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Camostat Efficacy vs. Placebo for Outpatient Treatment of COVID-19 (CAMELOT)

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of the Efficacy of Camostat Mesilate for Treatment of COVID-19 in Outpatients

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04583592
Enrollment
295
Registered
2020-10-12
Start date
2020-11-09
Completion date
2021-03-31
Last updated
2022-01-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

COVID-19

Brief summary

This is a randomized, double-blind, placebo-controlled study of camostat mesilate in ambulatory patients with confirmed COVID-19 with at least one risk factor for severe illness.

Detailed description

Participants will be randomized in a 2:1 ratio of camostat:placebo. Approximately 300 participants are planned to be enrolled (200 participants to camostat mesilate and 100 participants to placebo). Participants will be treated with camostat mesilate 200 mg or placebo drug orally 4 times a day for 14 days, and receive local standard of care (SOC) in addition to study drug. Participants will be followed until Day 28. Participants will be seen in the clinic for assessments, blood draws, and mid-turbinate nasal samples on Screening/Day 1, Day 7, Day 15 and early termination.

Interventions

Camostat mesilate administered as oral 100 mg round tablets. Study dose: Two 100 mg tablets (200 mg total) taken orally 4 times daily for 14 days.

DRUGPlacebo

Placebo administered as oral round tablets. Study dose: Two placebo tablets taken orally 4 times daily for 14 days.

Sponsors

Sagent Pharmaceuticals Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Adults willing and able to provide informed consent before performing study procedures 2. Adults ≥18 years of age at time of informed consent 3. Participants must have written notification of laboratory confirmed COVID-19 infection performed prior to screening, at a local laboratory by RT-PCR or other commercial or public health assay in any specimen; and participants must be randomized within 72 hours of receiving the above notification of laboratory confirmed COVID-19 4. Have a mild or moderate form of COVID-19 defined as SpO2 \> 94% at screening 5. Participants must have at least 1 of the following risk factors for severe illness 1. Aged 65 years or older 2. Hypertension 3. Diabetes mellitus 4. Chronic lung disease including asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (eg, idiopathic pulmonary fibrosis) 5. Chronic cardiac conditions, including coronary artery disease (CAD), heart failure, congenital heart disease, cardiomyopathy 6. Severe obesity (body mass index \[BMI\] ≥ 40 kg/m\^2) 7. Chronic liver disease, including cirrhosis 6. Must agree not to enroll in another study of an investigational agent or take any other drug that has been granted Emergency Use Authorization prior to completion of Day 28 7. If women of childbearing potential (WOCBP) or men whose sexual partners are WOCBP, must be able and willing to use at least 1 highly effective method of contraception during the study and for 90 days after receiving the last dose of study drug

Exclusion criteria

1. Physician makes a decision that trial involvement is not in participants' best interest, or has any condition that does not allow the protocol to be followed safely 2. Known severe liver disease (eg, Child Pugh score \> 12, AST \>5 times upper limit) 3. SaO2/SPO2 ≤94% on room air condition, or the Pa02/Fi02 ratio \< 300 mgHg 4. Known allergic reaction to camostat mesilate or one of its excipients 5. Known severe renal impairment (estimated glomerular filtration rate ≤30 mL/min/1.73 m\^2) or receiving dialysis 6. Pregnant or breastfeeding, or positive pregnancy test in a predose examination 7. Receipt of any experimental treatment for COVID-19, including agents with demonstrated or possible direct acting antiviral activity, including, but not limited to, remdesivir, hydroxychloroquine, lopinavir/ritonavir, tocilizumab, or ivermectin, within the 30 days prior to the time of the screening evaluation. No off label use of a drug for COVID 19 is allowed. 8. History of human immunodeficiency virus infection on highly active antiretroviral therapy (HAART)

Design outcomes

Primary

MeasureTime frameDescription
Disease Progression at Day 2828 daysDisease progression will be defined as the number of participants requiring hospitalization (including emergency room visit) or who die due to any cause within 28 days of randomization.

Secondary

MeasureTime frameDescription
Time to Fever ResolutionUp to 28 daysTime (in days) from initiation of study treatment until normalization of fever (≤ 37.2 °C oral or tympanic) and sustained for at least 3 days only assessed in participants who experienced a fever within 1 day of enrollment up to Day 28.
Resolution of Viral SheddingDay 1, Day 7 and Day 15Number of participants with no viral shedding (yes/no) using reverse transcriptase-polymerase chain reaction (RT-PCR) at Day 7, Day 15, and at early termination.
Rate of Adverse Events and Serious Adverse Events28 daysNumber of participants with Adverse events (AEs) and Serious adverse events (SAEs) of any grade from randomization up to Day 28.
Cumulative Rate of Grade 3 and 4 Adverse Events28 daysCumulative number of participants with grade 3 and 4 AEs from randomization up to Day 28.
Rate of Discontinuation28 daysNumber of participants that discontinued from study due to an AE/SAE (discontinued participants will be followed up to Day 28).
Laboratory Parameter - Platelet CountDay 1 and Day 15Clinical Laboratory Value of Platelet Count at Day 1 and Day 15
Laboratory Parameter - Potassium LevelDay 1 and Day 15Clinical laboratory value of Potassium Levels at Day 1 and Day 15
Survival RateUp to Day 15 and Day 28The overall survival rate (the number of randomized participants who survive up to Day 15 and Day 28).
Laboratory Parameter - Alanine Aminotransferase (ALT)Day 1 and Day 15Clinical laboratory value of Alanine Aminotransferase (ALT) at Day 1 and Day 15
Laboratory Parameter - Alkaline Phosphatase (ALP)Day 1 and Day 15Clinical laboratory value of Alkaline Phosphatase (ALP) at Day 1 and Day 15
Laboratory Parameter - Gamma-Glutamyl Transferase (GGT)Day 1 and Day 15Clinical laboratory value of Gamma-Glutamyl Transferase (GGT) at Day 1 and Day 15
Vital Signs - Heart RateDay 1, Day 7 and Day 15Heart rate at Day 1, Day 7 and Day 15
Vital Signs - Blood PressureDay 1, Day 7 and Day 15Blood pressure (BP) at Day 1, Day 7 and Day 15
Vital Signs - Peripheral Capillary Oxygen Saturation (SpO2)Day 1, Day 7 and Day 15Peripheral Capillary Oxygen Saturation (SpO2) at Day 1, Day 7 and Day 15
Laboratory Parameter - Aspartate Aminotransferase (AST)Day 1 and Day 15Clinical laboratory values of Aspartate Aminotransferase (AST) at Day 1 and Day 15

Countries

United States

Participant flow

Recruitment details

The study was performed between November 09, 2020 to March, 30 2021. Subjects were recruited from \ 25 sites across United States.

Participants by arm

ArmCount
Camostat Mesilate
Participants will receive camostat mesilate for 14 days in addition to standard of care treatment. Camostat Mesilate: Camostat mesilate administered as oral 100 mg round tablets. Study dose: Two 100 mg tablets (200 mg total) taken orally 4 times daily for 14 days.
194
Placebo
Participants will receive placebo for 14 days in addition to standard of care treatment. Placebo: Placebo administered as oral round tablets. Study dose: Two placebo tablets taken orally 4 times daily for 14 days.
101
Total295

Baseline characteristics

CharacteristicCamostat MesilatePlaceboTotal
Age, Customized
< 55 years
105 Participants53 Participants158 Participants
Age, Customized
> or = 55 years
89 Participants48 Participants137 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
115 Participants62 Participants177 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
78 Participants39 Participants117 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants0 Participants1 Participants
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants0 Participants2 Participants
Race (NIH/OMB)
Asian
4 Participants1 Participants5 Participants
Race (NIH/OMB)
Black or African American
29 Participants17 Participants46 Participants
Race (NIH/OMB)
More than one race
3 Participants0 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants3 Participants6 Participants
Race (NIH/OMB)
White
153 Participants80 Participants233 Participants
Sex: Female, Male
Female
108 Participants61 Participants169 Participants
Sex: Female, Male
Male
86 Participants40 Participants126 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 1950 / 99
other
Total, other adverse events
8 / 1959 / 99
serious
Total, serious adverse events
10 / 1955 / 99

Outcome results

Primary

Disease Progression at Day 28

Disease progression will be defined as the number of participants requiring hospitalization (including emergency room visit) or who die due to any cause within 28 days of randomization.

Time frame: 28 days

Population: The Intent-to-Treat population includes all subjects who were randomized

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Camostat MesilateDisease Progression at Day 2810 Participants
PlaceboDisease Progression at Day 286 Participants
p-value: 0.787Chi-squared
Secondary

Cumulative Rate of Grade 3 and 4 Adverse Events

Cumulative number of participants with grade 3 and 4 AEs from randomization up to Day 28.

Time frame: 28 days

Population: A total of 295 subjects were randomized (2:1) to receive a 2-week course of Camostat (n=194) or placebo (n=101) One participant randomized to the placebo group decided to withdraw before taking the first dose of study drug, and one subject randomized to the placebo group was erroneously given Camostat mesilate (As Treated Population: Camostat mesilate, n=195 and placebo, n=99).

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Camostat MesilateCumulative Rate of Grade 3 and 4 Adverse EventsGrade 3 AEs6 Participants
Camostat MesilateCumulative Rate of Grade 3 and 4 Adverse EventsGrade 4 AEs1 Participants
PlaceboCumulative Rate of Grade 3 and 4 Adverse EventsGrade 3 AEs0 Participants
PlaceboCumulative Rate of Grade 3 and 4 Adverse EventsGrade 4 AEs1 Participants
Secondary

Laboratory Parameter - Alanine Aminotransferase (ALT)

Clinical laboratory value of Alanine Aminotransferase (ALT) at Day 1 and Day 15

Time frame: Day 1 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateLaboratory Parameter - Alanine Aminotransferase (ALT)Day 1 ALT30.2 U/LStandard Deviation 27.58
Camostat MesilateLaboratory Parameter - Alanine Aminotransferase (ALT)Day 15 ALT27.9 U/LStandard Deviation 20.1
PlaceboLaboratory Parameter - Alanine Aminotransferase (ALT)Day 1 ALT29.0 U/LStandard Deviation 17.01
PlaceboLaboratory Parameter - Alanine Aminotransferase (ALT)Day 15 ALT27.9 U/LStandard Deviation 22.28
Secondary

Laboratory Parameter - Alkaline Phosphatase (ALP)

Clinical laboratory value of Alkaline Phosphatase (ALP) at Day 1 and Day 15

Time frame: Day 1 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateLaboratory Parameter - Alkaline Phosphatase (ALP)Day 1 ALP76.3 U/LStandard Deviation 24.44
Camostat MesilateLaboratory Parameter - Alkaline Phosphatase (ALP)Day 15 ALP77.8 U/LStandard Deviation 27.6
PlaceboLaboratory Parameter - Alkaline Phosphatase (ALP)Day 1 ALP80.5 U/LStandard Deviation 25.55
PlaceboLaboratory Parameter - Alkaline Phosphatase (ALP)Day 15 ALP78.6 U/LStandard Deviation 24.91
Secondary

Laboratory Parameter - Aspartate Aminotransferase (AST)

Clinical laboratory values of Aspartate Aminotransferase (AST) at Day 1 and Day 15

Time frame: Day 1 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateLaboratory Parameter - Aspartate Aminotransferase (AST)Day 1 AST24.6 U/LStandard Deviation 14.71
Camostat MesilateLaboratory Parameter - Aspartate Aminotransferase (AST)Day 15 AST21.8 U/LStandard Deviation 10.18
PlaceboLaboratory Parameter - Aspartate Aminotransferase (AST)Day 1 AST25.3 U/LStandard Deviation 12.33
PlaceboLaboratory Parameter - Aspartate Aminotransferase (AST)Day 15 AST21.8 U/LStandard Deviation 10.65
Secondary

Laboratory Parameter - Gamma-Glutamyl Transferase (GGT)

Clinical laboratory value of Gamma-Glutamyl Transferase (GGT) at Day 1 and Day 15

Time frame: Day 1 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateLaboratory Parameter - Gamma-Glutamyl Transferase (GGT)Day 1 GGT33.5 U/LStandard Deviation 25.61
Camostat MesilateLaboratory Parameter - Gamma-Glutamyl Transferase (GGT)Day 15 GGT34.1 U/LStandard Deviation 30.5
PlaceboLaboratory Parameter - Gamma-Glutamyl Transferase (GGT)Day 1 GGT33.4 U/LStandard Deviation 29.91
PlaceboLaboratory Parameter - Gamma-Glutamyl Transferase (GGT)Day 15 GGT31.1 U/LStandard Deviation 20.3
Secondary

Laboratory Parameter - Platelet Count

Clinical Laboratory Value of Platelet Count at Day 1 and Day 15

Time frame: Day 1 and Day 15

Population: The Intent-to Treat Population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateLaboratory Parameter - Platelet CountDay 1 Platelet Count243 10^9 platelets/LStandard Deviation 71.69
Camostat MesilateLaboratory Parameter - Platelet CountDay 15 Platelet Count288.3 10^9 platelets/LStandard Deviation 86.66
PlaceboLaboratory Parameter - Platelet CountDay 1 Platelet Count252.1 10^9 platelets/LStandard Deviation 80.45
PlaceboLaboratory Parameter - Platelet CountDay 15 Platelet Count281.5 10^9 platelets/LStandard Deviation 83.22
Secondary

Laboratory Parameter - Potassium Level

Clinical laboratory value of Potassium Levels at Day 1 and Day 15

Time frame: Day 1 and Day 15

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateLaboratory Parameter - Potassium LevelDay 1 Potassium Level4.26 mmol/LStandard Deviation 0.397
Camostat MesilateLaboratory Parameter - Potassium LevelDay 15 Potassium Level4.30 mmol/LStandard Deviation 0.363
PlaceboLaboratory Parameter - Potassium LevelDay 1 Potassium Level4.23 mmol/LStandard Deviation 0.391
PlaceboLaboratory Parameter - Potassium LevelDay 15 Potassium Level4.29 mmol/LStandard Deviation 0.407
Secondary

Rate of Adverse Events and Serious Adverse Events

Number of participants with Adverse events (AEs) and Serious adverse events (SAEs) of any grade from randomization up to Day 28.

Time frame: 28 days

Population: A total of 295 subjects were randomized (2:1) to receive a 2-week course of Camostat (n=194) or placebo (n=101) One participant randomized to the placebo group decided to withdraw before taking the first dose of study drug, and one subject randomized to the placebo group was erroneously given Camostat mesilate (As Treated Population: Camostat mesilate, n=195 and placebo, n=99).

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Camostat MesilateRate of Adverse Events and Serious Adverse EventsTreatment Emergent Adverse Event (TEAE)17 Participants
Camostat MesilateRate of Adverse Events and Serious Adverse EventsSerious TEAEs10 Participants
PlaceboRate of Adverse Events and Serious Adverse EventsTreatment Emergent Adverse Event (TEAE)13 Participants
PlaceboRate of Adverse Events and Serious Adverse EventsSerious TEAEs5 Participants
Secondary

Rate of Discontinuation

Number of participants that discontinued from study due to an AE/SAE (discontinued participants will be followed up to Day 28).

Time frame: 28 days

Population: The Intent-to-Treat (ITT) population includes all subjects who were randomized.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Camostat MesilateRate of Discontinuation11 Participants
PlaceboRate of Discontinuation5 Participants
Secondary

Resolution of Viral Shedding

Number of participants with no viral shedding (yes/no) using reverse transcriptase-polymerase chain reaction (RT-PCR) at Day 7, Day 15, and at early termination.

Time frame: Day 1, Day 7 and Day 15

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Camostat MesilateResolution of Viral SheddingNo Viral Shedding at Day 132 Participants
Camostat MesilateResolution of Viral SheddingNo Viral Shedding at Day 777 Participants
Camostat MesilateResolution of Viral SheddingNo Viral Shedding at Day 15136 Participants
PlaceboResolution of Viral SheddingNo Viral Shedding at Day 125 Participants
PlaceboResolution of Viral SheddingNo Viral Shedding at Day 736 Participants
PlaceboResolution of Viral SheddingNo Viral Shedding at Day 1565 Participants
Secondary

Survival Rate

The overall survival rate (the number of randomized participants who survive up to Day 15 and Day 28).

Time frame: Up to Day 15 and Day 28

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Camostat MesilateSurvival RateSurvival Status at Day 15194 Participants
Camostat MesilateSurvival RateSurvival Status at Day 28193 Participants
PlaceboSurvival RateSurvival Status at Day 15101 Participants
PlaceboSurvival RateSurvival Status at Day 28101 Participants
Secondary

Time to Fever Resolution

Time (in days) from initiation of study treatment until normalization of fever (≤ 37.2 °C oral or tympanic) and sustained for at least 3 days only assessed in participants who experienced a fever within 1 day of enrollment up to Day 28.

Time frame: Up to 28 days

ArmMeasureValue (MEDIAN)
Camostat MesilateTime to Fever Resolution3 Days
PlaceboTime to Fever Resolution1 Days
Secondary

Vital Signs - Blood Pressure

Blood pressure (BP) at Day 1, Day 7 and Day 15

Time frame: Day 1, Day 7 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateVital Signs - Blood PressureSystolic BP Day 1128.7 mmHgStandard Deviation 13.87
Camostat MesilateVital Signs - Blood PressureSystolic BP Day 7128.2 mmHgStandard Deviation 16.61
Camostat MesilateVital Signs - Blood PressureSystolic BP Day 15128.1 mmHgStandard Deviation 16.61
Camostat MesilateVital Signs - Blood PressureDiastolic BP Day 180.7 mmHgStandard Deviation 8.9
Camostat MesilateVital Signs - Blood PressureDiastolic BP Day 780.2 mmHgStandard Deviation 9.34
Camostat MesilateVital Signs - Blood PressureDiastolic BP Day 1578.9 mmHgStandard Deviation 8.72
PlaceboVital Signs - Blood PressureDiastolic BP Day 780.9 mmHgStandard Deviation 9.6
PlaceboVital Signs - Blood PressureSystolic BP Day 1129.6 mmHgStandard Deviation 13.97
PlaceboVital Signs - Blood PressureDiastolic BP Day 180.8 mmHgStandard Deviation 7.43
PlaceboVital Signs - Blood PressureSystolic BP Day 7129.2 mmHgStandard Deviation 15.54
PlaceboVital Signs - Blood PressureDiastolic BP Day 1581.3 mmHgStandard Deviation 10.65
PlaceboVital Signs - Blood PressureSystolic BP Day 15129.2 mmHgStandard Deviation 15.54
Secondary

Vital Signs - Heart Rate

Heart rate at Day 1, Day 7 and Day 15

Time frame: Day 1, Day 7 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateVital Signs - Heart RateHeart rate Day 181.2 Beats/MinuteStandard Deviation 10.25
Camostat MesilateVital Signs - Heart RateHeart rate Day 781.2 Beats/MinuteStandard Deviation 10.07
Camostat MesilateVital Signs - Heart RateHeart rate Day 1579.8 Beats/MinuteStandard Deviation 10.16
PlaceboVital Signs - Heart RateHeart rate Day 180.1 Beats/MinuteStandard Deviation 10.48
PlaceboVital Signs - Heart RateHeart rate Day 780.5 Beats/MinuteStandard Deviation 9.09
PlaceboVital Signs - Heart RateHeart rate Day 1579.2 Beats/MinuteStandard Deviation 9.94
Secondary

Vital Signs - Peripheral Capillary Oxygen Saturation (SpO2)

Peripheral Capillary Oxygen Saturation (SpO2) at Day 1, Day 7 and Day 15

Time frame: Day 1, Day 7 and Day 15

Population: The Intent-to-Treat population includes all subjects who were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
Camostat MesilateVital Signs - Peripheral Capillary Oxygen Saturation (SpO2)SpO2 Day 197.3 Percentage of SpO2Standard Deviation 1.33
Camostat MesilateVital Signs - Peripheral Capillary Oxygen Saturation (SpO2)SpO2 Day 797.3 Percentage of SpO2Standard Deviation 1.78
Camostat MesilateVital Signs - Peripheral Capillary Oxygen Saturation (SpO2)SpO2 Day 1597.6 Percentage of SpO2Standard Deviation 1.46
PlaceboVital Signs - Peripheral Capillary Oxygen Saturation (SpO2)SpO2 Day 197.4 Percentage of SpO2Standard Deviation 1.3
PlaceboVital Signs - Peripheral Capillary Oxygen Saturation (SpO2)SpO2 Day 797.3 Percentage of SpO2Standard Deviation 1.43
PlaceboVital Signs - Peripheral Capillary Oxygen Saturation (SpO2)SpO2 Day 1597.5 Percentage of SpO2Standard Deviation 2.22

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026