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Convalescent Plasma Therapy - Zurich Protocol (CPT-ZHP)

27. april 2021 opdateret af: University of Zurich

A Phase i, Open-label, Single-centre Clinical Study to Evaluate Safety and Efficacy of Passive Immunization of High-risk SARS-CoV-2 Positive Patients With Convalescent Plasma Therapy

This is an open-label, single-center, phase I study to assess the safety and efficacy of convalescent plasma therapy (CPT) obtained from donors who were tested positive for SARS-CoV-2 and fully recovered from the infection and administered to patients who are infected with the new coronavirus and present dyspnea or a poor prognosis

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The outbreak of a new highly contagious and life-threatening infective disease was first reported in China in December 2019. Regardless of the undertaken containing measures, its spreading could not be effectively stopped and currently we are confronting the pandemic diffusion of a newly identified Coronavirus (SARS-CoV-2) (1). This causes a systemic disease, known as (Coronavirus Disease-19) COVID-19, characterised by a broad spectrum of clinical manifestations, including ineffective hyper-inflammation and severe pneumonia, with provisional epidemiologic data indicating a mortality rate of 0.1-15% (2). Do to the lack of vaccination, specific anti-virus sera or monoclonal antibodies, the therapeutic efforts to limit COVID-19 mostly rely on the empirical use of anti-viral drugs. Therefore, being the option of an active immunisation not available and because of the controversial efficacy of the available anti-viral therapies (3), we suggest the option of a passive immunisation for those patients who are infected with the new coronavirus and present dyspnea or a poor prognosis. The use of convalescent plasma, i.e. plasma obtained from donors who were tested positive for SARS-CoV-2 and fully recovered from the infection, could provide a rapid protection, limiting the observed evolution of COVID-19 towards life-threating manifestations (7-9).

When carried on according to standardised measures, the transfusion of plasma is highly safe (10-11) and we assume that products containing anti- SARS-CoV- 2 antibodies will provide the recipients a passive immunity through different mechanisms, including viral neutralisation, antibody-dependent cellular cytotoxicity and/or phagocytosis.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

30

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Schweiz
      • Zürich, Schweiz, 8091
        • University Hospital Zurich

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

A) Proven Sars-CoV-2 by PCR and hospitalization for COVID-19 in combination with either (1) or (2):

  1. Age ≥50

    AND (at least one):

    • Pre-existing cardiovascular disease
    • Diabetic disease
    • Immunodeficiency/immunosuppression
    • Neoplastic disease
    • COPD or chronic liver disease or chronic renal failure
  2. Age ≥18

AND (at least one):

  • SpO2 ≤ 94% on room air or requiring supplemental oxygen at screening
  • Typical changes on chest x-ray and/or lung-CT scan
  • Immunosuppression or neoplastic disease

B) Informed Consent as documented by signature (Appendix Informed Consent Form) of the patient or, in case of inability, of the next relative/care-taking person. In the latter case, an independent doctor will also be involved and her/his signature will be required in order to enrol the patient.

Exclusion Criteria:

  1. Contraindications to the class of drugs under study, e.g. known hypersensitivity or allergy to class of drugs or the investigational product (FFP)
  2. Known IgA deficiency
  3. Cytokine Release Syndrome grade ≥3 (see score)*
  4. ARDS
  5. Patients already hospitalized in intensive care unit and/or already receiving mechanical ventilation
  6. Known or suspected non-compliance, drug or alcohol abuse
  7. Previous enrolment into the current study
  8. Enrolment of the investigator, his/her family members, employees and other dependent persons
  9. Women who are pregnant or breast feeding
  10. Intention to become pregnant during the course of the study
  11. Lack of safe contraception, defined as: Female participants of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases. Please note that female participants who are surgically sterilised / hysterectomised or post-menopausal for longer than 2 years are not considered as being of child bearing potential

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Safety of CPT applied to COVID-19 patients
Tidsramme: clinical observation up to 48 hours after the last dose of plasma
Absence of clinical signs of Transfusion Related Lung Inflammation (TRALI) and/or allergic reactions and/or Transfusion Associated Circulatory Overload (TACO)
clinical observation up to 48 hours after the last dose of plasma
Safety of CPT applied to COVID-19 patients
Tidsramme: 1 week (laboratory monitoring up to 7 days after the last administration of plasma)
Absence of laboratory signs of haemolytic reactions
1 week (laboratory monitoring up to 7 days after the last administration of plasma)
Improvement of respiratory frequency
Tidsramme: 3 weeks after the last administration of plasma
Respiratory frequency will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of O2-saturation
Tidsramme: 3 weeks after the last administration of plasma
O2-Saturation will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of Inflammatory markers (C Reactive Protein, CRP)
Tidsramme: 3 weeks after the last administration of plasma
CRP will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of Inflammatory markers (Ferritin)
Tidsramme: 3 weeks after the last administration of plasma
Ferritin will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of Inflammatory markers (IL-6)
Tidsramme: 3 weeks after the last administration of plasma
IL-6 will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of coagulation-markers (D-dimer)
Tidsramme: 3 weeks after the last administration of plasma
D-Dimer will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of coagulation-markers (Fibrinogen)
Tidsramme: 3 weeks after the last administration of plasma
Fibrinogen will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of coagulation-markers (LDH)
Tidsramme: 3 weeks after the last administration of plasma
LDH will be measured at each study visit
3 weeks after the last administration of plasma
Prevention of ICU-admission
Tidsramme: 3 weeks after the last administration of plasma
clinical conditions will be assessed throughout the study
3 weeks after the last administration of plasma

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Characterisation of virus reaction to plasma Therapy
Tidsramme: 10 Weeks
Measurement of viral load after plasma therapy
10 Weeks
Characterisation of the dynamic of humoral response after therapy
Tidsramme: 10 Weeks
Measurement of antibody-titres after plasma therapy
10 Weeks
Better characterize the the in-vivo anti-virus humoral response against SARS-CoV-2.
Tidsramme: 10 Weeks
Performance of neutralisation assay after administration of plasma
10 Weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Zurich

Efterforskere

  • Studiestol: Markus Manz, Professor, University of Zurich

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

29. april 2020

Primær færdiggørelse (Faktiske)

30. november 2020

Studieafslutning (Faktiske)

30. marts 2021

Datoer for studieregistrering

Først indsendt

8. april 2021

Først indsendt, der opfyldte QC-kriterier

27. april 2021

Først opslået (Faktiske)

3. maj 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

3. maj 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. april 2021

Sidst verificeret

1. april 2021

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2020-00787

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

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Kliniske forsøg med COVID-19

Kliniske forsøg med Convalescent plasma

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