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Study on Safety and Clinical Efficacy of AZVUDINE in Initial Stage COVID-19 Patients (SARS-CoV-2 Infected)

Phase 3
Completed
Conditions
COVID-19
Interventions
Registration Number
NCT05033145
Lead Sponsor
HRH Pharmaceuticals Limited
Brief Summary

Phase III, single-center with co-participating units, randomized, double-blind, parallel, placebo-controlled clinical study

Detailed Description

Hypothesis:

AZVUDINE has a therapeutic potential and safety profile for the treatment of patients infected with SARS-CoV-2.

Goals:

Main goal:

To evaluate the efficacy and safety of AZVUDINE (FNC) in patients infected with SARS-COV-2, in a mild stage;

Specific objective:

To assess the clinical outcome of mild-stage SARS-CoV-2 infected participants treated with AZVUDINE (FNC) versus placebo

Statistical planning:

Statistical description: all statistical tests are performed by bilateral testing. A significance level of 5% will be adopted.

Baseline analysis: including subject distribution, data demographics, and baseline analysis.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
312
Inclusion Criteria

Individuals who present the following characteristics will be included in this study:

  1. Age ≥18 years, regardless of gender;
  2. Fluorescence RT-PCR test result of respiratory or blood samples must be positive for COVID-19, or viral gene sequencing of respiratory tract samples must be highly homologous to COVID-19; Individuals with COVID-19 must meet the diagnostic criteria in the "latest version of clinical guidelines for COVID-19" issued by the World Health Organization (WHO) on June 4, 2020;
  3. Symptomatic patients who meet the case definition for COVID-19, according to WHO, without evidence of bacterial pneumonia or hypoxia (Sat O2 < 95%) P. [score 1-3];
  4. Voluntary participation and signing of the informed consent form.
Exclusion Criteria

Individuals who present one or more of the following characteristics will not be eligible to participate in this study:

  1. Know or suspect that you are allergic to any of the components of AZVUDINE tablets (inactive ingredients: microcrystalline cellulose, lactose hydrate, polyvinylpyrrolidone K30, croscarmellose sodium, magnesium stearate);
  2. Individual presenting shortness of breath and Sat O2 < 95%; or any other symptom requiring treatment through hospital admission;
  3. Patients with liver disease (total bilirubin ≥2mg/dL, ALT/TGP e AST/TGO ≥5 times above normal limit);
  4. Pactients with a history of known liver disease (cirrhosis with ChildPugh classification B and C);
  5. Patients with a history of renal insufficiency (glomerular filtration rate < 60mL/min/1,73m2);
  6. Patients with history of congestive heart failure (NYHA ¾ grade), untreated symptomatic arrhythmias ormyocardial infarction within 6 months;
  7. Individuals with malabsorption syndrome, or other conditions affecting gastrointestinal absorption, and circumstances in which patients require intravenous nutrition, or cannot take medications orally or nasogastrically;
  8. Total neutrophil count <750 cells/L;

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AZVUDINE placeboAZVUDINE placeboControl: AZVUDINE placebo Intervention: AZVUDINE placebo tablet, 5 tablets QD + standard treatment, for up to 14 days
AZVUDINEAZVUDINEExperimental: AZVUDINE 1mg tablet Interventions: AZVUDINE 1mg tablet, 5 tablets QD + standard treatment, for up to 14 days
Primary Outcome Measures
NameTimeMethod
Proportion of patients hospitalized during the study through day 28Day 14 to Day 30

WHO clinical progression ordinal scale (Jun/2020), Score 4 to 10.Health Organization Ordinal Clinical Progression Scale (WHO, Jun/2020; scale 0 \[asymptomatic\] to 10 \[death\]), with score 4 to 7.

Proportion of participants with a clinical outcome of CURE during the study;Day 14 to Day 30

The clinical outcome of cure is defined in this protocol as the absence of viral RNA in samples collected and clinical conditions for outpatient discharge.

Secondary Outcome Measures
NameTimeMethod
Improvement in clinical status in at least one category compared to screeningDay 14 to Day 30

Ordinal Scale of Clinical Improvement (WHO, Jun/2020)

Severity and duration of symptoms: fever, cough, fatigue or tiredness, breathlessness, myalgia, nasal congestion or runny nose, sore throat, headache, chills, nausea, vomiting, anosmia, ageusia.Day 1 to Day 14

Intensity (1= Mild; 2= Moderate; 3= Severe; 4= Critical)

Changes in kidney functionDay 1 to Day 30

Change in urea/creatinine

Changes in liver functionDay 1 to Day 30

Changes in ALT/AST

Time of use of AZVUDINE until the second negative conversion of RT-PCRDay 1 to Day 14

Rate of change in biochemical markers of inflammatory function in relation to the physiological reference intervals between the AZVUDINA and PLACEBO groups.

Assessment of liver function biochemical markers (AST/TGO, ALT/TGP, ALP, GGT, BIL total, and direct BIL)Day 1 to Day 60

Rate of change in biochemical markers of hepatic function in relation to the physiological reference intervals between the AZVUDINA and PLACEBO groups.

Evaluation of SARS-CoV-2 viral load negative conversion time by RT-PCR between AZVUDINE group (FNC) and control groupDay 1 to Day 28

RT-PCR performed on treatment days.

Occurrence of drug interactionsDay 1 to Day 14

Monitoring of concomitant medication

All-cause mortality rate during the studyDay 1 to Day 60

mortality and its causes

Frequency and intensity of adverse events, unexpected adverse events, and serious adverse eventsDay 1 to Day 30

Intensity of adverse events (1= Mild; 2= Moderate; 3= Severe; 4= Critical)

Proportion of comorbidity-related worsening [Obesity, diabetes, alcoholism, smoking, lung disease]Day 1 to Day 30

relationship between comorbidities and aggravations

hospitalization for all causes occurring in post-treatment periodDay 1 to Day 60

hospitalization for all causes after treatment

To assess the tolerability of using AZVUDINE (FNC) at 5mg/dayDay 1 to Day 14

calculation of participants who completed treatment

Trial Locations

Locations (7)

Clinical Research Unit / High Complexity Center (CRU/HCC) / Galzu Institute

🇧🇷

Campos Dos Goytacazes, Rio De Janeiro, Brazil

Hospital Moacyr Gomes de Azevedo

🇧🇷

Cambuci, RJ, Brazil

Hospital Santa Casa de Misericórdia de Campos

🇧🇷

Campos Dos Goytacazes, RJ, Brazil

Unidade de Pesquisa Clínica / Centro de Alta Complexidade

🇧🇷

Campos dos Goytacazes, RJ, Brazil

Hospital de Itaocara

🇧🇷

Itaocara, RJ, Brazil

Hospital Armando Vidal

🇧🇷

São Fidelis, RJ, Brazil

Unidade Pré Hospitalar São José

🇧🇷

Campos Dos Goytacazes, RJ, Brazil

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