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Presatovir in Hematopoietic Cell Transplant Recipients With Respiratory Syncytial Virus Infection of the Upper Respiratory Tract

Primary Purpose

Respiratory Syncytial Virus

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Presatovir
Placebo
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Respiratory Syncytial Virus focused on measuring Respiratory Syncytial Virus (RSV), Antiviral, Hematopoietic Cell Transplant (HCT), Upper respiratory tract infection

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Received an autologous or allogeneic HCT using any conditioning regimen
  • Documented to be RSV-positive as determined by local testing (eg, polymerase chain reaction, direct fluorescence antibody, respiratory viral panel assay, or culture) using an upper respiratory tract sample collected ≤ 6 days prior to Day 1
  • New onset of at least 1 of the following respiratory symptoms for ≤ 7 days prior to Day 1: nasal congestion, runny nose, cough, or sore throat, or worsening of one of these chronic (associated with a previously existing diagnosis, eg, chronic rhinorrhea, seasonal allergies, chronic lung disease) respiratory symptoms ≤ 7 days prior to Day 1
  • No evidence of new abnormalities consistent with lower respiratory tract infection (LRTI) on a chest X-ray relative to the most recent chest X-ray, as determined by the local radiologist. If a chest X-ray is not available or was not obtained during standard care < 48 hours prior to screening, a chest X-ray must be obtained for screening
  • O2 saturation ≥ 92% on room air
  • An informed consent document signed and dated by the participant or a legal guardian of the participant and the investigator or his/her designee
  • A negative urine or serum pregnancy test is required for female participants (unless surgically sterile or greater than two years post-menopausal)
  • Male and female participants of childbearing potential must agree to contraceptive requirements as described in the study protocol
  • Willingness to complete necessary study procedures and have available a working telephone or email

Exclusion Criteria:

Related to concomitant or previous medication use:

  • Use of non-marketed (according to region) investigational agents within 30 days, OR use of any monoclonal anti-RSV antibodies within 4 months or 5 half-lives of screening, whichever is longer, OR use of any investigational RSV vaccines after HCT

Related to medical history:

  • Pregnant, breastfeeding, or lactating females
  • Unable to tolerate nasal sampling required for this study, as determined by the investigator
  • Known history of HIV/AIDS with a CD4 count <200 cells/μL within the last month
  • History of drug and/or alcohol abuse that, in the opinion of the investigator, may prevent adherence to study activities

Related to medical condition at screening:

  • Documented to be positive for other respiratory viruses (limited to influenza, parainfluenza, human rhinovirus, adenovirus, or human metapneumovirus, or coronavirus) within 7 days prior to the screening visit, as determined by local testing (additional testing is not required)
  • Clinically significant bacteremia or fungemia within 7 days prior to screening that has not been adequately treated, as determined by the investigator
  • Clinically significant bacterial, fungal, or viral pneumonia within 2 weeks prior to screening that has not been adequately treated, as determined by the investigator
  • Excessive nausea/vomiting at screening, as determined by the investigator, or an inability to swallow pills that precludes oral administration of the investigational medical product (for participants without an nasogastric tube in place)
  • Any condition which, in the opinion of the investigator, would prevent full participation in this trial or would interfere with the evaluation of the trial endpoints

Related to laboratory results:

  • Creatinine clearance < 30 mL/min (calculated using the Cockcroft-Gault method)
  • Clinically significant aspartate aminotransferase/alanine aminotransferase, as determined by the investigator
  • Clinically significant total bilirubin, as determined by the investigator

Sites / Locations

  • Mayo Clinic Arizona
  • City of Hope
  • UCLA David Geffen School of Medicine
  • Stanford University
  • Emory University
  • NorthSide Medical Center
  • Northwestern University
  • University of Chicago
  • Loyola University
  • John Hopkins
  • Dana Farber Cancer Institute
  • University of Massachusetts Memorial Cancer Center
  • University of Michigan
  • Wayne State University
  • University of Minnesota
  • Washington University
  • Memorial Sloan Kettering
  • New York Presbyterian Hospital Cornell Medical Center
  • Duke University
  • University Hospital Case Medical
  • Oregon Health Sciences University
  • Vanderbilt University Medical Center
  • MD Anderson Cancer Center
  • Texas Transplant Institute (SCRI)
  • University of Utah
  • Fred Hutchison Cancer Research Center
  • Medical College of Wisconsin
  • Westmead Hospital
  • Royal Brisbane & Women's Hospital
  • Royal Melbourne Hospital
  • Hospital de Clínicas de Porto Alegre
  • Hospital Israelita Albert Einstein
  • Hospital Universitario USP
  • Fundacao Faculdade Regional Medicina de Sao Jose do Rio Preto
  • Fundação Antonio Prudente - Hospital do Câncer AC Camargo
  • Hospital Santa Marcelina
  • Instituto Brasileiro de Controle do Câncer-IBCC
  • Hopital Maisonneuve-Rosemont
  • Tom Baker Cancer Centre
  • CHU de Bordeaux
  • Hopital Saint-Louis, APHP
  • Hopital Foch
  • Institut Universitaire du Cancer Oncopole
  • Universitatsklinikum Wurzburg
  • Soroka Medical Center
  • Rambam Medical Center
  • Hadassah Medical Center
  • Rabin Medical Center
  • Chaim Sheba Medical Center
  • Tel Aviv Sourasky Medical Center
  • Asan Medical Center
  • Samsung Medical Center
  • Seoul National University Hospital
  • Seoul Saint Mary's Hospital
  • Severance Hospital, Yonsei University Health System
  • VUmc cancer center
  • Erasmus Medical Center (Rotterdam)
  • Singapore General Hospital
  • UMC National University Health System
  • Hospital universitario Virgen del Rocio
  • Karolinska Institutet
  • University Clinic Basel
  • Kaohsiung Medical University Chung-Ho Memorial Hospital
  • China Medical University Hospital
  • National Taiwan University Hospital
  • Chang Gung Medical Foundation-LinKou Branch
  • Leeds Teaching Hospitals Trust
  • King's College Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Presatovir

Placebo

Arm Description

Participants will receive presatovir on Days 1, 5, 9, 13, and 17, with follow-up visits through Day 28, and may continue in an optional extended monitoring phase with visits through Day 56.

Participants will receive placebo on Days 1, 5, 9, 13, and 17, with follow-up visits through Day 28, and may continue in an optional extended monitoring phase with visits through Day 56.

Outcomes

Primary Outcome Measures

Time-Weighted Average Change in Nasal Respiratory Syncytial Virus (RSV ) Viral Load From Baseline (Day 1) to Day 9
The time-weighted average change, often referred to as the DAVG, provides the average viral burden change from baseline. The mean values presented were calculated using the ANCOVA model and are adjusted for baseline value and stratification factor.
Percentage of Participants Who Developed a Lower Respiratory Tract Complication
A Lower Respiratory Tract Complication (LRTC) was defined as one of the below as determined by the adjudication committee: Primary RSV lower respiratory tract infection (LRTI) Secondary bacterial LRTI LRTI due to unusual pathogens Lower respiratory tract complication of unknown etiology

Secondary Outcome Measures

Percentage of Participants Who Developed Respiratory Failure (of Any Cause) Requiring Mechanical Ventilation (Invasive or Noninvasive) or All-cause Mortality
Participants were considered to have an event if either condition is met: Participant develops a respiratory failure (of any cause) requiring mechanical ventilation (invasive or noninvasive) or; Participant dies prior to or on Day 28

Full Information

First Posted
September 29, 2014
Last Updated
July 10, 2018
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT02254408
Brief Title
Presatovir in Hematopoietic Cell Transplant Recipients With Respiratory Syncytial Virus Infection of the Upper Respiratory Tract
Official Title
A Phase 2b, Randomized, Double-Blind, Placebo-Controlled Multi-Center Study Evaluating Antiviral Effects, Pharmacokinetics, Safety, and Tolerability of GS-5806 in Hematopoietic Cell Transplant (HCT) Recipients With Respiratory Syncytial Virus (RSV) Infection of the Upper Respiratory Tract
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
January 23, 2015 (Actual)
Primary Completion Date
July 14, 2017 (Actual)
Study Completion Date
July 14, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

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
The primary objective of this study is to evaluate the effect of presatovir on respiratory syncytial virus (RSV) viral load in autologous or allogeneic hematopoietic cell transplant (HCT) recipients with an acute RSV upper respiratory tract infection (URTI), the effect of presatovir on development of lower respiratory tract complication, being free of any supplemental oxygen progression to respiratory failure, and pharmacokinetics (PK), safety, and tolerability of presatovir.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Respiratory Syncytial Virus
Keywords
Respiratory Syncytial Virus (RSV), Antiviral, Hematopoietic Cell Transplant (HCT), Upper respiratory tract infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
189 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Presatovir
Arm Type
Experimental
Arm Description
Participants will receive presatovir on Days 1, 5, 9, 13, and 17, with follow-up visits through Day 28, and may continue in an optional extended monitoring phase with visits through Day 56.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive placebo on Days 1, 5, 9, 13, and 17, with follow-up visits through Day 28, and may continue in an optional extended monitoring phase with visits through Day 56.
Intervention Type
Drug
Intervention Name(s)
Presatovir
Other Intervention Name(s)
GS-5806
Intervention Description
Presatovir 200 mg (4 × 50 mg tablets) administered orally or via nasogastric (NG) tube
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Tablets administered orally or via nasogastric tube
Primary Outcome Measure Information:
Title
Time-Weighted Average Change in Nasal Respiratory Syncytial Virus (RSV ) Viral Load From Baseline (Day 1) to Day 9
Description
The time-weighted average change, often referred to as the DAVG, provides the average viral burden change from baseline. The mean values presented were calculated using the ANCOVA model and are adjusted for baseline value and stratification factor.
Time Frame
Baseline; Day 9
Title
Percentage of Participants Who Developed a Lower Respiratory Tract Complication
Description
A Lower Respiratory Tract Complication (LRTC) was defined as one of the below as determined by the adjudication committee: Primary RSV lower respiratory tract infection (LRTI) Secondary bacterial LRTI LRTI due to unusual pathogens Lower respiratory tract complication of unknown etiology
Time Frame
Up to Day 28
Secondary Outcome Measure Information:
Title
Percentage of Participants Who Developed Respiratory Failure (of Any Cause) Requiring Mechanical Ventilation (Invasive or Noninvasive) or All-cause Mortality
Description
Participants were considered to have an event if either condition is met: Participant develops a respiratory failure (of any cause) requiring mechanical ventilation (invasive or noninvasive) or; Participant dies prior to or on Day 28
Time Frame
Up to Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Received an autologous or allogeneic HCT using any conditioning regimen Documented to be RSV-positive as determined by local testing (eg, polymerase chain reaction, direct fluorescence antibody, respiratory viral panel assay, or culture) using an upper respiratory tract sample collected ≤ 6 days prior to Day 1 New onset of at least 1 of the following respiratory symptoms for ≤ 7 days prior to Day 1: nasal congestion, runny nose, cough, or sore throat, or worsening of one of these chronic (associated with a previously existing diagnosis, eg, chronic rhinorrhea, seasonal allergies, chronic lung disease) respiratory symptoms ≤ 7 days prior to Day 1 No evidence of new abnormalities consistent with lower respiratory tract infection (LRTI) on a chest X-ray relative to the most recent chest X-ray, as determined by the local radiologist. If a chest X-ray is not available or was not obtained during standard care < 48 hours prior to screening, a chest X-ray must be obtained for screening O2 saturation ≥ 92% on room air An informed consent document signed and dated by the participant or a legal guardian of the participant and the investigator or his/her designee A negative urine or serum pregnancy test is required for female participants (unless surgically sterile or greater than two years post-menopausal) Male and female participants of childbearing potential must agree to contraceptive requirements as described in the study protocol Willingness to complete necessary study procedures and have available a working telephone or email Exclusion Criteria: Related to concomitant or previous medication use: Use of non-marketed (according to region) investigational agents within 30 days, OR use of any monoclonal anti-RSV antibodies within 4 months or 5 half-lives of screening, whichever is longer, OR use of any investigational RSV vaccines after HCT Related to medical history: Pregnant, breastfeeding, or lactating females Unable to tolerate nasal sampling required for this study, as determined by the investigator Known history of HIV/AIDS with a CD4 count <200 cells/μL within the last month History of drug and/or alcohol abuse that, in the opinion of the investigator, may prevent adherence to study activities Related to medical condition at screening: Documented to be positive for other respiratory viruses (limited to influenza, parainfluenza, human rhinovirus, adenovirus, or human metapneumovirus, or coronavirus) within 7 days prior to the screening visit, as determined by local testing (additional testing is not required) Clinically significant bacteremia or fungemia within 7 days prior to screening that has not been adequately treated, as determined by the investigator Clinically significant bacterial, fungal, or viral pneumonia within 2 weeks prior to screening that has not been adequately treated, as determined by the investigator Excessive nausea/vomiting at screening, as determined by the investigator, or an inability to swallow pills that precludes oral administration of the investigational medical product (for participants without an nasogastric tube in place) Any condition which, in the opinion of the investigator, would prevent full participation in this trial or would interfere with the evaluation of the trial endpoints Related to laboratory results: Creatinine clearance < 30 mL/min (calculated using the Cockcroft-Gault method) Clinically significant aspartate aminotransferase/alanine aminotransferase, as determined by the investigator Clinically significant total bilirubin, as determined by the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilead Study Director
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Mayo Clinic Arizona
City
Phoenix
State/Province
Arizona
Country
United States
Facility Name
City of Hope
City
Duarte
State/Province
California
Country
United States
Facility Name
UCLA David Geffen School of Medicine
City
Los Angeles
State/Province
California
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
Country
United States
Facility Name
NorthSide Medical Center
City
Atlanta
State/Province
Georgia
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
Loyola University
City
Maywood
State/Province
Illinois
Country
United States
Facility Name
John Hopkins
City
Baltimore
State/Province
Maryland
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
University of Massachusetts Memorial Cancer Center
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
Country
United States
Facility Name
Wayne State University
City
Detroit
State/Province
Michigan
Country
United States
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
Country
United States
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
Country
United States
Facility Name
Memorial Sloan Kettering
City
New York
State/Province
New York
Country
United States
Facility Name
New York Presbyterian Hospital Cornell Medical Center
City
New York
State/Province
New York
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
Country
United States
Facility Name
University Hospital Case Medical
City
Cleveland
State/Province
Ohio
Country
United States
Facility Name
Oregon Health Sciences University
City
Portland
State/Province
Oregon
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
Country
United States
Facility Name
Texas Transplant Institute (SCRI)
City
San Antonio
State/Province
Texas
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
Country
United States
Facility Name
Fred Hutchison Cancer Research Center
City
Seattle
State/Province
Washington
Country
United States
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
Country
United States
Facility Name
Westmead Hospital
City
Westmead
State/Province
New South Wales
Country
Australia
Facility Name
Royal Brisbane & Women's Hospital
City
Herston
Country
Australia
Facility Name
Royal Melbourne Hospital
City
Melbourne
Country
Australia
Facility Name
Hospital de Clínicas de Porto Alegre
City
Porto Alegre
Country
Brazil
Facility Name
Hospital Israelita Albert Einstein
City
Sao Paulo
Country
Brazil
Facility Name
Hospital Universitario USP
City
Sao Paulo
Country
Brazil
Facility Name
Fundacao Faculdade Regional Medicina de Sao Jose do Rio Preto
City
São Paulo
Country
Brazil
Facility Name
Fundação Antonio Prudente - Hospital do Câncer AC Camargo
City
São Paulo
Country
Brazil
Facility Name
Hospital Santa Marcelina
City
São Paulo
Country
Brazil
Facility Name
Instituto Brasileiro de Controle do Câncer-IBCC
City
São Paulo
Country
Brazil
Facility Name
Hopital Maisonneuve-Rosemont
City
Montreal
State/Province
Quebec
Country
Canada
Facility Name
Tom Baker Cancer Centre
City
Calgary
Country
Canada
Facility Name
CHU de Bordeaux
City
Bordeaux
Country
France
Facility Name
Hopital Saint-Louis, APHP
City
Paris
Country
France
Facility Name
Hopital Foch
City
Suresnes
Country
France
Facility Name
Institut Universitaire du Cancer Oncopole
City
Toulouse
Country
France
Facility Name
Universitatsklinikum Wurzburg
City
Wurzburg
Country
Germany
Facility Name
Soroka Medical Center
City
Beer Sheva
Country
Israel
Facility Name
Rambam Medical Center
City
Haifa
Country
Israel
Facility Name
Hadassah Medical Center
City
Jerusalem
Country
Israel
Facility Name
Rabin Medical Center
City
Petah Tikva
Country
Israel
Facility Name
Chaim Sheba Medical Center
City
Ramat Gan
Country
Israel
Facility Name
Tel Aviv Sourasky Medical Center
City
Tel Aviv
Country
Israel
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul Saint Mary's Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Severance Hospital, Yonsei University Health System
City
Seoul
Country
Korea, Republic of
Facility Name
VUmc cancer center
City
Amsterdam
Country
Netherlands
Facility Name
Erasmus Medical Center (Rotterdam)
City
Rotterdam
Country
Netherlands
Facility Name
Singapore General Hospital
City
Singapore
Country
Singapore
Facility Name
UMC National University Health System
City
Singapore
Country
Singapore
Facility Name
Hospital universitario Virgen del Rocio
City
Seville
Country
Spain
Facility Name
Karolinska Institutet
City
Stockholm
Country
Sweden
Facility Name
University Clinic Basel
City
Basel
Country
Switzerland
Facility Name
Kaohsiung Medical University Chung-Ho Memorial Hospital
City
Kaohsiung
Country
Taiwan
Facility Name
China Medical University Hospital
City
Taichung
Country
Taiwan
Facility Name
National Taiwan University Hospital
City
Taipei
Country
Taiwan
Facility Name
Chang Gung Medical Foundation-LinKou Branch
City
Taoyuan
Country
Taiwan
Facility Name
Leeds Teaching Hospitals Trust
City
Leeds
Country
United Kingdom
Facility Name
King's College Hospital
City
London
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
31793991
Citation
Chemaly RF, Dadwal SS, Bergeron A, Ljungman P, Kim YJ, Cheng GS, Pipavath SN, Limaye AP, Blanchard E, Winston DJ, Stiff PJ, Zuckerman T, Lachance S, Rahav G, Small CB, Mullane KM, Patron RL, Lee DG, Hirsch HH, Waghmare A, McKevitt M, Jordan R, Guo Y, German P, Porter DP, Gossage DL, Watkins TR, Marty FM, Chien JW, Boeckh M. A Phase 2, Randomized, Double-blind, Placebo-Controlled Trial of Presatovir for the Treatment of Respiratory Syncytial Virus Upper Respiratory Tract Infection in Hematopoietic-Cell Transplant Recipients. Clin Infect Dis. 2020 Dec 31;71(11):2777-2786. doi: 10.1093/cid/ciz1166.
Results Reference
derived

Learn more about this trial

Presatovir in Hematopoietic Cell Transplant Recipients With Respiratory Syncytial Virus Infection of the Upper Respiratory Tract

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