Ensayo de plataforma antiviral adaptativa para el dengue (ADAPT)
Ensayo adaptativo de plataforma antiviral contra el dengue (ADAPT): un ensayo de fase 2, aleatorizado, adaptativo y abierto para la detección de antivirales en pacientes con dengue sintomático temprano
This is a randomized, open-label adaptive platform trial aiming to screen the antiviral effectiveness of the experimental drug(s) in early dengue infection
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Primary objectives:
- To determine the antiviral effectiveness of the experimental drug(s) in early dengue infection
- To assess the safety and tolerability of the experimental drug(s) in dengue patients
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Secondary objective:
- To assess the effect of the experimental drug(s) in dengue patients on physiological, clinical and virological parameters
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
This is a randomized, open-label adaptive platform trial investigating the antiviral effectiveness of various intervention arms in patients with lab-confirmed dengue and less than 48 hours of fever. The antiviral candidates in this trial will include the repurposed antiviral drugs, novel small molecule drugs and dengue monoclonal antibody. Patients will be randomly allocated between available treatment arms and compared to standard of care ("no study drug": no placebos will be made for this trial).
The current sites include Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam and Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia. Local ethical approvals have been released. Other sites and countries may be added in due course.
This is a continually running adaptive platform trial, which begins with initial candidate drugs (a total of 4 arms): molnupiravir, remdesivir and VIS513 (a dengue monoclonal antibody). New therapies may be added and poorly performing arms or interventions meeting pre-specific thresholds for in vivo antiviral efficacy will be removed.
The sample size is adaptive with multiple planned interim analyses. The number of patients recruited depends on the results. For each intervention studied the sample size will be adaptive and determined by pre-specified stopping rules for futility and efficacy. Patients are invited to participate in the trial if they present at the healthcare settings with early symptomatic dengue virus infection (less than 48 hours since the onset of fever and positive NS1 antigen test) and can be able to return for follow up visits at 30 and 60 days after randomization.
The randomization ratios will be uniform for all available and eligible arms (1:1:1...).
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- Fase 2
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Sophie Yacoub, MD., PhD.
- Número de teléfono: +84 77728736
- Correo electrónico: syacoub@oucru.org
Copia de seguridad de contactos de estudio
- Nombre: Clinical Trials Unit Oxford University Clinical Research Unit
- Número de teléfono: +84 28 3924 1983
- Correo electrónico: CTU-Ethics@oucru.org
Ubicaciones de estudio
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Kuala Lumpur, Malasia, 59100
- Aún no reclutando
- Universiti Malaya Medical Centre
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Contacto:
- Hang Cheng Ong, Doctor
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Ho Chi Minh City, Vietnam, 700000
- Reclutamiento
- Hospital for Tropical Diseases, Ho Chi Minh city
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Contacto:
- Lan TH Nguyen, Doctor
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Investigador principal:
- Lan TH Nguyen, Doctor
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Sub-Investigador:
- Trieu T Huynh, Doctor
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Sub-Investigador:
- Tho V Phan, Doctor
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Sub-Investigador:
- Huy X Vo, Doctor
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Sub-Investigador:
- Huong TC Nguyen, Doctor
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Sub-Investigador:
- Phong T Nguyen, Doctor
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Sub-Investigador:
- Vien TD Tran, Doctor
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Sub-Investigador:
- Men TH Pham, Doctor
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Sub-Investigador:
- Quy T Vo, Doctor
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Female or male patients with a clinical diagnosis of dengue virus infection and less than 48 hours of fever
- Positive NS1 rapid diagnostic test
- >= 10 years or ≥ 18 years of age (depending on license of therapeutic being evaluated)
- Patient is able to give written informed consent or assent for full participation in the study.
- Agreement to stay in hospital for duration of the intervention (most will be 5 days) and follow-up visits at day 30 and 60 post enrolment.
Exclusion Criteria:
- Meets criteria for severe dengue at baseline (severe plasma leakage leading to dengue shock syndrome, fluid accumulation with respiratory distress, severe bleeding, severe organ involvement - AST/ALT>1000 U/L, impaired consciousness, multiple organ dysfunction)
- Pregnancy (either clinically confirmed or by urine dipstick for human chorionic gonadotrophin hormone)
- Breastfeeding women
- Localising features suggesting an alternative/additional diagnosis, e.g. pneumonia, sepsis
- Renal failure (baseline eGFR < 30ml/min)
- History or presence of clinically significant cardiovascular, respiratory, hepatic, renal, gastrointestinal, neuropsychiatric, autoimmune, dermatologic or immunosuppressive disorders
- History of allergic disease, allergic reactions or known hypersensitivity to any component of the study product (Mild non-medication allergies allowed)
- Any condition that, in the opinion of the investigator, would complicate or compromise the study or well-being of the participant
- Participation or planned participation in a study involving the administration of an investigational compound within the past one month.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación Secuencial
- Enmascaramiento: Ninguno (etiqueta abierta)
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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Sin intervención: Standard of care (arm A)
Patients, who are randomly allocated into arm A will receive the standard of care (no study drug) |
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Experimental: Molnupiravir (arm B)
Patients, who are randomly allocated into arm B, will receive 800mg po bid of Molnupiravir for 5 days |
This is an antiviral drug (an RNA dependent RNA polymerase inhibitor, with broad spectrum antiviral activity) currently approved for use in treatment for COVID-19 patients. In this trial, its antiviral effectiveness on the early phase of dengue virus infection will be assessed.
Otros nombres:
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Experimental: Monoclonal antibody (arm C)
Patients, who are randomly allocated into arm C, will receive a single dose of 6mg/Kg of the dengue monoclonal antibody via an intravenous line over 2 hours. |
VIS513 is an engineered humanised monoclonal antibody produced by recombinant DNA technology in a mammalian cell (i.e. Chinese hamster ovary) line. It was discovered in the USA by Visterra Inc and subsequently technology for manufacturing and further development was transferred to Serum Institute of India Pvt. Ltd., Pune, India. It has shown potent, specific neutralization of all four serotypes of DENV.
Otros nombres:
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Experimental: Remdesivir (arm D)
Patients, who are randomly allocated into arm D, will receive:
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Remdesivir (GS-443902) is a nucleoside analogue - RNA dependent RNA polymerase inhibitor.
Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Viral clearance rate
Periodo de tiempo: From randomization until day 5 of study
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Rate of viral clearance estimated under a hierarchical log-linear model fit to the serial viral load measurements over 5 days after enrolment. The viremia kinetics will be measured using the qRT-PCR assay, which will be performed on samples taken twice a day from day 1 to day 3 of study and then once a day on days 4 and 5 of study (total 9 samples per patient). |
From randomization until day 5 of study
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Number of AEs (grade 3, 4 and 5)
Periodo de tiempo: Until day 30 post-enrolment
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All patients will be followed up daily until discharge and then at around days 30 after randomization to collect information on clinical progress of dengue illness and any adverse events occurring during the study course. All AEs and SAEs will be recorded. |
Until day 30 post-enrolment
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Area under the viremia curve
Periodo de tiempo: From randomisation until day 5 of study
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Area under the curve (AUC) of the serial viremia measurements during the first 5 days of study |
From randomisation until day 5 of study
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Viral log reduction
Periodo de tiempo: up to 48 hours of study
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Reduction of viremia at the 24 and 48 hours compared to baseline |
up to 48 hours of study
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NS1 clearance time
Periodo de tiempo: up to day 5
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Time to NS1 clearance as estimated under a non-linear model |
up to day 5
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Number of patients progress to severe dengue (WHO 2009 criteria)
Periodo de tiempo: From enrolment until discharge, assessed up to 30 days
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All patients will be followed up daily until discharge to collect information about the clinical progress of dengue |
From enrolment until discharge, assessed up to 30 days
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Number of patients requiring for ICU admission
Periodo de tiempo: From enrolment until discharge, assessed up to 30 days
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All patients will be followed up daily until discharge to collect information about the clinical progress of dengue |
From enrolment until discharge, assessed up to 30 days
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Fever clearance time
Periodo de tiempo: From enrolment until discharge, assessed up to 30 days
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Time elapsed from enrolment to the afebrile time-point (defined as body temperature <37.5 °C for at least 48 hours) |
From enrolment until discharge, assessed up to 30 days
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Platelet nadir
Periodo de tiempo: Until day 30 post-enrolment
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The lowest platelet count recorded during admission |
Until day 30 post-enrolment
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Maximum AST/ALT
Periodo de tiempo: Until day 30 post-enrolment
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The highest values of AST/ALT measured |
Until day 30 post-enrolment
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Change in haematocrit
Periodo de tiempo: Until day 30 post-enrolment
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Change in haematocrit during the hospitalisation |
Until day 30 post-enrolment
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Investigadores
Investigadores
- Investigador principal: Sophie Yacoub, MD., PhD., University of Oxford, UK
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
- Enfermedades transmitidas por vectores
- Enfermedades transmitidas por mosquitos
- Infecciones
- Infecciones por virus de ARN
- Enfermedades virales
- Infecciones por arbovirus
- Infecciones por Flavivirus
- Infecciones por Flaviviridae
- Fiebres Hemorrágicas Virales
- Dengue
- Terapéutica
- Rutas de administración de drogas
- Terapia con drogas
- Administración, intravenosa
- Infusiones, parenteral
- Infusiones, intravenosas
- remdesivir
- molnupiravir
Otros números de identificación del estudio
Otros números de identificación del estudio
- 71DX
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
The database may be shared with researchers not directly involved in this study but only after the main paper has been published and in accordance with OUCRU guidelines on data sharing. The database will only be shared if future publications are not compromised. No identifiable information will be shared with any other person/organisation than that authorised in the protocol.
Marco de tiempo para compartir IPD
starting 6 months after publications of study findings
Tipo de información de apoyo para compartir IPD
- PROTOCOLO DE ESTUDIO
Información sobre medicamentos y dispositivos, documentos del estudio
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