A Phase 3, Multicentre, Randomised, Controlled Trial to Determine the Efficacy and Safety of Two Dose Levels of Plitidepsin Versus Control in Adult Patients Requiring Hospitalisation for Management of Moderate COVID-19 Infectio
- Conditions
- 07.1 COVID-19, virusCOVID-19, virusU07.1
- Registration Number
- PER-031-21
- Lead Sponsor
- Pharma Mar S.A.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Without startig enrollment
- Sex
- All
- Target Recruitment
- 0
1. Signed informed consent obtained prior to initiation of any study-specific procedures and study treatment
2. Laboratory confirmed SARS-CoV-2 infection as determined by qualitative polymerase chain reaction (PCR) by local laboratory from oro/nasopharyngeal exudate (or other respiratory specimen) collected no more than 24 hours prior to study treatment on Day 1
3. Admitted to hospital as clinically indicated for management of moderate SARS-CoV-2 (COVID-19) infection, defined by the following criteria:
• Positive PCR test for SARS-CoV-2
• Symptoms of moderate illness with COVID-19, which could include e any symptoms of mild illness or shortness of breath with exertion
• Clinical signs suggestive of moderate illness with COVID-19 such as respiratory rate =20 breaths but <30 breaths per minute, SpO2 >93% but <95% on room air at sea level, heart rate =90 but <125 beats per minute, and requiring O2 supplementation. If SpO2 on room air is not possible to be measured, the ratio PaO2/FiO2 should be >= 300 mm Hg (see Appendix 9); in addition, if the site is located at high altitude over sea level (> 1000 m), the ratio PaO2/FiO2 should be adjusted ( Appendix 10)
• No clinical signs indicative of severe illness, which could include shortness of breath at rest or respiratory distress, or PaO2/FiO2 ratio < 300 mm Hg (sea level)(Appendices 9, 10)
4. Onset of COVID-19 symptoms no later than 6 days prior to initiation of study treatment on Day 1
5. Male or female aged =18 years
6. Adequate bone marrow, liver, kidney, and metabolic function, defined by the following tests performed at local laboratory:
• Absolute neutrophil count =1000/mm3 (1.0 x 109/L)
• Lymphocyte count =500/mm3 (0.5 x 109/L)
• Platelet count =100 000/mm3 (100 x 109/L)
• Haemoglobin >9.0 g/dL
• Alanine transaminase (ALT), aspartate transaminase (AST) =3 x upper limit of normal (ULN)
• Serum bilirubin =1 x ULN
• Calculated creatinine clearance =30 mL/min (Cockcroft and Gault formula)
• Creatine phosphokinase =2.5 x ULN
7. Agree not to participate in another interventional clinical trial through Day 31
8. Females of reproductive capacity must have a negative serum pregnancy test by local laboratory at study enrolment and must be non-lactating
9. Females and males with partners of child-bearing potential must use effective contraception while on study treatment and for 6 months after last dose of plitidepsin.
1. Subjects with a pre-baseline (ie, in the prior month) impairment in general health condition for whatever reason except COVID-19, requiring either assistance for daily living activities or chronic oxygen therapy
2. Participating in another clinical trial for treatment of COVID-19 infection or patients previously enrolled in clinical trials and currently in follow-up, or patients previously vaccinated for COVID-19
3. Evidence of respiratory failure at the time of randomisation, based on resource utilisation requiring at least 1 of the following: endotracheal intubation and mechanical ventilation, oxygen delivered by high-flow nasal cannula, noninvasive positive pressure ventilation, ECMO, or clinical diagnosis of respiratory failure (ie, clinical need for 1 of the preceding therapies, but preceding therapies not able to be administered in setting of resource limitation)
4. Patients clinically indicated for management of SARS-CoV-2 (COVID-19), with baseline disease severity rated as severe (if positive testing by standard RT-PCR assay or equivalent test, symptoms suggestive of severe illness with COVID-19, which could include any symptom of moderate illness or shortness of breath at rest, or respiratory distress, clinical signs indicative of severe systemic illness with COVID-19, such as respiratory rate =30 per minute, heart rate =125 per minute, SpO2 =93% on room air at sea level, or PaO2/FiO2 <300) (Appendices 9, 10)
5. Patients receiving treatment with antivirals, IL-6 receptor inhibitor, corticosteroids, or immunomodulatory drugs for COVID-19 infection within 4 weeks before enrolment
6. History of live vaccination within the last 4 weeks prior to study enrolment; subjects must not receive live, attenuated influenza vaccine within 4 weeks before enrolment or at any time during the study
7. Patients receiving treatment with chloroquine or derivatives within 8 weeks before enrolment or during the study
8. Receiving treatment with strong cytochrome P450 3A4 (CYP3A4) inhibitors or inducers (see Appendix 4)
9. Viral illness (other than COVID-19) requiring therapy, except for patients with treated and adequately controlled (undetectable) human immunodeficiency virus infection are eligible
10. Any of the following cardiac conditions or risk factors:
? Sinus bradycardia (<50 beats/min), sinus nodal dysfunction (sick sinus disease), atrio-ventricular block of any degree (PR >200 msec), or any other bradyarrhthymia (< 50 beats/min), except for patients with permanent pacemarkers;
? Cardiac infarction, cardiac surgery or cardiac insufficiency episode within the last 6 months;
? Known abnormal value of left ventricular ejection fraction (LVEF < LLN), unless documented confirmation of recovery (LVEF > LLN) in the previous month;? QT interval corrected using Fridericia’s formula (QTcF) >450 msec for males or >470 msec for females, based on triplicate ECG at screening;
• History of known congenital or acquired QT prolongation;
• Uncorrected hypokaliemia, hypocalcemia (adjusted) and/or hypomagnesemia at baseline;
• Concomitant treatments with drugs known to be associated with a risk of QT prolongation or cardiac arrhythmia (Appendix 8a); or
• Baseline troponin > 1.5 x ULN.
11. Pre-existing neuropathies of any type Grade =2
12. Hypersensitivity to the active ingredient or any of the excipients (mannitol, macrogolglycerol hydroxystearate, and ethan
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Compare plitidepsin 1.5 or 2.5 mg versus control on the percentage of patients who achieve complete recovery by Day 8 (±1), defined as (i) meeting categories 0 to 2 on the 11- point WHO Clinical Progression Scale below, (ii) having Barthel Index >90/100 at the time of discharge (Appendix 7), and (iii) with no re-admission for COVID-19 signs or symptoms through Day 31.<br> NAME OF THE RESULT: Efficacy<br> PERIOD OF TIME WHERE TE MEASUREMENT WILL BE CONDUCTED AND WHICH WILL ALLOW OBTAINING THE<br> PRIMARY RESULT: Day 8 (±1)
- Secondary Outcome Measures
Name Time Method