Opaganib, a Sphingosine Kinase-2 (SK2) Inhibitor in COVID-19 Pneumonia: a Randomized, Double-blind, Placebo-Controlled Phase 2/3 Study, in Adult Subjects Hospitalized With Severe SARS-CoV-2 Positive Pneumonia
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 475
- 试验地点
- 57
- 主要终点
- Supplemental Oxygen Requirement
研究概览
简要总结
A phase 2/3 multi-center randomized, double-blind, parallel arm, placebo- controlled study in Adult Subjects Hospitalized with Severe SARS-CoV-2 Positive Pneumonia to determine the potential of opaganib to improve and/or stabilize the clinical status of the patient.
详细描述
This is a phase 2/3 multi-center randomized, double-blind, parallel arm, placebo- controlled study with an adaptive design that will utilize a futility assessment. The study is planned be performed worldwide in up to approximately 80 clinical sites.
After informed consent is obtained, patients will enter a screening phase for no more than 3 days, to determine eligibility. Approximately 464 eligible patients will be randomized and receive either opaganib added to standard of care, or matching placebo added to standard of care, in a randomization ratio of 1:1. Treatment assignments will remain blinded to the patient, investigator and hospital staff, as well as the sponsor. As the approval and/or guidance for treating COVID-19 are evolving, for this protocol, standard of care will be defined by the recommended schemes of treatment according to the severity of the disease, taking into consideration regulatory approvals in one or more regions.
Study participants will receive either opaganib 2 x 250 mg capsules (500 mg) every 12 hours, or matching placebo, in addition to standard of care (pharmacological as defined above and/or supportive) at any given institution. Study drug will be administered every day for 14 days (Day 1 to Day 14). All participants will be followed up for 28 days after their last dose of study drug, which may occur at Day 14 or after premature study drug discontinuation, based upon patient or physician determination.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult male or female ≥18 to ≤80 years of age
- •Proven COVID-19 infection per RT-PCR assay of a pharyngeal sample (nasopharyngeal or oropharyngeal) AND pneumonia defined as radiographic opacities on chest X-ray or CT scan. that diagnosed COVID-19 pneumonia. Pharyngeal samples collected either at screening or within 7-days prior to screening for the same ongoing COVID-19 pneumonia illness are acceptable
- •The patient requires, at baseline, high flow supplemental oxygen or positive pressure ventilation or is receiving oxygen via face mask, such as a non-rebreather or reservoir mask, capable of delivering high concentrations of oxygen
- •Patient agrees to use appropriate methods of contraception during the study and 3 months after the last dose of study drug
- •The patient or legal representative has signed a written informed consent approved by the IRB/Ethics Committee
排除标准
- •Any co-morbidity that may add risk to the treatment in the judgment of the investigator, particularly patients with known cardiac conditions, and serious neuropsychiatric conditions such as psychosis or major depression
- •Requiring intubation and mechanical ventilation at baseline
- •Patient has a 'Do Not Intubate' and/or 'Do Not Resuscitate' order in place
- •Oxygen saturation >95% on room air
- •Any preexisting respiratory condition that requires intermittent or continuous ambulatory oxygen prior to hospitalization
- •Patient is, in the investigator's clinical judgement, unlikely to survive >72 hours
- •Pregnant (positive serum or urine test within 3 days prior to randomization) or nursing women .
- •Unwillingness or inability to comply with procedures required in this protocol.
- •Corrected QT (QTc) interval on electrocardiogram (ECG) >470 ms for females or >450 ms for males, calculated using Friedericia's formula (QTcF)
- •AST (SGOT) or ALT (SGPT) > 2.0 x upper limit of normal (ULN)
- •Total bilirubin >1.5x ULN (except where bilirubin increase is due to Gilbert's Syndrome)
- •Serum creatinine >2.0 X ULN
- •Absolute neutrophil count <1000 cells/mm3
- •Platelet count <75,000/mm3
- •Hemoglobin <8.0 g/dL
- •Medications that are sensitive substrates, or substrates with a narrow therapeutic range, for CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19 CYP2D6 , CYP3A4, P-gP, BCRP and OATP1B1 should be avoided with opaganib
- •Moderate or strong inhibitors of CYP1A2, CYP3A4, CYP2D6 or P-gP or moderate to strong inducers of CYP3A4 and CYP1A2 are prohibited
- •Currently taking warfarin, apixaban, argatroban or rivaroxaban due to drug-drug interaction based on CYP450 metabolism
- •Current drug or alcohol abuse
- •Currently participating in a clinical study assessing pharmacological treatments, including anti-viral studies
- •Treatment with any medication that causes QT prolongation within seven days, or 5 half-lives, whichever is longest, prior to initiation of study drug, or intention to use them throughout the study, including but not limited to: amiodarone, amitriptyline, citalopram dose greater than 20 mg/day, dihydroergotamine, disopyramide, dofetilide, dronedarone, ergotamine, ibutilde, ondansetron or other 5-HT3 receptor antagonists, pimozide, procainamide, quinidine, quinine, quinolone, ranolazine, risperidone, sotaloland tolteridine. Investigators are directed to the following up-to-date web site listing QT prolonging drugs: https://www.crediblemeds.org/index.php/drugsearch
研究组 & 干预措施
Opaganib
In addition to standard of care, opaganib will be administered orally with 2 x 250 mg capsules (500 mg) every 12 hours. When required this may be made into a suspension form and may be administered by nasogastric tube.
干预措施: Opaganib (Drug)
Placebo
In addition to standard of care, a matching placebo will be administered orally with 2 x 250 mg capsules (500 mg) every 12 hours. Where required this may be made into a suspension form and may be administered by nasogastric tube.
干预措施: Placebo (Drug)
结局指标
主要结局
Supplemental Oxygen Requirement
时间窗: 14 days maintained up to 42 days
To compare the proportion of patients no longer requiring supplemental oxygen for at least 24 hours by Day 14 between subjects taking opaganib and those on placebo.
次要结局
- Number of Participants With Low Oxygen Flow Via Nasal Cannula(14 days maintained up to 42 days)
- Time to Discharge From Hospital Measured at 14 Days(14 days)
- Patients Requiring Intubation and Mechanical Ventilation by Day 42(42 days)
- Percentage of Subjects With ≥ 2 Category Improvement on the World Health Organization (WHO) Ordinal Scale for Clinical Improvement by Day 14 Maintained to Day 42(14 days maintained up to 42 days)
- Number of Subjects With Improvement to a Score of 3 or Less on the WHO Ordinal Scale for Clinical Improvement With a Scale Ranging From 8 Down to 0(14 days maintained up to 42 days)
- Number of Patients With Two Consecutive Negative Swabs for SARS-CoV-2 at Day 14(14 days)
- Patients With Negative Swabs for SARS-CoV-2 at Day 14(14 days)
- Mortality Due to Any Cause(42 days)