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The University of the Philippines Hydroxychloroquine PEP Against COVID-19 Trial

Primary Purpose

COVID-19

Status
Withdrawn
Phase
Phase 3
Locations
Philippines
Study Type
Interventional
Intervention
Hydroxychloroquine plus standard preventive measures
Placebo plus standard preventive measures
Sponsored by
University of the Philippines
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for COVID-19 focused on measuring COVID-19, SARS-COV-2, Hydroxychloroquine, Post-exposure prophylaxis, Healthcare workers

Eligibility Criteria

18 Years - 59 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • any medical or non-medical personnel of the Philippine General Hospital and the UP Manila National Institutes of Health to include physicians (consultants, fellows-in-training, residents-in-training); nurses and other nursing staff (nursing aide, institutional or utility worker); janitors and cleaning staff, medical technologists and personnel of the laboratory where the COVID PCR testing is done; technicians of the radiology department, electrocardiography (ECG) station, arterial blood gas (ABG) stations and other personnel employed by the hospital on a tenured, part-time or full-time,and temporary. Because of the sample size, there is also a plan to include also health care workers in the community quarantine centers in the Manila area such as the Rizal Coliseum or the Ninoy Aquino Stadium, or at the World Trade Center
  • aged 18-59 years
  • exposure to a probable or confirmed COVID19 case within 4 days prior to study enrollment that is considered to be medium or high risk as defined by the HICU
  • asymptomatic (no acute respiratory, flu-like, gastrointestinal signs and symptoms at the time of enrollment
  • negative baseline COVID19 RT-PCR test result*
  • for female participants of child bearing potential they must agree to effective birth control methods during the clinical trial or abstinence from any sexual activity during the duration of the study.

    • Since RT-PCR result may not be released right away, volunteers who test positive after preliminary enrollment will be screen-failed and will not be included in the analysis.

Exclusion Criteria:

  • active COVID19 disease: positive RT-PCR COVID19 test
  • prior COVID19 disease
  • weight less than 40kg or a BMI less than 18kg/m2
  • current or recent hospitalization within the past year
  • known allergy to or intolerance of hydroxychloroquine (HCQ) or chloroquine (CQ)
  • current use of HCQ or CQ for whatever indications (malaria, lupus)
  • current use of other medication with known antiviral effects
  • current or known use in the last two weeks of known arrhythmogenic drugs or drugs that prolong the QT interval in the ECG, including but not limited to quinolones, macrolides, amiodarone, digoxin, flecainide, propafenone
  • any previous known or suspected retinopathy; in case of doubt, an ophthalmology clearance be secured prior to enrollment
  • known G6PD deficiency discovered through the newborn screening program or known intolerance or allergies to beans and any food that contains beans
  • women who are pregnant or breastfeeding, or a positive pregnancy test at baseline for women of child bearing age
  • history of known seizures or treatment with anti-epileptic medications
  • history of known existing arrhythmia
  • intake or use of anti diabetic agents especially sulfonylureas or any type of insulin
  • presence of abnormalities in baseline tests:

    1. ECG abnormalities that are exclusionary: Baseline QTc > 500 msec or QTc > 550 msec in patients with wide QRS; any form of tachy- or bradyarrythmias NB: sinus arrhythmia is not exclusionary
    2. CBC abnormalities showing anemia with hemoglobin value less than 12.5 g/dL or low platelet count or thrombocytopenia with platelet count less than 150,000 platelets per microliter
    3. Creatinine levels above normal values: 60 to 110 micromoles per liter (0.7 to 1.2 mg/dL for men and 45 to 90 micromoles per liter (0.5 to 1.0 mg/dL) for women
    4. ALT test that is elevated above 2x the upper limit of the normal: NV is 7 to 56 units per liter

Sites / Locations

  • Philippine General Hospital - University of the Philippines Manila

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Hydroxychloroquine plus standard preventive measures

Placebo plus standard preventive measure

Arm Description

Hydroxychloroquine oral loading dose of 400mg two times per day on Day 1 then 400 mg once a day for Day 2-10 plus standard preventive measures as defined by PGH Hospital Infection Control Unit (HICU)

Placebo tablet plus standard preventive measures as defined by PGH-HICU

Outcomes

Primary Outcome Measures

Efficacy of HCQ Prophylaxis in Preventing COVID-19 infection
Incidence of COVID-19 infection confirmed by RT-PCR COVID-19 test within the PEP treatment period (28 days) with or without symptoms of COVID-19 infection

Secondary Outcome Measures

Efficacy of study drug as post-exposure prophylaxis in preventing COVID-19 related symptoms (to be reported as absolute number and frequency of events)
Incidence of patient self-reported COVID-19 related symptoms anytime during follow up period as measured by a standardized patient diary
Time to COVID-19 infection in patients receiving study drug (in days)
Interval from exposure to COVID-19 case Interval from first dose of study drug
Safety and tolerability of study drug (to be reported as absolute number and frequency of events)
Incidence of study drug discontinuation Incidence of all adverse events based on patients a) self-report using daily symptom diary and b) study physicians

Full Information

First Posted
April 22, 2020
Last Updated
November 4, 2020
Sponsor
University of the Philippines
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1. Study Identification

Unique Protocol Identification Number
NCT04364815
Brief Title
The University of the Philippines Hydroxychloroquine PEP Against COVID-19 Trial
Official Title
Efficacy and Safety of Hydroxychloroquine for COVID-19 Post-Exposure Prophylaxis of Healthcare Workers in the Philippine General Hospital and UP Manila National Institutes of Health: A Randomized, Double-blind, Placebo-controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Investigators opted to change the design of the study.
Study Start Date
December 2020 (Anticipated)
Primary Completion Date
May 2021 (Anticipated)
Study Completion Date
May 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of the Philippines

4. Oversight

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

5. Study Description

Brief Summary
This COVID-19 pandemic warrants urgent strategies to protect people at high risk of infection, particularly the healthcare workers. Secondary prevention through post-exposure prophylaxis (PEP) and early treatment of infection are needed to prevent severe cases and cut secondary transmission. Hydroxycholoroquine (HCQ) is an inexpensive anti-malarial drug with immunomodulatory effects that are currently used as an off-label treatment for symptomatic COVID-19 patients. In vitro studies have shown that it can efficiently inhibit SARS-CoV-2 infection and has potential as a post-exposure prophylaxis drug.
Detailed Description
To compare the efficacy and safety of hydroxychloroquine with an oral loading dose of 400 mg two times a day on D1 followed by 400mg/day from Day 2-10 plus standard preventive measures and standard preventive measures alone as post-exposure prophylaxis for healthcare workers in a Metro Manila COVID Referral Center

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
COVID-19, SARS-COV-2, Hydroxychloroquine, Post-exposure prophylaxis, Healthcare workers

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Randomized, assessor- and patient- blinded, placebo controlled, parallel group trial
Masking
ParticipantOutcomes Assessor
Masking Description
Randomized allocation concealment Computer-generated random numbers for two groups will be used by a third party to create an allocation list for participants The pharmacist will prepare the test medication in sequentially numbered packages The third party will be contacted upon enrollment of a participant for the assigned group Blinding Placebo tablets will have the same appearance as the HCQ tablets The pharmacist will prepare the test medications in sequentially numbered packages Blinding of the outcome assessor will be achieved by using numerical codes on the Case Record Form of each patient with no indication of the group assignment on the Case Record Forms Laboratory specimens, ECG strip, and RT-PCR test specimens will be labeled with the numerical code of the participant and test number
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Hydroxychloroquine plus standard preventive measures
Arm Type
Experimental
Arm Description
Hydroxychloroquine oral loading dose of 400mg two times per day on Day 1 then 400 mg once a day for Day 2-10 plus standard preventive measures as defined by PGH Hospital Infection Control Unit (HICU)
Arm Title
Placebo plus standard preventive measure
Arm Type
Placebo Comparator
Arm Description
Placebo tablet plus standard preventive measures as defined by PGH-HICU
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine plus standard preventive measures
Other Intervention Name(s)
Hydroxychloroquine and standard preventive measures
Intervention Description
Hydroxychloroquine and standard preventive measures
Intervention Type
Drug
Intervention Name(s)
Placebo plus standard preventive measures
Intervention Description
Placebo tablet plus standard preventive measures as defined by PGH-HICU
Primary Outcome Measure Information:
Title
Efficacy of HCQ Prophylaxis in Preventing COVID-19 infection
Description
Incidence of COVID-19 infection confirmed by RT-PCR COVID-19 test within the PEP treatment period (28 days) with or without symptoms of COVID-19 infection
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Efficacy of study drug as post-exposure prophylaxis in preventing COVID-19 related symptoms (to be reported as absolute number and frequency of events)
Description
Incidence of patient self-reported COVID-19 related symptoms anytime during follow up period as measured by a standardized patient diary
Time Frame
30 days
Title
Time to COVID-19 infection in patients receiving study drug (in days)
Description
Interval from exposure to COVID-19 case Interval from first dose of study drug
Time Frame
30 days
Title
Safety and tolerability of study drug (to be reported as absolute number and frequency of events)
Description
Incidence of study drug discontinuation Incidence of all adverse events based on patients a) self-report using daily symptom diary and b) study physicians
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
59 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: any medical or non-medical personnel of the Philippine General Hospital and the UP Manila National Institutes of Health to include physicians (consultants, fellows-in-training, residents-in-training); nurses and other nursing staff (nursing aide, institutional or utility worker); janitors and cleaning staff, medical technologists and personnel of the laboratory where the COVID PCR testing is done; technicians of the radiology department, electrocardiography (ECG) station, arterial blood gas (ABG) stations and other personnel employed by the hospital on a tenured, part-time or full-time,and temporary. Because of the sample size, there is also a plan to include also health care workers in the community quarantine centers in the Manila area such as the Rizal Coliseum or the Ninoy Aquino Stadium, or at the World Trade Center aged 18-59 years exposure to a probable or confirmed COVID19 case within 4 days prior to study enrollment that is considered to be medium or high risk as defined by the HICU asymptomatic (no acute respiratory, flu-like, gastrointestinal signs and symptoms at the time of enrollment negative baseline COVID19 RT-PCR test result* for female participants of child bearing potential they must agree to effective birth control methods during the clinical trial or abstinence from any sexual activity during the duration of the study. Since RT-PCR result may not be released right away, volunteers who test positive after preliminary enrollment will be screen-failed and will not be included in the analysis. Exclusion Criteria: active COVID19 disease: positive RT-PCR COVID19 test prior COVID19 disease weight less than 40kg or a BMI less than 18kg/m2 current or recent hospitalization within the past year known allergy to or intolerance of hydroxychloroquine (HCQ) or chloroquine (CQ) current use of HCQ or CQ for whatever indications (malaria, lupus) current use of other medication with known antiviral effects current or known use in the last two weeks of known arrhythmogenic drugs or drugs that prolong the QT interval in the ECG, including but not limited to quinolones, macrolides, amiodarone, digoxin, flecainide, propafenone any previous known or suspected retinopathy; in case of doubt, an ophthalmology clearance be secured prior to enrollment known G6PD deficiency discovered through the newborn screening program or known intolerance or allergies to beans and any food that contains beans women who are pregnant or breastfeeding, or a positive pregnancy test at baseline for women of child bearing age history of known seizures or treatment with anti-epileptic medications history of known existing arrhythmia intake or use of anti diabetic agents especially sulfonylureas or any type of insulin presence of abnormalities in baseline tests: ECG abnormalities that are exclusionary: Baseline QTc > 500 msec or QTc > 550 msec in patients with wide QRS; any form of tachy- or bradyarrythmias NB: sinus arrhythmia is not exclusionary CBC abnormalities showing anemia with hemoglobin value less than 12.5 g/dL or low platelet count or thrombocytopenia with platelet count less than 150,000 platelets per microliter Creatinine levels above normal values: 60 to 110 micromoles per liter (0.7 to 1.2 mg/dL for men and 45 to 90 micromoles per liter (0.5 to 1.0 mg/dL) for women ALT test that is elevated above 2x the upper limit of the normal: NV is 7 to 56 units per liter
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Belen L Dofitas, MD
Organizational Affiliation
Philippine General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Philippine General Hospital - University of the Philippines Manila
City
Manila
Country
Philippines

12. IPD Sharing Statement

Plan to Share IPD
No

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The University of the Philippines Hydroxychloroquine PEP Against COVID-19 Trial

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