Glucocorticoid Therapy for COVID-19 Critically Ill Patients With Severe Acute Respiratory Failure
Glucocorticoid Therapy for Critically Ill Patients With Severe Acute Respiratory Infections Caused by COVID-19: a Prospective, Randomized Controlled Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
COVID-19 is a novel coronavirus that was initially outbreak in Wuhan, China. Severe acute respiratory infection with COVID-19 causes severe acute respiratory failure with substantial mortality. Currently, the standard care is supportive care, and no treatment is proven to be effective for this condition.
Glucocorticoid therapy is widely used among critically ill patients with other coronavirus infection such as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). However, whether glucocorticoid improved the outcome of COVID-19 remains unknown. We hypothesized that glucocorticoid would improve the prognosis of patietns with COVID-19.
In this study, critically ill patients with COVID-19 were enrolled and randomized to receive ether standard care or standard care in combination with methylprednisolone therapy. The primary outcome is the difference of Murray lung injury score between two groups.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
- Fase 3
Kontakter og lokationer
Studiesteder
-
-
Beijing
-
Beijing, Beijing, Kina, 010
- Medical ICU,Peking Union Medical College Hospital
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Adult
- PCR confirmed COVID-19 infection
- Symptoms developed more than 7 days
- PaO2/FiO2 < 200 mmHg
- Positive pressure ventilation (non-invasive or invasive) or high flow nasal cannula (HFNC) higher than 45 L/min for less than 48 hours
- Requiring ICU admission
Exclusion Criteria:
- pregnancy;
- patients currently taking corticosteroids (cumulative 400 mg prednisone or equivalent);
- Severe underlying disease, i.e. end stage of malignancy disease or end stage of pulmonary disease;
- Severe adverse events before ICU admission, i.e. cardiac arrest;
- Underlying disease requiring corticosteroids;
- Contraindication for corticosteroids;
- Recruited in other clinical intervention trial
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Placebo komparator: standard care
|
Standard pleje
|
|
Eksperimentel: standard care + methylprednisolone therapy
Methylprednisolone 40 mg q12h for 5 days
|
Methylprednisolone 40 mg q12h for 5 days
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Lower Murray lung injury score
Tidsramme: 7 days after randomization
|
Murray lung injury score decreased more than one point means better outcome.The Murray scoring system range from 0 to 4 according to the severity of the condition.
|
7 days after randomization
|
|
Lower Murray lung injury score
Tidsramme: 14 days after randomization
|
Murray lung injury score decreased more than one point means better outcome.The Murray scoring system range from 0 to 4 according to the severity of the condition.
|
14 days after randomization
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
The difference of PaO2/FiO2 between two groups
Tidsramme: 7 days after randomization
|
PaO2/FiO2 denotes ratio of arterial partial pressure of O2 and the fraction of inspired oxygen, with a higher PaO2/FiO2 means favorable outcome.
|
7 days after randomization
|
|
Lower Sequential Organ Failure Assessment (SOFA) score
Tidsramme: 7 days after randomization
|
Lower SOFA score means better outcome.
The SOFA score system range from 0 to 24 according to the severity of the condition.
|
7 days after randomization
|
|
Mechanical ventilation support
Tidsramme: 7 days after randomization
|
Percentage of patients requiring Mechanical ventilation support
|
7 days after randomization
|
|
The difference of PaO2/FiO2 between two groups
Tidsramme: 14 days after randomization
|
PaO2/FiO2 denotes ratio of arterial partial pressure of O2 and the fraction of inspired oxygen, with a higher PaO2/FiO2 means favorable outcome.
|
14 days after randomization
|
|
Lower Sequential Organ Failure Assessment (SOFA) score
Tidsramme: 14 days after randomization
|
Lower SOFA score means better outcome.
The SOFA score system range from 0 to 24 according to the severity of the condition.
|
14 days after randomization
|
|
Mechanical ventilation support
Tidsramme: 14 days after randomization
|
Percentage of patients requiring Mechanical ventilation support
|
14 days after randomization
|
|
Clearance of noval coronavirus
Tidsramme: 14 days after randomization
|
Clearance of noval coronavirus in upper respiratory tract or lower respiratory tract
|
14 days after randomization
|
|
All-cause mortality
Tidsramme: 30 days after randomization
|
All-cause mortality
|
30 days after randomization
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Publikationer og nyttige links
Generelle publikationer
- Arabi YM, Mandourah Y, Al-Hameed F, Sindi AA, Almekhlafi GA, Hussein MA, Jose J, Pinto R, Al-Omari A, Kharaba A, Almotairi A, Al Khatib K, Alraddadi B, Shalhoub S, Abdulmomen A, Qushmaq I, Mady A, Solaiman O, Al-Aithan AM, Al-Raddadi R, Ragab A, Balkhy HH, Al Harthy A, Deeb AM, Al Mutairi H, Al-Dawood A, Merson L, Hayden FG, Fowler RA; Saudi Critical Care Trial Group. Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome. Am J Respir Crit Care Med. 2018 Mar 15;197(6):757-767. doi: 10.1164/rccm.201706-1172OC.
- Auyeung TW, Lee JS, Lai WK, Choi CH, Lee HK, Lee JS, Li PC, Lok KH, Ng YY, Wong WM, Yeung YM. The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study. J Infect. 2005 Aug;51(2):98-102. doi: 10.1016/j.jinf.2004.09.008.
- Raghavendran K, Napolitano LM. Definition of ALI/ARDS. Crit Care Clin. 2011 Jul;27(3):429-37. doi: 10.1016/j.ccc.2011.05.006.
- Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998 Nov;26(11):1793-800. doi: 10.1097/00003246-199811000-00016.
- Sultana J, Crisafulli S, Gabbay F, Lynn E, Shakir S, Trifiro G. Challenges for Drug Repurposing in the COVID-19 Pandemic Era. Front Pharmacol. 2020 Nov 6;11:588654. doi: 10.3389/fphar.2020.588654. eCollection 2020.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Coronavirus infektioner
- Coronaviridae infektioner
- Nidovirales infektioner
- RNA-virusinfektioner
- Virussygdomme
- Luftvejsinfektioner
- Luftvejssygdomme
- Lungebetændelse, viral
- Lungebetændelse
- Lungesygdomme
- COVID-19
- Infektioner
- Lægemidlers fysiologiske virkninger
- Autonome agenter
- Agenter fra det perifere nervesystem
- Anti-inflammatoriske midler
- Antineoplastiske midler
- Antiemetika
- Gastrointestinale midler
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Antineoplastiske midler, hormonelle
- Neuroprotektive midler
- Beskyttelsesagenter
- Prednisolon
- Methylprednisolonacetat
- Methylprednisolon
- Methylprednisolon Hemisuccinat
- Prednisolonacetat
- Prednisolon hemisuccinat
- Prednisolonfosfat
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- Glucocorticoid COVID-19
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med COVID-19 infektioner
-
NCT06923137Aktiv, ikke rekrutterendeCOVID-19 | Coronavirus sygdom 2019 (COVID-19) | Covid-19-infektion | Vacciner mod covid-19 | SARS-CoV-2-infektion, COVID19 | COVID-19-vaccination | SARS-CoV-2-infektion, COVID-19 | COVID-19 (Coronavirus sygdom 2019) | COVID-19 SARS-CoV-2-infektion
-
NCT07552779RekrutteringLuftvejssygdomme | COVID-19 | Lungebetændelse | Lungesygdomme | Coronavirussygdom 2019 | Coronavirus sygdom 2019 (COVID-19) | Covid-19-infektion | Øvre luftvejsinfektioner | Luftvejsinfektion | COVID-19 (Coronavirus sygdom 2019)
-
NCT06768697Ikke rekrutterer endnu
-
NCT07110714RekrutteringTilstand efter COVID-19 | Efter COVID-19 | Post COVID-19 syndrom | Langt COVID-19 syndrom | Post COVID-19 tilstand (PCC)
-
NCT05839236Aktiv, ikke rekrutterendeCOVID-19 luftvejsinfektion | COVID-19 stresssyndrom | COVID-19-vaccinebivirkning | COVID-19-associeret tromboembolisme | COVID-19 Post-Intensive Care Syndrome | COVID-19-associeret slagtilfælde
-
NCT06294756AfsluttetPostakutte følgesygdomme af COVID-19 | Tilstand efter COVID-19 | Langtids-COVID | Kronisk COVID-19 syndrom
-
NCT06156176RekrutteringTræthed | Post-COVID-19 syndrom | Tilstand efter COVID-19 | Post-COVID syndrom | Lang COVID-19 | Langtids-COVID | Post-COVID tilstand
-
NCT04844632RekrutteringUdnyttelse af sundhedsvæsenet | Health Care Associated Infection
-
NCT07450209Aktiv, ikke rekrutterende
Kliniske forsøg med Standard pleje
-
NCT07480954RekrutteringEpitelial ovariecancer | Æggelederkarcinom | Primært peritonealt karcinom | Recidiverende eller refraktær sygdom efter standardbehandlinger
-
NCT07266181Rekruttering
-
NCT06485232Ikke rekrutterer endnuMultipel sclerose | Neuromyelitis Optica Spectrum Disorders | Kronisk inflammatorisk demyeliniserende polyradiculoneuropati | Myasthenia Gravis, generaliseret
-
NCT06596057Aktiv, ikke rekrutterendeSikkerhed og effektivitet
-
NCT06572956Aktiv, ikke rekrutterendeSikkerhed og effektivitet af cellulære lægemidler, objektiv responsrate for forsøgspersoner osv
-
NCT02976857AfsluttetRefraktært diffust stort B-cellet lymfom
-
NCT01853631RekrutteringKronisk lymfatisk leukæmi | Non-Hodgkin lymfom | Akut lymfatisk leukæmi
-
NCT06461624RekrutteringKlinisk forsøg med autologe GPC3 CAR-T-celler (CBG166) terapi for avanceret hepatocellulært karcinomAvanceret hepatocellulært karcinom
-
NCT06097832RekrutteringLet kæde (AL) amyloidose
-
NCT05585996RekrutteringRecidiverende og refraktær B-celle lymfom