of participants with hospitalization or emergency department (ED) visits.
Time Frame
Up to 28 days
Title
Count of Participants With Development of SARS-CoV-2 Antibodies
Time Frame
Up to 28 days
Title
Time Until Cessation of Symptoms
Description
Time until cessation of symptoms is reported as days until initial resolution and sustained resolution of symptoms.
Time Frame
Up to 28 days
Title
Count of Participant With Absence of Development of Any Symptoms
Description
This outcome will be assessed in patient who are asymptomatic of COVID-19 infection at the time of enrollment
Time Frame
Up to 28 days
Title
Cmax of Favipiravir
Description
Cmax is a pharmacokinetic parameter that measures the maximum concentration of drug in plasma.
Time Frame
Days 1 and 10 (samples taken 30 minutes prior to and 1 hour following favipiravir administration)
Title
Cmin of Favipiravir
Description
Cmin is a pharmacokinetic parameter that measures the minimum concentration of drug in plasma.
Time Frame
Days 1 and 10 (samples taken 30 minutes prior to and 1 hour following favipiravir administration)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of COVID-19 disease: If symptomatic, presence of mild to moderate symptoms without signs of respiratory distress, with positive for SARS-CoV-2 diagnostic assay within 72 hours prior to.informed consent. If asymptomatic, initial diagnosis obtained no more than 72 hours prior to informed consent Subject agrees to maintain home or other quarantine as recommended by the study physician, except to visit the study site as required by the protocol Members of the same household may participate in the study as long as the inclusion and exclusion criteria are met Males must be sterile, OR agree not to donate semen AND agree to strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication Females must be unable to bear children, OR ensure that their male partner is incapable of fathering a child, OR, if of childbearing potential will strictly adhere to contraceptive measures during the study and for seven days following the last dose of study medication Females must agree to stop breast-feeding prior to first dose of study drug and through seven days after completing therapy Females must have a negative pregnancy test at screening Participant agrees to maintain home or other quarantine as recommended by the study physician, except to visit the study site as required by the protocol Exclusion Criteria: Concomitant bacterial respiratory infection documented by respiratory culture. NOTE: Subjects on empirical antibiotic treatment for possible but unproven bacterial pneumonia, but who are positive for SARS-CoV-2, are allowed in the study (will be randomized to the same treatment to maintain blinding). History of abnormal uric acid metabolism. History of hypersensitivity to an anti-viral nucleoside-analog drug targeting a viral RNA polymerase. Abnormal laboratory test results at screening: Use of adrenocorticosteroids (except topical or inhaled preparations or oral preparations equivalent to or less than 10 mg of oral prednisone) or immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer drugs, interleukins, interleukin antagonists or interleukin receptor blockers). NOTE: Treatment of study participants following institutional COVID-19 treatment policies or guidelines, including the use of immunomodulatory medications, is permitted. This excludes treatment with agents that have the potential for direct antiviral activity, including convalescent plasma and NO, and co-enrollment into other clinical studies that evaluate investigational agents for COVID-19. Serious chronic disease (e.g., human immunodeficiency virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or moderate or severe hepatic insufficiency). Previously received favipiravir within the past 30 days. Advanced kidney disease Advanced liver disease History of alcohol or drug abuse in the previous two years. Psychiatric illness that is not well controlled (defined as stable on a regimen for more than one year). Taken another investigational drug within the past 30 days. Seemed by the Investigator to be ineligible for any reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yvonne (Bonnie) A Maldonado, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No current plan to share individual participant data (IPD).
Citations:
PubMed Identifier
35446944
Citation
Holubar M, Subramanian A, Purington N, Hedlin H, Bunning B, Walter KS, Bonilla H, Boumis A, Chen M, Clinton K, Dewhurst L, Epstein C, Jagannathan P, Kaszynski RH, Panu L, Parsonnet J, Ponder EL, Quintero O, Sefton E, Singh U, Soberanis L, Truong H, Andrews JR, Desai M, Khosla C, Maldonado Y. Favipiravir for Treatment of Outpatients With Asymptomatic or Uncomplicated Coronavirus Disease 2019: A Double-Blind, Randomized, Placebo-Controlled, Phase 2 Trial. Clin Infect Dis. 2022 Nov 30;75(11):1883-1892. doi: 10.1093/cid/ciac312.
Results Reference
result
PubMed Identifier
33624010
Citation
Jacobson KB, Rao M, Bonilla H, Subramanian A, Hack I, Madrigal M, Singh U, Jagannathan P, Grant P. Patients With Uncomplicated Coronavirus Disease 2019 (COVID-19) Have Long-Term Persistent Symptoms and Functional Impairment Similar to Patients with Severe COVID-19: A Cautionary Tale During a Global Pandemic. Clin Infect Dis. 2021 Aug 2;73(3):e826-e829. doi: 10.1093/cid/ciab103.
Results Reference
derived

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Oral Favipiravir Compared to Placebo in Subjects With Mild COVID-19

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