Chloroquine Diphosphate for the Treatment of Severe Acute Respiratory Syndrome Secondary to SARS-CoV2
- Conditions
- SARS-CoV InfectionSevere Acute Respiratory Syndrome (SARS) Pneumonia
- Interventions
- Registration Number
- NCT04323527
- Lead Sponsor
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado
- Brief Summary
In December 2019, the Municipal Health Committee of Wuhan, China, identified an outbreak of viral pneumonia of unknown cause. This new coronavirus was called SARS-CoV-2 and the disease caused by that virus, COVID-19. Recent numbers show that 222,643 infections have been diagnosed with 9115 deaths, worldwide. Currently, there are no approved therapeutic agents available for coronaviruses. In this scenario, the situation of a global public health emergency and evidence about the potential positive effect of chloroquine (CQ) in most coronaviruses, including SARS-CoV-1, and recent data on small trials on SARS-CoV-2, the investigators intend to investigate the efficacy and the safety of CQ diphosphate in the treatment of hospitalized patients with severe acute respiratory syndrome in the scenario of SARS-CoV2. Preliminary in vitro studies and uncontrolled trials with low number of patients of CQ repositioning in the treatment of COVID-19 have been encouraging. The main hypothesis is that CQ diphosphate will reduce mortality in 50% in those with severe acute respiratory syndrome infected by the SARS-COV2. Therefore, the main objective is to assess whether the use of chloroquine diphosphate reduces mortality by 50% in the study population. The primary outcome is mortality in day 28 of follow-up. According to local contingency plan, developed by local government for COVID-19 in the State of Amazonas, the Hospital Pronto-Socorro Delphina Aziz, located in Manaus, is the reference unit for the admission of serious cases of the new virus. The unit currently has 50 ICU beds, with the possibility of expanding to 335 beds, if needed. The hospital also has trained multiprofessional human resources and adequate infrastructure. In total, 440 participants (220 per arm) will receive either high dose chloroquine 600 mg bid regime (4x150 mg tablets, every 12 hours, D1-D10) or low dose chloroquine 450mg bid regime (3x150mg tablets + 1 placebo tablet every 12 hours on D1, 3x150mg tablets + 1 placebo followed by 4 placebo tablets 12h later from D2 to D5, and 4 placebo tablets every 12 hours, D6-D10). Placebo tablets were used to standardize treatment duration and blind research team and patients. All drugs administered orally (or via nasogastric tube in case of orotracheal intubation). Both intervention and placebo drugs will be produced by Farmanguinhos. Clinical and laboratory data during hospitalization will be used to assess efficacy and safety outcomes.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 278
Not provided
• None.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Low Dose Chloroquine Diphosphate (5 days) (Study stage 2) - Clorocovid 3 Chloroquine diphosphate Low dose chloroquine group consisted of 450 mg bid (3 tablets of 150 mg) on D1, and 3x150mg tablet once daily from D2 to D5. Oral administration or via a nasogastric tube in case of orotracheal intubation. (this was a second stage of the original study and was approved by the Brazilian IRB on 03/May/2020). Placebo (5 days) (Study stage 2) - Clorocovid 3 Chloroquine diphosphate Placebo group consists of 3 placebo tablets bid (day 1), and 3 placebo tablets once daily from D2 to D5. Oral administration or via a nasogastric tube in case of orotracheal intubation. (this was a second stage of the original study and was approved by the Brazilian IRB on 03/May/2020). Low Dose Chloroquine Diphosphate (5 days) (Study stage 1) - Clorocovid 1 Chloroquine diphosphate Low dose chloroquine group consists of 450 mg bid (3 tablets of 150 mg + 1 placebo tablet, every 12 hours) on D1, 3x150mg tablets + 1 placebo followed by 4 placebo tablets 12h later from D2 to D5, and 4 placebo tablets every 12 hours, D6-D10 . Oral administration or via nasogastric tube in case of orotracheal intubation. (this was the first stage of the original study and was approved by the Brazilian IRB on 23/March/2020). High Dose Chloroquine Diphosphate (10 days) (Study stage 1) - Clorocovid 1 Chloroquine diphosphate High dose chloroquine group consists of 600 mg bid (4 tablets of 150 mg, every 12 hours) for 10 days. Oral administration or via nasogastric tube in case of orotracheal intubation. (this was the first stage of the original study and was approved by the Brazilian IRB on 23/March/2020).
- Primary Outcome Measures
Name Time Method Mortality rate reduction of 50% by day 28 28 days after randomization proportion of deaths at day 28 between groups compared
- Secondary Outcome Measures
Name Time Method Absolute duration of hospital stay in days during and after intervention, up to 28 days hospitalization
Prevalence of grade 3 and 4 adverse events during and after intervention, up to 28 days adverse events grade 3 and 4
Change in serum CK-MB level during and after intervention, up to 28 days increase or decrease in serum aspartate aminotransferase compared to baseline
Absolute mortality on days 7 and 14 7 and 14 days after first dose number of deaths at days 7 and 14 between groups compared
Improvement in overall subject's clinical status assessed in standardized clinical questionnaires on days 14 and 28 14 and 28 days after first dose clinical status
Improvement in daily clinical status assessed in standardized clinical questionnaires during hospitalization during and after intervention, up to 28 days clinical status
Duration of supplemental oxygen (if applicable) during and after intervention, up to 28 days supplemental oxygen
Duration of mechanical ventilation (if applicable) during and after intervention, up to 28 days mechanical ventilation
Prevalence of serious adverse events during and after intervention, up to 28 days adverse events
Change in serum creatinine level during and after intervention, up to 28 days increase or decrease in serum creatinine compared to baseline
Change in serum troponin I level during and after intervention, up to 28 days increase or decrease in serum troponin I compared to baseline
Change in serum aspartate aminotransferase level during and after intervention, up to 28 days increase or decrease in serum aspartate aminotransferase compared to baseline
Change in detectable viral load in respiratory tract swabs during and after intervention, up to 28 days virus clearance from respiratory tract secretion
Absolute number of causes leading to participant death (if applicable) during and after intervention, up to 28 days death
Viral concentration in blood samples during and after intervention, up to 28 days viremia in blood detected through RT-PCR
Trial Locations
- Locations (1)
Hospital e Pronto Socorro Delphina Rinaldi Abdel Aziz
🇧🇷Manaus, Amazonas, Brazil