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A Study of Rilematovir in Infants and Children and Subsequently in Neonates Hospitalized With Acute Respiratory Tract Infection Due to Respiratory Syncytial Virus (RSV)

Phase 3
Terminated
Conditions
Respiratory Tract Infections
Interventions
Registration Number
NCT04583280
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of the study is to evaluate the efficacy of rilematovir compared to placebo treatment with respect to the clinical outcome on the RSV Recovery Scale (RRS).

Detailed Description

Respiratory syncytial virus (RSV), a negative-stranded ribonucleic acid (RNA) virus belonging to the Pneumoviridae family, is considered the most important cause of acute lower respiratory tract infection (LRTI) in infants and young children. In most patients, RSV results in upper respiratory tract infection (URTI) eliciting "common cold"-like symptoms, which might last up to 2 weeks, and are usually self-limiting. RSV-related LRTI is a major cause of hospital admissions and death in young children worldwide. Rilematovir is an investigational, small molecule, RSV fusion inhibitor. This study aims to evaluate the efficacy and safety of rilematovir in hospitalized infants and children (greater than or equal to \[\>=\] 28 days to less than or equal to \[\<=\] 5 years) and, subsequent to completion of the neonatal substudy, in hospitalized neonates (born at term, less than \[\<\] 28 days of age) with RSV infection. The study will include a Screening Period, a Treatment Period, and a Follow-up Period. The total study duration for each participant will be approximately 36 days (Screening included). The efficacy assessments include evaluation under the RRS and the safety assessments include evaluations of physical examinations, vital signs, electrocardiograms, clinical laboratory tests, and adverse events.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
28
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RilematovirRilematovir X mg/kgParticipants will receive rilematovir orally based on body weight and age group.
PlaceboPlaceboParticipants will receive matching placebo of rilematovir based on body weight and age group.
RilematovirRilematovirParticipants will receive rilematovir orally based on body weight and age group.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants by Respiratory Syncytial Virus (RSV) Recovery Scale (RRS) CategoryBaseline to Day 8

RRS was an ordinal scale to assess a participant's clinical status. The RRS provided 7 mutually exclusive categories ordered from best (1) to worst (7) where 1 =home without signs/symptoms, 2 =home with sign/symptoms, 3 =ward without supplemental oxygen (O2) or feeding/hydration, 4 =ward with supplemental or feeding/hydration, 5 =intensive care unit (ICU) without mechanical ventilation (included both invasive and non-invasive mechanical ventilation), 6 =required mechanical ventilation and 7=worst (death). Higher category indicates worse condition. With or without signs/symptoms was defined as the key RSV signs/symptoms (breathing problems, retractions, tachypnea, cough, wheezing/breathing sounds, and tachycardia) resolved (absent or mild) or not resolved assessed by parent/caregiver.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Clinically Resolved From RSV Disease Based on the Clinician Reported Outcome (ClinRO) Sign/Symptoms at Day 8Day 8

Clinically resolved was defined as participant required no oxygen supplementation, no supplemental feeding/hydration, no need for ICU and had Key RSV signs/symptoms resolved to absent or mild as per ClinRO signs/symptoms. Clinically resolved Key RSV signs/symptoms were assessed based on clinician's observations as resolved if participant had no retractions, tachypnea, tachycardia, breathing problems (nasal flaring, head bobbing, grunting); cough (resolved if little or no coughing or occasional strong cough or sometimes productive) and wheezing (resolved if no wheezing or terminal expiratory wheezing or only with stethoscope).

Number of Participants With Abnormalities in Clinical Laboratory ValuesUp to Day 35

Number of participants with abnormally low (AL) and abnormally high (AH) values of bicarbonate, direct bilirubin, urea nitrogen, basophils, eosinophils, erythrocyte (Ery). mean corpuscular hemoglobin (HGB) concentration (conc), Ery. mean corpuscular hemoglobin, erythrocytes, leukocytes, lymphocytes, monocytes, neutrophils and reticulocytes were reported based on the investigator's discretion.

Number of Participants With Abnormalities in Electrocardiograms (ECGs)Up to Day 35

Number of participants with abnormally low and abnormally high values of ECG parameters (PR interval and RR interval) as assessed based on the investigator's discretion were reported.

Percentage of Participants Requiring Intensive Care Unit (ICU) Stay After First Dose of RilematovirUp to Day 35

Percentage of participants requiring ICU stay was analyzed and reported.

Percentage of Participants With Acceptability and Palatability of the Rilematovir Formulation as Assessed by Parent(s)/Caregiver(s)Day 8

Acceptability and palatability were assessed by clinician electronic clinical outcome assessment (eCOA) questionnaire which consisted of 7 questions, 1- child took medicine easily, 2- disgusted expressions after tasting medicine, 3- cried after tasting medicine, 4- would not open mouth or turned head away to avoid medicine, 5- spit out or coughed out medicine, 6- gagged, 7- vomited (within 2 minutes of swallowing medicine).

Number of Participants With Medical Encounters and TreatmentsUp to Day 35

Medical resource utilization was assessed by medical care encounters and treatments. Medical encounters and treatments included physician or emergency room visits, tests and procedures, and medications, surgeries and other selected procedures, inpatient and outpatient.

Number of Participants With Post-baseline RSV-related ComplicationsUp to Day 35

RSV related complications included respiratory complications (respiratory failure, apnoeic attacks, bronchiolitis, bronchial obstruction, pneumonia and asthmatic crisis), infectious complications (otitis media, bacterial respiratory tract infections and sepsis), cardiovascular complications (arrhythmia, cardiogenic shock, hemodynamic instability, congestive cardiac failure), acid-base or electrolyte complications (metabolic acidosis, metabolic alkalosis, hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, hypercalcemia, hypoglycemia and hyperglycemia). Participants were counted only once, regardless of the number of complications they actually experienced.

Number of Participants With Abnormalities in Vital SignsUp to Day 35

Number of participants with abnormally low and abnormally high values of vital signs from baseline were assessed based on investigator's discretion. Vital signs included systolic blood pressure (SBP) (millimeter of mercury \[mmHg\]), diastolic blood pressure (DBP) (mmHg), pulse rate (beats per minute), respiratory rate (breaths per minute), temperature (degree Celsius) and oxygen saturation (in percentage).

Duration of Oxygen SupplementationUp to Day 35

Duration (in hours) of oxygen supplementation was defined as total number of hours a participant used supplemental oxygen from either prior to first dose and/or after first dose of drug until study termination, calculated as the sum of all separate records of supplementation.

Percentage of Participants Requiring Hydration and/or Feeding by Intravenous (IV) Administration or Nasogastric Tube After First Dose of RilematovirUp to Day 35

Percentage of participants requiring any type of hydration and/or feeding by intravenous (IV) administration or nasogastric tube or percutaneous endoscopic gastrostomy was reported.

Time From First Study Dose to Resolution of Key RSV Signs/Symptoms Based on Observer Reported Outcome (ObsRO) After Free of Supplementation (Oxygen/Feeding/Hydration) for at Least 24 HoursUp to Day 21

Time (in hours) from first dose of study intervention to first resolution of key RSV signs/symptoms was evaluated based on ObsRO assessment after free of supplementation (O2/feeding/hydration) for at least 24 hours. Clinically resolved was defined as participant required no oxygen supplementation, no supplemental feeding/hydration, no need for ICU and had key RSV signs/symptoms resolved to absent or mild as per ObsRO signs/symptoms. Resolution of key signs/symptoms assessment was based on observations of child's parent/caregiver as resolved if no retractions, tachypnea, tachycardia, breathing problems (gasping for air nostrils, flaring when breathing, head bobbed back and forth when breathing), no breathing sound; cough (no coughing, little coughing without problems). Kaplan-Meier method was used for estimation.

Number of Participants With Treatment-emergent Adverse Events (TEAEs)Day 1 up to Day 35

An adverse event (AE) is any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product and did not necessarily have a causal relationship with the treatment. A TEAE was defined as an AE with an onset after the initiation study drug (Day 1) up to end of study (Day 35). AEs included both serious and non-serious AEs.

Percentage of Participants Requiring Re-hospitalization for Respiratory/Other ReasonsUp to Day 35

Percentage of participants requiring re-hospitalization (participants re-hospitalized \[ward or ICU\] after been discharged from hospital) for respiratory/other reasons were reported.

Percentage of Participants Requiring Oxygen Supplementation After First Dose of RilematovirUp to Day 35

Percentage of participants requiring any type of oxygen supplementation (invasive mechanical ventilation, non-invasive mechanical ventilation and non-invasive non-mechanical ventilation) were reported.

RSV Viral Load at Baseline, Days 2, 3, 5, 8, 14 and 21Baseline, Days 2, 3, 5, 8, 14 and 21

Antiviral activity was determined based on measurements of RSV viral load which was measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR) in the mid-turbinate (MT) nasal swab specimens.

Change From Baseline in RSV Viral Load at Days 2, 3, 5, 8, 14 and 21Baseline, Days 2, 3, 5, 8, 14 and 21

Antiviral activity was determined based on measurements of RSV viral load which was measured by qRT-PCR in the MT nasal swab specimens.

Percentage of Participants With Undetectable RSV Viral LoadBaseline, Days 2, 3, 5, 8, 14 and 21

Percentage of participants with undetectable RSV viral load was analyzed.

Plasma Concentrations of Rilematovir1 hour Post-dose (Day 1) and pre-dose (Day 2)

Plasma concentrations of rilematovir were assessed. Participant wise data were reported for this outcome measure.

Duration of ICU StayUp to Day 35

Duration (in hours) of ICU stay was defined as total number of hours a participant experienced an ICU stay from first dose of rilematovir until study termination, calculated as the sum of all separate records of ICU stay.

Duration of Supplemental Feeding/HydrationUp to Day 35

Duration (in hours) of supplemental feeding/hydration was defined as total number of hours a participant was administered feeding/hydration supplementation from either prior to first dose and/or after first dose of drug until study termination, calculated as the sum all separate records of supplementation use per participant.

Trial Locations

Locations (142)

MNPE City Children's Clinical Hospital № 6 of Dnipro City Council

🇺🇦

Dnipro, Ukraine

ME 'Dnipropetrovsk Regional Children's Clinical Hospital of Dnipropetrovsk Regional Council'

🇺🇦

Dnipro, Ukraine

Kharkiv National Medical University on based CHPI Kharkiv Municipal Clinical Children's Hospital 16

🇺🇦

Kharkiv, Ukraine

Arnold Palmer Hospital For Children

🇺🇸

Orlando, Florida, United States

Acibadem City Clinic Tokuda Hospital

🇧🇬

Sofia, Bulgaria

UMHAT 'Aleksandrovska' EAD

🇧🇬

Sofia, Bulgaria

SHATCD 'Prof. Ivan Mitev' EAD

🇧🇬

Sofia, Bulgaria

Capital Institute of Pediatrics

🇨🇳

Beijing, China

Beijing Children's Hospital, Capital Medical University

🇨🇳

Beijing, China

West China Second University Hospital, Sichuan University

🇨🇳

Chengdu, China

Guangzhou Women And Children's Medical Center

🇨🇳

Guangzhou, China

Fakultni nemocnice Brno

🇨🇿

Brno, Czechia

Fakultni nemocnice Kralovske Vinohrady

🇨🇿

Praha 10, Czechia

Thomayerova nemocnice

🇨🇿

Praha 4, Czechia

Tallinn Children's Hospital

🇪🇪

Tallinn, Estonia

Tartu University Hospital

🇪🇪

Tartu, Estonia

Universitätsklinik Freiburg

🇩🇪

Freiburg, Germany

Bacs-kiskun Megyei Korhaz

🇭🇺

Kecskemet, Hungary

Borsod-Abauj-Zemplen Megyei Korhaz es Egyetemi Oktato Korhaz

🇭🇺

Miskolc, Hungary

Szegedi Tudomanyegyetem

🇭🇺

Szeged, Hungary

Csolnoky Ferenc Korhaz

🇭🇺

Veszprém, Hungary

Sourasky MC

🇮🇱

Tel-Aviv, Israel

A O U Sant Orsola Malpighi

🇮🇹

Bologna, Italy

Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

🇮🇹

Milan, Italy

Department of Pediatrics University of Pavia, Policlinico San Matteo

🇮🇹

Pavia, Italy

Ospedale degli Infermi

🇮🇹

Ponderano, Italy

Fukui Prefectural Hospital

🇯🇵

Fukui-shi, Japan

Fukuyama City Hospital

🇯🇵

Fukuyama, Japan

Kagoshima Children's Hospital

🇯🇵

Hioki, Japan

Teine Keijinkai Hospital

🇯🇵

Hokkaido, Japan

National Hospital Organization Kanazawa Medical Center

🇯🇵

Ishikawa, Japan

Japan Community Health care Organization Kyushu Hospital

🇯🇵

Kitakyushu-shi, Japan

Kojunkai Daido Hospital

🇯🇵

Nagoya, Japan

National Hospital Organization Niigata National Hospital

🇯🇵

Niigata, Japan

National Hospital Organization Beppu Medical Center

🇯🇵

Oita, Japan

National Hospital Organization Saitama National Hospital

🇯🇵

Saitama, Japan

Yamanashi Prefectural Central Hospital

🇯🇵

Yamanashi, Japan

Kangbuk Samsung Hospital

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital Infantil de Mexico Federico Gomez

🇲🇽

Ciudad De Mexico, Mexico

Hospital Universitario Dr Jose Eleuterio Gonzalez

🇲🇽

Monterrey, Mexico

Centro Medico Zambrano Hellion

🇲🇽

Monterrey, Mexico

Cevaxin Avenida Mexico

🇵🇦

Panama, Panama

Krakowski Szpital Specjalistyczny im Jana Pawla II

🇵🇱

Krakow, Poland

Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im M Kopernika w Lodzi

🇵🇱

Lodz, Poland

Uniwersytecki Szpital Dzieciecy w Lublinie

🇵🇱

Lublin, Poland

Dzieciecy Szpital Kliniczny im Jozefa Polikarpa Brudzinskiego

🇵🇱

Warszawa, Poland

DFNsP Banska Bystrica

🇸🇰

Banska Bystrica, Slovakia

Pediatric Pulmonology Clinic, University Hospital Bratislava

🇸🇰

Bratislava, Slovakia

Hosp. Univ. Germans Trias I Pujol

🇪🇸

Badalona, Spain

Hosp. Univ. de Cruces

🇪🇸

Barakaldo, Spain

Hosp Reina Sofia

🇪🇸

Córdoba, Spain

Hosp. Univ. de Getafe

🇪🇸

Getafe, Spain

Hosp Univ Fund Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital Das Clinicas Da Faculdade De Medicina De RPUSP HCRP

🇧🇷

Ribeirão Preto, Brazil

Fundacao Jose Luiz Egydio Setubal

🇧🇷

Sao Paulo, Brazil

Santa Casa de Misericórdia de Votuporanga

🇧🇷

Votuporanga, Brazil

UMHAT 'Sveti Georgi'-Plovdiv

🇧🇬

Plovdiv, Bulgaria

UMHAT 'Kanev' EAD

🇧🇬

Ruse, Bulgaria

Hosp. Univ. 12 de Octubre

🇪🇸

Madrid, Spain

Hosp. Univ. La Paz

🇪🇸

Madrid, Spain

Hosp. Univ. Hm Monteprincipe

🇪🇸

Madrid, Spain

Hosp. Univ. Severo Ochoa

🇪🇸

Madrid, Spain

Hosp. Univ. Pta. de Hierro Majadahonda

🇪🇸

Majadahonda, Spain

Hosp. Puerta Del Sur

🇪🇸

Mostoles, Spain

Complejo Hosp. de Navarra

🇪🇸

Pamplona, Spain

Hosp. Quiron Madrid Pozuelo

🇪🇸

Pozuelo de Alarcón, Spain

Hosp. Clinico Univ. de Santiago

🇪🇸

Santiago de Compostela, Spain

Astrid Lindgrens barnsjukhus Solna

🇸🇪

Stockholm, Sweden

Mackay Memorial Hospital

🇨🇳

Taipei, Taiwan

Maharaj Nakorn Chiangmai Hospital

🇹🇭

Chiang Mai, Thailand

Srinagarind Hospital

🇹🇭

Khon Kaen, Thailand

Bamrasnaradura Infectious Disease Institute

🇹🇭

Nonthaburi, Thailand

Gazi University Medical Faculty

🇹🇷

Ankara, Turkey

Istanbul University Istanbul Medical Faculty

🇹🇷

Istanbul, Turkey

Ege University Medical Faculty

🇹🇷

Izmir, Turkey

Saglik Bilimleri University Sariyer Hamidiye Etfal Training and Research Hospital

🇹🇷

Sarıyer, Turkey

Karadeniz Teknik University Medical Faculty

🇹🇷

Trabzon, Turkey

University of Mississippi Medical Center

🇺🇸

Jackson, Mississippi, United States

Jacobi Medical Center

🇺🇸

Bronx, New York, United States

Le Bonheur Children's Hospital

🇺🇸

Memphis, Tennessee, United States

MultiCare Health Systems for Research and Innovation

🇺🇸

Tacoma, Washington, United States

Hospital Interzonal General de Agudos Dr. Jose Penna

🇦🇷

Bahia Blanca, Argentina

Hospital Italiano Regional Del Sur

🇦🇷

Bahía Blanca, Argentina

Hospital General de Niños Pedro de Elizalde

🇦🇷

Buenos Aires, Argentina

Hospital Universitario Austral

🇦🇷

Pilar, Argentina

Instituto Medico Rio Cuarto

🇦🇷

Rio Cuarto, Argentina

Clinica Mayo de UMCB

🇦🇷

San Miguel de Tucuman, Argentina

Hospital del Niño Jesús

🇦🇷

San Miguel de Tucumán, Argentina

ULB Hôpital Erasme

🇧🇪

Anderlecht, Belgium

AZ Sint Jan Brugge Oostende AV

🇧🇪

Brugge, Belgium

UZ Brussel

🇧🇪

Brussel, Belgium

Cliniques Universitaires Saint Luc

🇧🇪

Bruxelles, Belgium

UZ Leuven

🇧🇪

Leuven, Belgium

Santa Casa de Misericordia de Belo Horizonte

🇧🇷

Belo Horizonte, Brazil

Fundacao para o Desenvolvimento Medico Hospitalar (UNESP Botucatu)

🇧🇷

Botucatu, Brazil

Sociedade Campineira de Educacao e Instrucao Hospital e Maternidade Celso Pierro

🇧🇷

Campinas, Brazil

Nucleo de Pesquisa do Hospital Pequeno Princípe

🇧🇷

Curitiba, Brazil

Secretaria da Saude do Estado do Ceara - Hospital Doutor Carlos Alberto Studart Gomes

🇧🇷

Fortaleza, Brazil

Associacao Hospitalar Moinhos de Vento

🇧🇷

Porto Alegre, Brazil

Peking University Third Hospital

🇨🇳

Beijing, China

HELIOS Klinikum Wuppertal GmbH

🇩🇪

Wuppertal, Germany

Universitatsklinikum Wurzburg

🇩🇪

Würzburg, Germany

Semmelweis Egyetem, II. sz. Gyermekgyógyászati Klinika

🇭🇺

Budapest, Hungary

Bethesda Gyermekkórház

🇭🇺

Budapest, Hungary

Debreceni Egyetem Klinikai Kozpont

🇭🇺

Debrecen, Hungary

Petz Aladar Megyei Oktato Korhaz

🇭🇺

Győr, Hungary

Soroka University Medical Center

🇮🇱

Beer-Sheba, Israel

Ruth Rappaport Children's Hospital, Rambam Health Care Campus

🇮🇱

Haifa, Israel

Schneider Children's Medical Center

🇮🇱

Petah Tikva, Israel

Pediatrics B, Safra Children's Hospital, Tel Hashomer

🇮🇱

Ramat Gan, Israel

Kobe City Medical Center General Hospital

🇯🇵

Kobe, Japan

Kochi Health Sciences Center

🇯🇵

Kochi, Japan

Maebashi Red Cross Hospital

🇯🇵

Maebashi, Japan

National Hospital Organization Ureshino Medical Center

🇯🇵

Ureshino-shi, Japan

Kyungpook National University Hospital

🇰🇷

Daegu, Korea, Republic of

CHA Bundang Medical Center, CHA University

🇰🇷

Gyeonggi-do, Korea, Republic of

Korea Institute of Radiological and Medical Sciences

🇰🇷

Seoul, Korea, Republic of

Nowon Eulji Medical Center, Eulji University

🇰🇷

Seoul, Korea, Republic of

Inje University Sanggye Paik Hospital

🇰🇷

Seoul, Korea, Republic of

Children's Clinical University Hospital

🇱🇻

Riga, Latvia

Hospital Selayang

🇲🇾

Batu Caves, Malaysia

Hospital Bintulu

🇲🇾

Bintulu, Malaysia

Hospital Miri

🇲🇾

Miri, Malaysia

Hospital Sibu

🇲🇾

Sibu, Malaysia

Hospital Taiping

🇲🇾

Taiping, Malaysia

Instituto Nacional de Pediatría

🇲🇽

Ciudad de Mexico, Mexico

Hsinchu MacKay Memorial Hospital

🇨🇳

Hsinchu, Taiwan

Taipei Medical University Shuang Ho Hospital

🇨🇳

New Taipei City, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Chang Gung Medical Foundation

🇨🇳

Taoyuan City, Taiwan

Tropical Medicine Hospital, Mahidol University

🇹🇭

Bangkok, Thailand

Siriraj Hospital Mahidol University

🇹🇭

Bangkok, Thailand

Faculty of Medicine Chulalongkorn University

🇹🇭

Pathumwan, Thailand

Cukurova University Medical Faculty Balcali Hospital

🇹🇷

Adana, Turkey

Hacettepe University Medical Faculty

🇹🇷

Ankara, Turkey

MUNICIPAL NON-PROFIT ENTERPRISE 'Kryvyi Rih CITY HOSPITAL №16' Kryvyi Rih CITY COUNCIL

🇺🇦

Kryvyi Rih, Ukraine

Odessa Regional Child Hospital

🇺🇦

Odessa, Ukraine

SSU Division MU Ch of pediatrics of PGE with propedeutic pediatrics and children infections course

🇺🇦

Sumy, Ukraine

Sumy Regional Childrens Clinical Hospital

🇺🇦

Sumy, Ukraine

Municipal institution 'Vinnytsia Regional Clinical Children's Infectious Diseases Hospital'

🇺🇦

Vinnytsia, Ukraine

MNPE Zaporizhzhya Regional Clinical Children's Hospital of Zaporizhzhya Regional Council

🇺🇦

Zaporizhzhia, Ukraine

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