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A Study to Learn About a Study Medicine Called Ibuzatrelvir in Adult and Adolescent Patients With COVID-19 Who Are Not Hospitalized But Are at Risk For Severe Disease

Phase 3
Recruiting
Conditions
COVID-19 SARS-CoV-2 Infection
Interventions
Drug: placebo
Registration Number
NCT06679140
Lead Sponsor
Pfizer
Brief Summary

The purpose of the study is to evaluate whether ibuzatrelvir is effective and safe in adults and adolescents with COVID-19 who do not need to be in the hospital but who are at high risk for progression to severe disease. Eligible participants will be randomly assigned (by chance) to receive ibuzatrelvir or matching placebo orally for 5 days. Co-administration of locally available standard of care is allowed. The total duration of the study is around 6 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
2330
Inclusion Criteria
  1. 12 to <18 years of age, weighing at least 40 kg, or ≥18 years of age of any weight at screening.

  2. Presence of risk factors for progression to severe COVID-19 at the time of screening based on age:

    1. 12 to 49 years of age with at least two risk factors, where one must be moderate immunocompromise;
    2. 50 to 64 years of age with at least two risk factors;
    3. 65 to 74 years of age with at least one risk factor;
    4. For participants 75 years of age or older, there are no requirements related to risk factors.

    The list of risk factors includes:

    BMI ≥30 kg/m2; Current smoker; Chronic lung disease; Cardiovascular disease; Type 1 or Type 2 diabetes mellitus; Mild to moderate renal impairment; Neurodevelopmental disorders; Sickle cell disease; Moderate immunosuppression.

  3. Confirmed SARS-CoV-2 infection as determined by RAT in nasal specimen collected within 1 day prior to randomization. Initial onset of symptoms attributable to COVID-19 within 5 days prior to randomization and at least 1 of the specified symptoms attributable to COVID-19 present on the day of randomization. Randomization must occur no later than the 5th day, where the onset of symptoms is the first day.

  4. Participants must be unable or unwilling to take nirmatrelvir/ritonavir.

Exclusion Criteria
  1. Current need or anticipated need for hospitalization within 24 hours, due to signs of severe COVID-19 illness (eg, SpO2 <94% on room air, respiratory rate >30 breaths/minute, or lung infiltrates >50%) or due to other medical conditions requiring hospitalization in the opinion of the site investigator.
  2. Receiving dialysis or have known severe renal impairment [ie, eGFR <30 mL/min/1.73 m2 for adults or CrCl <30 mL/min for adolescents] within 6 months of the screening visit, using the serum creatinine-based CKD-EPI formula or the Cockroft Gault, respectively.
  3. Active liver disease with AST or ALT >3 ULN, Total bilirubin ≥2 × ULN (for Gilbert's syndrome, direct bilirubin >ULN is exclusionary) within the past 3 months, or liver function impairment with Class C per Child Pugh classification.
  4. Suspected or confirmed concurrent active systemic infection other than COVID-19 that may interfere with the evaluation of response to the study intervention.
  5. Ongoing Long COVID or Post Acute Sequelae of COVID-19 diagnosis.
  6. Severely immunocompromised.
  7. Any comorbidity requiring hospitalization and/or surgery within 7 days prior to study entry, or that is considered life threatening within 30 days prior to study entry, as determined by the investigator.
  8. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study.
  9. Current use of any prohibited concomitant medication(s).
  10. Has received any other antiviral for the treatment of COVID-19, including remdesivir, nirmatrelvir/ritonavir, molnupiravir, or COVID-19 mAbs within 30 days or 5 half-lives [whichever is longer] prior to screening, or received convalescent COVID-19 plasma within 12 months.
  11. Received any dose of a COVID-19 vaccine within 4 months of randomization or expected to receive one through Day 34.
  12. Previous administration of an investigational product (drug or vaccine) within 30 days or 5 half lives preceding the first dose of study intervention used in this study (whichever is longer).
  13. Prior participation in this clinical trial or any other clinical trial of ibuzatrelvir.
  14. Investigator site staff directly involved in the conduct of the study and their family members, site staff otherwise supervised by the investigator, and sponsor and sponsor delegate employees directly involved in the conduct of the study and their family members.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ibuzatrelviribuzatrelvirIbuzatrelvir administered orally every 12 hours (twice daily) for a total of 5 days.
placeboplaceboplacebo administered orally every 12 hours (twice daily) for 5 days.
Primary Outcome Measures
NameTimeMethod
Proportion of participants with COVID-19 related emergency department visits, all cause hospitalization and all cause mortalityDay 1 through Day 28

The difference in proportions of patients requiring COVID 19 related emergency department visits with administration of supplemental oxygen, COVID-19 antiviral or IV treatment (eg hydration, antibiotics, or corticosteroids), all-cause hospitalization, or all-cause death through Day 28 between ibuzatrelvir and placebo, among patients who were treated ≤5 days after COVID-19 symptom onset and who were not receiving background SoC treatment for their COVID-19 infection at baseline.

Secondary Outcome Measures
NameTimeMethod
Time to all COVID-19 targeted symptoms resolutionDay 1 to Day 28

The difference in median time to sustained resolution of all targeted symptoms. Symptoms will be assessed through a daily electronic diary and include sore throat, cough, fever and diarrhea, among others.

Proportion of participants with post acute COVID-19 medical eventsDay 29 to Week 24

Medical events include cardiovascular events, pulmonary events, acute kidney disease and thromboembolic events.

Proportion of participants with cardiovascular, renal and pulmonary eventsDay 1 to Week 24

Medical events include cardiovascular events, pulmonary events, acute kidney disease and thromboembolic events.

Proportion of participants with Long COVID symptomsDay 29 to Week 24

The difference in proportions of patients with Long COVID symptoms at Week 24. Symptoms will be assessed through a weekly electronic diary.

Changes from baseline in SARS-CoV-2 RNA levels in nasopharyngeal swabsDay 1 through Day 34

The viral load is measured in nasal or nasopharyngeal samples using reverse transcription polymerase chain reaction (RT-PCR)

Time to SARS-CoV-2 RNA <LLOQDay 1 through Day 34

Time needed to achieve a viral load below the lower limit of quantification of the essay used to measure it.

Proportion of participants with SARS-CoV-2 RNA <LLOQ at each visitDay 1 through Day 34

Proportion of participants with a SARS-CoV-2 viral load below the lower limit of quantification of the essay used to measure it.

Proportion of participants with rebound in SARS-CoV-2 RNA levels in nasopharyngeal swabDay 10 and Day 14

Virologic rebound is defined as:

at any follow up visit, a viral RNA level increase from End of Treatment (Day 5) of ≥ 1.0 log10 copies/mL resulting in a viral RNA level ≥3.0 log10 copies/mL.

Proportion of participants with virologic and symptomatic rebound through Day 28Day 10 to Day 34

symptoms rebound is defined as: after achieving short symptom recovery (the first day of at least two consecutive diary entries where all targeted symptoms are absent), symptom rebound is the first day of at least two consecutive diary entries after Day 5 where there is any targeted symptom (regardless of severity), or when a participant is hospitalized after symptom recovery.

Proportion of participants with COVID-19-related hospitalization or all cause death through Day 28.Day 1 to Day 28
Number of days in hospital and ICU stay in participants with hospitalization (all-cause).Day 1 to Week 24
Number of medical visits through Week 24.Day 1 to Week 24

medical visits include emergency department visits, hospitalizations, visits to the general practitioner and specialist.

Proportion of participants with hospitalization (all-cause) or death (all-cause) through Week 24.Day 1 to Week 24
Time (days) to alleviation of all targeted symptoms through Day 28.Day 1 to Day 28

The difference in median time to sustained alleviation of all targeted symptoms. Symptoms will be assessed through a daily electronic diary and include sore throat, cough, fever and diarrhea, among others.

Proportion of participants with severe symptoms attributed to COVID-19 through Day 28.Day 1 to Day 28

Participants are required to record the severity of their Covid-19 symptoms over the past 24 hours daily on a 4-point scale ranging from 0 to 3, higher scores indicated more severity. The scale was reported as 0= no symptoms, 1=mild, 2=moderate and 3=severe. A participant with severe score for any targeted symptoms post-baseline is counted as severe. Percentage of participants with severe Covid-19 signs and symptoms is reported.

Duration of each targeted COVID-19 sign/symptom.Day 1 to Day 28

Duration of each targeted COVID-19 sign/symptom is defined as (First Date when the symptom achieved sustained alleviation/resolved)-(First Dose Date) + I for each participant with baseline severity of mild, moderate, or severe. Missing severity at baseline will be treated as mild.

Proportion of participants with symptomatic rebound through Day 28.Day 1 to Day 28

Definition of symptomatic rebound: After achieving short symptom recovery (the first day of at least two consecutive diary entries where all targeted symptoms are absent), symptom rebound is the first day of at least two consecutive diary entries after Day 5 where there is any targeted symptom (regardless of severity), or when a participant is hospitalized after symptom recovery

Incidence of treatment emergent adverse eventsDay 1 to Day 34

An adverse event (AE) is any untoward medical occurrence in a participant, temporarily associated with the use of study intervention, whether or not considered related to the study intervention. Serious adverse event (SAE) is any untoward medical occurrence that, at any dose: resulted in death; required inpatient hospitalization or prolongation of existing hospitalization; was life-threatening; resulted in persistent or significant disability/ incapacity; congenital anomaly/birth defect; a suspected transmission via a Pfizer product of an infectious agent, pathogenic or non-pathogenic and other important medical events. AEs included both SAEs and all non-SAEs. An AE is considered as TEAE if the event started on or after start date of study intervention.

Incidence of SAEs and AEs leading to discontinuations.Day 1 to Day 34

Trial Locations

Locations (77)

Applied Research Center of Arkansas

🇺🇸

Little Rock, Arkansas, United States

National Institute of Clinical Research - Bakersfield

🇺🇸

Bakersfield, California, United States

310 Clinical Research

🇺🇸

Inglewood, California, United States

Long Beach Research Institute

🇺🇸

Long Beach, California, United States

Downtown L.A. Research Center, Inc.

🇺🇸

Los Angeles, California, United States

Clinica mi Salud by Focil Med

🇺🇸

Oxnard, California, United States

FOMAT Medical Research

🇺🇸

Oxnard, California, United States

Tweedy Medical Group - Charity Health

🇺🇸

S. Gate, California, United States

Acclaim Clinical Research

🇺🇸

San Diego, California, United States

Breathe Clear Institute for Sinus and Allergy Relief

🇺🇸

Torrance, California, United States

Clinical Research of California

🇺🇸

West Hills, California, United States

Paradigm Clinical Research, LLC

🇺🇸

Wheat Ridge, Colorado, United States

Emerson Clinical Research Institute

🇺🇸

Washington, District of Columbia, United States

Innovative Research of West Florida

🇺🇸

Clearwater, Florida, United States

Invictus Clinical Research Group

🇺🇸

Coconut Creek, Florida, United States

Alliance for Multispecialty Research, LLC

🇺🇸

Nashville, Tennessee, United States

Herco Medical and Research Center Inc

🇺🇸

Coral Gables, Florida, United States

Hillcrest Medical Research LLC

🇺🇸

DeLand, Florida, United States

Hillcrest Medical Research

🇺🇸

DeLand, Florida, United States

Universal Axon Clinical Research, LLC

🇺🇸

Doral, Florida, United States

Proactive Clinical Research,LLC

🇺🇸

Fort Lauderdale, Florida, United States

Qway Research LLC

🇺🇸

Hialeah, Florida, United States

Sunbright Health Medical Centers

🇺🇸

Homestead, Florida, United States

Global Health Research Center, Inc.

🇺🇸

Miami Lakes, Florida, United States

Bio-Medical Research LLC

🇺🇸

Miami, Florida, United States

Kendall South Medical Center

🇺🇸

Miami, Florida, United States

Adult Medicine of Lake County, Inc.

🇺🇸

Mount Dora, Florida, United States

Innovation Medical Research Center

🇺🇸

Palmetto Bay, Florida, United States

DBC Research USA

🇺🇸

Pembroke Pines, Florida, United States

GCP Research, Global Clinical professionals

🇺🇸

Saint Petersburg, Florida, United States

Global Health Research Center - Tampa

🇺🇸

Tampa, Florida, United States

Javara - Privia Medical Group Georgia - Fayetteville

🇺🇸

Fayetteville, Georgia, United States

Coastal Heritage Clinical Research

🇺🇸

Hinesville, Georgia, United States

Koch Family Medicine

🇺🇸

Morton, Illinois, United States

Centennial Medical Group

🇺🇸

Columbia, Maryland, United States

Jadestone Clinical Research

🇺🇸

Silver Spring, Maryland, United States

University of Massachusetts Chan Medical School

🇺🇸

Worcester, Massachusetts, United States

Revival Research Institute, LLC

🇺🇸

Dearborn, Michigan, United States

Henry Ford St. John Hospital

🇺🇸

Grosse Pointe Woods, Michigan, United States

Mercury Street Medical Group, PLLC

🇺🇸

Butte, Montana, United States

Velocity Clinical Research, Grand Island

🇺🇸

Grand Island, Nebraska, United States

McGill Family Practice

🇺🇸

Papillion, Nebraska, United States

Las Vegas Clinical Trials

🇺🇸

North Las Vegas, Nevada, United States

Prime Global Research

🇺🇸

Bronx, New York, United States

Monroe Biomedical Research

🇺🇸

Monroe, North Carolina, United States

Remington-Davis, Inc

🇺🇸

Columbus, Ohio, United States

Preferred Primary Care Physicians

🇺🇸

Uniontown, Pennsylvania, United States

WR-Clinsearch, LLC

🇺🇸

Chattanooga, Tennessee, United States

Southwest Family Medicine Associates

🇺🇸

Dallas, Texas, United States

Southwest Mind and Body Care

🇺🇸

Dallas, Texas, United States

Next Level Urgent Care

🇺🇸

Houston, Texas, United States

Gulf Coast Clinical Research - Houston

🇺🇸

Houston, Texas, United States

Mercury Clinical Research - Santa Clara Family Clinic

🇺🇸

Houston, Texas, United States

The Crofoot Research Center

🇺🇸

Houston, Texas, United States

Epic Clinical Research

🇺🇸

Lewisville, Texas, United States

Javara - Privia Medical Group North Texas - Stephenville

🇺🇸

Stephenville, Texas, United States

Javara - Privia Medical Group Gulf Coast - Sugarland

🇺🇸

Sugar Land, Texas, United States

Mercury Clinical Research - North Houston Internal Medicine & Pediatric Clinic

🇺🇸

Tomball, Texas, United States

Alpine Research Organization

🇺🇸

Clinton, Utah, United States

Eastside Research Associates

🇺🇸

Redmond, Washington, United States

Vancouver Infectious Diseases Centre

🇨🇦

Vancouver, British Columbia, Canada

Clinical Research of Ontario

🇨🇦

Scarborough, Ontario, Canada

Diex Recherche Quebec

🇨🇦

Quebec, Canada

Kamezawa Clinic

🇯🇵

Kasugai, Aichi, Japan

International University of Health and Welfare Narita Hospital

🇯🇵

Narita, Chiba, Japan

Tashiro Endocrinology Clinic

🇯🇵

Fukuoka-shi, Fukuoka, Japan

Medical Corporation Kouhoukai Takagi Hospital

🇯🇵

Okawa-shi, Fukuoka, Japan

Nishioka Hospital

🇯🇵

Sapporo, Hokkaido, Japan

Terada Clinic Respiratory Medicine & General Practice

🇯🇵

Himeji, Hyogo, Japan

Tsuchiura Beryl Clinic

🇯🇵

Tsuchiura, Ibaraki, Japan

National Hospital Organization Okinawa Hospital

🇯🇵

Ginowan, Okinawa, Japan

Fukuwa Clinic

🇯🇵

Chuo-ku, Tokyo, Japan

Musashino Emergency Hospital

🇯🇵

Kodaira-shi, Tokyo, Japan

Swing Nozaki Clinic

🇯🇵

Musashino-shi, Tokyo, Japan

Yoshijima Hospital

🇯🇵

Hiroshima, Japan

Rakuwakai Otowa Hospital

🇯🇵

Kyoto, Japan

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

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