Safety and Efficacy of Inhaled XW001 For Hospitalized COVID-19 Patients Requiring Oxygen Therapy
COVID-19 Acute Respiratory Distress Syndrome
About this trial
This is an interventional treatment trial for COVID-19 Acute Respiratory Distress Syndrome focused on measuring Respiratory Distress Syndrome
Eligibility Criteria
Inclusion Criteria:
- Male or nonpregnant or nonlactating female, aged 18 to 70 years at the time of consenting
- Hospitalized due to infection with SARS-CoV-2 confirmed on validated local RT-PCR or other equivalent assays within 48 hours prior to screening and within 96 hours prior to randomization
- Assessed to be hospitalized cases (rated at WHO-OSCI score 4 [on oxygen therapy by mask or nasal prongs]) within 24 hours prior to randomization
Admitted to hospital as clinically indicated for management of severe COVID-19 defined by the following criteria:
- Positive RT-PCR test for SARS-CoV-2 or an equivalent test
- Symptom suggestive of severe systemic illness with COVID-19, which could include any symptom of moderate illness or shortness of breath at rest, or respiratory distress
Clinical signs indicative of severe illness with COVID-19, being given oxygenation and meeting one of the following:
- Respiratory rate ≥30 breaths per minute
- Heart rate ≥125 beats per minute
- Oxygen saturation (SpO2) <94% on room air at sea level
- Arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) <300 mmHg or SpO2/FiO2 <315 mmHg
- Lung infiltrates >50%
- No criteria for critical severity
- Female of childbearing potential must be postmenopausal for 1 year or longer, surgically sterile or having used a medically effective method of contraception for at least 3 months prior to hospitalization
- Willing and able to provide a signed and dated or electronic informed consent for participation in this study.
Exclusion Criteria:
Patients will be excluded from the study if they satisfy any of the following criteria at the screening visit unless otherwise stated:
- Having become symptomatic (fever, cough, and other likely symptoms) or positive on virologic test for more than 8 days prior to hospitalization
- Diagnosed with SARS-CoV-2 confirmed more than 48 hours prior to hospitalization, otherwise reconfirmed positive on repeated RT-PCR (local laboratory) or other equivalent assays within 48 hours prior to randomization
- Having been hospitalized for more than 48 hours, or showing a worsening medical condition within 48 hours after hospitalization in the opinion of the investigator
- Known to have received any approved or investigational COVID-19 vaccines within 6 months prior to randomization. Vaccination records can be self-reported by the patient if there is no recorded history
- Known to have received any approved or investigational therapeutic agents against SARS-CoV-2 including convalescent plasma, monoclonal antibodies, except for remdesivir, dexamethasone, or IL-6 inhibitors as a part of SoC
- Having received any investigational medicinal products within 90 days of randomization
- On noninvasive ventilation, eg, continuous positive airway pressure or bilevel positive airway pressure or high-flow oxygen therapy (at WHO-OSCI score 5)
- Intubated, ventilated (invasively), on any advanced organ/life support (pressors, renal replacement therapy, ECMO), or remaining in the intensive care unit (at WHO-OSCI score 6 and 7)
- Known to be hypersensitive or allergic to any natural or recombinant protein products
- Inability to utilize nebulized drugs, or history of bronchospasm with inhaled medications
- Patients with cardiac disease (New York Heart Association III/IV), liver cirrhosis (>5 x upper limit of normal [ULN]), on chemotherapy, dialysis patients with estimated glomerular filtration rate <30 mL/min/1.73m2, or have other debilitating condition or any other clinically significant medical condition or laboratory abnormality that, in the opinion of the investigator, would jeopardize the safety of the patient or non- COVID-19 irreversible underlying condition with projected fatal course within 6 months or with high-risk of mortality
- Female patients are pregnant or lactating, or male or female patients have a childbearing plan within 30 days prior to randomization until 90 days after the last dosing.
Sites / Locations
- Hospital Pirovano
- Hospital Nacional Arzobispo Loayza
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
XW001
Placebo
Treatment arm patients will receive inhaled XW001 1 mg, once daily, using a commercially available nebulizer (Aerogen Solo, Aerogen Ireland) for up to 14 days. Treatment should be continued until discharge or progression to score 6 or higher but maximum up to 14 days. Dosing must be started within 48 hours of hospitalization.
Placebo arm patients will receive volume-matching placebo 1 mL, once daily, using a commercially available nebulizer (Aerogen Solo, Aerogen Ireland) for up to 14 days. Treatment should be continued until discharge or progression to score 6 or higher but maximum up to 14 days. Dosing must be started within 48 hours of hospitalization.