- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04750317
Efficacy and Safety of Tofacitinib in Patients With COVID-19 Pneumonia (TOFA-COV-2)
Study Overview
Detailed Description
TOFA-COV-2 is a cohort study that is conducted in the three clinics of the Sechenov University (Moscow, Russia) in patients with moderately severe COVID-19 pneumonia. A diagnosis of COVID-19 associated pneumonia suspected clinically was confirmed by polymerase chain reaction (PCR) and/or chest CT. In patients with inconclusive or negative results of PCR on nasopharyngeal swab, SARS-CoV-2 induced pneumonia was defined as an acute respiratory infection with typical CT findings (4 or 5 on CO-RADS scale) and no other obvious aetiology.
In order to be included in this study, patients must have COVID-19 pneumonia involving at least 25% of lung tissue in combination with at least one of the following: (1) oxygen saturation at rest ≤93% on ambient air, (2) increased C-reactive protein (CRP ≥50 mg/L) and/or (3) fever (≥38.0°C) that persisted for at least two days despite treatment with nonsteroidal antiinflammatory drugs or paracetamol. Exclusion criteria for the administration of tofacitinib were coexistent infection other than COVID-19; requirement for invasive mechanical ventilation; estimated glomerular filtration rate calculated using CKD-EPI formula ≤30 ml/min/1.73 m2; elevated ALT and/or AST levels more than 3 times the upper limit of normal; chronic use of glucocorticoids or immunosuppressive agents; and administration of interleukin-6 inhibitors and/or high-dose glucocorticoids (≥250 mg prednisone equivalent intravenously) for the treatment of COVID-19.
All patients are divided into four groups depending on nadir levels of oxygen saturation and therapy: (1) patients with oxygen saturation ≤93% who received tofacitinib and SoC, (2) patients with oxygen saturation ≤93% who received only SoC, (3) patients with oxygen saturation >93% who received tofacitinib and SoC, (4) patients with oxygen saturation >93% who received only SoC. The aim of the study is to test the hypothesis that administration of tofacitinib could influence the risk of mechanical ventilation and/or death.
All patients provided written, informed consent for the off-label use of experimental medications, including tofacitinib, according to the provisional recommendations issued by the Russian Ministry of Health during the outbreak of infection.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
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Moscow, Russian Federation, 119991
- Sechenov First Moscow State Medical University (Sechenov University) - University Clinical Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
SARS-CoV2 Infection diagnosed by PCR and/or typical lesions on CT-scan (4 or 5 on CO-RADS scale) in combination with at least one of the following:
- oxygen saturation at rest ≤93% on ambient air,
- AND/OR C-reactive protein ≥50 mg/L,
- AND/OR fever (≥38.0°C) that persisted for at least two days despite treatment with nonsteroidal antiinflammatory drugs or paracetamol
- Written Informed Consent
Exclusion Criteria:
- Age <18 years
- Coexistent infection other than COVID-19
- Requirement for invasive mechanical ventilation
- Estimated glomerular filtration rate calculated using CKD-EPI formula ≤30 ml/min/1.73 m2;
- Elevated ALT and/or AST levels more than 3 times the upper limit of normal
- Chronic use of glucocorticoids or immunosuppressive agents
- Administration of interleukin-6 inhibitors and/or high-dose glucocorticoids (≥250 mg prednisone equivalent intravenously) for the treatment of COVID-19
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patients with reduced oxygen saturation ≤93% treated with tofacitinib
Patients with oxygen saturation ≤93% on admission treated with tofacitinib and standard of care treatment
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Tofacitinib was administered at a dose 10 mg twice daily on day 1, followed by 5 mg twice daily on day 2-5.
The dosage was reduced up to 5 mg once daily in patients with moderate renal impairment or moderate hepatic impairment.
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No Intervention: Patients with reduced oxygen saturation treated with SoC
Patients with oxygen saturation ≤93% on admission treated with standard of care only
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Experimental: Patients with preserved oxygen saturation >93% on admission treated with tofacitinib
Patients with oxygen saturation >93% on admission treated with tofacitinib and standard of care
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Tofacitinib was administered at a dose 10 mg twice daily on day 1, followed by 5 mg twice daily on day 2-5.
The dosage was reduced up to 5 mg once daily in patients with moderate renal impairment or moderate hepatic impairment.
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No Intervention: Patients with preserved oxygen saturation >93% on admission treated with SoC
Patients with oxygen saturation >93% on admission treated with standard of care only
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Death
Time Frame: Within 28 days from admission
|
Death registered by medical personnel during in-hospital stay
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Within 28 days from admission
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Mechanical ventilation
Time Frame: Within 28 days from admission
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Initiation of mechanical ventilation during in-hospital stay in patients who did not require ventilation on admission
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Within 28 days from admission
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Collaborators and Investigators
Investigators
- Principal Investigator: Sergey Moiseev, MD, I.M. Sechenov First Moscow State Medical University (Sechenov University)
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
- Pneumonia, Viral
- Lung Diseases
- COVID-19
- Pneumonia
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protein Kinase Inhibitors
- Tofacitinib
Other Study ID Numbers
- 107892
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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