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Study of Obeldesivir in Nonhospitalized Participants With COVID-19

Phase 3
Completed
Conditions
COVID-19
Interventions
Drug: Obeldesivir Placebo
Registration Number
NCT05715528
Lead Sponsor
Gilead Sciences
Brief Summary

The goal of this clinical study is to test if obeldesivir (GS-5245) is safe and effective for the treatment of coronavirus disease 2019 (COVID-19) in participants who have a standard risk of developing severe illness. This study will also measure how much obeldesivir gets into the blood and how long it takes for the body to get rid of it.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2011
Inclusion Criteria
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed, ≤ 3 days before randomization, by polymerase chain reaction (PCR), rapid antigen test, or an approved alternative assay. Serologic tests will not be accepted.

  • Willing and able to complete the coronavirus disease 19 (COVID-19) symptom questionnaire prior to first dose and daily throughout the study period.

  • Initial onset of COVID-19 signs/symptoms ≤ 3 days before randomization with ≥ 2 of the following targeted symptoms, at moderate or higher severity, present at randomization.

    • Stuffy or runny nose.
    • Sore throat.
    • Shortness of breath (difficulty breathing).
    • Cough.
    • Low energy or tiredness.
    • Muscle or body aches.
    • Headache.
    • Chills or shivering.
    • Feeling hot or feverish.
  • Not currently hospitalized or requiring hospitalization.

Key

Exclusion Criteria
  • Any risk factors for progression to severe disease.
  • Planning to receive a direct acting antiviral or monoclonal antibody against SARS-CoV-2 for the treatment of COVID-19.
  • Received any direct acting antiviral drug or monoclonal antibody against SARS-CoV-2 for the treatment of COVID-19 < 28 days or < 5 half-lives, whichever is longer, before randomization.
  • Received any convalescent COVID-19 plasma or other antibody-based anti-SARS-CoV-2 prophylaxis at any time prior to study entry.
  • Received an COVID-19 vaccine (including booster dose) < 120 days before randomization.
  • Self-reported COVID-19 diagnosis < 120 days before randomization.
  • Anticipated need for hospitalization < 48 hours after randomization.
  • New oxygen requirement < 24 hours before randomization.
  • Known influenza, or any other suspected or confirmed concurrent active systemic infection other than COVID-19 that may interfere with the evaluation of response to the study drug.
  • Known history of chronic liver disease, limited to cirrhosis, nonalcoholic steatohepatitis, alcoholic liver disease, and autoimmune hepatitis.
  • Undergoing dialysis, or known history of chronic kidney disease.
  • Persistent symptoms from previous COVID-19 illness that may interfere with the evaluation of response to the study drug.
  • Pregnant or breastfeeding.
  • Unwilling to use protocol-mandated contraception.
  • Any other factor, including inability to complete the patient-reported outcome (PRO) questionnaire for the primary endpoint, making the individual, in the opinion of the investigator, unsuitable to participate in the study.
  • Concurrent participation/enrollment in a separate therapeutic clinical study.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Obeldesivir PlaceboObeldesivir PlaceboParticipants will receive obeldesivir placebo twice daily for 5 days.
ObeldesivirObeldesivirParticipants will receive obeldesivir 350 mg twice daily for 5 days.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Experiencing Treatment-emergent Adverse Events (TEAEs)First dose date up to Day 5 plus 30 days

TEAEs were defined as 1 or both of the following:

* Any AEs with an onset date on or after the study drug start date and no later than 30 days after permanent discontinuation of study drug.

* Any AEs leading to premature discontinuation of study drug. Percentages were rounded off.

Percentage of Participants Experiencing Laboratory AbnormalitiesFirst dose date up to Day 5 plus 30 days

Treatment-emergent laboratory abnormalities were defined as values that increase at least 1 toxicity grade from baseline at any postbaseline time point, up to and including the date of last dose of study drug plus 30 days.

Percentages were rounded off.

Percentage of Participants Experiencing Serious Adverse Events (SAEs) and Adverse Events (AEs) Leading to Study Drug DiscontinuationFirst dose date up to Day 5 plus 30 days

Percentages were rounded off.

Time to Coronavirus Disease 2019 (COVID-19) Symptom Alleviation by Day 29First dose date up to Day 29

The time to alleviation of targeted COVID-19 symptoms by Day 29 for participants with symptom alleviation, was calculated as symptom alleviation date/time minus first dose date/time. For participants who completed Day 29 of the study or discontinued from the study before Day 29 without symptom alleviation (censored) and without inter-current events, time was calculated as last date/time on which symptom alleviation was assessed minus the first dose date/time or Day 28, whichever occurred first. Symptom alleviation was defined as, all targeted symptoms scored moderate or severe at baseline were scored as mild/none and all targeted symptoms scored mild/none at baseline were scored as none, for at least 48 consecutive hours. Targeted symptoms included: stuffy or runny nose, sore throat, shortness of breath, cough, low energy or tiredness, muscle or body aches, headache, chills or shivering and feeling hot or feverish.

Kaplan-Meier (KM) estimates were used in outcome measure analysis.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Moderate Relapse of COVID-19 Symptoms by Day 29Up to Day 29

COVID-19 moderate symptom relapse was defined as having at least 1 symptom being moderate or severe OR at least 2 mild symptoms OR a hospitalization for COVID-19 or death, observed on a day during COVID-19 symptom relapse.

Percentages were rounded off.

Percentage of Participants With COVID-19 Related Hospitalization or All-cause Death by Day 29Up to Day 29

COVID-19-related hospitalization was defined as ≥ 24 hours of acute care for a reason related to COVID-19, in a hospital or similar acute care facility, including emergency rooms or temporary facilities instituted to address medical needs of those with COVID-19. This included specialized acute medical care units within an assisted living facility or nursing home. This did not include hospitalization for the purposes of public health and/or clinical trial execution. The date and duration (if there was 1 day difference between the start date and end date) of hospital admission, and primary reason for hospitalization (including if the hospitalization was related to COVID-19) was to be recorded.

Percentages were rounded off.

Time to Antigen NegativityDay 1 up to Day 29

Time to antigen negativity was defined (in days) as the number of days to the first date of 2 consecutive dates achieving a negative result. Antigen negativity was defined as 2 consecutive negative SARS-CoV-2 rapid antigen test (regardless if there was missing data in between), or negative test at last available sample for participants who completed or discontinued from the study after at least 1 positive antigen test.

Percentage of Participants With Viral Antigen ReboundUp to Day 29

Viral antigen rebound was defined as any positive SARS-CoV-2 rapid antigen test after antigen negativity.

Percentages were rounded off.

Plasma Concentrations of GS-441524 (Metabolite of Obeldesivir)Day 1, 0.75 hour and 2 hours; Day 3, Predose and 0.75 hour; Day 5, Predose and 0.75 hour
Pharmacokinetic (PK) Parameter: AUCtau,Steady-State of GS-441524Day 5

AUCtau is defined as the area under the concentration versus time curve over the dosing interval at steady-state.

PK Parameter: Ctau of GS-441524Day 1 and Day 5

Ctau is defined as the observed drug concentration at the end of the dosing interval.

Percentage of Participants With Relapse of COVID-19 Symptoms by Day 29Up to Day 29

Symptom relapse means at least 2 consecutive diary entries (regardless of missing data in between) where there was any symptom (regardless of severity) OR a hospitalization for COVID-19 or a death after short symptom recovery.

Percentages were rounded off.

Time to COVID-19 Symptom Resolution by Day 29Day 1 up to 29

COVID-19 symptom resolution was defined as all targeted symptoms scored as none for at least 48 consecutive hours. The first day of the 48 consecutive hours was considered the date of symptom resolution. The time to COVID-19 symptom resolution was the time (expressed as days) from the first dose date/time to the date/time of symptom resolution.

KM estimates were used in the outcome measure analysis.

Percentage of Participants With COVID-19 Related Medically Attended Visits (MAVs) or All-cause Death by Day 29Up to Day 29

Medically attended visits were defined as interactions with health care professionals other than study staff or designees including hospitalization; in-person emergency, urgent, or primary care visits; or any other in-person visit attended by the participant and a health care professional. The nature and cause of the visit were identified.

KM estimates were used in the outcome measure analysis. Percentages were rounded off.

Change From Baseline in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Nasal Swab Viral Load at Day 5Day 5
PK Parameter: Cmax of GS-441524Day 1 and Day 5

Cmax is defined as the maximum observed plasma concentration of drug.

Trial Locations

Locations (105)

EmVenio Research

🇺🇸

Fort Worth, Texas, United States

Institute for Liver Health dba Arizona Clinical Trials

🇺🇸

Chandler, Arizona, United States

The Institute for Liver Health dba Arizona Liver Health

🇺🇸

Tucson, Arizona, United States

Franco Felizarta, MD

🇺🇸

Bakersfield, California, United States

Velocity Clinical Research, Banning (IP Delivery and Administering Location)

🇺🇸

Banning, California, United States

Benchmark Research

🇺🇸

Colton, California, United States

Ascada Research

🇺🇸

Fullerton, California, United States

Velocity Clinical Research

🇺🇸

Lafayette, Louisiana, United States

IMAX Clinical Trials, LLC

🇺🇸

La Palma, California, United States

Om Research LLC

🇺🇸

Lancaster, California, United States

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EmVenio Research
🇺🇸Fort Worth, Texas, United States

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