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The Potential of Oral Camostat in Early COVID-19 Disease in an Ambulatory Setting to Reduce Viral Load and Disease Burden

Primary Purpose

Covid19

Status
Unknown status
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
Camostat
Placebo
Camostat
Placebo
Sponsored by
University Hospital, Ghent
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19 focused on measuring antiviral

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Aged ≥18
  • Willing to participate and fill out a daily symptom diary
  • Willing to take the parameters such as blood oxygenation and temperature
  • Willing to attend follow-up visits both by phone as at the clinic
  • Capable of understanding the commitment in the trial
  • Signed informed consent
  • Signs and symptoms suggestive of COVID disease in absence of hospitalization criteria as defined by the flowchart used at the emergency department of our institution (appendix 4), present for maximum 5 days and confirmed by PCR.
  • OR documented COVID-19 infection by PCR with CT value below the threshold of 30 in asymptomatic individuals.
  • For women of childbearing potential*: they should be willing to use highly effective method of contraception during treatment and until the end of study defined as having a failure rate of less than 1% per year when used consistently and correctly.

Such methods include:

  • combined (estrogen and progestogen containing) hormonal contraception
  • associated with inhibition of ovulation: oral, intravaginal or transdermal
  • progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable or implantable
  • intrauterine device (IUD) and intrauterine hormone-releasing system ( IUS)
  • bilateral tubal occlusion
  • vasectomised partner
  • sexual abstinence

    • For men of reproductive potential**: condom should be used as contraception during treatment and until the end of study when having a partner of childbearing potential

      • a woman is considered of childbearing potential (WOCBP), i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. However in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient.

        • a man is considered fertile after puberty unless permanently sterile by bilateral orchidectomy.

Exclusion Criteria

  • Inability to make a decision to participate
  • Pregnant or breast feeding
  • Inability to take oral medication
  • Inability to provide informed written consent
  • Known hypersensitivity towards Camostat or other Serine protease inhibitors
  • Any condition that, in the Investigator's opinion, prevents adequate compliance with study therapy.
  • Any COVID infection at risk for hospitalisation as described in the emergency department flowchart (cfr appendix 4)
  • With regard to exclusion of women of child-bearing potential, women who tell us they know they are pregnant are excluded. All women of child-bearing potential who test positive for pregnancy by urine test at first visit are excluded.
  • Severe chronic pancreatitis requiring suction of gastric juice, fasting or abstention from drinking
  • Postoperative reflux oesophagitis due to reflux or gastric juice
  • Postoperative reflux oesophagitis (if improvement of symptoms is not observed).

Sites / Locations

  • Ghent University Hospital, Algemene Inwendige ZiektenRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Camostat

Placebo

Arm Description

camostat 100mg 3 tablets 3x/day D1->D5 (+ possible extension D6->D10)

Placebo 3 tablets 3x/day D1->D5 (+ possible extension D6->D10)

Outcomes

Primary Outcome Measures

Efficacy in terms of viral load or surrogate
The primary endpoint is to assess the efficacy of the drug in terms of change from day 0 to day 5 in respiratory (oropharyngeal swab RT-PCR) log10 viral load. Surrogate market CT value will be used as well.

Secondary Outcome Measures

Full Information

First Posted
November 5, 2020
Last Updated
August 18, 2021
Sponsor
University Hospital, Ghent
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1. Study Identification

Unique Protocol Identification Number
NCT04625114
Brief Title
The Potential of Oral Camostat in Early COVID-19 Disease in an Ambulatory Setting to Reduce Viral Load and Disease Burden
Official Title
The Potential of Oral Camostat in Early COVID-19 Disease in an Ambulatory Setting to Reduce Viral Load and Disease Burden
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
November 4, 2020 (Actual)
Primary Completion Date
October 1, 2022 (Anticipated)
Study Completion Date
January 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Ghent

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The investigators are conducting a pilot trial where they will study safety, efficacy and compliance in a cohort of ambulatory patients in the Ghent region with confirmed COVID-19 infection, in both an early stage of disease, defined as less than 5 days of symptoms and who at presentation do not meet any criteria for hospitalisation as well as asymptomatic individuals with a PCR CT value below 30. The primary endpoint is to assess the efficacy of the drug in terms of change from day 0 to day 5 in respiratory (oropharyngeal swab RT-PCR) log10 viral load. The aim of the study is to assess whether Camostat, a serine protease inhibitor available in an oral formulation has the potential to be studied as an antiviral drug in a large scale ambulatory setting to prevent transmission by decreasing viral load, to prevent symptoms after exposure (PEP) in asymptomatic individuals or to prevent disease progression in the occurrence of early symptomatology.
Detailed Description
Core study After eligibility assessment participants will be randomized and will receive the study drugs. We will define D1 as the first dose of the medication which can be the morning, midday or evening dose. They will be treated for 5 consecutive days. In patients with a positive PCR at D5 (CT value with threshold below 30) and/or presence of clinical symptoms after exclusion of hospitalization criteria (flowchart emergency department appendix 4), the treatment will be extended up to D10 at the same dosage in both treatment arms for 5 consecutive days: D6 and D10). Follow-up will be as follows: D1->D14 (D28): The study participants will be asked to fill in daily questionnaires assessing symptoms (cfr daily self-score). They will receive a kit enabling to monitor heart rate (HR), respiratory rate (RR), temperature and oxygen saturation 3 times per day (every 4-8 hours, preferentially at the timing of medication intake at D1 to D5 or D10). Compliance and tolerance will be assessed during the treatment period, D0->D5 (or D0->D10 if the treatment is prolonged). During the study D1-D28: If indicated in the opinion of the investigator, a physical exam and biochemistry will be performed through a consultation at the clinic. This can be requested at any time during the study based on clinical symptoms or signs. Consultation at D0, D5, (D10) and D28 at our COVID consultation facility. This will be done by a study nurse and/or a study physician.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19
Keywords
antiviral

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Masking Description
double blinded placebo controlled
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Camostat
Arm Type
Experimental
Arm Description
camostat 100mg 3 tablets 3x/day D1->D5 (+ possible extension D6->D10)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo 3 tablets 3x/day D1->D5 (+ possible extension D6->D10)
Intervention Type
Drug
Intervention Name(s)
Camostat
Intervention Description
Standard of care (SOC) + Camostat mesilate (Foipan) 100mg 3 tablets 3 times a day for 5 consecutive days (D1->D5);
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
SOC + placebo 500 mg 3 tablets 3 times a day for five consecutive days (D1->D5).
Intervention Type
Drug
Intervention Name(s)
Camostat
Intervention Description
Standard of care (SOC) + Camostat mesilate (Foipan) 100mg 3 tablets 3 times a day for 5 consecutive days (D6->D10);
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
SOC + placebo 500 mg 3 tablets 3 times a day for five consecutive days (D6->D10).
Primary Outcome Measure Information:
Title
Efficacy in terms of viral load or surrogate
Description
The primary endpoint is to assess the efficacy of the drug in terms of change from day 0 to day 5 in respiratory (oropharyngeal swab RT-PCR) log10 viral load. Surrogate market CT value will be used as well.
Time Frame
5 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Aged ≥18 Willing to participate and fill out a daily symptom diary Willing to take the parameters such as blood oxygenation and temperature Willing to attend follow-up visits both by phone as at the clinic Capable of understanding the commitment in the trial Signed informed consent Signs and symptoms suggestive of COVID disease in absence of hospitalization criteria as defined by the flowchart used at the emergency department of our institution (appendix 4), present for maximum 5 days and confirmed by PCR. OR documented COVID-19 infection by PCR with CT value below the threshold of 30 in asymptomatic individuals. For women of childbearing potential*: they should be willing to use highly effective method of contraception during treatment and until the end of study defined as having a failure rate of less than 1% per year when used consistently and correctly. Such methods include: combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal or transdermal progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable or implantable intrauterine device (IUD) and intrauterine hormone-releasing system ( IUS) bilateral tubal occlusion vasectomised partner sexual abstinence For men of reproductive potential**: condom should be used as contraception during treatment and until the end of study when having a partner of childbearing potential a woman is considered of childbearing potential (WOCBP), i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. However in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient. a man is considered fertile after puberty unless permanently sterile by bilateral orchidectomy. Exclusion Criteria Inability to make a decision to participate Pregnant or breast feeding Inability to take oral medication Inability to provide informed written consent Known hypersensitivity towards Camostat or other Serine protease inhibitors Any condition that, in the Investigator's opinion, prevents adequate compliance with study therapy. Any COVID infection at risk for hospitalisation as described in the emergency department flowchart (cfr appendix 4) With regard to exclusion of women of child-bearing potential, women who tell us they know they are pregnant are excluded. All women of child-bearing potential who test positive for pregnancy by urine test at first visit are excluded. Severe chronic pancreatitis requiring suction of gastric juice, fasting or abstention from drinking Postoperative reflux oesophagitis due to reflux or gastric juice Postoperative reflux oesophagitis (if improvement of symptoms is not observed).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marie-Angélique De Scheerder
Phone
+32476937613
Email
marie-angelique.descheerder@uzgent.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven Callens
Organizational Affiliation
UZ Gent
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ghent University Hospital, Algemene Inwendige Ziekten
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marie-Angélique De Scheerder
Phone
0476937613
Email
marie-angelique.descheerder@uzgent.be

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35803469
Citation
Tobback E, Degroote S, Buysse S, Delesie L, Van Dooren L, Vanherrewege S, Barbezange C, Hutse V, Romano M, Thomas I, Padalko E, Callens S, De Scheerder MA. Efficacy and safety of camostat mesylate in early COVID-19 disease in an ambulatory setting: a randomized placebo-controlled phase II trial. Int J Infect Dis. 2022 Sep;122:628-635. doi: 10.1016/j.ijid.2022.06.054. Epub 2022 Jul 5.
Results Reference
derived

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The Potential of Oral Camostat in Early COVID-19 Disease in an Ambulatory Setting to Reduce Viral Load and Disease Burden

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