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適応型デング熱抗ウイルスプラットフォーム試験 (ADAPT)

適応型デング熱抗ウイルスプラットフォーム試験(ADAPT):早期の症候性デング熱患者における抗ウイルススクリーニングのための第2相ランダム化適応型非盲検試験

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

調査の概要

状態

募集

条件

介入・治療

詳細な説明

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...).

研究の種類

介入

入学 (推定)

500

段階

  • フェーズ2

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

  • 名前:Sophie Yacoub, MD., PhD.
  • 電話番号:+84 77728736
  • メール:syacoub@oucru.org

研究連絡先のバックアップ

  • 名前:Clinical Trials Unit Oxford University Clinical Research Unit
  • 電話番号:+84 28 3924 1983
  • メール:CTU-Ethics@oucru.org

研究場所

      • Ho Chi Minh City、ベトナム、700000
        • 募集
        • Hospital for Tropical Diseases, Ho Chi Minh city
        • コンタクト:
          • Lan TH Nguyen, Doctor
        • 主任研究者:
          • Lan TH Nguyen, Doctor
        • 副調査官:
          • Trieu T Huynh, Doctor
        • 副調査官:
          • Tho V Phan, Doctor
        • 副調査官:
          • Huy X Vo, Doctor
        • 副調査官:
          • Huong TC Nguyen, Doctor
        • 副調査官:
          • Phong T Nguyen, Doctor
        • 副調査官:
          • Vien TD Tran, Doctor
        • 副調査官:
          • Men TH Pham, Doctor
        • 副調査官:
          • Quy T Vo, Doctor
      • Kuala Lumpur、マレーシア、59100
        • まだ募集していません
        • Universiti Malaya Medical Centre
        • コンタクト:
          • Hang Cheng Ong, Doctor

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

10年歳以上 (子、大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:順次割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
介入なし:Standard of care (arm A)

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

実験的: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.

他の名前:
  • モルヌピラビルステラ400mg
実験的: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.

他の名前:
  • デング熱モノクローナル抗体 (デング熱 mAb/Dv Mab)
実験的: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.

他の名前:
  • VEKLURY™ for IV Infusion 100 mg

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Viral clearance rate
時間枠: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)
時間枠: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

二次結果の測定

結果測定
メジャーの説明
時間枠
Area under the viremia curve
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠:Until day 30 post-enrolment

The lowest platelet count recorded during admission

Until day 30 post-enrolment
Maximum AST/ALT
時間枠:Until day 30 post-enrolment

The highest values of AST/ALT measured

Until day 30 post-enrolment
Change in haematocrit
時間枠:Until day 30 post-enrolment

Change in haematocrit during the hospitalisation

Until day 30 post-enrolment

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

協力者

捜査官

  • 主任研究者:Sophie Yacoub, MD., PhD.、University of Oxford, UK

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年4月20日

一次修了 (推定)

2029年12月31日

研究の完了 (推定)

2030年12月31日

試験登録日

最初に提出

2024年8月6日

QC基準を満たした最初の提出物

2024年8月11日

最初の投稿 (実際)

2024年8月13日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月28日

QC基準を満たした最後の更新が送信されました

2026年9月23日

最終確認日

2026年4月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 71DX

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

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.

IPD 共有時間枠

starting 6 months after publications of study findings

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。