Covid19, COVID-19 Pneumonia
Conditions
Keywords
COVID-19, Antiviral
Brief summary
The PJS-539 is a multicentre, phase 2, randomized, double-blind, placebo-controlled clinical trial to evaluate the effect of PJS-539 in the viral load of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Detailed description
COVID-19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became a pandemic in March 2020. Clinically, the coronavirus disease 2019 (COVID-19) ranges from asymptomatic disease in some to severe forms. However, until now, only the use of corticosteroids in selected patients has been shown to improve clinical outcomes in patients with COVID-19. PJS-539 has been demonstrated to inhibit viral uptake and replication of SARS-CoV-2. The objective of this Phase II trial is to assess the effect of PJS-539 in the viral load of patients with mild to moderate COVID-19 symptoms.
Interventions
DRUGPJS-539 Dose 1
Patients will receive PJS-539 dose 1 daily for 10 days.
DRUGPJS-539 Dose 2
Patients will receive PJS-539 Dose 2 daily for 10 days.
DRUGPlacebo
Patients will receive placebo daily for 10 days.
Sponsors
Covicept
Hospital do Coracao
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
The placebo used in this study will consist of the diluent solution used in the interventional drug preparation, which has the same physical characteristics as the interventional drug preparation. All the solutions will be prepared at a central pharmacy and will be sent to each site center in specific boxes containing the necessary regulatory information. The solutions for each study arm will be identified by a random letter from A to I (three letters each arm).
Intervention model description
Patients will be randomized at a 1: 1: 1 ratio to each of the treatment groups.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adult patients (age ≥ 18 years); 2. COVID-19 diagnosis confirmed by: 1. Detection of SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR), or 2. Rapid genetic or antigen tests validated by Brazilian National Health Surveillance Agency (ANVISA); 3. Mild or moderate symptoms without indication for hospitalization; 4. Symptoms started seven days ago or less; 5. Be able to access the study's online questionnaire.
Exclusion criteria
1. Pregnant or lactating women; 2. Known allergy or hypersensitivity to the study drug; 3. Patients at high risk of bleeding, defined by: 1. Previous Intracranial hemorrhage, 2. Ischemic stroke in the last 3 months, 3. Anatomical vascular alteration of the central nervous system known, such as aneurysms or arteriovenous malformations, 4. Malignant neoplasm of the central nervous system known, 5. Metastatic solid neoplasia, 6. Significant closed head or facial trauma in the last 3 months (defined as any trauma that required medical evaluation or hospitalization), 7. Known intracranial abnormalities not listed as absolute contraindications (e.g., benign intracranial tumor), 8. Bleeding in the last 2 to 4 weeks (excluding menstrual bleeding), 9. Surgical procedure in the last 3 weeks, 10. Current use of full-dose anticoagulants (warfarin, enoxaparin or new anticoagulants) or dual antiplatelet therapy, 11. Thrombocytopenia (\<100,000/mL) or international normalized ratio (INR) \> 1.3; 4. Renal failure, defined as glomerular filtration rate (GFR) estimated by the formulas Modification of Diet in Renal Disease (MDRD) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) \<30 mL/min/1.73m2; 5. Previous participation in the study; 6. History of liver disease (cirrhosis) reported by the patient or in medical records, presence of esophageal varices or presence of ascites; 7. Decompensated heart failure, defined by the presence of dyspnea attributed to cardiac cause, edema of the lower limbs, crackles on pulmonary auscultation or pathological jugular turgency. 8. Participation in other clinical trials with antivirals in COVID-19
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Decay rate of the SARS-CoV-2 viral load. | At day 10 | Decay rate of the SARS-CoV-2 viral load logarithmic curve obtained via nasopharyngeal swab between the baseline and the fifth and tenth days after randomization. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital admission | Day 28 | Need for hospital admission. |
| Need for invasive mechanical ventilation | Day 28 | Intubation and initiation of mechanical ventilation for any given reason |
| Time to symptoms resolution | Day 10 | Time from randomization to symptoms resolution |
| Ordinal clinical scale of symptoms | Day 14 | Evaluation of the clinical scale of symptoms, which ranges from 1 to 7 as follows: 1. not hospitalized, without limitation of daily activities; 2. not hospitalized, with limitation of daily activities; 3. hospitalized, without the need for supplemental oxygen; 4. hospitalized, requiring supplemental oxygen; 5 hospitalized, requiring high-flow nasal oxygen therapy, non-invasive mechanical ventilation, or both; 6. hospitalized, requiring blood oxygenation through a membrane system, invasive mechanical ventilation, or both; 7. Death. |
| Adverse events | Up to 28 days | Grade 1, 2, 3 and 4 adverse events, which were not present at the patient's entrance, defined by the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events |
| Bleeding | Up to 28 days | Defines as: Major: Defined as clinical bleeding associated with any of the following: fatal outcome, critical site involvement (intracranial, intraspinal, intraocular, pericardial, intra-articular, intramuscular with compartmental or retroperitoneal syndrome), or clinical bleeding with a drop in hemoglobin concentration ≥2g/dL, or need for transfusion of ≥2 units of packed red blood cells or whole blood. All intracerebral (or intraparenchymal) bleeds are included in the primary analysis as hemorrhagic stroke. Clinically relevant non-major: Defined as clinical bleeding that does not present major bleeding criteria, but requires medical intervention, unscheduled contact (in person or by telephone) with a doctor, temporary interruption of the study drug, pain or impairment of daily activities. Minor: Defined as clinical bleeding that does not meet criteria for clinically relevant major or non-major bleeding. |
Countries
Brazil
Outcome results
None listed