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Convalescent Plasma Therapy - Zurich Protocol (CPT-ZHP)

27. april 2021 oppdatert av: University of Zurich

A Phase i, Open-label, Single-centre Clinical Study to Evaluate Safety and Efficacy of Passive Immunization of High-risk SARS-CoV-2 Positive Patients With Convalescent Plasma Therapy

This is an open-label, single-center, phase I study to assess the safety and efficacy of convalescent plasma therapy (CPT) obtained from donors who were tested positive for SARS-CoV-2 and fully recovered from the infection and administered to patients who are infected with the new coronavirus and present dyspnea or a poor prognosis

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The outbreak of a new highly contagious and life-threatening infective disease was first reported in China in December 2019. Regardless of the undertaken containing measures, its spreading could not be effectively stopped and currently we are confronting the pandemic diffusion of a newly identified Coronavirus (SARS-CoV-2) (1). This causes a systemic disease, known as (Coronavirus Disease-19) COVID-19, characterised by a broad spectrum of clinical manifestations, including ineffective hyper-inflammation and severe pneumonia, with provisional epidemiologic data indicating a mortality rate of 0.1-15% (2). Do to the lack of vaccination, specific anti-virus sera or monoclonal antibodies, the therapeutic efforts to limit COVID-19 mostly rely on the empirical use of anti-viral drugs. Therefore, being the option of an active immunisation not available and because of the controversial efficacy of the available anti-viral therapies (3), we suggest the option of a passive immunisation for those patients who are infected with the new coronavirus and present dyspnea or a poor prognosis. The use of convalescent plasma, i.e. plasma obtained from donors who were tested positive for SARS-CoV-2 and fully recovered from the infection, could provide a rapid protection, limiting the observed evolution of COVID-19 towards life-threating manifestations (7-9).

When carried on according to standardised measures, the transfusion of plasma is highly safe (10-11) and we assume that products containing anti- SARS-CoV- 2 antibodies will provide the recipients a passive immunity through different mechanisms, including viral neutralisation, antibody-dependent cellular cytotoxicity and/or phagocytosis.

Studietype

Intervensjonell

Registrering (Faktiske)

30

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Sveits
      • Zürich, Sveits, 8091
        • University Hospital Zurich

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

A) Proven Sars-CoV-2 by PCR and hospitalization for COVID-19 in combination with either (1) or (2):

  1. Age ≥50

    AND (at least one):

    • Pre-existing cardiovascular disease
    • Diabetic disease
    • Immunodeficiency/immunosuppression
    • Neoplastic disease
    • COPD or chronic liver disease or chronic renal failure
  2. Age ≥18

AND (at least one):

  • SpO2 ≤ 94% on room air or requiring supplemental oxygen at screening
  • Typical changes on chest x-ray and/or lung-CT scan
  • Immunosuppression or neoplastic disease

B) Informed Consent as documented by signature (Appendix Informed Consent Form) of the patient or, in case of inability, of the next relative/care-taking person. In the latter case, an independent doctor will also be involved and her/his signature will be required in order to enrol the patient.

Exclusion Criteria:

  1. Contraindications to the class of drugs under study, e.g. known hypersensitivity or allergy to class of drugs or the investigational product (FFP)
  2. Known IgA deficiency
  3. Cytokine Release Syndrome grade ≥3 (see score)*
  4. ARDS
  5. Patients already hospitalized in intensive care unit and/or already receiving mechanical ventilation
  6. Known or suspected non-compliance, drug or alcohol abuse
  7. Previous enrolment into the current study
  8. Enrolment of the investigator, his/her family members, employees and other dependent persons
  9. Women who are pregnant or breast feeding
  10. Intention to become pregnant during the course of the study
  11. Lack of safe contraception, defined as: Female participants of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases. Please note that female participants who are surgically sterilised / hysterectomised or post-menopausal for longer than 2 years are not considered as being of child bearing potential

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Safety of CPT applied to COVID-19 patients
Tidsramme: clinical observation up to 48 hours after the last dose of plasma
Absence of clinical signs of Transfusion Related Lung Inflammation (TRALI) and/or allergic reactions and/or Transfusion Associated Circulatory Overload (TACO)
clinical observation up to 48 hours after the last dose of plasma
Safety of CPT applied to COVID-19 patients
Tidsramme: 1 week (laboratory monitoring up to 7 days after the last administration of plasma)
Absence of laboratory signs of haemolytic reactions
1 week (laboratory monitoring up to 7 days after the last administration of plasma)
Improvement of respiratory frequency
Tidsramme: 3 weeks after the last administration of plasma
Respiratory frequency will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of O2-saturation
Tidsramme: 3 weeks after the last administration of plasma
O2-Saturation will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of Inflammatory markers (C Reactive Protein, CRP)
Tidsramme: 3 weeks after the last administration of plasma
CRP will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of Inflammatory markers (Ferritin)
Tidsramme: 3 weeks after the last administration of plasma
Ferritin will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of Inflammatory markers (IL-6)
Tidsramme: 3 weeks after the last administration of plasma
IL-6 will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of coagulation-markers (D-dimer)
Tidsramme: 3 weeks after the last administration of plasma
D-Dimer will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of coagulation-markers (Fibrinogen)
Tidsramme: 3 weeks after the last administration of plasma
Fibrinogen will be measured at each study visit
3 weeks after the last administration of plasma
Improvement of coagulation-markers (LDH)
Tidsramme: 3 weeks after the last administration of plasma
LDH will be measured at each study visit
3 weeks after the last administration of plasma
Prevention of ICU-admission
Tidsramme: 3 weeks after the last administration of plasma
clinical conditions will be assessed throughout the study
3 weeks after the last administration of plasma

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Characterisation of virus reaction to plasma Therapy
Tidsramme: 10 Weeks
Measurement of viral load after plasma therapy
10 Weeks
Characterisation of the dynamic of humoral response after therapy
Tidsramme: 10 Weeks
Measurement of antibody-titres after plasma therapy
10 Weeks
Better characterize the the in-vivo anti-virus humoral response against SARS-CoV-2.
Tidsramme: 10 Weeks
Performance of neutralisation assay after administration of plasma
10 Weeks

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of Zurich

Etterforskere

  • Studiestol: Markus Manz, Professor, University of Zurich

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

29. april 2020

Primær fullføring (Faktiske)

30. november 2020

Studiet fullført (Faktiske)

30. mars 2021

Datoer for studieregistrering

Først innsendt

8. april 2021

Først innsendt som oppfylte QC-kriteriene

27. april 2021

Først lagt ut (Faktiske)

3. mai 2021

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

3. mai 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

27. april 2021

Sist bekreftet

1. april 2021

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 2020-00787

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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