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Teste de plataforma antiviral adaptativa para dengue (ADAPT)

23 de setembro de 2026 atualizado por: Oxford University Clinical Research Unit, Vietnam

Ensaio de plataforma antiviral adaptativo para dengue (ADAPT): um ensaio de fase 2 randomizado, adaptativo e aberto para triagem antiviral em pacientes com dengue sintomática 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

Visão geral do estudo

Status

Recrutamento

Condições

Intervenção / Tratamento

Descrição detalhada

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 de estudo

Intervencional

Inscrição (Estimado)

500

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

  • Nome: Sophie Yacoub, MD., PhD.
  • Número de telefone: +84 77728736
  • E-mail: syacoub@oucru.org

Estude backup de contato

  • Nome: Clinical Trials Unit Oxford University Clinical Research Unit
  • Número de telefone: +84 28 3924 1983
  • E-mail: CTU-Ethics@oucru.org

Locais de estudo

      • Kuala Lumpur, Malásia, 59100
        • Ainda não está recrutando
        • Universiti Malaya Medical Centre
        • Contato:
          • Hang Cheng Ong, Doctor
      • Ho Chi Minh City, Vietnã, 700000
        • Recrutamento
        • Hospital for Tropical Diseases, Ho Chi Minh city
        • Contato:
          • Lan TH Nguyen, Doctor
        • Investigador principal:
          • Lan TH Nguyen, Doctor
        • Subinvestigador:
          • Trieu T Huynh, Doctor
        • Subinvestigador:
          • Tho V Phan, Doctor
        • Subinvestigador:
          • Huy X Vo, Doctor
        • Subinvestigador:
          • Huong TC Nguyen, Doctor
        • Subinvestigador:
          • Phong T Nguyen, Doctor
        • Subinvestigador:
          • Vien TD Tran, Doctor
        • Subinvestigador:
          • Men TH Pham, Doctor
        • Subinvestigador:
          • Quy T Vo, Doctor

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

10 anos e mais velhos (Filho, Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição sequencial
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Sem intervenção: Standard of care (arm A)

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

Experimental: 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.

Outros nomes:
  • Molnupiravir STELLA 400 mg
Experimental: 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.

Outros nomes:
  • Anticorpo monoclonal da dengue (mAb da dengue/Dv Mab)
Experimental: 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.

Outros nomes:
  • VEKLURY™ for IV Infusion 100 mg

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Viral clearance rate
Prazo: 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)
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Area under the viremia curve
Prazo: 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
Prazo: 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
Prazo: 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)
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: Until day 30 post-enrolment

The lowest platelet count recorded during admission

Until day 30 post-enrolment
Maximum AST/ALT
Prazo: Until day 30 post-enrolment

The highest values of AST/ALT measured

Until day 30 post-enrolment
Change in haematocrit
Prazo: Until day 30 post-enrolment

Change in haematocrit during the hospitalisation

Until day 30 post-enrolment

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Sophie Yacoub, MD., PhD., University of Oxford, UK

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

20 de abril de 2026

Conclusão Primária (Estimado)

31 de dezembro de 2029

Conclusão do estudo (Estimado)

31 de dezembro de 2030

Datas de inscrição no estudo

Enviado pela primeira vez

6 de agosto de 2024

Enviado pela primeira vez que atendeu aos critérios de CQ

11 de agosto de 2024

Primeira postagem (Real)

13 de agosto de 2024

Atualizações de registro de estudo

Última Atualização Postada (Real)

28 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

23 de setembro de 2026

Última verificação

1 de abril de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 71DX

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano 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.

Prazo de Compartilhamento de IPD

starting 6 months after publications of study findings

Tipo de informação de suporte de compartilhamento de IPD

  • PROTOCOLO DE ESTUDO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .