A Study to Learn About the Study Medicine (Nirmatrelvir Plus Ritonavir) in Pregnant Women With COVID-19
A PHASE 1, OPEN-LABEL STUDY TO EVALUATE THE PHARMACOKINETICS, SAFETY, AND TOLERABILITY OF ORALLY ADMINISTERED NIRMATRELVIR/RITONAVIR IN PREGNANT WOMEN WITH MILD-TO-MODERATE COVID-19
The purpose of this clinical trial is to learn about how study medicine (Paxlovid, which contains nirmatrelvir and ritonavir) is changed and eliminated from the body, as well as its safety, and the extent to which side effects can be tolerated for treatment of pregnant women with mild or moderate COVID-19 compared to non-pregnant women with mild or moderate COVID-19.
This study is seeking participants who:
- are expecting a healthy baby and are in their second or third trimester pregnancy and have mild or moderate COVID-19
- are not pregnant and have mild or moderate COVID-19.
All participants in this study will take Paxlovid by mouth every 12 hours for 5 days. We will study the experiences of people receiving the study medicine. This will help us decide if the study medicine is safe.
All participants will take part in this study for at least 34 days; pregnant participants will take part until their delivery, so that the study duration may be up to 6 months, depending on their delivery date.
During this time, participants will have 7to 8 visits and, if pregnant, a visit at delivery. Around 2 to 3 visits and the delivery visit will be done in person (at the clinic or at the participant's home). The other 5 visits may be done over the phone, unless in-person visit is necessary as decided by the doctor. Blood samples will be collected on the first 4 to 5 study visits (and at other study visits, if necessary).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Pfizer CT.gov Call Center
- Phone Number: 1-800-718-1021
- Email: ClinicalTrials.gov_Inquiries@pfizer.com
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35233
- University of Alabama at Birmingham/Center for Women's Reproductive Health
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Florida
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Cutler Bay, Florida, United States, 33157
- Beautiful Minds Clinical Research Center
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DeBary, Florida, United States, 32713
- Omega Research DeBary
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Orlando, Florida, United States, 32808
- Omega Research Orlando
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Tampa, Florida, United States, 33615
- Santos Research Center
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Idaho
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Idaho Falls, Idaho, United States, 83404
- Clinical Research Prime
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Montana
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Missoula, Montana, United States, 59804
- Boeson Research MSO
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Missoula, Montana, United States, 59804
- Origin Health
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Texas
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League City, Texas, United States, 77573
- Maximos Ob/Gyn
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Utah
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Salt Lake City, Utah, United States, 84108
- University of Utah
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Salt Lake City, Utah, United States, 84112
- University of Utah
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Salt Lake City, Utah, United States, 84132
- University of Utah Hospital
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Salt Lake City, Utah, United States, 84132
- University of Utah Clinical Neuroscience Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All cohorts: Mild-to-moderate COVID-19 infection confirmed in sample collected ≤5 days prior to enrollment; onset within 5 days prior to enrollment and presence of ≥1 sign/symptom on the day of enrollment.
- Cohorts 1&2: Expecting single baby; Pregnant in 2nd trimester, 14 0/7 to 27 6/7 weeks of gestational age (Cohort 1) or 3rd trimester, ≥28 0/7 and ≤34 6/7 weeks of gestational age (Cohort 2), by ultrasound.
- All cohorts: Otherwise healthy participants who are determined by medical history, physical examination, and clinical judgment to be appropriate for inclusion in the study
Exclusion Criteria:
- All cohorts: Current need for hospitalization or anticipated need for hospitalization in the clinical opinion of the site investigator.
- Cohorts 1&2: Prior/current major condition or illness of mother/fetus substantially increasing risk of study participation/completion or impacting pregnancy/fetal outcomes in investigator's judgement.
- All cohorts: Current use of any medications that are highly dependent on CYP3A4 for clearance, and which are contraindicated in combination with nirmatrelvir/ritonavir.
- All cohorts: Has received or is expected to receive monoclonal antibody treatment, convalescent COVID-19 plasma, or anti-viral treatment (eg, molnupiravir) for the current SARSCoV-2 infection.
- All cohorts: Participants with moderate to severe kidney impairment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Cohort 1
Pregnant women in their second trimester
|
Nirmatrelvir (tablets) administered by mouth every 12 hours for 5 days (10 doses total)
Other Names:
Ritonavir (capsules) administered by mouth every 12 hours for 5 days (10 doses total)
|
|
Experimental: Cohort 2
Pregnant women in their third trimester
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Nirmatrelvir (tablets) administered by mouth every 12 hours for 5 days (10 doses total)
Other Names:
Ritonavir (capsules) administered by mouth every 12 hours for 5 days (10 doses total)
|
|
Experimental: Cohort 3
Non-pregnant women
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Nirmatrelvir (tablets) administered by mouth every 12 hours for 5 days (10 doses total)
Other Names:
Ritonavir (capsules) administered by mouth every 12 hours for 5 days (10 doses total)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Apparent Oral Clearance (CL/F)
Time Frame: Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
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Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
|
Apparent Volume of Distribution (Vz/F)
Time Frame: Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
|
Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau)
Time Frame: Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
|
Maximum Observed Plasma Concentration (Cmax)
Time Frame: Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
|
Plasma Decay Half-Life (t1/2)
Time Frame: Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
|
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Observed Plasma Trough Concentration (Ctrough)
Time Frame: Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
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Day 1: 1-3 hour post-dose; Day 3: 4-8 hour post-dose; Day 4: 8 to less than 12 hour post dose; Day 5: 2-4 hour, 6-8 hour, 10 to less than 12 hour post dose.
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Incidence of Treatment Emergent Adverse Events (TEAEs)
Time Frame: Baseline up through Day 34
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Baseline up through Day 34
|
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Incidence of TEAEs, SAEs, and AEs leading to discontinuations
Time Frame: Baseline up through end of treatment (Day 5/Day 6)
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Baseline up through end of treatment (Day 5/Day 6)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Number of participants with delivery at medical facility
Time Frame: At delivery of the baby
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At delivery of the baby
|
|
Number of participants with delivery at home
Time Frame: At delivery of the baby
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At delivery of the baby
|
|
Number of participants with delivery at other location
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with caesarean section delivery
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with vaginal delivery
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with complications during delivery
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of full-term live deliveries
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of premature live deliveries
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with stillbirths
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with spontaneous abortions
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with induced/elective abortions
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of participants with unknown delivery
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Number of aborted or stillborn fetuses with abnormal findings upon gross visual inspection
Time Frame: At delivery of the baby
|
At delivery of the baby
|
|
Gestational age of newborn infants
Time Frame: At birth
|
At birth
|
|
Number of neonates with congenital malformation/anomaly or other neonatal problem
Time Frame: At birth
|
At birth
|
|
Body weight of newborn infants
Time Frame: At birth
|
At birth
|
|
Body length of newborn infants
Time Frame: At birth
|
At birth
|
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Head circumference of newborn infants
Time Frame: At birth
|
At birth
|
|
Incidence of SAEs in newborn infants
Time Frame: Birth through 24 hours after birth or until Study Day 34 (whichever is later)
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Birth through 24 hours after birth or until Study Day 34 (whichever is later)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Pfizer CT.gov Call Center, Pfizer
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Respiratory Tract Infections
- Infections
- RNA Virus Infections
- Virus Diseases
- Respiratory Tract Diseases
- Lung Diseases
- Pneumonia, Viral
- Pneumonia
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- COVID-19
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Thiazoles
- Azoles
- Ritonavir
- nirmatrelvir
Other Study ID Numbers
Other Study ID Numbers
- C4671035
- NCT05386472 (Registry Identifier: ClinicalTrials.gov)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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