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Efficiency of Antagonist Drugs of the Cellular Transcriptomic Signature of Influenza A Virus Infection.

Phase 2
Terminated
Conditions
Flu
Interventions
Registration Number
NCT03212716
Lead Sponsor
University Hospital, Lille
Brief Summary

The aim of this study is to evaluate the possibility to repropose marketed drugs as antiviral ones, based on their ability to reverse the transcriptomic signature of the infected cells. This strategy has to be considered is the context of emerging viral diseases and of increase of resistance to antivirals. Concerning infection by Influenza viruses, the main drugs were identified and evaluated on in vitro and in vivo models: diltiazem. Therefore, it will be assess the efficacy of these the drug, compared to placebo, to treat severe flu.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
85
Inclusion Criteria
  • patients hospitalized in intensive care units,
  • patients with mechanical ventilation invasive or non-invasive or Optiflow® ventilation system.
  • for a suspicion of severe flu,
  • with a symptoms for less than 96 hours,
  • and a respiratory failure defined by the necessity to resort to mechanical ventilation, invasive or Optiflow® Ventilation System The inclusion is conditioned to the detection of Influenza A viruses by PCR on nasopharyngeal swab.
Exclusion Criteria
  • No consent.
  • Hypersensibility to Oseltamivir
  • Negative PCR on nasopharyngeal swab
  • Symptoms for more than 96 hours.
  • Moribund patients at inclusion.
  • Pregnant/nursing woman.
  • Patients already taking diltiazem in the 48 hours before.
  • Patients having taken more than 3 intakes of oseltamivir before randomization.
  • Hemodynamic instability needing a dose of noradrenaline exceeding 2mg/h

Contraindication to diltiazem:

  • sinusal dysfunction without device.
  • auriculo-ventricular heart block without device.
  • Cardiogenic pulmonary oedema.
  • Left cardiac failure
  • bradycardia<40/min
  • Concomitant use of beta-blockers, antiarrythmic drugs, especially amiodarone.
  • Concomitant use of ivabradine, pimozide, nifedipine, ergot alkaloids.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
oseltamivir + placeboPlacebososeltamivir + placebo of diltiazem
diltiazemOseltamiviroseltamivir + diltiazem
diltiazemDiltiazemoseltamivir + diltiazem
oseltamivir + placeboOseltamiviroseltamivir + placebo of diltiazem
Primary Outcome Measures
NameTimeMethod
Percentage of alive patients without detection of influenza A virus by RT-PCR in nasopharyngeal swabs,7 days after the beginning of the treatment.
Secondary Outcome Measures
NameTimeMethod
Delay needed for the negativation of influenza A detection by RT-PCRup to 10days
Overall mortalityAt 28 days
Length of mechanical ventilationan average of 10 days
Change in Oxygenation (PaO2/FiO2 Ratio)once day for 10 days and at 28 days

Arterial blood samples for blood gas analysis are collected during the treatment period. The differences in the mean values of PaO2/FiO2 ratio are registered and analysed.

Length of hospitalizationan average of 10 days in ICU and of 16 days in hospital
Length of extracorporeal membrane oxygenation (ECMO) if implemented.an average of 10 days
Transcriptomic signature determined by the DNA microarray technology and analysed by bioinformatic toolsFour time points : at inclusion, the first day after inclusion, the fourth day after inclusion, and the seventh day after inclusion

evaluation of the capacity of tested molecules to reverse the transcriptomic signature linked to the viral infection

Trial Locations

Locations (19)

Chu Amiens Picardie

🇫🇷

Amiens, France

CH ARRAS

🇫🇷

Arras, France

Ch Pierre Oudot Bourgoin Jallieu

🇫🇷

Bourgoin-Jallieu, France

Hôpital Raymond Poincaré

🇫🇷

Garches, France

Chru Brest

🇫🇷

Brest, France

Hôpital Roger Salengro, CHRU

🇫🇷

Lille, France

CH LENS

🇫🇷

Lens, France

Hôpital Bretonneau

🇫🇷

Tours, France

CH DOUAI

🇫🇷

Douai, France

CH de Montauban

🇫🇷

Montauban, France

Ch Hnfc Site de Belfort

🇫🇷

Belfort, France

Ch Bethune

🇫🇷

Béthune, France

Hôpital Edouard Herriot Hospices Civils de Lyon

🇫🇷

Lyon, France

Ch de Valenciennes

🇫🇷

Valenciennes, France

Centre Hospitalier de Versailles - Le Chesnay Rocquencourt

🇫🇷

Versailles, France

Gpe Hosp Cochin Saint Vincent de Paul - Paris

🇫🇷

Paris, France

Ch Regional Orleans

🇫🇷

Orléans, France

Hopitaux Universitaires de Strasbourg

🇫🇷

Strasbourg, France

Hu Paris Sud Site Kremlin Bicetre Aphp

🇫🇷

Paris, France

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