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

2021年9月11日 更新者：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.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

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.

研究の種類

介入

入学 (予想される)

200

段階

  • フェーズ2
  • フェーズ 3

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

研究連絡先のバックアップ

研究場所

  • アルゼンチン
      • Ciudad Autónoma De Buenos Aires、アルゼンチン、1408
        • 募集
        • Hospital General de Agudos Donación Francisco J. Santojanni
        • コンタクト：
        • コンタクト：
        • 主任研究者：
          • Guillermo A Keller, MD PhD
        • 副調査官：
          • Guillermo Di Girolamo, MD PhD

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

18年～80年 (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:

  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.

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：並列代入
  • マスキング：4倍

武器と介入

参加者グループ / アーム
介入・治療
アクティブコンパレータ：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-).
薬：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)
他の名前：
  • 治療群
  • Purified F(ab')2 Fragments of Equine hyperimmune Serum
  • F(ab')2 Fragments
  • Passive Immunotherapy
  • Equine F(ab')2 Fragments
  • Hyperimmune Equine Serum
プラセボコンパレーター：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-).
薬：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-).
他の名前：
  • 対照群

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
Change in time needed to clinical improvement
時間枠：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

二次結果の測定

結果測定
メジャーの説明
時間枠
Change in the number of patients in each World Health Organization (WHO) Ordinal Scale Category (0 to 8 being 0 better and 8 worse)
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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

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

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

捜査官

  • 主任研究者：Guillermo A Keller, PhD、INPB - ANLIS Malbrán

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)

2021年6月1日

一次修了 (予想される)

2021年11月30日

研究の完了 (予想される)

2021年12月31日

試験登録日

最初に提出

2021年6月1日

QC基準を満たした最初の提出物

2021年6月2日

最初の投稿 (実際)

2021年6月4日

学習記録の更新

投稿された最後の更新 (実際)

2021年9月17日

QC基準を満たした最後の更新が送信されました

2021年9月11日

最終確認日

2021年9月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • INPB001
  • PRIISA.BA 2578 (レジストリ識別子：PRIISA.BA)
  • RENIS IS003268 (レジストリ識別子：RENIS)
  • DI-2021-2196-APN-ANMAT#MS (その他の識別子：Disposición ANMAT)

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

Publication of the results of all data obtained is planned.

IPD 共有時間枠

After completion of the study.

IPD 共有アクセス基準

By request to the Principal Investigator

IPD 共有サポート情報タイプ

  • 研究プロトコル
  • 統計分析計画 (SAP)
  • インフォームド コンセント フォーム (ICF)
  • 臨床試験報告書（CSR）
  • 分析コード

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

米国で製造され、米国から輸出された製品。

いいえ

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