IMATINIB IN COVID-19 DISEASE IN AGED PATIENTS.
- Conditions
- SARS Virus
- Interventions
- Drug: Experimental drug
- Registration Number
- NCT04357613
- Lead Sponsor
- Versailles Hospital
- Brief Summary
High-throughput screening studies identified Abl kinase inhibitors (including imatinib) as inhibitors of coronaviruses SARS and MERS. The SARS-CoV-2 coronavirus depend on Abl2 kinase activity to fuse and enter into the cells. Pharmacokinetic studies demonstrated that IC50 of imatinib for ABL1, BCR-ABL1 and ABL2 kinase inhibition is less than 1 microM (around 0.3 microM) below the expected trough plasmatic concentrations of imatinib 400 mg/day (1.7 microM). The EC50 of imatinib for the inhibition of the virus is under investigation but we now have a first estimates with EC50 close to 2.5 microM. This plasmatic concentration is achievable with imatinib 800 mg/d. We hypothesize that clinically achievable imatinib concentration will block the first round of cell to cell virus infection and therefore stop or prevent from SARS-CoV-2 infection in human. Based on our 20 years' experience of prescribing imatinib in patients, we expect that most of the adverse events and pharmacological interactions of imatinib can be anticipated and corrected. The eligible population will be aged (\>70y) patients hospitalized for a non-severe COVID-19 disease for less than 7 days. Patients will be randomized 1/1 between standard of care and imatinib 800 mg per day during 14 days. The primary endpoint will be the death rate by 30 days. Secondary endpoint will include progression to severe CIVID-19 disease, safety, outcome at 3 months. We plan to randomize 90 patients in order to show a 10% benefit in term of death rate reduction from 16% to 6%.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 99
. Patient aged > 70y 2. Patient with a documented COVID-19 disease by SARS-CoV-2 RT-PCR (if no test is available, suspected COVID-19 disease on CT SCAN).
- Initial phase (≤ 7 days) of COVID-19 disease 4. Non severe COVID-19 disease 5. Signed informe consent
- Patient in palliative care
- Severe COVID-19 disease (SpO2 ≤ 94% with O2 ≥ 5 l/min)
- Contra-indication to imatinib
- Therapy with Warfarin (Heparin allowed)
- Stage II to IV congestive heart failure (CHF) as determined by the New York Heart Association (NYHA)
- Peripheral edema grade > 2
- Known HBV, HBC or HIV infection
- Known hepatic failure
- Patient under legal protection
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Expérimental ARM Experimental drug 800mg/d IMATINIB during 14days
- Primary Outcome Measures
Name Time Method To evaluate the benefit of early imatinib therapy to prevent severe COVID-19 disease in hospitalized aged patients. 30 days To evaluate the 30 days mortality rate in aged patients hospitalized with COVID-19
- Secondary Outcome Measures
Name Time Method To evaluate plasmatic levels of imatinib 14 days Imatinib trough level
To evaluate mortality 90 days number of death
To evaluate viral load 14 days Viral load by SARS-CoV-2 PCR
To evaluate the feasibility of imatinib therapy. Day 14 Drop out rate of imatinib mesylate therapy
To evaluate safety of imatinib therapy 3 months Adverse events related to imatinib mesylate therapy
To evaluate the clinical evolution 3 months Clinical (WHO COVID scale) and geriatric scores (GIR, ADL and IADL) modification
To evaluate the progression rate to severe COVID-19 disease 3 months Clinical (WHO COVID scale) and geriatric scores (GIR, ADL and IADL) modification
Trial Locations
- Locations (2)
CHU Bordeaux
🇫🇷Bordeaux, France
CH de Versailles
🇫🇷Le Chesnay, France
CHU Bordeaux🇫🇷Bordeaux, FranceMalvyContact