Phase III Double-blind, Placebo-controlled Study of AZD7442 for Pre-exposure Prophylaxis of COVID-19 in Adult. (PROVENT)

November 25, 2022 updated by: AstraZeneca

A Phase III Randomized, Double-blind, Placebo-controlled, Multi-center Study in Adults to Determine the Safety and Efficacy of AZD7442, a Combination Product of Two Monoclonal Antibodies (AZD8895 and AZD1061), for Pre-exposure Prophylaxis of COVID-19.

This study will assess the safety and efficacy of a single dose of AZD7442(× 2 IM injections) compared to placebo for the prevention of COVID-19.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

SARS-CoV-2 is the causative agent of the ongoing COVID-19 pandemic that, as of 29 September 2020, has resulted in a high death toll to date. Unlike the majority of coronaviruses that cause mild disease in humans and animals, SARS-CoV-2 can replicate in the lower respiratory tract to cause acute respiratory distress syndrome and fatal pneumonia. Effective interventions to prevent or treat COVID-19 remain limited in number and clinical experience is limited. Clinical management is limited to supportive care, consequently overwhelming resources of healthcare systems around the world. As a response to the ongoing pandemic, AstraZeneca is developing mAbs to the SARS-CoV-2 S protein. The SARS-CoV-2 spike protein contains the virus's RBD, which enables the virus to bind to receptors on human cells. By targeting this region of the virus's spike protein, antibodies can block the virus's attachment to human cells, and, therefore, is expected to block infection. Amino acid substitutions have been introduced into the antibodies to both extend their half-lives, which should prolong their potential prophylactic benefit, and decrease Fc effector function in order to decrease the potential risk of antibody-dependent enhancement of disease. AZD7442, a combination of 2 of these mAbs (AZD8895 and AZD1061), is being evaluated for administration to prevent and/or treat COVID-19. There is currently one completed and 2 ongoing Phase I studies with AZD7442.

-The Provent repeat dose open-label sub-study is initiated to assess the safety, PK and immunogenicity of repeat doses of AZD7442 in participants currently enrolled in the Provent study who may benefit from repeat dose of AZD7442.

Study Type

Interventional

Enrollment (Actual)

5254

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Alken, Belgium, 3570
        • Research Site
      • Bruxelles, Belgium, 1000
        • Research Site
      • Gozée, Belgium, 6534
        • Research Site
      • Namur, Belgium, 5101
        • Research Site
      • Wetteren, Belgium, 9230
        • Research Site
      • Clermont-Ferrand cedex, France, 63003
        • Research Site
      • Dijon cedex, France, 21079
        • Research Site
      • La Roche S/ Yon Cedex 9, France, 85925
        • Research Site
      • Lille, France, 59037
        • Research Site
      • Limoges cedex, France, 87000
        • Research Site
      • Nantes Cedex 1, France, 44093
        • Research Site
      • Paris cedex 10, France, 75475
        • Research Site
      • Paris cedex 14, France, 75679
        • Research Site
      • Saint Etienne Cedex 2, France, 42055
        • Research Site
      • Tours cedex 9, France, 37044
        • Research Site
      • Barcelona, Spain, 08036
        • Research Site
      • Madrid, Spain, 28034
        • Research Site
      • Madrid, Spain, 28040
        • Research Site
      • Marbella (Málaga), Spain, 29603
        • Research Site
      • Pozuelo de Alarcón, Spain, 28223
        • Research Site
      • Bournemouth, United Kingdom, BH7 7DW
        • Research Site
      • Enfield, United Kingdom, EN3 4GS
        • Research Site
      • Hayle, United Kingdom, TR27 5DT
        • Research Site
      • London, United Kingdom, WC1N 3BG
        • Research Site
      • Preston, United Kingdom, PR1 6YA
        • Research Site
      • Rochdale, United Kingdom, OL11 4AU
        • Research Site
      • Salford, United Kingdom, M6 8HD
        • Research Site
      • Torpoint, United Kingdom, PL11 2TB
        • Research Site
      • Wakefield, United Kingdom, WF1 5RH
        • Research Site
    • Alabama
      • Birmingham, Alabama, United States, 35215
        • Research Site
    • Arizona
      • Tempe, Arizona, United States, 85284
        • Research Site
    • Arkansas
      • Little Rock, Arkansas, United States, 72205
        • Research Site
    • California
      • Cerritos, California, United States, 90703
        • Research Site
      • Fresno, California, United States, 93720
        • Research Site
      • Garden Grove, California, United States, 92844
        • Research Site
      • Huntington Beach, California, United States, 92647
        • Research Site
      • Lancaster, California, United States, 93534
        • Research Site
      • Modesto, California, United States, 95350
        • Research Site
      • Victorville, California, United States, 92394
        • Research Site
      • Westminster, California, United States, 92683
        • Research Site
    • Connecticut
      • Hartford, Connecticut, United States, 06112
        • Research Site
      • Middlebury, Connecticut, United States, 06762
        • Research Site
    • Florida
      • Clearwater, Florida, United States, 33756
        • Research Site
      • Coral Springs, Florida, United States, 33071
        • Research Site
      • Hollywood, Florida, United States, 33024
        • Research Site
      • Lauderdale Lakes, Florida, United States, 33313
        • Research Site
      • Miami, Florida, United States, 33125
        • Research Site
      • Ormond Beach, Florida, United States, 32174
        • Research Site
      • Pompano Beach, Florida, United States, 33064
        • Research Site
      • Wesley Chapel, Florida, United States, 33545
        • Research Site
      • West Palm Beach, Florida, United States, 33409
        • Research Site
    • Georgia
      • Atlanta, Georgia, United States, 30328
        • Research Site
      • Columbus, Georgia, United States, 31904
        • Research Site
      • Conyers, Georgia, United States, 30094
        • Research Site
    • Illinois
      • Chicago, Illinois, United States, 60607
        • Research Site
      • Hazel Crest, Illinois, United States, 60429
        • Research Site
      • Quincy, Illinois, United States, 62301
        • Research Site
    • Indiana
      • Evansville, Indiana, United States, 47714
        • Research Site
      • Noblesville, Indiana, United States, 46060
        • Research Site
    • Kansas
      • Wichita, Kansas, United States, 67205
        • Research Site
      • Wichita, Kansas, United States, 67214
        • Research Site
    • Minnesota
      • Minneapolis, Minnesota, United States, 55404
        • Research Site
      • Minneapolis, Minnesota, United States, 55435
        • Research Site
    • Missouri
      • Saint Louis, Missouri, United States, 63141
        • Research Site
    • Nebraska
      • Omaha, Nebraska, United States, 68134
        • Research Site
    • Nevada
      • Las Vegas, Nevada, United States, 89128
        • Research Site
    • New Mexico
      • Albuquerque, New Mexico, United States, 87109
        • Research Site
    • New York
      • Bronx, New York, United States, 10461
        • Research Site
      • Jamaica, New York, United States, 11432
        • Research Site
      • Ridgewood, New York, United States, 11385
        • Research Site
    • North Carolina
      • Greensboro, North Carolina, United States, 27410
        • Research Site
    • Ohio
      • Columbus, Ohio, United States, 43213
        • Research Site
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73104
        • Research Site
    • South Carolina
      • Summerville, South Carolina, United States, 29485
        • Research Site
    • South Dakota
      • Rapid City, South Dakota, United States, 57701
        • Research Site
    • Texas
      • Austin, Texas, United States, 78751
        • Research Site
      • El Paso, Texas, United States, 79935
        • Research Site
      • El Paso, Texas, United States, 79925
        • Research Site
      • Houston, Texas, United States, 77054
        • Research Site
      • San Antonio, Texas, United States, 78251
        • Research Site
      • San Antonio, Texas, United States, 78215
        • Research Site
      • Shenandoah, Texas, United States, 77384
        • Research Site
      • Sugar Land, Texas, United States, 77479
        • Research Site
    • Utah
      • Layton, Utah, United States, 84041
        • Research Site
    • Virginia
      • Alexandria, Virginia, United States, 22304
        • Research Site
      • Chesapeake, Virginia, United States, 23320
        • Research Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years to 118 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. ≥ 18 years of age at the time of signing the informed consent
  2. Can benefit from passive immunization with antibodies
  3. Medically stable
  4. Negative result from point of care SARS-CoV-2 serology testing at screening
  5. Contraceptive used by women of child bearing potential, condom used by men
  6. Able to understand and comply with study requirements/procedures based on the assessment of the investigator

Sub-study Inclusion criteria which are additional to those in parent study are as follows:

  • The participant has been randomized, dosed, and is ongoing in the PROVENT parent study and is 12±2 months post first dose of blinded IMP.
  • If one or more of the following apply:

    1. Immunocompromised and/or may be at increased risk for an inadequate immune response to a COVID-19 vaccine.
    2. In the opinion of the Investigator, are at increased risk and would benefit from a repeat dose of AZD7442.
  • Documented negative SARS-CoV-2 RT-PCR test collected ≤ 3 days prior to sub-study Day 1 or a negative rapid SARS-CoV-2 antigen test at screening.

Exclusion Criteria:

  1. Significant infection or other acute illness, including fever >100°F (>37.8°C) on the day prior to or day of randomization.
  2. History of laboratory-confirmed SARS-CoV-2 infection or any positive SARS-CoV-2 result based on available data at screening.
  3. History of infection with severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS).
  4. Known history of allergy or reaction to any component of the study drug formulation.
  5. Previous hypersensitivity, infusion-related reaction, or severe adverse reaction following administration of a mAb.
  6. Any prior receipt of investigational or licensed vaccine or other mAb/biologic indicated for the prevention of SARS-CoV-2 or COVID-19 or expected receipt during the period of study follow-up.
  7. Bleeding disorder or prior history of significant bleeding or bruising following IM injections or venepuncture.
  8. Any other significant disease, disorder, or finding. that may significantly increase the risk to the participant because of participation in the study, affect the ability of the participant to participate in the study, or impair interpretation of the study data.
  9. Receipt of any IMP in the preceding 90 days or expected receipt of IMP during the period of study follow-up, or concurrent participation in another interventional study
  10. Currently pregnant or breastfeeding.
  11. Blood drawn in excess of a total of 450 mL (1 unit) for any reason within 30 days prior to randomization.
  12. Employees of the Sponsor involved in planning, executing, supervising, or reviewing the AZD7442 program,, clinical study site staff, or any other individuals involved with the conduct of the study, or immediate family members of such individuals.
  13. In nations, states, or other jurisdictions that for legal or ethical reasons bar the enrollment of participants who lack capacity to provide their own informed consent, such subjects are excluded.

Sub-study Exclusion criteria are as follows:

  1. Patient have received a COVID-19 vaccination ≤ 14 days before sub-study Day1 or plan to receive a COVID-19 vaccination ≤ 14 days after sub-study Day1. (Such participants can subsequently be included in the study once they have reached >14 days after their last dose of vaccine).
  2. Patient have two or more untreated cardiac risk factors or suspected unstable cardiac disease.
  3. Judgment by the Investigator that the participant should not participate in the study if the participant is unlikely to comply with study procedures, restrictions, and requirements.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: AZD7442

Approximately 5150 participants will be randomized in a 2:1 ratio

• Arm 1 (n=approximately 3433) will receive a single dose (× 2IM injections) of 300 mg of AZD7442

  • Single dose (× 2IM injections) of 300 mg of AZD7442 on parent study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 183.
  • Single dose (x 2IM injections) of 600mg of AZD7442 on sub-study Day 183 and Day 366
Other Names:
  • Combination of 2mAbs(AZD8895 and AZD1061)
Placebo Comparator: Placebo

Approximately 5150 participants will be randomized in a 2:1 ratio

• Arm 2 (n=approximately 1717) will receive saline placebo

Single dose (× 2IM injections) of saline placebo on parent study Day 1.
Experimental: Sub-study AZD7442 Arm 1

Approximately 500 participants will receive AZD7442 in the repeat dose sub-study.

-Sub-study Arm 1 (~ 12 month repeat dose interval): Participants who received AZD7442 300 mg IM on Day 1 of the parent study will receive a second dose of AZD7442 300mg IM on sub-study Day 1.

  • Single dose (× 2IM injections) of 300 mg of AZD7442 on parent study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 183.
  • Single dose (x 2IM injections) of 600mg of AZD7442 on sub-study Day 183 and Day 366
Other Names:
  • Combination of 2mAbs(AZD8895 and AZD1061)
Experimental: Sub-study AZD7442 Arm 2

Approximately 500 participants will receive AZD7442 in the repeat dose sub-study.

-Sub-study Arm 2(~ 6 month repeat dose interval): Participants who received placebo on Day 1 of the parent study will receive their first dose of AZD7442 300mg IM on sub-study Day1 followed by a second dose on sub-study Day 183.

  • Single dose (× 2IM injections) of 300 mg of AZD7442 on parent study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 183.
  • Single dose (x 2IM injections) of 600mg of AZD7442 on sub-study Day 183 and Day 366
Other Names:
  • Combination of 2mAbs(AZD8895 and AZD1061)
Experimental: Sub-study AZD7442 Arm 3
A subset of Arm 1 and Arm 2 participants who will receive additional doses of AZD7442, 600mg, at Day 183 and Day 366 of the sub-study.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on parent study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 1.
  • Single dose (× 2IM injections) of 300 mg of AZD7442 on sub-study Day 183.
  • Single dose (x 2IM injections) of 600mg of AZD7442 on sub-study Day 183 and Day 366
Other Names:
  • Combination of 2mAbs(AZD8895 and AZD1061)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With First Case of SARS-CoV-2 RT-PCR-positive Symptomatic Illness
Time Frame: Planned to be evaluated through Day 183, however, the number of participants required was achieved 166 days after the study start date
To estimate the efficacy of a single IM dose of AZD7442 compared to placebo for the prevention of COVID-19 prior to Day 183
Planned to be evaluated through Day 183, however, the number of participants required was achieved 166 days after the study start date

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The incidence of participants who have a post-treatment response (negative at baseline to positive at any time post-baseline) for SARS-CoV-2 nucleocapsid antibodies.
Time Frame: 1 year
To estimate the efficacy of a single IM dose of AZD7442 compared to placebo for the prevention of SARS-CoV-2 infection
1 year
The incidence of SARS-CoV-2 RT-PCR-positive severe or critical symptomatic illness occurring after dosing with IMP
Time Frame: 1 year
To estimate the efficacy of a single IM dose of AZD7442 compared to placebo for the prevention of severe or critical symptomatic COVID-19
1 year
The incidence of COVID-19-related Emergency Department visits occurring after dosing with IMP
Time Frame: 1 year
To estimate the efficacy of a single IM dose of AZD7442 compared to placebo for the prevention of COVID-19-related Emergency Department visits
1 year
Serum AZD7442 concentrations, PK parameters if data permit.
Time Frame: Day 457
To assess the pharmacokinetics of AZD7442 administered as a single dose of 300 mg IM
Day 457
Incidence of ADA to AZD7442 in serum.
Time Frame: Day 457
To evaluate ADA responses to AZD7442 in serum
Day 457

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sub-study Primary Endpoint: AEs, SAEs, MAAEs and AESIs post repeat dose of IMP.
Time Frame: Day 457 for Group 1 and Day 639 for Group 2
To evaluate the safety and tolerability of repeat doses of AZD7442 300 mg IM.
Day 457 for Group 1 and Day 639 for Group 2
Sub-study Secondary Endpoint: Serum AZD7442 concentrations after repeat dosing PK parameters if data permit after repeat dosing.
Time Frame: Day 457 for Group 1 and Day 639 for Group 2
To evaluate the PK of repeat doses of AZD7442 300 mg IM
Day 457 for Group 1 and Day 639 for Group 2
Sub-study Secondary Endpoint: Incidence of ADA to repeat doses of AZD7442 in serum
Time Frame: Day 457 for Group 1 and Day 639 for Group 2
To evaluate ADA responses to repeat doses of AZD7442 300 mg IM in serum
Day 457 for Group 1 and Day 639 for Group 2
Sub-study Secondary Endpoint: Post dose GMTs and GMFRs from baseline values after a repeat IM dose in SARS-CoV-2 nAbs (wild-type assay or pseudo-neutralization assay)
Time Frame: Day 457 for Group 1 and Day 639 for Group 2
To determine anti-SARS-CoV-2 nAb level in serum following repeat doses of AZD7442 300mg IM.
Day 457 for Group 1 and Day 639 for Group 2

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 21, 2020

Primary Completion (Actual)

May 5, 2021

Study Completion (Anticipated)

November 30, 2023

Study Registration Dates

First Submitted

November 10, 2020

First Submitted That Met QC Criteria

November 10, 2020

First Posted (Actual)

November 12, 2020

Study Record Updates

Last Update Posted (Actual)

December 20, 2022

Last Update Submitted That Met QC Criteria

November 25, 2022

Last Verified

November 1, 2022

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Plan Description

Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure

IPD Sharing Time Frame

AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

IPD Sharing Access Criteria

When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure

IPD Sharing Supporting Information Type

  • Study Protocol
  • Statistical Analysis Plan (SAP)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

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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