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Trial to Evaluate the Safety and Efficacy of Maraviroc in Patients Hospitalized for Coronavirus Disease 2019 (COVID-19)

Phase 2
Completed
Conditions
Virus Diseases
Interventions
Other: Standard treatment
Registration Number
NCT04710199
Lead Sponsor
Fundación Pública Andaluza para la gestión de la Investigación en Sevilla
Brief Summary

Maraviroc (MVC) is a drug, very well tolerated, it has been seen that MVC has properties of modulating the immune system, exerting an anti-inflammatory effect in different diseases. In COVID-19, very high levels of inflammation occur that cause organs and systems to be damaged. MVC could reduce this inflammation achieving a better prognosis of COVID-19.

Detailed Description

In this clinical trial the investigators want to evaluate if standard treatment together with Maraviroc (MVC) compared to standard treatment alone, achieves better clinical evolution in participants hospitalized for COVID-19.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Subjects aged ≥ 18 years.
  • Infection confirmed by SARS-CoV-2 by polymerase chain reaction (PCR) at least 3 days before randomization.
  • Hospitalized or emergency patient in hospitalization phase.
  • Mild / moderate pneumonia, with fever, persistent cough and severe asthenia, confirmed by imaging tests (conventional radiology or computerized axial tomography (CT)) with ambient air oxygen saturation (SatO2)> 94%.
  • Less than 12 days from the onset of symptoms.
  • Women of childbearing potential must have a negative serum or urine pregnancy test prior to inclusion in the study and must commit to using highly effective contraceptive methods (intrauterine device, bilateral tubal occlusion, vasectomized partner, and sexual abstinence).
  • Accepts written consent or oral informed in the case that due to the relevant security protocols, written consent is not possible.
Exclusion Criteria
  • Patient with severe pneumonia confirmed by imaging test (conventional radiology or computerized axial tomography (CT)) with ambient air oxygen saturation (SatO2) ≤94%.
  • Another acute active infection other than that produced by SARS-CoV-2.
  • Chronic renal failure (estimated glomerular filtration ≤ 30 ml / min / 1.73 m2 or receiving renal replacement therapy in any of its modalities).
  • Known HIV infection. Unless the patient has> 500 CD4 + / mm3 and an undetectable viral load for more than 6 months.
  • Active co-infection with known hepatitis B or C viruses.
  • Cirrhosis, portal hypertension and / or hypersplenism of any etiology.
  • Past or current neoplasms subsidiary to treatment with steroids, immunomodulators or chemotherapy
  • Laboratory abnormalities.
  • Concomitant use of drugs with major pharmacological interactions with the study drugs, according to the respective technical specifications of the products.
  • Pregnancy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Maraviroc experimental groupMaraviroc experimental groupMaraviroc tablet combined with standard treatment
Standard treatmentStandard treatmentIt is based on the treatment protocol for hospitalized COVID-19 patients and that will depend on the clinical status of the patient.
Primary Outcome Measures
NameTimeMethod
Evaluate the efficacy of Maraviroc in SARS-CoV-2 infected patients hospitalized for COVID-19 using the Ordinal scale.Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Ordinal scale: (1) Not hospitalized, without limitations in activities; (2) Not hospitalized, limitations in activities; (3) Hospitalized, with no oxygen supplement requirement; (4) Hospitalized, requiring supplemental oxygen; (5) Hospitalized, with non-invasive ventilation or high flow oxygen device or oxygen mask with reservoir); (6) Hospitalized, with invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); (7) Death. treatment versus standard treatment, in relation to the clinical progression of COVID-19 in hospitalized patients.

Secondary Outcome Measures
NameTimeMethod
Analyze changes in analytical variables: changes in ambient air oxygen saturation (SatO2),related to the progression of COVID-19.Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Analytical variables related to the progression of COVID-19: changes in ambient air oxygen saturation (SatO2) (mmHg).

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Study the variation in the number of biomarkers of inflammation.Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Changes in levels of macrophage inflammatory proteins-1 α (MIP-1 α), MIP-1 β, regulated on activation normal T cell expressed and secreted (RANTES), interleukin-6 (IL-6), IL-8, interferon-inducible protein 10 (IP-10), IL-1β, TNF-α, gamma interferon (IFN-γ), soluble cluster of differentiation 25 (CD25), β2 microglobulin, dimers D, soluble cluster of differentiation 14 (CD14), soluble cluster of differentiation 40 (CD40) ligand and soluble cluster of differentiation 163 (CD163).

Analyze changes in the number of innate immune activation (monocytes and dendritic cells) and adaptive (T lymphocytes).Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Changes in levels subpopulations (classical, intermediate and non-classical monocytes) and activation markers in them. Dendritic cell subpopulations (myeloid and plasmacytoid dendritic cells) and their activation markers. Subpopulations of T lymphocytes (naive, central memory, effector memory and terminally differentiated) and markers of activation, senescence and wasting in them.

Quantify the number of immunomodulatory treatments added to therapyBaseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Quantification of additional treatments added to the administered therapy , this is immunomodulatory treatments such as: IL-6,or IL-1 inhibitors, high-dose corticosteroids, anti-tumor necrosis factor (anti-TNF) antibodies, janus kinases (JAK) kinase inhibitors or any other immunomodulatory effect and / or under investigation

Analytical variables related to the progression of COVID-19: changes in lactate dehydrogenase (LDH).Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Changes in levels of lactate dehydrogenase in blood (U/L)

Analyze changes in analytical variables: changes in platelets, related to the progression of COVID-19.Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Changes in levels of platelets in blood (x10e9/L)

Analyze changes in analytical variables: changes in C-reactive protein, related to the progression of COVID-19.Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Changes in levels of C-reactive protein in blood (mg/L)

Analyze changes in analytical variables:changes in neutrophils, related to the progression of COVID-19.Baseline, change from baseline at 7 days, change from baseline at 14 days, change from baseline at 21 days and change from baseline at 28 days

Changes in levels of neutrophils in blood (x10e9/L)

Trial Locations

Locations (2)

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain

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