- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04357444
Low Dose of IL-2 In Acute Respiratory DistrEss Syndrome Related to COVID-19 (LILIADE-COVID)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
About 25% of hospitalized patients with SARS-CoV2 infection presented life-threatening respiratory conditions. Of these, 60% met ARDS criteria leading to death in 25% to 63% of the cases. SARS-CoV2-related ARDS is caused by a massive inflammatory cell infiltration leading to dysregulated cytokine/chemokine responses with lung immunopathological changes. To date, there is no treatment available.
Regulatory T cells (Treg) are a subpopulation of CD4+ T cells playing a crucial role in the control of immune responses, in part by preventing excessive inflammation. Depletion of Treg cells in models of lung infection or after berylium exposure exacerbated lung inflammation. In contrast, a beneficial role for Treg during early ARDS and its resolution has been observed.
Low-dose interleukin 2 (Ld-IL2) is the first therapy driving Treg-specific expansion and activation. Ld-IL2 was successfully tested in a wide range of preclinical models of inflammatory diseases, including beryllium-induced lung inflammation. Moreover, Ld-IL2 has been shown to be safe and free of serious adverse events when administered in patients with various autoimmune diseases. Importantly, in our previous work, we observed only very low concentrations of IL-2 in the blood (0.1 pg/mL [0.0-2.0]) as well as in the BAL supernatant (0.8 pg/mL [0.4-1.3]) collected from patients during the early phase of ARDS, suggesting that additional IL-2 could be beneficial for Treg expansion/activation.
Our objective is therefore to investigate the therapeutic benefit of Ld-IL2 as a Treg inducer for controlling SARS-CoV2-related ARDS.
After admission of patients to the intensive care unit at one of the recruiting centers, the eligibility criteria will be checked by the investigating physician and participation in the study will be proposed to the patient or parent/family member/trusted person. If the patient is unable to consent and there is no parent/family member/trusted person, the patient may be included in the emergency procedure.
After inclusion (J0), the patient will be randomized to one of the 2 treatment arms (low dose IL-2 or placebo).
The experimental treatment will be daily administered to the patient from D1 to D10.
The patient will be monitored daily until D28 during hospitalization.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Paris, France, 75013
- Service Anesthésie Réanimation - Groupe Hospitalier Pitié-Salpêtrière
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male or female, age ≥ 18 years
- Laboratory (RT-PCR) confirmed infection with SARS-CoV2
- Patient is either under invasive or non-invasive mechanical ventilation (including high flow nasal oxygen therapy).
- Diagnosis of ARDS according to the Berlin definition of ARDS
- Onset of ARDS <96 hours
- Patient with French Social Security System
- A written informed consent by the designated substitute decision maker, if present. In the event of absence, the patient can be included by investigator's decision alone.
Exclusion Criteria:
- Previous history of ARDS in the last month
- Chronic respiratory diseases requiring long-term oxygen therapy and/or long-term respiratory assistance
- History of organ allograft.
- Active cancer
- Liver cirrhosis with basal Child and Pugh of C
- Pulmonary fibrosis
- Patient with end-of-life decision
- Patient not expected to survive for 24 hours
- Woman known to be pregnant, lactating or with a positive (urine or serum test) or indeterminate (serum test) pregnancy test
- Patient already enrolled in another interventional pharmacotherapy protocol on COVID-19
- Patient with known hypersensitivity to natural or recombinant Interleukin-2 or to any of the excipients
- Presence of any of the following abnormal laboratory values at screening: absolute neutrophil count (ANC) less than 1.5x109/L, AST or ALT greater than 5 x ULN, platelets <50,000 per mm3
- Use of chronic oral corticosteroids > 10 mg prednisone equivalent a day for a non-COVID-19-related condition
- Current uncontrolled autoimmune disease
- Patients with uncontrolled suspected or known active systemic bacterial or fungal infections
- Patient with severe, uncontrolled pre-existing (chronic) organ failure (myocardial, hepatic or renal)
- Vaccination with live attenuated vaccines in the month preceding the inclusion
- Patient with burns to ≥ 15% of their total body surface area
- Patient receiving extra-corporeal membrane oxygenation, high-frequency oscillatory ventilation or any form of extra-corporeal lung support
- Patient under legal protection (protection of the court, or in curatorship or guardianship).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1: ILT101
ILT-101 in Subcutaneous route
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Subcutaneous injections, once-daily administration for 10 consecutive days.
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Placebo Comparator: 2: Placebo Comparator
Placebo in subcutaneous injections every day during 10 days
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placebo in Subcutaneous route
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The PaO2/FiO2 ratio at D11
Time Frame: at Day11
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at Day11
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in Tregs between Baseline and Day 7 (expressed in %)
Time Frame: at Day0 and Day7
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at Day0 and Day7
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Number of days alive with oxygen therapy within 28 days
Time Frame: at Day28
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at Day28
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Maximal oxygen rate within 28 days
Time Frame: at Day28
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at Day28
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Number of days alive free of invasive or non-invasive ventilation within 28 days
Time Frame: At Day28
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At Day28
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Number of days alive outside ICU within 28 days
Time Frame: at Day28
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at Day28
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Number of days alive outside hospital within 28 days
Time Frame: at Day28
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at Day28
|
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Time (in days) from randomization to death
Time Frame: through study completion at day 28
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through study completion at day 28
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Mortality rate at D28
Time Frame: at Day28
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at Day28
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Difference between CRP levels at randomization and at Day 7 (or at the time of discharge if occurs before Day 7)
Time Frame: at Day0 and Day7 or at the time of discharge
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at Day0 and Day7 or at the time of discharge
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Use of antibiotics for respiratory (proved or suspected) infection within 28 days
Time Frame: at Day28
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at Day28
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Number of prone positioning sessions
Time Frame: throughout the follow up period at day 28
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throughout the follow up period at day 28
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Changes in Tregs during the different visits between baseline and day 28
Time Frame: at Day0, 5, 7, 11, 14 and Day28
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at Day0, 5, 7, 11, 14 and Day28
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Cytokines analysis on plasma samples at Day 0, 7 and 14
Time Frame: at Day 0, 7 and 14
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To evaluate selected immune and inflammatory markers: Serum concentrations of cytokines and soluble factors related to the immune response and inflammatory processes will be evaluated and compare to baseline by multiplex immunoprofiling to analyse a larger number of molecules including at least IFNα2, IFNγ, IL-1α, IL-1β, IL-1RA, IL-2, IL-6, IL-8, IL-10, IL-17, TNFα, TNFβ, VEGF-A, TGF-beta, S-RAGE, SP-A, SP-D, Angiopoétine 1 and KGF.
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at Day 0, 7 and 14
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Tregs numbers during induction period and throughout the follow up period at day 5, 7, 11, 14 and 28 compared to baseline before the first IL-2 injection.
Time Frame: at Day0, 5, 7, 11, 14 and Day28
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at Day0, 5, 7, 11, 14 and Day28
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Tregs percentages during induction period and throughout the follow up period at day 5, 7, 11, 14 and 28 compared to baseline before the first IL-2 injection.
Time Frame: at Day0, 5, 7, 11, 14 and Day28
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at Day0, 5, 7, 11, 14 and Day28
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Deep Immunophenotyping of Cellular components in blood samples at Day 0, 7, and 14
Time Frame: at Day0, 7 and Day14
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Cellular components will be analysed by flow cytometry covering (i) most of the innate and adaptive immune cells including Tregs, T helper cell subsets including follicular helper cells, B cell subsets, NK cell subsets, (ii) the associated relevant markers of activation/function/differentiation, tissue migration, as well as (iii) unconventional lymphoid cells (NKT/MAIT, innate lymphoid cells), myeloid-derived suppressor cells, classical and non-classical monocytes and dendritic cells (mDC1/2, pDC).
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at Day0, 7 and Day14
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T cell repertoire on Treg, after sorting from blood at Day 7 and Day 14 and compared to baseline
Time Frame: at Day0, 7 and Day14
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at Day0, 7 and Day14
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T cell repertoire on Teff (CD4 and CD8) after sorting from blood at Day 7 and Day 14 and compared to baseline
Time Frame: at Day0, 7 and Day14
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at Day0, 7 and Day14
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Single cells sequencing will be performed in BAL at Day 7 and Day 14 and compared to baseline.
Time Frame: at Day0, 7 and Day14
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at Day0, 7 and Day14
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Jean-Michel CONSTANTIN, Assistance Publique - Hôpitaux de Paris
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- RNA Virus Infections
- Virus Diseases
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Respiration Disorders
- Pneumonia, Viral
- Pneumonia
- Lung Diseases
- Infant, Newborn, Diseases
- Lung Injury
- Infant, Premature, Diseases
- COVID-19
- Respiratory Distress Syndrome
- Respiratory Distress Syndrome, Newborn
- Acute Lung Injury
Other Study ID Numbers
- APHP200406
- 2020-001571-32 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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