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Tocilizumab for the Treatment of Cytokine Release Syndrome in Patients With COVID-19 (SARS-CoV-2 Infection)

2020年6月16日 更新者：Ajay Nooka、Emory University

Tociluzumab for Cytokine Release Syndrome With SARS-CoV-2: An Open-Labeled, Randomized Phase 3 Trial

This phase III trial compares the effect of adding tocilizumab to standard of care versus standard of care alone in treating cytokine release syndrome (CRS) in patients with SARS-CoV-2 infection. CRS is a potentially serious disorder caused by the release of an excessive amount of substance that is made by cells of the immune system (cytokines) as a response to viral infection. Tocilizumab is used to decrease the body's immune response. Adding tocilizumab to standard of care may work better in treating CRS in patients with SARS-CoV-2 infection compared to standard of care alone.

研究概览

地位

撤销

条件

干预/治疗

详细说明

PRIMARY OBJECTIVE:

I. To decrease the length of invasive mechanical ventilation (MV) and rate of 30-day mortality from CRS due to SARS-CoV-2.

SECONDARY OBJECTIVES:

I. To decrease the rates of intensive care unit (ICU) transfer. II. To decrease the rate of invasive mechanical ventilation (MV). III. To decrease the length of ICU stay. IV. To decrease the rate of tracheostomy. V. Safety and efficacy of tociluzumab. VI. Biomarker assessment for response.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive tocilizumab intravenously (IV) every 12 hours for up to 3 doses in the absence of disease progression or unacceptable toxicity. Patients also receive standard of care.

ARM II: Patients receive standard of care.

研究类型

介入性

阶段

  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

  • 美国
    • Georgia
      • Atlanta、Georgia、美国、30322
        • Emory University Hospital/Winship Cancer Institute

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Diagnosis with SARS-CoV-2 by the currently available assays (Food and Drug Administration [FDA] approved)

  • Should be hospitalized and exhibit at least one of the following predictors of mortality

    • Age >= 65 years
    • Current smoker (smoked >= 100 cigarettes in life and actively smoking)
    • Chronic obstructive pulmonary disease (COPD)
    • Diabetes
    • Hypertension
    • Coronary artery disease
    • Cerebrovascular accident (CVA)
    • Chronic renal disease (creatinine of >= 2 mg/dl)
    • Cancer
    • Patients that have C-reactive protein (CRP) >= 10 mg/L
    • D-dimer >= 0.5 mg/L
    • Procalcitonin >= 0.5 mg/L
    • Lactate dehydrogenase (LDH) >= upper limit of normal (ULN)
  • Patients or authorized family member willing to sign informed consent to participate in this study

Exclusion Criteria:

  • Pregnant or lactating women
  • Hypersensitivity to tocilizumab
  • Patients or authorized family member unwilling to sign informed consent to participate in this study
  • Uncontrolled tuberculosis, or any uncontrolled fungal infection (eg: candidemia)

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
实验性的：Arm I (tocilizumab, standard of care)
Patients receive tocilizumab IV every 12 hours for up to 3 doses in the absence of disease progression or unacceptable toxicity. Patients also receive standard of care.
生物：托珠单抗
鉴于IV
其他名称：
  • 罗氏
  • 阿克泰姆拉
  • 免疫球蛋白 G1，抗（人白细胞介素 6 受体）（人-小鼠单克隆 MRA 重链），二硫化物与人-小鼠单克隆 MRA Kappa-链，二聚体
  • 互认协议
  • R-1569
其他：最佳实践
接受护理标准
其他名称：
  • 护理标准
  • 标准疗法
有源比较器：第二组（护理标准）
患者接受标准护理。
其他：最佳实践
接受护理标准
其他名称：
  • 护理标准
  • 标准疗法

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
7-day length of invasive mechanical ventilation (MV)
大体时间：Up to 7 days
The 7-day length of invasive MV for each arm will be estimated with 95% confidence intervals (CIs) using the exact binomial distribution. Their difference by the arms will be tested by Cochran-Mantel-Haenszel (CMH) test stratified by the age group and Sequential Organ Failure Assessment (SOFA) score at significance level of 0.05.
Up to 7 days
30-day mortality rate
大体时间：Up to 30-day after randomization
Defined as death within 30-day after randomization. The 30-day mortality rate for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Up to 30-day after randomization

次要结果测量

结果测量
措施说明
大体时间
Rate of intensive care (ICU) transfer
大体时间：Up to 2 years
The rate of ICU transfer for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Up to 2 years
Rate of invasive mechanical ventilation
大体时间：Up to 2 years
The rate of invasive mechanical ventilation for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Up to 2 years
Rate of tracheostomy
大体时间：Up to 2 years
The rate of tracheostomy for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Up to 2 years
Length of ICU stay
大体时间：Up to 2 years
Will first be described by median and inter-quartile, and then compared between two arms by Wilcoxon Sum-Rank test
Up to 2 years
Length of hospital stay
大体时间：Up 2 years
Up 2 years

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Emory University

合作者

National Cancer Institute (NCI)

调查人员

  • 首席研究员：Ajay K Nooka、Emory University Hospital/Winship Cancer Institute

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2020年4月7日

初级完成 (实际的)

2020年6月2日

研究完成 (实际的)

2020年6月2日

研究注册日期

首次提交

2020年4月7日

首先提交符合 QC 标准的

2020年4月22日

首次发布 (实际的)

2020年4月24日

研究记录更新

最后更新发布 (实际的)

2020年6月18日

上次提交的符合 QC 标准的更新

2020年6月16日

最后验证

2020年6月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • STUDY00000419
  • P30CA138292 (美国 NIH 拨款/合同)
  • NCI-2020-02314 (注册表标识符：CTRP (Clinical Trial Reporting Program))
  • WINSHIP4998-20 (其他标识符：Emory University Hospital/Winship Cancer Institute)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

IPD 计划说明

Results of the trial and not individual patient data will be shared. The study protocol, consent, and investigator's brochure will be available. The statistical plan is incorporated into the protocol, along with inclusion and exclusion criteria.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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