Chloroquine for Mild Symptomatic and Asymptomatic COVID-19

October 13, 2020 updated by: HaEmek Medical Center, Israel

Chloroquine for Mild Symptomatic and Asymptomatic COVID-19 in A Two Staged, Multicenter, Open Label and Randomized Trial

19 COVID (Coronavirus disease 2019 ) is a deadly viral disease that has been spreading around the world for several months, and is caused by a CORONA family virus (COVID-19). Following IN-VITRO evidence of the antiviral effect of CHLOROQUINE in CORONA viruses, this drug has been used empirically for COVID-19 patients and is currently recommended in Israel for the treatment of intermediate and severity disease.

The mechanism of action of chloroquine is in part by inhibiting the virus distribution, and changing the intracellular acidity, the virus distribution site. The intracellular chloroquine concentration is determined by a pump called PGP (permeability glycoprotein) that removes the drug from the cell and is activated by the drug. In the treatment of malaria, the benefit of low dosage of the drug has been shown to be effective due to the fact that the intracellular concentration of the drug is probably higher, and therefore the logic to examine this issue in COVID-19 treatment.

The purpose of this study is to test whether a low dose of Chloroquine will reduce the duration of the viral shedding and prevent the disease from worsening.

Study Overview

Status

Terminated

Conditions

Detailed Description

19 COVID is a deadly viral disease that has been spreading around the world for several months, and is caused by a CORONA family virus (COVID-19). This virus family causes upper respiratory tract disease and sometimes severe and fatal lung disease, as in the past: SARS-CoV (severe acute respiratory syndrome) and -MERS-CoV.

Since the outbreak of the pandemic there has been a constant search for effective drug treatment for the disease. Following IN-VITRO evidence of the antiviral effect of CHLOROQUINE in CORONA viruses, this drug has been used empirically for COVID-19 patients and is currently recommended in Israel for the treatment of intermediate and severity disease.

Currently, it is not common to treat patients with mild illness or asymptomatic carriers. In these situations, isolation is recommended until upper respiratory tract surfaces no longer show the presence of the virus, a period of approximately 20 days. .

The mechanism of action of chloroquine is in part by inhibiting the virus distribution, and changing the intracellular acidity, the virus distribution site. The intracellular chloroquine concentration is determined by a pump called PGP that removes the drug from the cell and is activated by the drug. In the treatment of malaria, the benefit of low dosage of the drug has been shown to be effective due to the fact that the intracellular concentration of the drug is probably higher, and therefore the logic to examine this issue in COVID-19 treatment.

The purpose of this study is to test whether a low dose of Chloroquine will reduce the duration of the viral shedding and prevent the disease from worsening. Reducing the duration of viral shedding, shortens the time when there is a risk that the person will spread the disease, and the time when the person is in isolation and cannot return to his normal life.

The trial will be conducted in two stages, first in patients with mild-grade symptomatology disease , and then, depending on the results of the first phase, Investigator's will consider chloroquine therapy in asymptomatic patients (carriers only) to reduce the duration of viral shedding and prevent the onset of symptomatic disease. (Chloroquine dosage at this stage will be determined by the results of the first stage) In the first stage, patients will be recruited at a slight level and will compare two doses of chloroquine (low and normal) with standard of care.

In the second stage, Investigator's plan to examine asymptomatic carriers. Progress between Phase 1 and Phase 2 of the experiment will be contingent upon receiving a renewed approval from the Helsinki Committee, based on an interim report to be submitted.

For the first study, patients diagnosed with COVID-19 patients will be recruited in a mild condition, with no background disease or drug therapy that endangers them with the side effects of chloroquine. will monitor patients' will be monitor for clinical status and periodic PCR (polymerase chain reaction ) results from nasal and pharyngeal surfaces.

Study Type

Interventional

Enrollment (Actual)

5

Phase

  • Phase 2
  • 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

      • Afula, Israel
        • Haemek Medical Center

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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age over 18
  • A person diagnosed with COVID-19 in the past 48 hours
  • Asymptomatic

Exclusion Criteria:

  • chronic lung disease with chronic hypoxia
  • Sleep apnea requiring BIPAP / continuous positive airway pressure
  • Retinal disease
  • Porphyria
  • Myastenia gravis
  • immunodeficiency disorders
  • Hearing Disorders
  • Scheduled for general anesthesia
  • treatment with antibiotics or antiretroviral for any reason
  • Pulse <50
  • Known Ventricular arrhythmias
  • Heart Failure: Systolic or Diastolic
  • kown QT prolongation
  • Taking medicines that increase the risk of QT prolongation in combination with CHLOROQUINE.

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: low dose chloroquine
oral chloroquine 125mg daily for 7 days (or until the condition worsens, whichever comes first)
oral treatment of chloroquine
Experimental: Regular dose chloroquine
oral chloroquine 500 mg twice daily for 7 days (or until the condition worsens, whichever comes first)
oral treatment of chloroquine
Other: Standard of care
The treatment is mostly supportive in character and is given, based on patient's clinical state. Antibiotics do not help patients fight novel coronavirus.
Currently, there is no specific treatment for novel coronavirus. The treatment is mostly supportive in character and is given, based on patient's clinical state. Antibiotics do not help patients fight novel coronavirus.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
change in virus duration (viral shedding)
Time Frame: 23 days
change in the extent and duration of virus shedding.
23 days
change in the number of patients going from asymptomatic to moderately disease
Time Frame: 1 month
change in the number of patients going from asymptomatic to moderately disease
1 month

Collaborators and Investigators

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

Collaborators

Investigators

  • Principal Investigator: Lee Goldstein, MD, HaEmek Medical Center, Israel

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)

June 1, 2020

Primary Completion (Actual)

September 1, 2020

Study Completion (Actual)

September 1, 2020

Study Registration Dates

First Submitted

April 1, 2020

First Submitted That Met QC Criteria

April 2, 2020

First Posted (Actual)

April 3, 2020

Study Record Updates

Last Update Posted (Actual)

October 14, 2020

Last Update Submitted That Met QC Criteria

October 13, 2020

Last Verified

October 1, 2020

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

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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