Ebola Virus Disease
Conditions
Keywords
Ebola, EVD, Adaptive design, therapeutics
Brief summary
The purpose of this study is to determine whether multiple therapeutic regimens are effective in the treatment of Ebola Virus Disease (EVD)
Detailed description
The ongoing epidemic of EVD has ravaged parts of West Africa, with initial cases reported in December 2013. There is no licensed specific therapy for the disease, which has a case-fatality rate of approximately 50-70%. Although anecdotal clinical data, recent studies in animal models, and in vitro screening suggest that treatment of EVD patients with anti-viral agents, immune modifying agents, and/or convalescent blood products may be effective, they have not been evaluated in clinical trials. This multi-arm clinical trial will evaluate the efficacy and safety of multiple regimens, both as mono-therapy and combination therapy. Provision of these regimens, if found effective and safe, would have a major impact on the current and future epidemics by providing effective treatment options. As described for previous adaptive trials, a randomization probability for each of the treatment regimens is created based on 14-day mortality, and is used for weighting randomization of subsequently enrolled participants. Participants will continually be preferentially assigned to regimens with better initial performance. New agents can be added or existing agents removed as the trial evolves.
Interventions
Adults (\>18 yrs): 3 x 500mg tablets daily for 5 days; Children (6 months to \<18 yrs): 30mg/kg (oral suspension) daily for 5 days
Sunitinib - Adults (\>18 yrs): 1 x 50mg tablet daily for 7 days; Children (6 months to \<18 yrs): 0.83 mg/kg (oral suspension) daily for 7 days. Erlotinib - Adults (\>18 yrs): 1 x 150mg tablet daily for 7 days; Children (8kg to \<20kg): 3.5 mg/kg daily for 7 days; Children (\>20kg to \<30kg): 3.0 mg/kg daily for 7 days; Children (\>30kg to \< 18 yrs): 25 mg/kg daily for 7 days
Atorvastatin - Adults (\>18 yrs): 1 x 40mg tablet daily until discharge; Children (6 years to \<18 yrs): 1 x 40mg tablet daily until discharge; Irbesartan - Adults (\>18 yrs): 1 x 150mg tablets daily until discharge; Children (6 years to \<18 yrs): 1 x 75mg tablet daily until discharge.
All arms will receive aggressive IV fluid rehydration and frequent laboratory tests to assist with medical management as indicated.
Sponsors
Study design
Eligibility
Inclusion criteria
* Males and females aged 6 months and \>8kg in weight * Confirmed case of EVD * Admission to the hospital \< 48 hours prior to enrollment * Participant or family member/guardian able and willing to provide signed informed consent
Exclusion criteria
* Prior treatment with any other specific experimental anti-EVD product, or expectation to receive another experimental anti-EVD product during the course of the study (this does not include general supportive care or nutritional supplements routinely administered to all hospitalized patients with EVD) * Unresponsive * In the treating physicians opinion, an inability to comply with the study treatment regimen
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Death by 14 days | 14 days after starting treatment regimen |
Secondary
| Measure | Time frame |
|---|---|
| Reduction in viral load | 14 days after starting treatment regimen |
| 2-week post discharge clinical sequelae, including signs and symptoms and laboratory abnormalities | 14 days after starting treatment |
Other
| Measure | Time frame |
|---|---|
| Severe adverse events that are inconsistent with EVD and are assessed as related to study agent(s) by the site principal investigator | 14 days after starting treatment |