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Presatovir in Hematopoietic Cell Transplant Recipients With Respiratory Syncytial Virus (RSV) Infection of the Lower Respiratory Tract

Primary Purpose

Respiratory Syncytial Virus Infection

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 Infection focused on measuring Respiratory Syncytial Virus (RSV), Antiviral, Hematopoietic Cell Transplant (HCT), Lower respiratory tract infection

Eligibility Criteria

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

Key Inclusion Criteria:

  • Received an autologous or allogeneic HCT using any conditioning regimen
  • Evidence of new abnormalities on chest X-ray obtained < 48 hours prior to screening, determined to be consistent with LRTI by the local radiologist, relative to the most recent previous chest X-ray. If chest X-ray is not available, a chest X-ray must be obtained for screening.
  • Documented RSV in both the upper (eg, nasal swab, nasopharyngeal swab, nasal wash) and lower (eg, induced sputum, bronchoalveolar lavage, lung biopsy, but not spontaneous sputum) respiratory tract as determined by local testing (eg, polymerase chain reaction, direct fluorescence antibody, respiratory viral panel assay, or culture). All samples must have been collected ≤ 6 days prior to Day 1, or as determined at screening as per protocol.
  • An informed consent document signed and dated by the participant or a legal guardian of the participant and 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

Key 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
  • Use of a moderate or strong cytochrome P450 enzyme inducer including but not limited to rifampin, St. John's Wort, carbamazepine, phenytoin, efavirenz, bosentan, etravirine, modafinil, and nafcillin, within 2 weeks prior to the first dose of study drug

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 conditions:

  • Requiring invasive mechanical ventilation at the time of randomization
  • Documented to be positive for other respiratory viruses (limited to influenza, parainfluenza, human rhinovirus, adenovirus, human metapneumovirus, or coronavirus), from the lower respiratory tract sample as determined by local testing
  • 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 individuals without an NG 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

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Sites / Locations

  • City of Hope
  • University of Chicago
  • John Hopkins
  • Dana Farber Cancer Institute
  • University of Michigan
  • University of Minnesota
  • New York Weill Cornell Medical Center
  • Duke University
  • MD Anderson Cancer Center
  • Fred Hutchison Cancer Research Center
  • Medical College of Wisconsin
  • Hopital Saint-Louis, APHP
  • Hopital Foch
  • CHU de Bordeaux
  • Seoul Saint Mary's Hospital
  • Karolinska Institutet
  • University Clinical Basel

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 to match 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.

Outcomes

Primary Outcome Measures

Time-weighted Average Change in Nasal Respiratory Syncytial Viral (RSV) Load From Baseline 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 factors.

Secondary Outcome Measures

Number of Supplemental O2-Free Days Through Day 28
Percentage of Participants Developing Respiratory Failure Requiring Mechanical Ventilation Through Day 28
Percentage of All-Cause Mortality Among Participants Through Day 28

Full Information

First Posted
September 29, 2014
Last Updated
August 24, 2018
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT02254421
Brief Title
Presatovir in Hematopoietic Cell Transplant Recipients With Respiratory Syncytial Virus (RSV) Infection of the Lower 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 Lower Respiratory Tract
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
January 31, 2015 (Actual)
Primary Completion Date
April 17, 2017 (Actual)
Study Completion Date
April 17, 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 lower respiratory tract infection (LRTI).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Respiratory Syncytial Virus Infection
Keywords
Respiratory Syncytial Virus (RSV), Antiviral, Hematopoietic Cell Transplant (HCT), Lower 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
60 (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 to match 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.
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
Placebo to match presatovir administered orally or via nasogastric tube
Primary Outcome Measure Information:
Title
Time-weighted Average Change in Nasal Respiratory Syncytial Viral (RSV) Load From Baseline 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 factors.
Time Frame
Baseline to Day 9
Secondary Outcome Measure Information:
Title
Number of Supplemental O2-Free Days Through Day 28
Time Frame
Up to Day 28
Title
Percentage of Participants Developing Respiratory Failure Requiring Mechanical Ventilation Through Day 28
Time Frame
Up to Day 28
Title
Percentage of All-Cause Mortality Among Participants Through 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
Key Inclusion Criteria: Received an autologous or allogeneic HCT using any conditioning regimen Evidence of new abnormalities on chest X-ray obtained < 48 hours prior to screening, determined to be consistent with LRTI by the local radiologist, relative to the most recent previous chest X-ray. If chest X-ray is not available, a chest X-ray must be obtained for screening. Documented RSV in both the upper (eg, nasal swab, nasopharyngeal swab, nasal wash) and lower (eg, induced sputum, bronchoalveolar lavage, lung biopsy, but not spontaneous sputum) respiratory tract as determined by local testing (eg, polymerase chain reaction, direct fluorescence antibody, respiratory viral panel assay, or culture). All samples must have been collected ≤ 6 days prior to Day 1, or as determined at screening as per protocol. An informed consent document signed and dated by the participant or a legal guardian of the participant and 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 Key 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 Use of a moderate or strong cytochrome P450 enzyme inducer including but not limited to rifampin, St. John's Wort, carbamazepine, phenytoin, efavirenz, bosentan, etravirine, modafinil, and nafcillin, within 2 weeks prior to the first dose of study drug 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 conditions: Requiring invasive mechanical ventilation at the time of randomization Documented to be positive for other respiratory viruses (limited to influenza, parainfluenza, human rhinovirus, adenovirus, human metapneumovirus, or coronavirus), from the lower respiratory tract sample as determined by local testing 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 individuals without an NG 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 Note: Other protocol defined Inclusion/Exclusion criteria may apply.
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
City of Hope
City
Duarte
State/Province
California
Country
United States
Facility Name
University of Chicago
City
Chicago
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 Michigan
City
Ann Arbor
State/Province
Michigan
Country
United States
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
Country
United States
Facility Name
New York Weill 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
MD Anderson Cancer Center
City
Houston
State/Province
Texas
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
Hopital Saint-Louis, APHP
City
Paris
Country
France
Facility Name
Hopital Foch
City
Suresnes
Country
France
Facility Name
CHU de Bordeaux
City
Talence
ZIP/Postal Code
33404
Country
France
Facility Name
Seoul Saint Mary's Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Karolinska Institutet
City
Stockholm
Country
Sweden
Facility Name
University Clinical Basel
City
Basel
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
31915807
Citation
Marty FM, Chemaly RF, Mullane KM, Lee DG, Hirsch HH, Small CB, Bergeron A, Shoham S, Ljungman P, Waghmare A, Blanchard E, Kim YJ, McKevitt M, Porter DP, Jordan R, Guo Y, German P, Boeckh M, Watkins TR, Chien JW, Dadwal SS. A Phase 2b, Randomized, Double-blind, Placebo-Controlled Multicenter Study Evaluating Antiviral Effects, Pharmacokinetics, Safety, and Tolerability of Presatovir in Hematopoietic Cell Transplant Recipients with Respiratory Syncytial Virus Infection of the Lower Respiratory Tract. Clin Infect Dis. 2020 Dec 31;71(11):2787-2795. doi: 10.1093/cid/ciz1167.
Results Reference
derived

Learn more about this trial

Presatovir in Hematopoietic Cell Transplant Recipients With Respiratory Syncytial Virus (RSV) Infection of the Lower Respiratory Tract

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