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Trial of Inhaled Anti-viral (SNG001) for SARS-CoV-2 (COVID-19) Infection

Primary Purpose

SARS-CoV-2

Status
Completed
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
SNG001
Placebo
Sponsored by
Synairgen Research Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for SARS-CoV-2 focused on measuring COVID-19

Eligibility Criteria

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

Inclusion Criteria:

  1. A. Hospital setting: positive virus test for SARS-CoV-2 using RT-PCR, or positive point-of-care viral infection test in the presence of strong clinical suspicion of SARS-CoV-2 infection.

    B. Home setting: positive virus test for SARS-CoV-2 using a molecular assay e.g. RT-PCR in the presence of strong clinical suspicion of SARS-CoV-2 infection.

  2. Male or female, ≥18 years of age (hospital setting) or ≥50 years of age (home setting) at the time of consent.
  3. A. Hospital setting: patients admitted to hospital due to the severity of their COVID 19 disease OR

    B. Home setting: non-hospitalised patients from high-risk groups, defined as ≥65-years of age, or ≥50 years of age and with any of the following risk factors:

    • Arterial hypertension
    • Cardiovascular disease
    • Diabetes mellitus
    • Chronic lung disease
    • Chronic kidney disease (eGFR <60 mL/min/1.73m2)
    • Chronic liver disease
    • Immunodeficiency due to a serious illness or medication
    • Cerebrovascular disease
    • Malignancy (except basal cell carcinoma) diagnosed in the last 5 years
    • Body Mass Index ≥30 who present with clinical symptoms consistent with COVID-19:
    • High temperature and/or
    • New, continuous cough.
    • Loss or change to sense of smell and/or taste
  4. Provide informed consent.
  5. A. Hospital setting: hospitalised female patients must be ≥1 year post-menopausal, surgically sterile, or using an acceptable method of contraception.

B. Home setting: non-hospitalised female patients must be ≥1 year post-menopausal or surgically sterile.

Exclusion Criteria:

  1. > 24 hours after confirmation of SARS-CoV-2 infection by a molecular assay e.g. RT-PCR test (hospital and home settings) or >24 hours after a positive point-of-care viral infection test (hospital setting only). This criterion does not apply to patients in the hospital setting who had their positive RT-PCR test for SARS-CoV-2 performed prior to hospitalisation.
  2. ≥ 8 days from onset of COVID-19 symptoms (cough and/or fever and/or loss or change to sense of smell and/or taste; home setting only).
  3. Any condition, including findings in the patients' medical history or in the pre-randomisation study assessments that in the opinion of the Investigator, constitute a risk or a contraindication for the participation of the patient into the study or that could interfere with the study objectives, conduct or evaluation.
  4. Current or previous participation in another clinical trial where the patient has received a dose of an Investigational Medicinal Product (IMP) containing small molecules within 30 days or 5 half-lives (whichever is longer) prior to entry into this study or containing biologicals within 3 months prior to entry into this study.
  5. Ventilated or in intensive care.
  6. Inability to use a nebuliser with a mouthpiece.
  7. History of hypersensitivity to natural or recombinant IFN-β or to any of the excipients in the drug preparation.
  8. Females who are breast-feeding, lactating, pregnant or intending to become pregnant.

Sites / Locations

  • Belfast City Hospital
  • Queen Elizabeth Hospital,
  • Bradford Royal Infirmary
  • Park and St Francis Surgery
  • Hull and East Yorkshire NHS Trust, Castle Hill Hospital,
  • Glenfield Hospital,
  • Wythenshawe Hospital
  • City Campus of Nottingham University
  • John Radcliffe Hospital
  • The Adam Practice
  • The Virtual Team
  • University Hospital Southampton Nhs Foundation Trust
  • Oaks Healthcare

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

SNG001

Placebo

Arm Description

inhalation using the I-neb device.

inhalation using the I-neb device.

Outcomes

Primary Outcome Measures

Ordinal Scale for Clinical Improvement
Change in condition measured using the Ordinal Scale for Clinical Improvement during the dosing period - minimum of 0 (patient is well) to a maximum of 8 (death)

Secondary Outcome Measures

Progression to pneumonia (hospital setting only)
Progression to pneumonia as diagnosed by chest x-ray, if no pneumonia is present at time of enrolment
Progression to pneumonia (hospital setting only)
Evolution of pneumonia, as diagnosed by chest x-ray, if pneumonia is present at time of enrolment
Time to clinical improvement (hospital setting only)
Time to clinical improvement
National Early Warning Score 2 (NEWS2) assessment of acute-illness severity (hospital setting only)
NEWS2 assessment of acute-illness severity on a scale of 0 ( being well) up to 24 (requiring emergency response)
Changes in daily breathlessness, cough and sputum scale (BCSS)
Changes in daily breathlessness, cough and sputum scale (BCSS) on a scale of 0 (no symptoms) up to 4 (severe symptoms)
Safety and tolerability - blood pressure (hospital setting only)
Looking at blood pressure measured in mmHg
Safety and tolerability - heart rate
Looking at heart rate measured in beats per minute
Safety and tolerability - temperature
Looking at temperature measured in degrees Celsius
Safety and tolerability - respiratory rate (hospital setting only)
Looking at respiratory rate measure in breaths per minute
Safety and tolerability - oxygen saturation
Looking at oxygen levels measured in a %
Safety and tolerability - adverse events
Looking at adverse events (numbers and terms)
Safety and tolerability - concomitant medications
Looking at concomitant medications given during treatment
Time to clinical improvement (home setting only)
Temperature ≤37.8 °C AND COVID-19 symptoms (breathing, cough, sputum, muscle aches, headache, fatigue, sore throat, loss or change to sense of smell and taste, rhinorrhoea and anorexia) all rated as absent or mild
Time to improvement of COVID-19 symptoms (home setting only).
Time to improvement of COVID-19 symptoms (fever, breathing, cough, sputum, muscle aches, headache, fatigue, sore throat, loss or change to sense of smell and/or taste, rhinorrhoea and anorexia)
Time to self-reported recovery (home setting only)
Time to self-reported recover
Self-reported daily rating of overall feeling of wellness (home setting only).
Self-reported daily rating of overall feeling of wellness scale from 1 (the worst you can imagine) to 10 (the best you can imagine)
Quality of life measured using EQ-5D-5L (home setting only).
Quality of life measured using EQ-5D-5L - 5 questions where minimum score is 1 (best outcome) to 5 (worst outcome), visual analogue scale is also included for this 100 is best health you can imagine to 0 worst health you can imagine
Virus clearance/load (if samples are available)
Time to virus clearance and viral load
Blood and sputum biomarkers (if samples are available).
Blood and sputum biomarkers
Contact with health services (home setting only)
Contact with health services
Consumption of antibiotics (home setting only)
Consumption of antibiotics
General Anxiety Disorder 7 (home setting only)
Assessment of anxiety - score of 0 (best) to 3 (worst)
Patient Health Questionnaire - 9
Assessment of mental health - score of 0 (best) to 3 (worst)
FACIT Fatigue Scale
Assessment of Fatigue - score of 0 (best) to 4 (worst)
Nottingham Extended Activities of Daily Living Scale
Assessment of activities of daily living - no score just tick the box that applies; 'Not at all', 'With help', 'On your own with difficulty' and 'On your own'

Full Information

First Posted
April 24, 2020
Last Updated
January 3, 2023
Sponsor
Synairgen Research Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04385095
Brief Title
Trial of Inhaled Anti-viral (SNG001) for SARS-CoV-2 (COVID-19) Infection
Official Title
A Randomised Double-blind Placebo-controlled Trial to Determine the Safety and Efficacy of Inhaled SNG001 (IFN-β1a for Nebulisation) for the Treatment of Patients With Confirmed SARS-CoV-2 Infection
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
March 16, 2020 (Actual)
Primary Completion Date
February 17, 2021 (Actual)
Study Completion Date
November 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Synairgen Research Ltd.

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
SNG001 is an inhaled drug that contains a antiviral protein called interferon beta (IFN-β). IFN-β in produced in the lungs during viral lung infections. It has been shown that older people and people with some chronic diseases have an IFN-β deficiency. Many viruses inhibit IFN-β as part of their strategy to evade the immune system. Addition of IFN-β in vitro protects lung cells from viral infection. IFN-β protects cells against the MERS and SARS coronaviruses (close relatives of SARS-CoV-2, the virus that causes COVID-19). SNG001 is an inhaled formulation of interferon beta-1a it is currently in Phase II clinical trials for COPD patients. Synairgen has conducted randomised placebo controlled clinical trials of SNG001 involving >200 asthma and COPD patients. These trials have shown that SNG001 has: been well tolerated during virus infections enhanced antiviral activity in the lungs (measured in sputum and blood samples) provided significant lung function benefit over placebo in asthma in two Phase II trials. Synairgen believes SNG001 could help prevent worsening or accelerate recovery of severe lower respiratory tract illness in COVID-19 patients. Patients who are in hospital or non-hospitalised but are a high risk groups (e.g. elderly or diabetics) will be invited to take part in the trial. The patient would receive either SNG001 or placebo once daily for 14 days. The severity of the patients condition would be recorded on a scale developed by the World Health Organisation and the patient would be asked questions about their breathlessness, cough and sputum every day, as well as assess their general medical condition and safety. The study will start as a Pilot phase where 100 patients will be randomised in the hospital setting and a 120 patients randomised in the home setting. Once each of the Pilot phases are complete, a Pivotal phase will be conducted. It is estimated that the size of each of the Pivotal phases (hospital and home) will be around 100 to 300 patients per arm. The actual number will be determined after the data review at the end of each of the Pilot phases. If SNG001 proves to be beneficial it would be a major breakthrough for the treatment of COVID-19.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
SARS-CoV-2
Keywords
COVID-19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomised double-blind placebo-controlled Pilot phase - 100 patients randomised in the hospital setting, 120 patients randomised in the home setting. Pivotal phase - estimated at an additional 100 to 300 patients per arm, but the actual number will be determined after the data review at the end of the Pilot phase
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double-blind
Allocation
Randomized
Enrollment
221 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SNG001
Arm Type
Active Comparator
Arm Description
inhalation using the I-neb device.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
inhalation using the I-neb device.
Intervention Type
Drug
Intervention Name(s)
SNG001
Intervention Description
SNG001 via inhalation
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo via inhalation
Primary Outcome Measure Information:
Title
Ordinal Scale for Clinical Improvement
Description
Change in condition measured using the Ordinal Scale for Clinical Improvement during the dosing period - minimum of 0 (patient is well) to a maximum of 8 (death)
Time Frame
Day 1 to Days 15 and 28
Secondary Outcome Measure Information:
Title
Progression to pneumonia (hospital setting only)
Description
Progression to pneumonia as diagnosed by chest x-ray, if no pneumonia is present at time of enrolment
Time Frame
Day 2 to Day 28
Title
Progression to pneumonia (hospital setting only)
Description
Evolution of pneumonia, as diagnosed by chest x-ray, if pneumonia is present at time of enrolment
Time Frame
Day 1 to Day 28
Title
Time to clinical improvement (hospital setting only)
Description
Time to clinical improvement
Time Frame
Time to hospital discharge OR Time to NEWS2 of ≤ 2 maintained for 24 hours
Title
National Early Warning Score 2 (NEWS2) assessment of acute-illness severity (hospital setting only)
Description
NEWS2 assessment of acute-illness severity on a scale of 0 ( being well) up to 24 (requiring emergency response)
Time Frame
Day 1 to Day 28
Title
Changes in daily breathlessness, cough and sputum scale (BCSS)
Description
Changes in daily breathlessness, cough and sputum scale (BCSS) on a scale of 0 (no symptoms) up to 4 (severe symptoms)
Time Frame
Day 1 to Day 28 (and Day 60 and 90 home setting only)
Title
Safety and tolerability - blood pressure (hospital setting only)
Description
Looking at blood pressure measured in mmHg
Time Frame
Day 1 to Day 15
Title
Safety and tolerability - heart rate
Description
Looking at heart rate measured in beats per minute
Time Frame
Day 1 to Day 15
Title
Safety and tolerability - temperature
Description
Looking at temperature measured in degrees Celsius
Time Frame
Day 1 to Day 15
Title
Safety and tolerability - respiratory rate (hospital setting only)
Description
Looking at respiratory rate measure in breaths per minute
Time Frame
Day 1 to Day 15
Title
Safety and tolerability - oxygen saturation
Description
Looking at oxygen levels measured in a %
Time Frame
Day 1 to Day 15
Title
Safety and tolerability - adverse events
Description
Looking at adverse events (numbers and terms)
Time Frame
Day 1 to Day 28
Title
Safety and tolerability - concomitant medications
Description
Looking at concomitant medications given during treatment
Time Frame
Day 1 to Day 28
Title
Time to clinical improvement (home setting only)
Description
Temperature ≤37.8 °C AND COVID-19 symptoms (breathing, cough, sputum, muscle aches, headache, fatigue, sore throat, loss or change to sense of smell and taste, rhinorrhoea and anorexia) all rated as absent or mild
Time Frame
Day 1 to Day 15
Title
Time to improvement of COVID-19 symptoms (home setting only).
Description
Time to improvement of COVID-19 symptoms (fever, breathing, cough, sputum, muscle aches, headache, fatigue, sore throat, loss or change to sense of smell and/or taste, rhinorrhoea and anorexia)
Time Frame
Day 1 to Day 28 and Day 60 and 90
Title
Time to self-reported recovery (home setting only)
Description
Time to self-reported recover
Time Frame
Day 2 to Day 15 and Day 28, 60 and 90
Title
Self-reported daily rating of overall feeling of wellness (home setting only).
Description
Self-reported daily rating of overall feeling of wellness scale from 1 (the worst you can imagine) to 10 (the best you can imagine)
Time Frame
Day 1 to Day 28 and Day 60 and 90
Title
Quality of life measured using EQ-5D-5L (home setting only).
Description
Quality of life measured using EQ-5D-5L - 5 questions where minimum score is 1 (best outcome) to 5 (worst outcome), visual analogue scale is also included for this 100 is best health you can imagine to 0 worst health you can imagine
Time Frame
Day 1 to Day 28 and Day 60 and 90
Title
Virus clearance/load (if samples are available)
Description
Time to virus clearance and viral load
Time Frame
Day 1 to Day 28
Title
Blood and sputum biomarkers (if samples are available).
Description
Blood and sputum biomarkers
Time Frame
Day 1 to Day 28
Title
Contact with health services (home setting only)
Description
Contact with health services
Time Frame
Day 1 to Day 28
Title
Consumption of antibiotics (home setting only)
Description
Consumption of antibiotics
Time Frame
Day 1 to Day 28
Title
General Anxiety Disorder 7 (home setting only)
Description
Assessment of anxiety - score of 0 (best) to 3 (worst)
Time Frame
Day 60 and 90
Title
Patient Health Questionnaire - 9
Description
Assessment of mental health - score of 0 (best) to 3 (worst)
Time Frame
Day 60 and 90
Title
FACIT Fatigue Scale
Description
Assessment of Fatigue - score of 0 (best) to 4 (worst)
Time Frame
Day 60 and 90
Title
Nottingham Extended Activities of Daily Living Scale
Description
Assessment of activities of daily living - no score just tick the box that applies; 'Not at all', 'With help', 'On your own with difficulty' and 'On your own'
Time Frame
Day 60 and 90

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A. Hospital setting: positive virus test for SARS-CoV-2 using RT-PCR, or positive point-of-care viral infection test in the presence of strong clinical suspicion of SARS-CoV-2 infection. B. Home setting: positive virus test for SARS-CoV-2 using a molecular assay e.g. RT-PCR in the presence of strong clinical suspicion of SARS-CoV-2 infection. Male or female, ≥18 years of age (hospital setting) or ≥50 years of age (home setting) at the time of consent. A. Hospital setting: patients admitted to hospital due to the severity of their COVID 19 disease OR B. Home setting: non-hospitalised patients from high-risk groups, defined as ≥65-years of age, or ≥50 years of age and with any of the following risk factors: Arterial hypertension Cardiovascular disease Diabetes mellitus Chronic lung disease Chronic kidney disease (eGFR <60 mL/min/1.73m2) Chronic liver disease Immunodeficiency due to a serious illness or medication Cerebrovascular disease Malignancy (except basal cell carcinoma) diagnosed in the last 5 years Body Mass Index ≥30 who present with clinical symptoms consistent with COVID-19: High temperature and/or New, continuous cough. Loss or change to sense of smell and/or taste Provide informed consent. A. Hospital setting: hospitalised female patients must be ≥1 year post-menopausal, surgically sterile, or using an acceptable method of contraception. B. Home setting: non-hospitalised female patients must be ≥1 year post-menopausal or surgically sterile. Exclusion Criteria: > 24 hours after confirmation of SARS-CoV-2 infection by a molecular assay e.g. RT-PCR test (hospital and home settings) or >24 hours after a positive point-of-care viral infection test (hospital setting only). This criterion does not apply to patients in the hospital setting who had their positive RT-PCR test for SARS-CoV-2 performed prior to hospitalisation. ≥ 8 days from onset of COVID-19 symptoms (cough and/or fever and/or loss or change to sense of smell and/or taste; home setting only). Any condition, including findings in the patients' medical history or in the pre-randomisation study assessments that in the opinion of the Investigator, constitute a risk or a contraindication for the participation of the patient into the study or that could interfere with the study objectives, conduct or evaluation. Current or previous participation in another clinical trial where the patient has received a dose of an Investigational Medicinal Product (IMP) containing small molecules within 30 days or 5 half-lives (whichever is longer) prior to entry into this study or containing biologicals within 3 months prior to entry into this study. Ventilated or in intensive care. Inability to use a nebuliser with a mouthpiece. History of hypersensitivity to natural or recombinant IFN-β or to any of the excipients in the drug preparation. Females who are breast-feeding, lactating, pregnant or intending to become pregnant.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tom Wilkinson
Organizational Affiliation
Study Chief Investigator
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nick Francis
Organizational Affiliation
Study Deputy Chief Investigator
Official's Role
Principal Investigator
Facility Information:
Facility Name
Belfast City Hospital
City
Belfast
ZIP/Postal Code
BT9 7AB
Country
United Kingdom
Facility Name
Queen Elizabeth Hospital,
City
Birmingham
ZIP/Postal Code
B15 2GW
Country
United Kingdom
Facility Name
Bradford Royal Infirmary
City
Bradford
ZIP/Postal Code
BD9 6RJ
Country
United Kingdom
Facility Name
Park and St Francis Surgery
City
Chandler's Ford
ZIP/Postal Code
SO53 4ST
Country
United Kingdom
Facility Name
Hull and East Yorkshire NHS Trust, Castle Hill Hospital,
City
Hull
ZIP/Postal Code
HU16 5JQ
Country
United Kingdom
Facility Name
Glenfield Hospital,
City
Leicester
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Facility Name
Wythenshawe Hospital
City
Manchester
ZIP/Postal Code
M23 9LT
Country
United Kingdom
Facility Name
City Campus of Nottingham University
City
Nottingham
ZIP/Postal Code
NG5 1PB
Country
United Kingdom
Facility Name
John Radcliffe Hospital
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom
Facility Name
The Adam Practice
City
Poole
ZIP/Postal Code
BH15 2HX
Country
United Kingdom
Facility Name
The Virtual Team
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
University Hospital Southampton Nhs Foundation Trust
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Oaks Healthcare
City
Waterlooville
ZIP/Postal Code
PO8 8DL
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No plan to share data
Citations:
PubMed Identifier
33189161
Citation
Monk PD, Marsden RJ, Tear VJ, Brookes J, Batten TN, Mankowski M, Gabbay FJ, Davies DE, Holgate ST, Ho LP, Clark T, Djukanovic R, Wilkinson TMA; Inhaled Interferon Beta COVID-19 Study Group. Safety and efficacy of inhaled nebulised interferon beta-1a (SNG001) for treatment of SARS-CoV-2 infection: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Respir Med. 2021 Feb;9(2):196-206. doi: 10.1016/S2213-2600(20)30511-7. Epub 2020 Nov 12.
Results Reference
derived
PubMed Identifier
32788708
Citation
Lee JS, Shin EC. The type I interferon response in COVID-19: implications for treatment. Nat Rev Immunol. 2020 Oct;20(10):585-586. doi: 10.1038/s41577-020-00429-3.
Results Reference
derived

Learn more about this trial

Trial of Inhaled Anti-viral (SNG001) for SARS-CoV-2 (COVID-19) Infection

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