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Study to Evaluate the Efficacy and Safety of Leronlimab for Mild to Moderate COVID-19

Primary Purpose

Coronavirus Disease 2019

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Placebo
Leronlimab (700mg)
Sponsored by
CytoDyn, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronavirus Disease 2019 focused on measuring COVID-19

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female adult ≥ 18 years of age at time of enrollment.
  2. Subjects with mild-to-moderate symptoms of respiratory illness caused by coronavirus 2019 infection as defined below:

    Mild (uncomplicated) Illness:

    • Diagnosed with COVID-19 by a standardized RT-PCR assay AND
    • Mild symptoms, such as fever, rhinorrhea, mild cough, sore throat, malaise, headache, muscle pain, or malaise, but with no shortness of breath AND
    • No signs of a more serious lower airway disease AND
    • RR<20, HR <90, oxygen saturation (pulse oximetry) > 93% on room air

    Moderate Illness:

    • Diagnosed with COVID-19 by a standardized RT-PCR assay AND
    • In addition to symptoms above, more significant lower respiratory symptoms, including shortness of breath (at rest or with exertion) OR
    • Signs of moderate pneumonia, including RR ≥ 20 but <30, HR ≥ 90 but less than 125, oxygen saturation (pulse oximetry) > 93% on room air AND
    • If available, lung infiltrates based on X-ray or CT scan < 50% present
  3. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Principal Investigator.
  4. Subject (or legally authorized representative) provides written informed consent prior to initiation of any study procedures.
  5. Understands and agrees to comply with planned study procedures.
  6. Women of childbearing potential must agree to use at least one medically accepted method of contraception (e.g., barrier contraceptives [condom, or diaphragm with a spermicidal gel], hormonal contraceptives [implants, injectables, combination oral contraceptives, transdermal patches, or contraceptive rings], or intrauterine devices) for the duration of the study.

Exclusion Criteria:

  1. Subjects showing signs of acute respiratory distress syndrome (ARDS) or respiratory failure necessitating mechanical ventilation at the time of screening;
  2. History of severe chronic respiratory disease and requirement for long-term oxygen therapy;
  3. Subjects showing signs of clinical jaundice at the time of screening;
  4. History of moderate and severe liver disease (Child-Pugh score >12);
  5. Subjects requiring Renal Replacement Therapy (RRT) at the time of screening;
  6. History of severe chronic kidney disease or requiring dialysis;
  7. Any uncontrolled active systemic infection requiring admission to an intensive care unit (ICU); Note: Subjects infected with chronic hepatitis B virus or hepatitis C virus will be eligible for the study if they have no signs of hepatic decompensation.

    Note: Subjects infected with HIV-1 will be eligible for the study with undetectable viral load and are on a stable ART regimen. Investigators are required to review the subjects' medical records to confirm HIV-1 RNA suppression within the previous 3 months.

    Note: Empirical antibiotic treatment for secondary bacterial infections is allowed during the course of study.

  8. Patients with malignant tumor, or other serious systemic diseases;
  9. Patients who are participating in other clinical trials;
  10. Patients who have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to leronlimab (PRO 140) are not eligible; and
  11. Inability to provide informed consent or to comply with test requirements

Sites / Locations

  • University of California, Los Angeles
  • Palmtree Clinical Research, Inc.
  • Eisenhower Health
  • Yale
  • Center for Advanced Research & Education (CARE)
  • Beth Israel Deaconess Medical Center
  • Atlantic Health System Hospital
  • Montefiore Medical Center
  • White Plains Hospital
  • Novant Health
  • Ohio Health
  • Oregon Health and Science University

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

700mg Leronlimab

Arm Description

The placebo comparator consists of the formulation buffer for leronlimab, i.e., the placebo is the same as the active arm without leronimab. The placebo is presented in the same container closure at the same fill volume as the active (nominal 1mL fill volume). The formulation buffer contains histidine, glycine, sodium chloride, sorbitol, polysorbate 20 and sterile water for injections.

Each vial of active contains 175mg of leronlimab at a concentration of 175mg/ml (nominal 1mL fill volume) in formulation buffer containing histidine, glycine, sodium chloride, sorbitol, polysorbate 20 and sterile water for injections.

Outcomes

Primary Outcome Measures

Mean Change From Baseline in Total Symptom Score
Clinical Improvement as assessed by change in total symptom score (for fever, myalgia, dyspnea and cough) by count of patients showing improvement, no change or worsened. Note: The total score per patient ranges from 0 to 12 points. Each symptom is graded from 0 to 3. [0=none, 1=mild, 2=moderate, and 3=severe]. Higher scores mean a worse outcome. A negative change from baseline shows an improvement in symptom score.

Secondary Outcome Measures

Time to Clinical Resolution (TTCR)
Defined as the time from initiation of study treatment to the resolution of clinical symptoms (fever, myalgia, dyspnea, cough). Data presented how the number of days at which a certain percentage of patients achieve resolution of symptoms, i.e., 50% of patients on placebo saw resolution of symptoms in 15 days, and 15 days for patients on leronlimab. The hazard ratio was 0.781, 95% Confidence Interval 0.43, 1.41 and the p-value was 0.4138. TTCR is defined as the duration from date of first exposure to treatment to the first occurrence of total symptom score equals 0.
Incidence of Hospitalization
Number of patients requiring hospitalization
Duration (Days) of Hospitalization
Duration of hospitalization in days
Incidence of Mechanical Ventilation
Incidence of mechanical ventilation supply
Duration of Mechanical Ventilation Supply
Duration (days) of mechanical ventilation supply
Incidence of Oxygen Use
Incidence of oxygen use over course of treatment
Duration of Oxygen Use
Duration of oxygen use in days
Mortality at Day 14
Incidence of mortality at day 14
Time to Return to Normal Activity
Time to return to normal activity from initiation of study treatment defined as duration from date of first exposure to treatment to the first occurrence of ordinal scale equals "not hospitalized, no limitations of activities"
Change From Baseline in National Early Warning Score 2 (NEWS2) to Day 3, 7 and 14
NEWS2 is an assessment based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness) developed by the Royal College of Physicians (https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2). Respiratory rate (bpm) scores 0-3; Sp02 (on room air or suppl) scores 0-3; SpO2 (hypercapnic resp failure) scores 0-3; room air or supplemental O2 scores 0 (room) or 2 (suppl); temperature - scores 0-3; systolic BP scores 0-3; pulse (bpm) scores 0-3; consciousness - alert (score 0) vs. new onset confusion (score 3). The total possible score ranges from 0 to 20. The higher the score the greater the clinical risk. Higher scores indicate the need for escalation, medical review and possible clinical intervention and more intensive monitoring. Change shown is positive or negative from baseline, with a negative number indicating improvement (i.e., a decrease in total score).
Mean Change in Percent Oxygen Saturation From Baseline to Days 3, 7 and 14
Mean change in percent oxygen saturation from baseline to Days 3, 7 and 14 for patients with paired values
Change From Baseline in the Patient's Health Status on a 7-category Ordinal Scale on Days 3, 7 and 14
A 7-category ordinal scale of patient health status ranges from: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. Lower scores mean a worse outcome.

Full Information

First Posted
March 31, 2020
Last Updated
December 8, 2022
Sponsor
CytoDyn, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04343651
Brief Title
Study to Evaluate the Efficacy and Safety of Leronlimab for Mild to Moderate COVID-19
Official Title
A Phase 2, Randomized, Double Blind, Placebo Controlled Study to Evaluate the Efficacy and Safety of Leronlimab for Mild to Moderate Coronavirus Disease 2019 (COVID-19)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
April 1, 2020 (Actual)
Primary Completion Date
July 21, 2020 (Actual)
Study Completion Date
September 20, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CytoDyn, Inc.

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
This is a Phase 2, two-arm, randomized, double blind, placebo controlled multicenter study to evaluate the safety and efficacy of leronlimab (PRO 140) in patients with mild-to-moderate symptoms of respiratory illness caused by coronavirus 2019 infection.
Detailed Description
This is a Phase 2, two-arm, randomized, double blind, placebo controlled multicenter study to evaluate the safety and efficacy of leronlimab (PRO 140) in patients with mild-to-moderate symptoms of respiratory illness caused by coronavirus 2019 infection. Patients will be randomized to receive weekly doses of 700 mg leronlimab (PRO 140), or placebo. Leronlimab (PRO 140) and placebo will be administered via subcutaneous injection. The study will have three phases: Screening Period, Treatment Period, and Follow-Up Period. A total of 75 subjects will be randomized 2:1 in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronavirus Disease 2019
Keywords
COVID-19

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
The placebo comparator consists of the formulation buffer for leronlimab, i.e., the placebo is the same as the active arm without leronimab. The placebo is presented in the same container closure at the same fill volume as the active (nominal 1mL fill volume). The formulation buffer contains histidine, glycine, sodium chloride, sorbitol, polysorbate 20 and sterile water for injections.
Arm Title
700mg Leronlimab
Arm Type
Experimental
Arm Description
Each vial of active contains 175mg of leronlimab at a concentration of 175mg/ml (nominal 1mL fill volume) in formulation buffer containing histidine, glycine, sodium chloride, sorbitol, polysorbate 20 and sterile water for injections.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Leronlimab (700mg)
Other Intervention Name(s)
PRO 140
Intervention Description
Leronlimab (PRO) 140 is a humanized IgG4, monoclonal antibody (mAb) to the C-C chemokine receptor type 5 (CCR5)
Primary Outcome Measure Information:
Title
Mean Change From Baseline in Total Symptom Score
Description
Clinical Improvement as assessed by change in total symptom score (for fever, myalgia, dyspnea and cough) by count of patients showing improvement, no change or worsened. Note: The total score per patient ranges from 0 to 12 points. Each symptom is graded from 0 to 3. [0=none, 1=mild, 2=moderate, and 3=severe]. Higher scores mean a worse outcome. A negative change from baseline shows an improvement in symptom score.
Time Frame
Clinical Improvement will be assessed at baseline and at EOT (day 14).
Secondary Outcome Measure Information:
Title
Time to Clinical Resolution (TTCR)
Description
Defined as the time from initiation of study treatment to the resolution of clinical symptoms (fever, myalgia, dyspnea, cough). Data presented how the number of days at which a certain percentage of patients achieve resolution of symptoms, i.e., 50% of patients on placebo saw resolution of symptoms in 15 days, and 15 days for patients on leronlimab. The hazard ratio was 0.781, 95% Confidence Interval 0.43, 1.41 and the p-value was 0.4138. TTCR is defined as the duration from date of first exposure to treatment to the first occurrence of total symptom score equals 0.
Time Frame
Time (in days) from initiation of study treatment until resolution of clinical symptoms (fever, myalgia, dyspnea and cough).
Title
Incidence of Hospitalization
Description
Number of patients requiring hospitalization
Time Frame
From visit 2 (day 0) through day 14 (in days)
Title
Duration (Days) of Hospitalization
Description
Duration of hospitalization in days
Time Frame
Total duration of hospitalization between visit 2 (day 0) in days and end of treatment
Title
Incidence of Mechanical Ventilation
Description
Incidence of mechanical ventilation supply
Time Frame
Total duration of mechanical ventilation since visit 2 (day 0) (days)
Title
Duration of Mechanical Ventilation Supply
Description
Duration (days) of mechanical ventilation supply
Time Frame
Duration of mechanical ventilation since visit 2 (day 0) (days
Title
Incidence of Oxygen Use
Description
Incidence of oxygen use over course of treatment
Time Frame
Use of oxygen since visit 2 (day 0) to end of treatment
Title
Duration of Oxygen Use
Description
Duration of oxygen use in days
Time Frame
Total duration of oxygen use since visit 2 (day 0) to EOT (day 14) (days)
Title
Mortality at Day 14
Description
Incidence of mortality at day 14
Time Frame
Mortality at EOT (day 14)
Title
Time to Return to Normal Activity
Description
Time to return to normal activity from initiation of study treatment defined as duration from date of first exposure to treatment to the first occurrence of ordinal scale equals "not hospitalized, no limitations of activities"
Time Frame
Date of first exposure to treatment to the first occurrence of ordinal scale equals "not hospitalized, no limitations of activities"
Title
Change From Baseline in National Early Warning Score 2 (NEWS2) to Day 3, 7 and 14
Description
NEWS2 is an assessment based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness) developed by the Royal College of Physicians (https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2). Respiratory rate (bpm) scores 0-3; Sp02 (on room air or suppl) scores 0-3; SpO2 (hypercapnic resp failure) scores 0-3; room air or supplemental O2 scores 0 (room) or 2 (suppl); temperature - scores 0-3; systolic BP scores 0-3; pulse (bpm) scores 0-3; consciousness - alert (score 0) vs. new onset confusion (score 3). The total possible score ranges from 0 to 20. The higher the score the greater the clinical risk. Higher scores indicate the need for escalation, medical review and possible clinical intervention and more intensive monitoring. Change shown is positive or negative from baseline, with a negative number indicating improvement (i.e., a decrease in total score).
Time Frame
Baseline to Day 3, 7 and 14
Title
Mean Change in Percent Oxygen Saturation From Baseline to Days 3, 7 and 14
Description
Mean change in percent oxygen saturation from baseline to Days 3, 7 and 14 for patients with paired values
Time Frame
Mean change in percent oxygen saturation from baseline to Days 3, 7 and 14
Title
Change From Baseline in the Patient's Health Status on a 7-category Ordinal Scale on Days 3, 7 and 14
Description
A 7-category ordinal scale of patient health status ranges from: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. Lower scores mean a worse outcome.
Time Frame
Assessments performed Day 0 (first treatment is Visit 2, day 0), Visit 3 (3+/- 1 day after first treatment) Visit 4 (second treatment, 7+/- 1 day from V2, day7) and end of treatment (7+/- 1 day from V4, day 14)
Other Pre-specified Outcome Measures:
Title
Change in Size of Lesion Area by Chest Radiograph or CT
Description
Change in size of lesion area by chest radiograph or CT - exploratory endpoint
Time Frame
Day 14
Title
Change From Baseline in Serum Cytokine and Chemokine Levels
Description
Change from baseline in serum cytokine and chemokine levels at day 3, day 7 and day 14
Time Frame
Days 3, 7, and 14
Title
Change From Baseline in CCR5 Receptor Occupancy Levels for Tregs and Macrophages
Description
Change from baseline in CCR5 receptor occupancy levels for Tregs and macrophages at day3, day 7 and day 14
Time Frame
Days 3, 7, and 14
Title
Change From Baseline in CD3+, CD4+ and CD8+ T Cell Count
Description
Change from baseline in CD3+, CD4+ and CD8+ T cell count at day 3, day 7 and day 14
Time Frame
Days 3, 7, and 14

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female adult ≥ 18 years of age at time of enrollment. Subjects with mild-to-moderate symptoms of respiratory illness caused by coronavirus 2019 infection as defined below: Mild (uncomplicated) Illness: Diagnosed with COVID-19 by a standardized RT-PCR assay AND Mild symptoms, such as fever, rhinorrhea, mild cough, sore throat, malaise, headache, muscle pain, or malaise, but with no shortness of breath AND No signs of a more serious lower airway disease AND RR<20, HR <90, oxygen saturation (pulse oximetry) > 93% on room air Moderate Illness: Diagnosed with COVID-19 by a standardized RT-PCR assay AND In addition to symptoms above, more significant lower respiratory symptoms, including shortness of breath (at rest or with exertion) OR Signs of moderate pneumonia, including RR ≥ 20 but <30, HR ≥ 90 but less than 125, oxygen saturation (pulse oximetry) > 93% on room air AND If available, lung infiltrates based on X-ray or CT scan < 50% present Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Principal Investigator. Subject (or legally authorized representative) provides written informed consent prior to initiation of any study procedures. Understands and agrees to comply with planned study procedures. Women of childbearing potential must agree to use at least one medically accepted method of contraception (e.g., barrier contraceptives [condom, or diaphragm with a spermicidal gel], hormonal contraceptives [implants, injectables, combination oral contraceptives, transdermal patches, or contraceptive rings], or intrauterine devices) for the duration of the study. Exclusion Criteria: Subjects showing signs of acute respiratory distress syndrome (ARDS) or respiratory failure necessitating mechanical ventilation at the time of screening; History of severe chronic respiratory disease and requirement for long-term oxygen therapy; Subjects showing signs of clinical jaundice at the time of screening; History of moderate and severe liver disease (Child-Pugh score >12); Subjects requiring Renal Replacement Therapy (RRT) at the time of screening; History of severe chronic kidney disease or requiring dialysis; Any uncontrolled active systemic infection requiring admission to an intensive care unit (ICU); Note: Subjects infected with chronic hepatitis B virus or hepatitis C virus will be eligible for the study if they have no signs of hepatic decompensation. Note: Subjects infected with HIV-1 will be eligible for the study with undetectable viral load and are on a stable ART regimen. Investigators are required to review the subjects' medical records to confirm HIV-1 RNA suppression within the previous 3 months. Note: Empirical antibiotic treatment for secondary bacterial infections is allowed during the course of study. Patients with malignant tumor, or other serious systemic diseases; Patients who are participating in other clinical trials; Patients who have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to leronlimab (PRO 140) are not eligible; and Inability to provide informed consent or to comply with test requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Angela Ritter, MD
Organizational Affiliation
Center for Advanced Research and Education
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Palmtree Clinical Research, Inc.
City
Palm Springs
State/Province
California
ZIP/Postal Code
92262-4871
Country
United States
Facility Name
Eisenhower Health
City
Rancho Mirage
State/Province
California
ZIP/Postal Code
92270
Country
United States
Facility Name
Yale
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Center for Advanced Research & Education (CARE)
City
Gainesville
State/Province
Georgia
ZIP/Postal Code
30501
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Atlantic Health System Hospital
City
Morristown
State/Province
New Jersey
ZIP/Postal Code
07962-1905
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
White Plains Hospital
City
White Plains
State/Province
New York
ZIP/Postal Code
10601
Country
United States
Facility Name
Novant Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Ohio Health
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43215
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
Description
NEWS2 Score

Learn more about this trial

Study to Evaluate the Efficacy and Safety of Leronlimab for Mild to Moderate COVID-19

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