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Prova della piattaforma antivirale adattiva per la dengue (ADAPT)

23 settembre 2026 aggiornato da: Oxford University Clinical Research Unit, Vietnam

Adaptive Dengue Antiviral Platform Trial (ADAPT): uno studio di fase 2 randomizzato, adattivo, in aperto per lo screening antivirale in pazienti con dengue sintomatica precoce

This is a randomized, open-label adaptive platform trial aiming to screen the antiviral effectiveness of the experimental drug(s) in early dengue infection

  • 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
  • Secondary objective:

    • To assess the effect of the experimental drug(s) in dengue patients on physiological, clinical and virological parameters

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

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 di studio

Interventistico

Iscrizione (Stimato)

500

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: Sophie Yacoub, MD., PhD.
  • Numero di telefono: +84 77728736
  • Email: syacoub@oucru.org

Backup dei contatti dello studio

  • Nome: Clinical Trials Unit Oxford University Clinical Research Unit
  • Numero di telefono: +84 28 3924 1983
  • Email: CTU-Ethics@oucru.org

Luoghi di studio

      • Kuala Lumpur, Malaysia, 59100
        • Non ancora reclutamento
        • Universiti Malaya Medical Centre
        • Contatto:
          • Hang Cheng Ong, Doctor
      • Ho Chi Minh City, Vietnam, 700000
        • Reclutamento
        • Hospital for Tropical Diseases, Ho Chi Minh city
        • Contatto:
          • Lan TH Nguyen, Doctor
        • Investigatore principale:
          • Lan TH Nguyen, Doctor
        • Sub-investigatore:
          • Trieu T Huynh, Doctor
        • Sub-investigatore:
          • Tho V Phan, Doctor
        • Sub-investigatore:
          • Huy X Vo, Doctor
        • Sub-investigatore:
          • Huong TC Nguyen, Doctor
        • Sub-investigatore:
          • Phong T Nguyen, Doctor
        • Sub-investigatore:
          • Vien TD Tran, Doctor
        • Sub-investigatore:
          • Men TH Pham, Doctor
        • Sub-investigatore:
          • Quy T Vo, Doctor

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

10 anni e precedenti (Bambino, Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

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.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione sequenziale
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Nessun intervento: Standard of care (arm A)

Patients, who are randomly allocated into arm A will receive the standard of care (no study drug)

Sperimentale: 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.

Altri nomi:
  • Molnupiravir STELLA 400 mg
Sperimentale: 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.

Altri nomi:
  • Anticorpo monoclonale dengue (Dengue mAb/Dv Mab)
Sperimentale: Remdesivir (arm D)

Patients, who are randomly allocated into arm D, will receive:

  • Adults or children ≥ 40Kg: 200mg loading dose on day 1, followed by 100mg once daily from day 2 to day 5.
  • Children < 40Kg: 5mg/Kg loading dose on day 1, followed by 2.5mg/Kg once daily from day 2 to day 5.

Remdesivir (GS-443902) is a nucleoside analogue - RNA dependent RNA polymerase inhibitor.

Altri nomi:
  • VEKLURY™ for IV Infusion 100 mg

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Viral clearance rate
Lasso di tempo: From randomization until day 5 of study

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
Number of AEs (grade 3, 4 and 5)
Lasso di tempo: Until day 30 post-enrolment

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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Area under the viremia curve
Lasso di tempo: From randomisation until day 5 of study

Area under the curve (AUC) of the serial viremia measurements during the first 5 days of study

From randomisation until day 5 of study
Viral log reduction
Lasso di tempo: up to 48 hours of study

Reduction of viremia at the 24 and 48 hours compared to baseline

up to 48 hours of study
NS1 clearance time
Lasso di tempo: up to day 5

Time to NS1 clearance as estimated under a non-linear model

up to day 5
Number of patients progress to severe dengue (WHO 2009 criteria)
Lasso di tempo: From enrolment until discharge, assessed up to 30 days

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
Number of patients requiring for ICU admission
Lasso di tempo: From enrolment until discharge, assessed up to 30 days

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
Fever clearance time
Lasso di tempo: From enrolment until discharge, assessed up to 30 days

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
Platelet nadir
Lasso di tempo: Until day 30 post-enrolment

The lowest platelet count recorded during admission

Until day 30 post-enrolment
Maximum AST/ALT
Lasso di tempo: Until day 30 post-enrolment

The highest values of AST/ALT measured

Until day 30 post-enrolment
Change in haematocrit
Lasso di tempo: Until day 30 post-enrolment

Change in haematocrit during the hospitalisation

Until day 30 post-enrolment

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Sophie Yacoub, MD., PhD., University of Oxford, UK

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

20 aprile 2026

Completamento primario (Stimato)

31 dicembre 2029

Completamento dello studio (Stimato)

31 dicembre 2030

Date di iscrizione allo studio

Primo inviato

6 agosto 2024

Primo inviato che soddisfa i criteri di controllo qualità

11 agosto 2024

Primo Inserito (Effettivo)

13 agosto 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

28 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

23 settembre 2026

Ultimo verificato

1 aprile 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 71DX

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano 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.

Periodo di condivisione IPD

starting 6 months after publications of study findings

Tipo di informazioni di supporto alla condivisione IPD

  • STUDIO_PROTOCOLLO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .