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Safety and Effectiveness of an Immunobiological Drug in CoViD-19 (INPB001)

11 de septiembre de 2021 actualizado por: Guillermo Alberto Keller, Administracion Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbran

Study to Evaluate the Safety and Effectiveness of an Immunobiological Drug (Anti SARS-CoV-2) in the Treatment of Coronavirus Disease 2019 (CoViD-19)

The aims of this study is to analyze the efficacy and safety of a passive immunotherapy strategy using hyperimmune equine serum known as Anti-SARS-CoV-2 elaborated by the National Institute for the Production of Biologicals (ANLIS-Malbrán) as an addition to the standard therapeutic approach for hospitalized patients with COVID-19, in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection aged 18 to 80 years.

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Descripción detallada

This is an adaptive phase II/III study that aims to analyze the efficacy and safety of a immunobiological drug (Anti SARS-CoV-2) in the treatment of CoViD-19. This treatment is a passive immunotherapy strategy developed as a purified F(ab')2 fraction of equine hyperimmune serum (Anti-SARS-CoV-2). The equine serum was generated from antigenic stimulation with the SARS-CoV-2 receptor binding domain (RBD) purified protein.

This type of product (equine hyperimmune serum F(ab')2) has been widely used in our country in the last 100 years with satisfactory results and an acceptable safety profile in the treatment of accidents with poisonous animals such as anti-loxosceles, anti -latrodectus, anti-scorpionic, and anti-phoneutria, anti-bothropic, anti-micrurus, and anti-crotalic sera, all developed by the National Institute of Biological Production (ANLIS-Malbrán) and distributed free of charge in public hospitals in the country .

In the present study, evaluates the effect and safety of this immunobiological treatment in patients with COVID-19 that require hospitalization.

Tipo de estudio

Intervencionista

Inscripción (Anticipado)

200

Fase

  • Fase 2
  • Fase 3

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Guillermo A Keller, MD PhD
  • Número de teléfono: 011-4961-0943
  • Correo electrónico: gkeller@anlis.gob.ar

Copia de seguridad de contactos de estudio

  • Nombre: Claudio Bonel, PhD
  • Número de teléfono: 011-4303-1801
  • Correo electrónico: cbonel@anlis.gob.ar

Ubicaciones de estudio

  • Argentina
      • Ciudad Autónoma De Buenos Aires, Argentina, 1408
        • Reclutamiento
        • Hospital General de Agudos Donación Francisco J. Santojanni
        • Contacto:
          • Guillermo A Keller, MD PhD
          • Número de teléfono: 01149610943
          • Correo electrónico: gkeller@anlis.gob.ar
        • Contacto:
          • Claudio Bonel, PhD
          • Número de teléfono: 011-4303-2492
          • Correo electrónico: cbonel@anlis.gob.ar
        • Investigador principal:
          • Guillermo A Keller, MD PhD
        • Sub-Investigador:
          • Guillermo Di Girolamo, MD PhD

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 80 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  1. Subjects over 18 years old and under 80 years old.
  2. Positive results by RT-PCR for SARS CoV-2
  3. Clinical picture compatible with respiratory compromise in the form of pneumonia attributed to COVID-19 (Stage 3, 4 or 5 according to the WHO scale), lasting up to 72 hours from the onset of symptoms to their evaluation to be incorporated into the study.
  4. Patient with good disposition towards the study and that signs the informed consent.

Exclusion Criteria:

  1. Patients with clinical disease corresponding to mild / asymptomatic forms (Absence of radiological infiltrate and risk factors, with normal auscultation and arterial saturation of oxygen (SatO2) greater than 95%)
  2. Patients with clinical disease corresponding to severe forms (Severe pneumonia: presence of severity criteria (ATS / IDSA), one of two major or three minor criteria.)
  3. Patients who have received other therapeutic strategies in the framework of an experimental study that make it difficult to evaluate the results obtained, including (but not limited to): convalescent plasma, lopinavir / ritonavir, hydroxychloroquine, and azithromycin.
  4. Pregnant or lactating women.
  5. Women of childbearing potential not using an effective contraceptive method (withdrawal, intrauterine device, or oral contraceptives).
  6. History of severe anaphylactic reaction with the administration of equine plasma.
  7. Patients with comorbidities that justify a risk of high mortality from causes independent of SARS-CoV-2 infection (eg, stage IV cancer)
  8. Patient who does not consent to participate.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Cuadruplicar

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Anti-SARS-CoV-2
Administration of 10 ml of a concentrated equine hyperimmune serum solution with neutralizing activity of SARS-CoV-2 not less than1/5120, administered in slow intravenous infusion (10 ml diluted in100 ml of physiological solution, administered over 50 to 60 minutes in slow drip), produced by ANLIS-Malbrán, administered twice (time 0 when incorporated into the study -initial dose- and at 48 hours -second dose-).
Droga: Anti-SARS-CoV-2
Purified F(ab')2 Fragments of Equine hyperimmune Serum with anti-SARS-CoV-2 neutralizing activity (titer 1/5120 or higher)
Otros nombres:
  • Grupo de tratamiento
  • Purified F(ab')2 Fragments of Equine hyperimmune Serum
  • F(ab')2 Fragments
  • Passive Immunotherapy
  • Equine F(ab')2 Fragments
  • Hyperimmune Equine Serum
Comparador de placebos: Placebo
Administration of 10 ml of a control-solution with no-neutralizing activity of SARS-CoV-2, administered in slow intravenous infusion (10ml diluted in 100 ml of physiological solution, administered over 50 to60 minutes in slow drip), produced by ANLIS-Malbrán, administered twice (time 0when incorporated into the study -initial dose- and at 48 hours -second dose-).
Droga: Placebo
Administration of 10 ml of a control-solution without neutralizing activity against SARS-CoV-2, administered in slow intravenous infusion (10 ml diluted in 100 ml of saline solution, administered over 50 to 60 minutes in slow drip), produced by ANLIS-Malbrán, administered twice (time 0 when incorporated into the study -initial dose- and at 48 hours -second dose-).
Otros nombres:
  • Grupo de control

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in time needed to clinical improvement
Periodo de tiempo: Reached each day between day 1 and 28 post-inclusion in the study
In subjects admitted to the general ward for active infection by SARS-CoV-2 and a clinical picture of pneumonia who receive supportive treatment recommended by the guidelines of the Ministry of Health of the Argentine Nation (Population), if slow intravenous administration of Anti SARS-CoV-2 in two doses 48 hours apart (Intervention) added to supportive treatment, compared to supportive treatment alone (patients will receive slow intravenous administration of a placebo solution in two doses 48 hours apart to maintain the "blind" as Comparator), changes the time needed to clinical improvement (Outcome), during 28 days after the assignment (Time).
Reached each day between day 1 and 28 post-inclusion in the study

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in the number of patients in each World Health Organization (WHO) Ordinal Scale Category (0 to 8 being 0 better and 8 worse)
Periodo de tiempo: days 7, 14 and 21 post-inclusion
(a) Change in the number of patients in each World Health Organization Ordinal Scale Category (0 to 8 being 0 better and 8 worse), expecting a lower proportion of patients in categories 4, 5, 6, and 7 (OUTCOME - Efficacy);
days 7, 14 and 21 post-inclusion
Change in Mortality rate
Periodo de tiempo: 28 days post-inclusion
(b) Change of all-cause mortality at day 28 (OUTCOME - Efficacy);
28 days post-inclusion
Change in Mechanical Ventilation Requirement rate
Periodo de tiempo: 28 days post-inclusion
(c) Determination of the frequency of invasive mechanical ventilation in the total analysis period (OUTCOME - Efficacy);
28 days post-inclusion
Change in duration of oxygen treatment requirement
Periodo de tiempo: 28 days post-inclusion
(d) Change of the duration of oxygen therapy quantified in days of oxygen therapy (OUTCOME - Efficacy);
28 days post-inclusion
Change in Length of Hospitalization
Periodo de tiempo: 28 days post-inclusion
(e) Change of hospital length of hospitalization, quantified in days from study inclusion until hospital discharge (OUTCOME - Efficacy);
28 days post-inclusion
Change in frequency of nosocomial infection
Periodo de tiempo: 28 days post-inclusion
(F) Change in the frequency of patients with nosocomial infection (OUTCOME - Efficacy);
28 days post-inclusion
Change in Lymphocyte cell count
Periodo de tiempo: 28 days post-inclusion
(g) Change of absolute lymphocyte count (OUTCOME - Efficacy);
28 days post-inclusion
Change in viral RNA Negativization rate on nasopharyngeal swab test
Periodo de tiempo: 7, 14, 21, and 28 days post-inclusion
(h) change in the proportion of patients with detected viral RNA and the viral RNA load, measured by quantitative reverse transcriptase polymerase chain reaction (RT-PCR), on day 7, 14, 21, and 28 (OUTCOME - Efficacy);
7, 14, 21, and 28 days post-inclusion
Description of adverse events type and frequency
Periodo de tiempo: 28 days post-inclusion
(i) description of reported adverse events, discriminated by their severity, and classified according to MedDRA (OUTCOME - Safety).
28 days post-inclusion
Requirement of additional treatments for Adverse Drug reactions
Periodo de tiempo: 28 days post-inclusion
(j) The number of subjects who required additional treatment as a consequence of reported adverse events in each therapeutic branch (OUTCOME - Safety)
28 days post-inclusion
Describe the AUC of purified F(ab')2 Anti-SARS-CoV-2
Periodo de tiempo: Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
(k1) Describe area under the curve (AUC) of the active drug, based on concentrations determined in plasma samples obtained from the first 20 patients
Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
Describe the Cmax of purified F(ab')2 Anti-SARS-CoV-2
Periodo de tiempo: Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
(k2) Describe maximum plasma concentration (Cmax) of the active drug, based on concentrations determined in plasma samples obtained from the first 20 patients (at time Minute 0 min, hours 1, 3, 6, 24, 48, 49 and 96, day 7, 14, 21 and 28 days).
Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
Describe the t1/2 of purified F(ab')2 Anti-SARS-CoV-2
Periodo de tiempo: Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
(k3) Describe plasma half life (t1/2) of the active drug, based on concentrations determined in plasma samples obtained from the first 20 patients (at time Minute 0 min, hours 1, 3, 6, 24, 48, 49 and 96, day 7, 14, 21 and 28 days).
Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
Describe the Ke of purified F(ab')2 Anti-SARS-CoV-2
Periodo de tiempo: Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days
(k4) Describe elimination constant (Ke) of the active drug, based on concentrations determined in plasma samples obtained from the first 20 patients (at time Minute 0 min, hours 1, 3, 6, 24, 48, 49 and 96, day 7, 14, 21 and 28 days).
Time 0 (Basal, prior to drug administration), hours 1, 3, 6, 24, 48, 49 and 96, days 7, 14, 21 and 28 days

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Administracion Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbran

Investigadores

  • Investigador principal: Guillermo A Keller, PhD, INPB - ANLIS Malbrán

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

1 de junio de 2021

Finalización primaria (Anticipado)

30 de noviembre de 2021

Finalización del estudio (Anticipado)

31 de diciembre de 2021

Fechas de registro del estudio

Enviado por primera vez

1 de junio de 2021

Primero enviado que cumplió con los criterios de control de calidad

2 de junio de 2021

Publicado por primera vez (Actual)

4 de junio de 2021

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

17 de septiembre de 2021

Última actualización enviada que cumplió con los criterios de control de calidad

11 de septiembre de 2021

Última verificación

1 de septiembre de 2021

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • INPB001
  • PRIISA.BA 2578 (Identificador de registro: PRIISA.BA)
  • RENIS IS003268 (Identificador de registro: RENIS)
  • DI-2021-2196-APN-ANMAT#MS (Otro identificador: Disposición ANMAT)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

Sí

Descripción del plan IPD

Publication of the results of all data obtained is planned.

Marco de tiempo para compartir IPD

After completion of the study.

Criterios de acceso compartido de IPD

By request to the Principal Investigator

Tipo de información de apoyo para compartir IPD

  • Protocolo de estudio
  • Plan de Análisis Estadístico (SAP)
  • Formulario de consentimiento informado (ICF)
  • Informe de estudio clínico (CSR)
  • Código analítico

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

producto fabricado y exportado desde los EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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