COVidIVERmectin: Ivermectin for Treatment of Covid-19

Phase 2

Terminated

• Conditions: Covid19
• Interventions: Other: Placebo; Drug: Ivermectin

• Registration Number: NCT04438850
• Lead Sponsor: IRCCS Sacro Cuore Don Calabria di Negrar

Brief Summary

Prospective, multi-centre, randomized, double-blind trial to assess efficacy and safety of ivermectin for the treatment of initial infection with SARS-CoV2 infection.

Study arms: A) placebo B) ivermectin 600 μg/kg daily for 5 consecutive days (I_600) + placebo. C) ivermectin 1200 μg/kg daily at empty stomach with water for 5 consecutive days (I_1200). Patients will be randomized at emergency room of hospitals as well as at outpatient ambulatory care as well as at home, according to routine procedures of recruiting centres.

In arm A and B, the number of placebo tablets to be administered will be calculated by the study dedicated pharmacist considering the number of tablets that should be taken in case a patient with the same weight is assigned to arm C.

Detailed Description

Primary objectives

The study is aimed:

1. at defining if ivermectin, administered at dosage of 600 μg/kg or 1200 μg/kg QD for five consecutive days is safe in patients with initial, asymptomatic or oligosymptomatic SARS_CoV-2 infection,

2. at defining if ivermectin, administered at the dosage(s) found to be safe decreases the viral load of SARS-CoV-2 at Day 7.

Secondary objectives To assess

1. the temporal profile of viral load at baseline, day 7, 14 and 30

2. the time to clinical cure (for symptomatic patients)

3. the proportion of patients with virological clearance at day 14 and 30.

4. the hospitalization rate.

5. the COVID-19 Severity Score at day 14 and 30

STUDY DESIGN

This is a multicentre, prospective, randomized, double-blind, adaptive phase II dose finding study.

Patients meeting the inclusion criteria will be asked to participate to the study and randomized in a 1:1:1 ratio to either:

* Placebo arm (arm A): placebo will be identical in appearance to ivermectin in order to preserve blinding and will be administered p.o. at empty stomach with water once daily, for 5 days

* Intervention arms: a) Ivermectin, single dose 600 μg/kg, for 5 days (I_600) and placebo (arm B) ; b) Ivermectin, single dose 1200 μg/kg, for 5 days (I_1200) (arm C) ); these drugs will be administered p.o. once daily, for 5 days.

In arm A and B, the number of placebo tablets to be administered will be calculated by the study dedicated pharmacist considering the number of tablets that should be taken in case a patient with the same weight is assigned to arm C.

Patients will be randomized by a centralized computer system. At randomization a treatment ID is assigned to the patient. Once a treatment ID is assigned this must not be re-assigned even in cases of errors.

Enrolled subjects will be identified by a unique subject number (patient code) that will remain consistent for the duration of the study.

Patients will be recruited at the emergency room of hospitals, and/or among asymptomatic hospital workers found positive for SARS-CoV-2 at routine screening and/or in outpatient ambulatory settings, and/or at home, if not meeting the clinical criteria for hospitalization, according to the routine procedure of each participating site. The expected duration of subject inclusion in the study is of 1 month, or until the planned number of subjects to be enrolled will be reached.

Study Timeline

• Study First Submitted: 2020-04-10
• Study First Submitted QC: 2020-06-18
• Study First Posted: 2020-06-19
• Study Start: 2020-07-31
• Status Verified: 2021-06
• Primary Completion: 2021-06-08
• Study Completion: 2021-06-08
• Last Update Submitted: 2021-06-17
• Last Update Posted: 2021-06-23

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 93

Inclusion Criteria

• Age >=18 years
• Positivity at RT-PCR per SARS_CoV2 (nasopharyngeal swabs)
• Consent to participation to the study and to the processing of personal data
• COVID-19 Severity Score < 3
• Patient able to take oral drugs

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Exclusion Criteria

• Pregnant or lactating women (pregnancy test not required, if doubt patient is excluded)
• Subjects suffering from known CNS diseases
• Lack of (or inability to provide) informed consent
• Patient under dialysis
• Any severe medical condition with a prognosis of < 6 months
• Patients under warfarin treatment
• Patients under antiviral treatment
• Patients under chloroquine phosphate or hydroxychloroquine

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Placebo	Placebo	placebo
I_600	Ivermectin	ivermectin 600 μg/kg daily for 5 consecutive days (I_600) + placebo
I_1200	Ivermectin	ivermectin 1200 μg/kg daily at empty stomach with water for 5 consecutive days

Primary Outcome Measures

Name	Time	Method
SADR	14 days	Number of serious adverse drug reaction
Viral load	Assessed at day 7	Quantitative viral load as measured by quantitative, digital droplet PCR.

Secondary Outcome Measures

Name	Time	Method
Clinical resolution	Assessed on Day 30	Time to clinical resolution (for symptomatic patients).
hospitalization rate	Day 30	rate of hospitalization
Severity score	Assessed at Day 14 and Day 30	COVID-19 Severity Score (Coronavirus Diseases 19 Severity Score) - min value 1 ("no limitation of activities), max value 8 ("death"). Higher scores mean worse outcome
Viral clearance	assessed on days 14 and 30	Time from diagnosis to documented viral clearance
Trend viral load	Days 7 and 14 from baseline	1. Trend over time of quantitative viral load at Day 7 and 14 as measured by quantitative, digital droplet PCR.
Virological clearance	Assessed at day 14 and 30	Proportion of patients with virological clearance

Trial Locations

Locations (5)

Ospedale Luigi Sacco; 🇮🇹 Milan, Italy

Ospedale di Rovereto; 🇮🇹 Rovereto, Italy

IRCCS Sacro Cuore Don Calabria hospital; 🇮🇹 Negrar, Verona, Italy

Ospedale Amedeo di Savoia; 🇮🇹 Turin, Italy

Policlinico S. Orsola; 🇮🇹 Bologna, Italy