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A Study to Learn About the Study Medicine (Nirmatrelvir Plus Ritonavir) in Pregnant Women With COVID-19

Phase 1
Active, not recruiting
Conditions
COVID-19
Interventions
Registration Number
NCT05386472
Lead Sponsor
Pfizer
Brief Summary

The purpose of this clinical trial is to learn about how study medicine (Paxlovid, which contains nirmatrelvir and ritonavir) is changed and eliminated from the body, as well as its safety, and the extent to which side effects can be tolerated for treatment of pregnant women with mild or moderate COVID-19 compared to non-pregnant women with mild or moderate COVID-19.

This study is seeking participants who:

* are expecting a healthy baby and are in their second or third trimester pregnancy and have mild or moderate COVID-19

* are not pregnant and have mild or moderate COVID-19.

All participants in this study will take Paxlovid by mouth every 12 hours for 5 days. We will study the experiences of people receiving the study medicine. This will help us decide if the study medicine is safe.

All participants will take part in this study for at least 34 days; pregnant participants will take part until their delivery, so that the study duration may be up to 6 months, depending on their delivery date.

During this time, participants will have 7to 8 visits and, if pregnant, a visit at delivery. Around 2 to 3 visits and the delivery visit will be done in person (at the clinic or at the participant's home). The other 5 visits may be done over the phone, unless in-person visit is necessary as decided by the doctor. Blood samples will be collected on the first 4 to 5 study visits (and at other study visits, if necessary).

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
25
Inclusion Criteria
  • All cohorts: Mild-to-moderate COVID-19 infection confirmed in sample collected ≤5 days prior to enrollment; onset within 5 days prior to enrollment and presence of ≥1 sign/symptom on the day of enrollment.
  • Cohorts 1&2: Expecting single baby; Pregnant in 2nd trimester, 14 0/7 to 27 6/7 weeks of gestational age (Cohort 1) or 3rd trimester, ≥28 0/7 and ≤34 6/7 weeks of gestational age (Cohort 2), by ultrasound.
  • All cohorts: Otherwise healthy participants who are determined by medical history, physical examination, and clinical judgment to be appropriate for inclusion in the study
Exclusion Criteria
  • All cohorts: Current need for hospitalization or anticipated need for hospitalization in the clinical opinion of the site investigator.
  • Cohorts 1&2: Prior/current major condition or illness of mother/fetus substantially increasing risk of study participation/completion or impacting pregnancy/fetal outcomes in investigator's judgement.
  • All cohorts: Current use of any medications that are highly dependent on CYP3A4 for clearance, and which are contraindicated in combination with nirmatrelvir/ritonavir.
  • All cohorts: Has received or is expected to receive monoclonal antibody treatment, convalescent COVID-19 plasma, or anti-viral treatment (eg, molnupiravir) for the current SARSCoV-2 infection.
  • All cohorts: Participants with moderate to severe kidney impairment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cohort 3nirmatrelvirNon-pregnant women
Cohort 2ritonavirPregnant women in their third trimester
Cohort 1nirmatrelvirPregnant women in their second trimester
Cohort 1ritonavirPregnant women in their second trimester
Cohort 2nirmatrelvirPregnant women in their third trimester
Cohort 3ritonavirNon-pregnant women
Primary Outcome Measures
NameTimeMethod
Apparent Oral Clearance (CL/F)Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
Apparent Volume of Distribution (Vz/F)Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
Maximum Observed Plasma Concentration (Cmax)Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
Observed Plasma Trough Concentration (Ctrough)Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau)Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
Incidence of TEAEs, SAEs, and AEs leading to discontinuationsBaseline up through end of treatment (Day 5/Day 6)
Plasma Decay Half-Life (t1/2)Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
Incidence of Treatment Emergent Adverse Events (TEAEs)Baseline up through Day 34
Secondary Outcome Measures
NameTimeMethod
Number of participants with vaginal deliveryAt delivery of the baby
Number of participants with induced/elective abortionsAt delivery of the baby
Number of participants with unknown deliveryAt delivery of the baby
Number of participants with delivery at other locationAt delivery of the baby
Number of participants with complications during deliveryAt delivery of the baby
Number of full-term live deliveriesAt delivery of the baby
Number of premature live deliveriesAt delivery of the baby
Number of aborted or stillborn fetuses with abnormal findings upon gross visual inspectionAt delivery of the baby
Incidence of SAEs in newborn infantsBirth through 24 hours after birth or until Study Day 34 (whichever is later)
Number of participants with caesarean section deliveryAt delivery of the baby
Number of participants with spontaneous abortionsAt delivery of the baby
Number of neonates with congenital malformation/anomaly or other neonatal problemAt birth
Number of participants with delivery at medical facilityAt delivery of the baby
Number of participants with delivery at homeAt delivery of the baby
Gestational age of newborn infantsAt birth
Body weight of newborn infantsAt birth
Body length of newborn infantsAt birth
Head circumference of newborn infantsAt birth
Number of participants with stillbirthsAt delivery of the baby

Trial Locations

Locations (12)

University of Alabama at Birmingham/Center for Women's Reproductive Health

🇺🇸

Birmingham, Alabama, United States

Beautiful Minds Clinical Research Center

🇺🇸

Cutler Bay, Florida, United States

Omega Research Debary

🇺🇸

DeBary, Florida, United States

Omega Research Orlando

🇺🇸

Orlando, Florida, United States

Santos Research Center

🇺🇸

Tampa, Florida, United States

Clinical Research Prime

🇺🇸

Idaho Falls, Idaho, United States

Boeson Research MSO

🇺🇸

Missoula, Montana, United States

Origin Health

🇺🇸

Missoula, Montana, United States

Maximos Ob/Gyn

🇺🇸

League City, Texas, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

University of Utah Clinical Neuroscience Center

🇺🇸

Salt Lake City, Utah, United States

University of Utah Hospital

🇺🇸

Salt Lake City, Utah, United States

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