- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT04657406
Udvidet adgang til Zofin for patienter med COVID-19
Udvidet adgang til Zofin til behandling af patienter med let til moderat COVID-19 på grund af SARS-Cov-2 for ambulante og indlagte patienter
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
En human coronavirus (HCoV-19) har forårsaget det nye udbrud af coronavirus sygdom (COVID-19) på verdensplan. Almindelige symptomer på COVID-19 omfatter feber, hoste og åndenød. De fleste tilfælde resulterer i milde symptomer, men nogle kan udvikle sig til lungebetændelse og multiorgansvigt. Alt efter sværhedsgraden opdeles det i mild, normal, svær og kritisk syg, hvilket er forbundet med intensivafdelingsindlæggelse og dødelighed. På nuværende tidspunkt er standardbehandlingen af COVD-19 patienter iltbehandling, mekanisk ventilation og medicin til at opretholde blodtrykket. I dag er der ingen specifik antiviral behandling tilgængelig for patienter med COVID-19. Immunaktivering hos nogle patienter og forekomsten af cytokinstormsyndrom (CSS) er en af de vigtige årsager til alvorlig skade på lunger og andre organer, som kan føre til døden. Der er et presserende behov for at udvikle nye interventioner for at undertrykke det overdrevne immunrespons rettidigt i løbet af sygdomsforløbet, beskytte alveolær funktion og reducere lunge- og systemiske organskader.
Zofin er et acellulært, minimalt manipuleret produkt, afledt af humant fostervand (HAF). Dette produkt indeholder over 300 vækstfaktorer, cytokiner og kemokiner samt andre ekstracellulære vesikler/nanopartikler afledt af amniotiske stam- og epitelceller. Produktet indeholder en gennemsnitlig koncentration på 5,24x10^11 partikler/ml med en middelstørrelse på 125,2nm. Overflademarkøranalyse bekræftede tilstedeværelsen af exosomassocierede proteiner CD63, CD81 og CD9 ud over høj ekspression af CD133. Den afsluttede sekventering afslørede 102 almindeligt udtrykte miRNA (med et minimum på 100 kopier). Bioinformatikanalyse koblede 63 miRNA'er til 1216 RNA-mål. Vigtige spillere i den proinflammatoriske cytokinkaskade, der blev fundet målrettet af miRNA, blev opdaget i Organicells produkt, herunder TNF, IL-6 og IL-8. Derudover er en bredere vifte af pro-inflammatoriske cytokiner også målrettet af indsamlingen af miRNA såsom FGF2, IFNB1, IGF1, IL36a, IL37, TGF-B2, VEGFA, CCL8 og CXCL12. Det er blevet foreslået i publiceret forskning, at hæmning eller undertrykkelse af denne pro-inflammatoriske cytokinkaskade kan reducere sværhedsgraden af symptomer forbundet med forhøjet immunrespons. Desuden blev miRNA fundet at målrette mod 148 gener forbundet med immunrespons.
Zofins egenskab viser det terapeutiske potentiale som en suppressor af cytokinaktivering til reduktion af COVID-19-infektionens sværhedsgrad. Dette er en åben-label udvidet adgangsprotokol til behandling af forsøgspersoner, der bruger ZofinTM (OrganicellTM Flow) til behandling af mild til moderat COVID-19 på grund af SARS-Cov-2.
Undersøgelsestype
Udvidet adgangstype
- Behandling IND/Protokol
Kontakter og lokationer
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inklusionskriterier:
- Giv skriftligt informeret samtykke
- Forsøgspersoner er over 18 år på tidspunktet for underskrivelsen af den informerede samtykkeformular.
- Mand eller kvinde
- Skal have en klinisk diagnose af COVID-19 ved den kvalitative revers-transkriptionspolymerasekædereaktion (RT-PCR), med mindst et af milde eller moderate COVID-19 kliniske symptomer, som er defineret nedenfor i #5
Personer med milde til moderate COVID-19 symptomer for ambulant og indlagt befolkning.
De vigtigste symptomer på mild sygdom er:
- lav feber <38°C (37,5 til 37,9)
- en tør hoste
- træthed
- føler sig lidt forpustet
- muskelsmerter
- hovedpine
- ondt i halsen
- diarré
De vigtigste symptomer på moderat sygdom er:
Ud over de symptomer, patienter kan få med en mild sygdom, kan de også opleve:
- feber ≥38°
- en tør og mere vedvarende hoste flere gange i timen
- træthed og behov for at blive i sengen
- åndenød, når du laver moderat træning (såsom at gå ovenpå)
- muskelsmerter og ømhed og behov for at blive i sengen
- hovedpine, især hvis du har det varmt
- ondt i halsen, ømhed fra hoste, men ingen smerter
- diarré
- en tør mund
- Tilstrækkelig venøs adgang
Kun for kvinder med fødedygtigt potentiale (WOCBP), villighed til at bruge FDA-anbefalet prævention indtil 6 måneder efter behandling. De FDA-godkendte og godkendte metoder til prævention er anført nedenfor:
- Permanent sterilisering
- Langtidsvirkende reversible præventionsmidler (LARC)
- Svangerskabsforebyggende injektion
- Korttidsvirkende hormonelle metoder
- Barrieremetoder
- Nødprævention
https://www.fda.gov/consumers/free-publications-women/birth-control
- Enhver mandlig forsøgsperson skal acceptere at bruge præventionsmidler og ikke donere sæd under undersøgelsen.
- Skal acceptere at overholde alle protokolkrav og være villig til at gennemføre alle studiebesøg
Ekskluderingskriterier:
- Patienter, der har moderat til svært respiratory distress syndrome på grund af COVID-19
- Vær en kvinde, der er gravid, ammer eller er i den fødedygtige alder, mens den ikke praktiserer effektive præventionsmetoder. Kvindelige forsøgspersoner skal gennemgå en blodgraviditetstest ved screening, som vil være inden for 72 timer efter IP-infusionen.
- Manglende evne til at udføre nogen af de nødvendige vurderinger.
- Aktiv notering (eller forventet fremtidig notering) for transplantation af ethvert organ.
- Vær en solid organtransplantationsmodtager. Dette inkluderer ikke tidligere cellebaseret terapi (>12 måneder før indskrivning), knogle-, hud-, ledbånds-, sene- eller hornhindetransplantation. Har en historie med organ- eller celletransplantationsafstødning.
- Historie om stofmisbrug (ulovlige "gade"-stoffer undtagen marihuana (hvis det er lovligt brug i stater, hvor patienten bor), eller receptpligtig medicin, der ikke bruges korrekt til en allerede eksisterende medicinsk tilstand eller alkoholmisbrug (≥ 5 drinks/dag i ˃ 3 måneder), eller dokumenterede medicinske, erhvervsmæssige eller juridiske problemer, der er opstået fra brug af alkohol eller stoffer inden for de seneste 24 måneder
- Patienter med ubehandlet HIV-infektion. Patienter kan dog tilmeldes, hvis de er blevet behandlet for HIV og testen negativ for HIV-virusmængden, men stadig er testet positiv for antistoffer.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Samarbejdspartnere og efterforskere
Sponsor
Publikationer og nyttige links
Generelle publikationer
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Datoer for undersøgelser
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Patologiske processer
- Coronaviridae infektioner
- Nidovirales infektioner
- RNA-virusinfektioner
- Virussygdomme
- Infektioner
- Luftvejsinfektioner
- Luftvejssygdomme
- Respirationsforstyrrelser
- Lungebetændelse, viral
- Lungebetændelse
- Lungesygdomme
- Sygdom
- Spædbarn, Nyfødt, Sygdomme
- Lungeskade
- Spædbørn, for tidligt fødte, Sygdomme
- Svært akut respiratorisk syndrom
- COVID-19
- Coronavirus infektioner
- Syndrom
- Respiratory Distress Syndrome
- Respiratory Distress Syndrome, nyfødt
- Akut lungeskade
Andre undersøgelses-id-numre
- 19881-EA
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