- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT04743011
Enriched Heparin Anti COVID-19 Trial (EnHanCed)
Nebulized Enriched Heparin to Treat no Critical Patients With Sars-Cov-2 - Triple Blind Clinical Trial
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
In view of the enormous health, financial and social crisis resulting of the pandemic caused by SARS-Cov-2, it is justified to urgently conduct tests with possible antiviral drugs. The high molecular weight heparin (HMWH) (heparin enriched by ultrafiltration process) proposed by this study, has a potential inhibition activity over viral replication, demonstrated by preliminary in vitro tests, carried out in a model established in partnership with the Laboratory of Clinical and Molecular Virology (LVCM) of the Institute of Biomedical Sciences of the University of São Paulo (ICB-USP).
Along with the findings in the literature, such as the study carried out by Phelps, M.K. et al (2020), among others, the use of inhaled heparin presents adequate levels of safety to be used in a clinical trial. Taking into account that the dose of high molecular weight heparin (enriched by this study team) with antiviral activity in vitro is much lower than the doses currently presented in published clinical trials using inhaled UFH, we have the safety premise to carry out this study. The intentions of this study differ from what has been presented in the world literature so far, as it does not aim to induce anticoagulation, nor to effectively inhibit the formation of pulmonary fibrin, but rather, to act as an inhibitor of viral replication.
Also, as characteristics of the product to be tested, this heparin (HMWH) is presented in a buffered solution free of low-sulfated low-weight molecules, which is obtained in a sterile environment through ultrafiltration of the unfractionated solution of porcine origin available in Brazil (Hemofol - Cristália) using Centriprep-10kDa® centrifuge filter (Millipore ™) used as recommended by the manufacturer.
The high molecular weight heparin (HMWH) - enriched heparin - had two process patents filed, one under the description "HIGH MOLECULAR WEIGHT DEFINITION HEPARINE DEVELOPMENT PROCESS", BR 102014027804-4 A2 - granted by the Instituto Nacional de Propriedade Industrial (INPI) and another with the description "COMPOSITION OF HIGH MOLECULAR WEIGHT NON-FRACTIONAL HEPARINE FOR ANTIVIRAL ACTION ", BR 102020 011964-8 - deposited at INPI.
Studietype
Registrering (Forventet)
Fase
- Fase 2
- Fase 1
Kontakter og plasseringer
Studiekontakt
- Navn: Matheus Bertanha, PhD
- Telefonnummer: +55(14)3880-1444
- E-post: matheusbertanha@gmail.com
Studer Kontakt Backup
- Navn: Carlos Magno CB Fortaleza, PhD
- Telefonnummer: +55(14)3880-1284
- E-post: carlos.fortaleza@unesp.br
Studiesteder
-
-
SP
-
Botucatu, SP, Brasil, 18607030
- Har ikke rekruttert ennå
- School of Medicine at Botucatu- Paulista State University- UNESP, São Paulo, Brazil
-
Ta kontakt med:
- Matheus Bertanha, PhD
- Telefonnummer: +55 14 3880-1444
- E-post: matheusbertanha@gmail.com
-
Ta kontakt med:
- Carlos Magno CB Fortaleza, PhD
- Telefonnummer: +55 14 38801284
- E-post: carlos.fortaleza@unesp.br
-
Hovedetterforsker:
- Matheus Bertanha, PhD
-
-
Sao Paulo
-
Botucatu, Sao Paulo, Brasil, 18618970
- Rekruttering
- Hospital das Clinicas de Boucatu
-
Ta kontakt med:
- Matheus Bertanha, Ph.D.
- Telefonnummer: +55(14)3880-1444
- E-post: matheusbertanha@gmail.com
-
Ta kontakt med:
- Carlos M Fortaleza, Ph.D.
- Telefonnummer: +55(14)3880-1284
- E-post: carlos.fortaleza@unesp.br
-
Hovedetterforsker:
- Matheus Bertanha, Ph.D.
-
Underetterforsker:
- Pedro L Mellucci Filho, M.D.
-
Underetterforsker:
- Vinicius R Grillo, M.D.
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Underetterforsker:
- Nathalia D Sertorio, M.D.
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Signature and agreement to the Free Consent Form;
- Both sexes, of any ethnic origin, aged between 18 and 90 years;
- COVID-19 infected patients diagnosed by RT-PCR (reverse-transcriptase polymerase chain reaction) or with a strong suspicion of COVID-19 by clinical evaluation through compatible clinical and radiological findings;
- Time of disease evolution less than 10 days;
- Radiological diagnosis of grade 2A pneumonia, with gas exchange ratio > 200 on blood gas analysis (paO2 / pFiO2), characterizing mild hypoxemia;
- Indication of hospital treatment regime, provided that the period of hospitalization before inclusion is not more than 24 hours;
- Need for supplemental oxygen therapy (O2) less than 5L / min.
Exclusion Criteria:
- No agreement to the terms of this study;
- Moderate or severe respiratory failure requiring admission to the ICU and the need for invasive mechanical ventilation or non-invasive ventilation (NIV) with positive pressure;
- Pregnancy or puerperium;
- Patients with hematological diseases, coagulation disorders, use of anticoagulants, previous heparin-induced allergy or thrombocytopenia, thrombocytopenia with a count of fewer than 50,000 platelets / mm3;
- COVID-19 not confirmed by RT-PCR within 72 hours of inclusion in the study.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Placebo komparator: Placebo
Participants will receive inhalation with 5mL 0.9% saline solution (placebo), 4/4h, during the day period (5 doses).
|
Nebulized inhalation of 5 mL of 0.9% saline solution, every 4 hours for 7 days, except during the nighttime (5 doses/day)
Andre navn:
|
Aktiv komparator: Heparin sodium
Participants will receive inhalation with 5mL 0.9% saline solution + 2,5mg of high molecular weight heparin - enriched heparin, 4/4h, during the day period (5 doses).
|
Nebulized inhalation of 5 mL of a solution containing high molecular weight heparin - enriched heparin - 2.5mg/mL and 0.9% saline solution, every 4 hours for 7 days, except during the nighttime (5 doses/day)
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Change in activated partial thromboplastin time (APTT) > 1.5
Tidsramme: Immediately or up to 8 days after starting treatment
|
Safety-related to the use of high molecular weight heparin inhaled in patients with SARS-COV-2 through the assessment of hemorrhagic events of any nature, alteration of the coagulogram that indicates an increase in APTT> 1.5, heparin-induced thrombocytopenia.
|
Immediately or up to 8 days after starting treatment
|
Viral load in nasal swab reverse transcription polymerase chain reaction (RT-PCR).
Tidsramme: Immediately or up to 8 days after starting treatment
|
Effectiveness related to the proposed treatment, based on the analysis of the viral load of SARS-COV-2 virus in the participants through a sequential assessment of the viral load in nasal swab RT-PCR.
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Immediately or up to 8 days after starting treatment
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Number of participants needing supplemental oxygen therapy
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of respiratory parameters measured by the need for supplemental oxygen therapy at greater doses than 5L/min;
|
Immediately or up to 8 days after starting treatment
|
Number of participants needing mechanical pulmonary ventilation
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of respiratory parameters measured by the need of definitive airway assisted pulmonary ventilation;
|
Immediately or up to 8 days after starting treatment
|
Number of hospitalization days
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by a prolonged hospital stay;
|
Immediately or up to 8 days after starting treatment
|
Number of participants that develop renal failure
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by renal failure through measurement of urea and creatinine;
|
Immediately or up to 8 days after starting treatment
|
Number of participants that develop major cardiovascular events
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by major cardiovascular events (pulmonary embolism, acute myocardial infarction)
|
Immediately or up to 8 days after starting treatment
|
Number of participants transferred to the intensive care unit (ICU)
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by need for Intensive Care Unit (ICU) treatment;
|
Immediately or up to 8 days after starting treatment
|
Number of participants presenting secondary pulmonary bacterial infections
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by presentation of secondary pulmonary bacterial infections (pneumonia);
|
Immediately or up to 8 days after starting treatment
|
Number of participants that develop deep vein thrombosis (DVT)
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by deep vein thrombosis (DVT);
|
Immediately or up to 8 days after starting treatment
|
Number of participants that develop pancreatitis
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by pancreatitis through measurement of amylase (> 200 U/L);
|
Immediately or up to 8 days after starting treatment
|
Number of participants that need corticosteroid therapy
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by need for hydrocortisone, dexamethasone or other corticosteroids due to inflammatory pulmonary disease;
|
Immediately or up to 8 days after starting treatment
|
Number of deaths among participants
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of clinical parameters characterized by death;
|
Immediately or up to 8 days after starting treatment
|
Number of participants with increased white blood cell count
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of laboratory parameters measured by increased white blood cell count (>10.000
cells/mm³);
|
Immediately or up to 8 days after starting treatment
|
Number of participants with increased C reactive protein test
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of laboratory parameters measured by increase in C reactive protein test (>3.00mg/L);
|
Immediately or up to 8 days after starting treatment
|
Number of participants with deterioration of arterial blood gas paO2/pFiO2 ratio
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of laboratory parameters measured by alterations in arterial blood gas measured by paO2/pFiO2 < 200;
|
Immediately or up to 8 days after starting treatment
|
Number of participants with altered sodium
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of laboratory parameters measured by alterations in sodium (< 135mEq/L or > 145mEq/L)
|
Immediately or up to 8 days after starting treatment
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Number of participants with altered potassium
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of laboratory parameters measured by alterations in potassium (< 3,5mEq/L or > 5,5mEq/L);
|
Immediately or up to 8 days after starting treatment
|
Number of participants with increased pulmonary area compromised (%)
Tidsramme: Immediately or up to 8 days after starting treatment
|
Worsening of tomographic parameters measured by the pulmonary area compromised by the infection and/or inflammation.
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Immediately or up to 8 days after starting treatment
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Matheus Bertanha, PhD, São Paulo State University (Unesp)
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Forventet)
Studiet fullført (Forventet)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Coronavirus-infeksjoner
- Coronaviridae-infeksjoner
- Nidovirales infeksjoner
- RNA-virusinfeksjoner
- Virussykdommer
- Infeksjoner
- Luftveisinfeksjoner
- Sykdommer i luftveiene
- Lungebetennelse, viral
- Lungebetennelse
- Lungesykdommer
- Covid-19
- Molekylære mekanismer for farmakologisk virkning
- Fibrinolytiske midler
- Fibrinmodulerende midler
- Antikoagulanter
- Heparin
- Kalsiumheparin
- Farmasøytiske løsninger
Andre studie-ID-numre
- UPECLIN-MB-2
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
IPD-delingstidsramme
Tilgangskriterier for IPD-deling
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
- SEVJE
- ICF
- CSR
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
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