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Evaluation of the Safety of CD24-Exosomes in Patients With COVID-19 Infection

Phase 1
Conditions
SARS-CoV-2
Interventions
Registration Number
NCT04747574
Lead Sponsor
Tel-Aviv Sourasky Medical Center
Brief Summary

This is an open-label Phase I study, four dose escalation groups, to evaluate the safety of CD24-exosomes in patients with moderate/severe COVID-19 disease.

Patients with moderate/severe COVID-19 infection and factors predictive of a cytokine storm are recruited from the Corona department of the Tel Aviv Sourasky Medical Center (TASMC), who have provided informed consent are being recruited in four dose groups who will receive the exosome treatment as an add-on treatment to standard treatment.

Detailed Description

Coronavirus disease 2019 (COVID-19) is a highly transmissible disease in the community. The main cause of clinical deterioration that leads to death is the cytokine storm in the lung.

CD24 is a small heavily glycosylated GPI-anchored protein. CD24 is a key player in the vast majority of human cancers and also plays an important role in controlling the homeostatic proliferation of T cells. Hence, CD24 can negatively regulate inflammation.

The treatment is a biologic therapeutic agent based on exosomes carrying CD24. The rationale for this treatment is that exosomes overexpressing CD24, isolated and purified from T-REx™-293 cells engineered to express CD24 at high levels, can suppress the cytokine storm and are delivered directly to the target organ using exosomes as a highly body-compatible delivery vehicle. This enables a strong reduction of the required dose (as opposed to systemic administration), and reduces the risk for adverse events.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
35
Inclusion Criteria

Not provided

Exclusion Criteria
  1. Age<18 years or >85 years
  2. Any concomitant illness that, based on the judgment of the Investigator is terminal
  3. Ventilated patient
  4. Pregnancy (positive urine pregnancy test [women of childbearing potential only]) or breastfeeding
  5. Unwilling or unable to provide informed consent
  6. Participation in any other study in the last 30 days

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
EXO-CD24 exosome treatmentEXO-CD24Group 1, 5 patients are treated with 1x10\^8 exosome particles per 2 ml saline. Group 2: 5 patients are treated with 5x10\^8 exosome particles per 2 ml saline. Group 3: 20 patients are treated with 1x10\^9 exosomes particles per 2 ml saline. Group 4: 5 patients are treated with 1x10\^10 exosomes particles per 2 ml saline. The drug is aerosolized in normal saline for inhalation and administered via a standard hospital-grade inhalation device, QD for 5 days. Study treatment is given as an add-on to the standard of care.
Primary Outcome Measures
NameTimeMethod
Primary safety endpoint: Adverse events35 days

Number of adverse events, and adverse events leading to premature study termination.

Secondary Outcome Measures
NameTimeMethod
Exploratory endpoint: Change in respiratory rate from baseline to Day 55 days

Change in respiratory rate from baseline to Day 5

Exploratory Endpoint: Alive at Day 5 without bronchospasms, unexpected infections, or clinical deterioration5 days

A composite endpoint comprised of alive at Day 5 without bronchospasms, unexpected infections, or a significant clinical deterioration compared to Baseline

Exploratory endpoint: Proportion of patients with SpO2 saturation ≥94% for at least 24 hours5 days

Proportion of patients with SpO2 saturation ≥94% for at least 24 hours

Exploratory endpoint: Proportion of patients with no artificial ventilation after 5 days of treatment5 days

Proportion of patients with no artificial ventilation after 5 days of treatment

Exploratory Endpoint: Proportion of patients with respiratory rate ≤ 23/min for 24 hours5 days

Proportion of patients with respiratory rate ≤ 23/min for 24 hours

Exploratory endpoint: Change in SpO2 saturation from baseline to Day 55 days

Change in SpO2 saturation from baseline to Day 5

Exploratory endpoint: Proportion of patients with a change in absolute lymphocyte count, sustained for ≥48 hours after 5 days of treatment7 days

Proportion of patients with a change in the absolute lymphocyte count, sustained for ≥48 hours after 5 days of treatment

Exploratory endpoint: Change in the absolute lymphocyte count from baseline to Day 55 days

Change in the absolute lymphocyte count from baseline to Day 5

Exploratory endpoint: Change in neutrophil-to-lymphocyte ratio (NLR), sustained for ≥48 hours after 5 days of treatment7 days

Proportion of patients with a change in the neutrophil-to-lymphocyte ratio, sustained for ≥48 hours after 5 days of treatment

Exploratory endpoint: Change in neutrophil-to-lymphocyte ratio (NLR) from baseline to Day 55 days

Change in neutrophil-to-lymphocyte ratio (NLR) from baseline to Day 5

Trial Locations

Locations (1)

Tel Aviv Medical Center

🇮🇱

Tel Aviv, Israel

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