Virus DiseasesPhase 2NCT02927431
Study to Evaluate the Efficacy and Safety of Danirixin Co-administered With Oseltamivir in the Treatment of Adults Hospitalized With Influenza
A Phase 2 study testing Danirixin 15 mg FBE, Danirixin 50 mg FBE and Oseltamivir 75 mg in people with Virus Diseases, run by GlaxoSmithKline at 8 sites in 4 countries.
Trial summary
Danirixin (DNX) is a novel, selective, and reversible antagonist of the C-X-C chemokine receptor (CXCR) 2 and has been shown to decrease neutrophil transmigration and activation to areas of inflammation. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Virus Diseases
- What is being tested?
- Danirixin 15 mg FBE, Danirixin 50 mg FBE and Oseltamivir 75 mg
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 10 participants
- Where
- 8 sitesin 4 countries
- Study dates
- 19 Jan 2017to 24 May 2017
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults 18 years (as per local laws) of age and older at the time of signing the informed consent.
- Presence of fever (>=38.0 degree Celsius [>=100.4 degree Fahrenheit] by any route) at Baseline (enrollment) or history of fever/feverishness during the 48 hours prior.
- Oxygen (O2) saturation <95% on room air by trans-cutaneous method OR need for any supplemental oxygenation (non-invasive ventilation, facemask, facetent, nasal canula, etc) or ventilator support (mechanical ventilation, bi-level positive airway pressure [BIPAP], continuous positive airway pressure [CPAP]) or increase in oxygen supplementation requirement of >=2 liters for subjects with chronic oxygen dependency. For those subjects with a history of chronic hypoxia (without supplemental oxygen), an oxygen saturation of at least 3% below the subject's historical baseline oxygen saturation.
- And at least 2 out of the following 3: respiratory rate >24 breaths per minute. For those subjects who require ventilator support or oxygen supplementation, this requirement is waived; heart rate >100 beats per minute; SBP <90 millimeters of mercury (mm Hg).
- Severity of symptoms at enrollment: 1) Less severe hospitalized subjects are those who (but not limited to): are hemodynamically stable; may require oxygenation with facemask, facetent, nasal canula, etc; may or may not have radiological signs of lower respiratory tract disease; or have exacerbation of underlying chronic disease, including asthma, chronic obstructive pulmonary disease (COPD), or other cardiovascular conditions not leading to hemodynamic compromise. 2) Critically ill hospitalized subjects are those who (but not limited to): require CPAP, BIPAP, mechanical ventilation; have hemodynamic instability (with or without pressor support); or have central nervous system involvement (example encephalopathy, encephalitis).
- Presence of influenza that in the Investigator's judgment requires hospitalization for treatment and supportive care
Show all 16Show fewer
- Onset of influenza symptoms within 6 days prior to study enrolment. Symptoms may include cough, dyspnea, sore throat, feverishness, myalgias, headache, nasal symptoms (rhinorrhea, congestion), fatigue, diarrhea, nausea and vomiting.
- A positive result from a rapid influenza test (provided by GlaxoSmithKline [GSK]) or other available, local laboratory diagnostic test
- Baseline renal criteria as follows: 1) Sentinel Cohorts: Normal renal function: Baseline creatinine clearance within normal reference ranges (>=80 milliliter per minute (mL/min) for the first approximately 30 subjects enrolled; Mild renal impairment: Baseline creatinine clearance of 50-79 mL/min for the next approximately 10 subjects enrolled into the sentinel cohort; Moderate renal impairment: Baseline creatinine clearance of 30-49 mL/min for the next approximately 10 subjects enrolled into the sentinel cohort. 2) Post-sentinel cohorts: Normal renal function, mild or moderate renal impairment: creatinine clearance >30mL/min.
- Baseline Liver Function Tests: Subjects will be included if:
- ALT is <=5 times the upper limit of normal (ULN) and bilirubin is <=2 times the ULN
- ALT is >5 but <=8 times the ULN and bilirubin is < 1.5 times the ULN
- Male or Female subjects could be eligible if: Male subjects with female partners of child bearing potential must comply with the pre-specified highly effective contraception requirements from the time of first dose of study medication until at least 36 hours (five half-lives) after the last dose of study medication. 1) Vasectomy with documentation of azoospermia 2) Male condom plus partner use of one of the contraceptive options below: Contraceptive subdermal implant; Intrauterine device or intrauterine system; Oral Contraceptive, either combined or progestogen alone; Injectable progestogen; Contraceptive vaginal ring; Percutaneous contraceptive patches
- For females, non-reproductive potential defined as: 1) Pre-menopausal females with one of the following: Documented tubal ligation; Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion; Hysterectomy; Documented Bilateral Oophorectomy 2) Postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) and estradiol levels consistent with menopause (refer to laboratory reference ranges for confirmatory levels)]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrolment. 3) Reproductive potential and agrees to follow one of the options listed in the Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) from the first dose of study medication until at least 36 hours after the last dose of study medication and completion of the post treatment (PT) Day 3 visit. The investigator is responsible for ensuring that subjects understand how to properly use these methods of contraception.
- Subjects willing and able to give written informed consent to participate in the study and to adhere to the procedures stated in the protocol OR Legally acceptable representative (LAR) willing and able to give written informed consent on behalf of the subject to participate in the study for unconscious adults, and those incapable of consenting themselves due to their medical condition (e.g. too weak or debilitated, severe shortness of breath), due to literacy issues or included as permitted by local regulatory authorities, institutional review board (IRB)/independent ethics committee (IECs) or local laws.
- French subjects: In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category.
Who cannot join
- Subjects who, in the opinion of the investigator, are not likely to survive the next 48 hours beyond Baseline;
- Immunosuppression, whether due to primary immunosuppressive conditions, such as history of inherited immunodeficiency syndromes, human immunodeficiency virus (HIV) infection, or secondary conditions, such as immunosuppressive medication, stem cell or solid organ transplantation, or malignancy;
- Documented current liver disease (including Hepatitis A, B, or C), or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones);
- Baseline Liver Function Tests: Subjects will be excluded if:
- ALT >8 times the ULN
- Bilirubin is >2 times the ULN
Show all 18Show fewer
- Corrected QT Interval (QTc) Criteria: Corrected QT Interval using Bazette's formula (QTcB) or Corrected QT Interval using Fridericia forumula (QTcF) >480 millisecond (msec) or >500 msec with bundle branch block;
- For subjects enrolled in the sentinel cohorts: diabetes mellitus and chronic kidney disease;
- Subjects who require dialysis, or are on renal replacement therapies;
- Subjects who require extra corporeal membrane oxygenation (ECMO) at baseline (enrolled subjects who subsequently require ECMO may continue in the study)
- Women who are pregnant as determined by a positive human chorionic gonadotrophin (hCG) ultrasensitive test prior to dosing or women who are breastfeeding;
- Subjects who received other treatments for influenza including vitaglutam, umifenovir, and neuraminidase inhibitors (oseltamivir, zanamivir, peramivir) for more than 72 hours during current acute illness;
- Subjects who received any immunoglobulins within 6 months of screening or planned administration of any of these products during the treatment period.
- Subjects treated with cytotoxic or immunosuppressive drugs within six months of study enrolment. Topical, intra-articularly injected, or inhaled glucocorticoids, topical calcineurin inhibitors or imiquimod are allowed.
- Known history of drug abuse within 6 months of study start.
- History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or Medical Monitor, contraindicates their participation.
- Absolute neutrophil count <1.0 giga per Liter (Gi/L)
- Subjects who have participated in a clinical trial using an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
Trial locations and contacts
8 sites in 4 countries.
8 sites in 4 countries
United States5 sites
GSK Investigational Site
Council Bluffs, Iowa, 51503
GSK Investigational Site
Durham, North Carolina, 27710
GSK Investigational Site
Natchitoches, Louisiana, 71457
GSK Investigational Site
Salem, Virginia, 24153
GSK Investigational Site
Stamford, Connecticut, 06902
About this study
Official title: A Phase II, Global, Randomized Study to Evaluate the Efficacy and Safety of Danirixin (GSK1325756) Co-administered With a Standard-of-care Antiviral (Oseltamivir), in the Treatment of Adults Hospitalized With Influenza
Danirixin (DNX) is a novel, selective, and reversible antagonist of the C-X-C chemokine receptor (CXCR) 2 and has been shown to decrease neutrophil transmigration and activation to areas of inflammation. An intravenous (IV) formulation of DNX hydrobromide (HBr) is being developed as an anti-inflammatory agent for treatment of adults hospitalized with influenza (IFV). While early therapy with antivirals decreases severity and duration of symptoms of influenza, there are no drugs that have demonstrated clinical efficacy in randomized clinical trials in this population. Current treatment guidelines for hospitalized IFV recommend neuraminidase inhibitors as standard of care therapy. IFV studies in animals have demonstrated that therapeutic treatment with the combination of a CXCR2 antagonist and a neuraminidase inhibitor reduced lung neutrophils and showed trends for improvements in clinical scores, lung function and pathology with no evidence of worsening outcomes, including viral load. This Phase 2, randomized, double-blind (for IV DNX), placebo-controlled (for IV DNX) 3-arm study will be the first study to determine the efficacy and safety of IV DNX when co-administered (in all groups) with standard of care antiviral treatment (open-label oral oseltamivir [OSV]) in subjects hospitalized with IFV. The primary objective of the study is to assess the efficacy of treatment with IV DNX twice daily given with oral OSV compared to oral OSV twice daily on time to clinical response (TTCR). In this study, subjects will be randomized in a 2:2:1 ratio to 15 milligram (mg) free base equivalent (FBE) IV DNX, 50 mg FBE IV DNX, or matching placebo twice daily. All subjects will also receive open-label 75 mg oral OSV, twice daily (given as standard of care). The study treatment duration will be for up to 5 days. The investigator may elect to continue treatment with OSV after 5 days of study treatment. Follow up will continue until Day 45 for all subjects. The study will begin with enhanced safety monitoring in sentinel cohorts, leading to stepwise enrollment of subjects. Subjects will be enrolled based on increasing levels of renal impairment, and less severe hospitalized subjects will be enrolled prior to enrollment of critically ill subjects, as this is the first study conducted in the hospitalized population with severe IFV. Approximately 300 subjects are targeted to be enrolled in the study.
- Conditions
- Virus Diseases
- Being tested
- Danirixin 15 mg FBE, Danirixin 50 mg FBE, Placebo, Oseltamivir 75 mg
- Keywords
- Anti-inflammatory, Danirixin, Influenza, Hospitalized patients
- Medical subject headings
- Virus Diseases, Influenza, Human
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Danirixin 15 mg FBEDrug
This intervention is available as a 50 mg FBE sterile lyophilized powder containing DNX (hydrobromide salt hemihydrate) equivalent to 50mg of free base along with Beta-cyclodextrin sulfobutylether, mannitol, citric acid and sodium hydroxide. The formulation is supplied as lyophilized powder/cake contained in a 30mL vial. Each vial is reconstituted with 9.5 mL water for injection and further diluted with saline for IV infusion to provide a dose of 15 mg FBE.
Danirixin 50 mg FBEDrug
This intervention is available as a 50 mg FBE sterile lyophilized powder containing DNX (hydrobromide salt hemihydrate) equivalent to 50mg of free base along with Beta-cyclodextrin sulfobutylether, mannitol, citric acid and sodium hydroxide. The formulation is supplied as lyophilized powder/cake contained in a 30mL vial. Each vial is reconstituted with 9.5 mL water for injection and further diluted with saline for IV infusion.
PlaceboDrug
No vials of placebo to match IV DNX will be provided. A normal saline solution of matched volume will be prepared by unblinded personnel at the site to act as a placebo to DNX. Clear solution of placebo will be administered as IV infusion.
Oseltamivir 75 mgDrug
Oseltamivir (Tamiflu - manufactured by Roche) formulation is available as 75 mg Capsule and as powder for oral suspension. After constitution with 55 mL of water, each bottle delivers a usable volume of 60 mL of oral suspension equivalent to 360 mg oseltamivir base (6 mg/mL). No oseltamivir capsules or powder for oral suspension will be provided. Sites will source the OSV locally and it will be provided open-label.
| Study group | Role | What they receive |
|---|---|---|
| Danirixin 15 mg FBE IV plus 75 mg oseltamivir | Experimental | Subjects will receive double blind 15 mg FBE IV danirixin twice daily with open label 75 mg oral oseltamivir twice daily for 5 days. If a subject is discharged from the hospital in less than 5 days, treatment with IV DNX will be discontinued. Receives: Drug: Danirixin 15 mg FBE; Drug: Oseltamivir 75 mg |
| Danirixin 50 mg FBE IV plus 75 mg oseltamivir | Experimental | Subjects will receive double blind 50 mg FBE IV danirixin twice daily with 75 mg oral oseltamivir twice daily for 5 days. If a subject is discharged from the hospital in less than 5 days, treatment with IV DNX will be discontinued. Receives: Drug: Danirixin 50 mg FBE; Drug: Oseltamivir 75 mg |
| Placebo of danirixin IV plus 75 mg oseltamivir | Placebo comparator | Subjects will receive double blind IV placebo of DNX twice daily with 75 mg oral oseltamivir twice daily for 5 days. If a subject is discharged from the hospital in less than 5 days, treatment with IV DNX will be discontinued. Receives: Drug: Placebo; Drug: Oseltamivir 75 mg |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to Clinical Response (TTCR)
The clinical response was defined as Hospital discharge due to clinical improvement OR normalization of temperature; and oxygen saturation; and respiratory status/heart rate/systolic blood pressure (normalization of 2 out of these 3 parameters). The clinical response based on vital signs/ventilation status required 24-hour confirmation. Considering 2-hour assessment window, the response confirmation period was 22 hours. Kaplan Meier estimates for the median of TTCR was provided. One participant had vital sign resolution at Baseline and was counted as having a clinical response but was not included in the Kaplan Meier Estimates. Influenza Positive Population (IPP) Population comprised of all participants in the Intent to Treat Exposed (ITT-E) Population with influenza infection (positive influenza Polymerase Chain Reaction [PCR] or culture at any time point) confirmed by central lab testing. Only those participants with data available at the indicated time point were analyzed.
Measured: Up to 45 Days
Secondary outcomes (24)
Time to Respiratory Response (TTRR)
Time to Respiratory Response was defined as meeting at least one of the following criteria, and maintained for 24 hours: return to pre-morbid oxygen requirement (participants with chronic oxygen use or ventilator support), or return to no requirement of supplemental oxygen, or respiratory rate <=24 per minute (without supplemental oxygen). Kaplan Meier estimates for the median of TTRR for each treatment group was provided. NA indicates data is not available. Due to limited data, no TTRR estimate could be calculated for any of the treatment groups.
Measured: Up to 45 Days
Time to Absence of Fever
Time from first dose of treatment to time to afebrile status (<=36.6 degree celsius-axilla/temporal or <=37.2 degree celsius- oral, or <=37.7 degree celsius-rectal/core, tympanic) was to be evaluated.
Measured: Up to 45 Days
Time to Improved Oxygen Saturation
Time from first dose of treatment to time of improved oxygen saturation was to be calculated. A participant with a history of chronic hypoxia (without supplemental oxygen) satisfied normalization criteria for oxygen saturation if the value (without supplemental oxygen) is <=2 percent from participant's historical oxygen saturation Baseline as recorded within 12 months prior to enrollment as documented in the participant's medical records. This requirement was to be waived for participants with a history of chronic supplemental oxygen requirement who had a Baseline oxygen saturation <95 percent with supplemental oxygen, within 12 months prior to enrollment as documented in the participant's medical records.
Measured: Up to 45 Days
Time to Improved Heart Rate
Time from first dose of treatment to time of heart rate <=100 beats per minute was to be evaluated.
Measured: Up to 45 Days
Time to Improved Systolic Blood Pressure (SBP)
Time from first dose of treatment to time of SBP at >=90 millimeters of mercury (mmHg) was to be evaluated.
Measured: Up to 45 Days
Percentage of Participants With Clinical Response Over Time
The clinical response was defined as Hospital discharge due to clinical improvement OR normalization of temperature; and oxygen saturation; and respiratory status/heart rate/systolic blood pressure (normalization of 2 out of these 3 parameters). The clinical response based on vital signs/ventilation status required 24-hour confirmation. Considering 2-hour assessment window, the response confirmation period was 22 hours. Percentage of participants with positive clinical response are presented.
Measured: Up to 45 Days
Percentage of Participants With Improved Respiratory Status Over Time
The Respiratory Response was defined as meeting at least one of the following criteria, and maintained for 24 hours: return to pre-morbid oxygen requirement (participants with chronic oxygen use or ventilator support), or return to no requirement of supplemental oxygen, or respiratory rate <=24 per minute (without supplemental oxygen). Percentage of participants with improved respiratory status has been presented.
Measured: Up to 45 Days
Time to Improvement of Ventilation Status
Time to improvement of ventilation status was assessed by modality, frequencies and durations of invasive and non-invasive ventilator support, duration of oxygen supplementation.
Measured: Up to 45 Days
Number of Days of Stay in the Intensive Care Unit (ICU)
Number of days of stay in the ICU over the treatment period and post treatment period was to be recorded.
Measured: Up to 45 Days
Number of Participants Requiring ICU Admission and Readmission
Number of participants requiring ICU admission during treatment period and after post treatment was to be recorded.
Measured: Up to 45 Days
Number of Days of Stay in the Hospital
Number of days of stay in the hospital over treatment period and post treatment period was to be recorded.
Measured: Up to 45 Days
Number of Participants With Development of Septic Shock
Development of septic shock was to be assessed by occurrence of hypotension requiring vasopressive therapy and serum lactate level >2 millimeter (mm) after adequate fluid resuscitation. Number of participants with development of septic shock were planned to be presented.
Measured: Up to 45 Days
Number of Participants Used Antibiotics for Complications of Influenza
Complications of influenza such as bacterial pneumonia, pneumothorax, pleural effusion, acute respiratory distress syndrome (ARDS), myositis, encephalitis, myocarditis, and associated antibiotic use was recorded. Number of participants who reqruied use of associated antibiotics for complications of influenza is presented.
Measured: Up to 45 Days
Number of Participants With Improvement in Ordinal Scale of Clinical Efficacy Over Time
Number of participants with improvement in ordinal scale of clinical efficacy over time was to be assessed by: death, mechanical vent, in the ICU, non-ICU hospitalization, and hospital discharge.
Measured: Up to 45 Days
Number of Participants With Any Non-serious Adverse Event (AE); Any Serious AE (SAE); Any AEs of Special Interest (AESIs)
An AE is any untoward medical occurrence in a participant or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Any untoward event resulting in death, life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, congenital anomaly/birth defect, any other situation according to medical or scientific judgment that may not be immediately life-threatening or result in death or hospitalization but may jeopardize the participant or may require medical or surgical intervention or event associated with liver injury and impaired liver function were categorized as SAE. Participants who received any of the study treatment and had any AE or SAE or AESI were considered for analysis. Safety Population comprised of all participants who received at least 1 dose of study treatment.
Measured: Up to 45 Days
Change From Baseline in Albumin and Total Protein
Blood samples were collected to evaluate albumin and total protein at indicated time points. Values at Day 1 were considered as Baseline values. Change from Baseline at each visit was calculated by subtracting Baseline value from post-dose visit value. Only those participants with data available at the specified time points were analyzed (represented by n=X in the category titles). NA indicates data is not available.
Measured: Baseline and up to 45 days
Change From Baseline in White Blood Cell Count (WBC) and Absolute Neutrophil Count (ANC)
Blood samples were collected to evaluate WBC and ANC at indicated time points. Values at Day 1 were considered as Baseline values. Change from Baseline at each visit was calculated by subtracting Baseline value from post-dose visit value. Only those participants with data available at the specified time points were analyzed (represented by n=X in the category titles). NA indicates data is not available.
Measured: Baseline and up to 45 days
Change From Baseline in Total Bilirubin (T. Bilirubin), Creatinine and Direct Bilirubin (D. Bilirubin)
Blood samples were collected to evaluate T. Bilirubin, creatinine and D. Bilirubin at indicated time points. Values at Day 1 were considered as Baseline values. Change from Baseline at each visit was calculated by subtracting Baseline value from post-dose visit value. Only those participants with data available at the specified time points were analyzed (represented by n=X in the category titles). NA indicates data is not available.
Measured: Baseline and up to 45 days
Change From Baseline in Alanine Amino Transferase (ALT), Aspartate Amino Transferase (AST) and Alkaline Phosphatase (ALP)
Blood samples were collected to evaluate ALT, AST and ALP at indicated time points. Values at Day 1 were considered as Baseline values. Change from Baseline at each visit was calculated by subtracting Baseline value from post-dose visit value. Only those participants with data available at the specified time points were analyzed (represented by n=X in the category titles). NA indicates data is not available.
Measured: Baseline and up to 45 days
Number of Participants With Clinically Significant Abnormality in Electrocardiogram (ECG)
Single 12-lead ECGs were obtained at Baseline and on the day of last dose during the study using an ECG machine that automatically calculates the heart rate (HR) and measures PR, QRS, QT, and QT duration corrected for heart rate (QTc). Number of participants with clinically significant abnormality in ECG are presented.
Measured: Up to 6 days
Maximum Observed Plasma Concentration (Cmax) of Intravenous (IV) DNX
Cmax of IV DNX was to be derived from the Pharmacokinetics (PK) samples collected at Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose. PK Population comprised of all participants who underwent blood PK sampling during the study and from whom one or more blood concentration was determined.
Measured: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Area Under the Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Concentration (AUC [0-t]) of IV DNX
AUC (0-t) of IV DNX was to be derived from the PK samples collected at Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose.
Measured: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Time to Reach Cmax (Tmax) of IV DNX
Tmax of IV DNX was to be derived from the PK samples collected at Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose.
Measured: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Average Concentration (Cavg) of IV DNX
Cavg of IV DNX was to be derived from the PK samples collected at Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose.
Measured: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Oct 2016 (estimated)
- Study start19 Jan 2017
- Primary completion24 May 2017
- Study completion24 May 2017
Why it stopped: The study was stopped early due to lack of enrollment.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Virus DiseasesStudies of the same condition, open and under way.
- More trials run by GlaxoSmithKlineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 10 participants (actual)
Sponsor and investigators
- Lead sponsor
- GlaxoSmithKline
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- GSK Clinical Trials, Study director, GlaxoSmithKline
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02927431
- Sponsor's protocol ID
- 201023
- Other IDs
- 2016-002512-40, 2016
- Status last verified
- Nov 2020
- First submitted
- 29 Sep 2016
- Last updated
- 30 Nov 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Madan A, Chen S, Yates P, Washburn ML, Roberts G, Peat AJ, Tao Y, Parry MF, Barnum O, McClain MT, Roy-Ghanta S. Efficacy and Safety of Danirixin (GSK1325756) Co-administered With Standard-of-Care Antiviral (Oseltamivir): A Phase 2b, Global, Randomized Study of Adults Hospitalized With Influenza. Open Forum Infect Dis. 2019 Apr 3;6(4):ofz163. doi: 10.1093/ofid/ofz163. eCollection 2019 Apr.
PubMed 31041358
Study at a glance
From the registry record, last updated by the sponsor on 30 Nov 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II, Global, Randomized Study to Evaluate the Efficacy and Safety of Danirixin (GSK1325756) Co-administered With a Standard-of-care Antiviral (Oseltamivir), in the Treatment of Adults Hospitalized With Influenza
- ClinicalTrials.gov ID
- NCT02927431
- Acronym / sponsor ID
- 201023
- Conditions
- Virus Diseases
- Keywords
- Anti-inflammatory, Danirixin, Influenza, Hospitalized patients
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The study was stopped early due to lack of enrollment.
- Enrolment
- 10 participants (actual)
- Lead sponsor
- GlaxoSmithKlineIndustry (pharma, biotech, devices)
- Study start
- 19 Jan 2017 (actual)
- Primary completion
- 24 May 2017 (actual)
- Study completion
- 24 May 2017 (actual)
- First posted
- 7 Oct 2016 (estimated)
- Results
- Posted 2 Jul 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Danirixin (DNX) is a novel, selective, and reversible antagonist of the C-X-C chemokine receptor (CXCR) 2 and has been shown to decrease neutrophil transmigration and activation to areas of inflammation. An intravenous (IV) formulation of DNX hydrobromide (HBr) is being developed as an anti-inflammatory agent for treatment of adults hospitalized with influenza (IFV). While early therapy with antivirals decreases severity and duration of symptoms of influenza, there are no drugs that have demonstrated clinical efficacy in randomized clinical trials in this population. Current treatment guidelines for hospitalized IFV recommend neuraminidase inhibitors as standard of care therapy. IFV studies in animals have demonstrated that therapeutic treatment with the combination of a CXCR2 antagonist and a neuraminidase inhibitor reduced lung neutrophils and showed trends for improvements in clinical scores, lung function and pathology with no evidence of worsening outcomes, including viral load. This Phase 2, randomized, double-blind (for IV DNX), placebo-controlled (for IV DNX) 3-arm study will be the first study to determine the efficacy and safety of IV DNX when co-administered (in all groups) with standard of care antiviral treatment (open-label oral oseltamivir [OSV]) in subjects hospitalized with IFV. The primary objective of the study is to assess the efficacy of treatment with IV DNX twice daily given with oral OSV compared to oral OSV twice daily on time to clinical response (TTCR). In this study, subjects will be randomized in a 2:2:1 ratio to 15 milligram (mg) free base equivalent (FBE) IV DNX, 50 mg FBE IV DNX, or matching placebo twice daily. All subjects will also receive open-label 75 mg oral OSV, twice daily (given as standard of care). The study treatment duration will be for up to 5 days. The investigator may elect to continue treatment with OSV after 5 days of study treatment. Follow up will continue until Day 45 for all subjects. The study will begin with enhanced safety monitoring in sentinel cohorts, leading to stepwise enrollment of subjects. Subjects will be enrolled based on increasing levels of renal impairment, and less severe hospitalized subjects will be enrolled prior to enrollment of critically ill subjects, as this is the first study conducted in the hospitalized population with severe IFV. Approximately 300 subjects are targeted to be enrolled in the study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Danirixin 15 mg FBE IV plus 75 mg oseltamivir | Experimental | Drug: Danirixin 15 mg FBE, Drug: Oseltamivir 75 mgSubjects will receive double blind 15 mg FBE IV danirixin twice daily with open label 75 mg oral oseltamivir twice daily for 5 days. If a subject is discharged from the hospital in less than 5 days, treatment with IV DNX will be discontinued. |
| Danirixin 50 mg FBE IV plus 75 mg oseltamivir | Experimental | Drug: Danirixin 50 mg FBE, Drug: Oseltamivir 75 mgSubjects will receive double blind 50 mg FBE IV danirixin twice daily with 75 mg oral oseltamivir twice daily for 5 days. If a subject is discharged from the hospital in less than 5 days, treatment with IV DNX will be discontinued. |
| Placebo of danirixin IV plus 75 mg oseltamivir | Placebo comparator | Drug: Placebo, Drug: Oseltamivir 75 mgSubjects will receive double blind IV placebo of DNX twice daily with 75 mg oral oseltamivir twice daily for 5 days. If a subject is discharged from the hospital in less than 5 days, treatment with IV DNX will be discontinued. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- Adults 18 years (as per local laws) of age and older at the time of signing the informed consent.
- Presence of fever (>=38.0 degree Celsius [>=100.4 degree Fahrenheit] by any route) at Baseline (enrollment) or history of fever/feverishness during the 48 hours prior.
- Oxygen (O2) saturation <95% on room air by trans-cutaneous method OR need for any supplemental oxygenation (non-invasive ventilation, facemask, facetent, nasal canula, etc) or ventilator support (mechanical ventilation, bi-level positive airway pressure [BIPAP], continuous positive airway pressure [CPAP]) or increase in oxygen supplementation requirement of >=2 liters for subjects with chronic oxygen dependency. For those subjects with a history of chronic hypoxia (without supplemental oxygen), an oxygen saturation of at least 3% below the subject's historical baseline oxygen saturation.
- And at least 2 out of the following 3: respiratory rate >24 breaths per minute. For those subjects who require ventilator support or oxygen supplementation, this requirement is waived; heart rate >100 beats per minute; SBP <90 millimeters of mercury (mm Hg).
- Severity of symptoms at enrollment: 1) Less severe hospitalized subjects are those who (but not limited to): are hemodynamically stable; may require oxygenation with facemask, facetent, nasal canula, etc; may or may not have radiological signs of lower respiratory tract disease; or have exacerbation of underlying chronic disease, including asthma, chronic obstructive pulmonary disease (COPD), or other cardiovascular conditions not leading to hemodynamic compromise. 2) Critically ill hospitalized subjects are those who (but not limited to): require CPAP, BIPAP, mechanical ventilation; have hemodynamic instability (with or without pressor support); or have central nervous system involvement (example encephalopathy, encephalitis).
Key exclusion criteria (18 listed)
- Subjects who, in the opinion of the investigator, are not likely to survive the next 48 hours beyond Baseline;
- Immunosuppression, whether due to primary immunosuppressive conditions, such as history of inherited immunodeficiency syndromes, human immunodeficiency virus (HIV) infection, or secondary conditions, such as immunosuppressive medication, stem cell or solid organ transplantation, or malignancy;
- Documented current liver disease (including Hepatitis A, B, or C), or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones);
- Baseline Liver Function Tests: Subjects will be excluded if:
- Corrected QT Interval (QTc) Criteria: Corrected QT Interval using Bazette's formula (QTcB) or Corrected QT Interval using Fridericia forumula (QTcF) >480 millisecond (msec) or >500 msec with bundle branch block;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Danirixin 15 mg FBEThis intervention is available as a 50 mg FBE sterile lyophilized powder containing DNX (hydrobromide salt hemihydrate) equivalent to 50mg of free base along with Beta-cyclodextrin sulfobutylether, mannitol, citric acid and sodium hydroxide. The formulation is supplied as lyophilized powder/cake contained in a 30mL vial. Each vial is reconstituted with 9.5 mL water for injection and further diluted with saline for IV infusion to provide a dose of 15 mg FBE. | Drug | Danirixin 15 mg FBE IV plus 75 mg oseltamivir |
| Danirixin 50 mg FBEThis intervention is available as a 50 mg FBE sterile lyophilized powder containing DNX (hydrobromide salt hemihydrate) equivalent to 50mg of free base along with Beta-cyclodextrin sulfobutylether, mannitol, citric acid and sodium hydroxide. The formulation is supplied as lyophilized powder/cake contained in a 30mL vial. Each vial is reconstituted with 9.5 mL water for injection and further diluted with saline for IV infusion. | Drug | Danirixin 50 mg FBE IV plus 75 mg oseltamivir |
| PlaceboNo vials of placebo to match IV DNX will be provided. A normal saline solution of matched volume will be prepared by unblinded personnel at the site to act as a placebo to DNX. Clear solution of placebo will be administered as IV infusion. | Drug | Placebo of danirixin IV plus 75 mg oseltamivir |
| Oseltamivir 75 mgOseltamivir (Tamiflu - manufactured by Roche) formulation is available as 75 mg Capsule and as powder for oral suspension. After constitution with 55 mL of water, each bottle delivers a usable volume of 60 mL of oral suspension equivalent to 360 mg oseltamivir base (6 mg/mL). No oseltamivir capsules or powder for oral suspension will be provided. Sites will source the OSV locally and it will be provided open-label. | Drug | Danirixin 15 mg FBE IV plus 75 mg oseltamivir, Danirixin 50 mg FBE IV plus 75 mg oseltamivir, Placebo of danirixin IV plus 75 mg oseltamivir |
Primary outcome
Time to Clinical Response (TTCR)
Time frame: Up to 45 Days
The clinical response was defined as Hospital discharge due to clinical improvement OR normalization of temperature; and oxygen saturation; and respiratory status/heart rate/systolic blood pressure (normalization of 2 out of these 3 parameters). The clinical response based on vital signs/ventilation status required 24-hour confirmation. Considering 2-hour assessment window, the response confirmation period was 22 hours. Kaplan Meier estimates for the median of TTCR was provided. One participant had vital sign resolution at Baseline and was counted as having a clinical response but was not included in the Kaplan Meier Estimates. Influenza Positive Population (IPP) Population comprised of all participants in the Intent to Treat Exposed (ITT-E) Population with influenza infection (positive influenza Polymerase Chain Reaction [PCR] or culture at any time point) confirmed by central lab testing. Only those participants with data available at the indicated time point were analyzed.
24 secondary outcomes
Time to Respiratory Response (TTRR)
Time frame: Up to 45 Days
Time to Absence of Fever
Time frame: Up to 45 Days
Time to Improved Oxygen Saturation
Time frame: Up to 45 Days
Time to Improved Heart Rate
Time frame: Up to 45 Days
Time to Improved Systolic Blood Pressure (SBP)
Time frame: Up to 45 Days
Percentage of Participants With Clinical Response Over Time
Time frame: Up to 45 Days
Percentage of Participants With Improved Respiratory Status Over Time
Time frame: Up to 45 Days
Time to Improvement of Ventilation Status
Time frame: Up to 45 Days
Number of Days of Stay in the Intensive Care Unit (ICU)
Time frame: Up to 45 Days
Number of Participants Requiring ICU Admission and Readmission
Time frame: Up to 45 Days
Number of Days of Stay in the Hospital
Time frame: Up to 45 Days
Number of Participants With Development of Septic Shock
Time frame: Up to 45 Days
Number of Participants Used Antibiotics for Complications of Influenza
Time frame: Up to 45 Days
Number of Participants With Improvement in Ordinal Scale of Clinical Efficacy Over Time
Time frame: Up to 45 Days
Number of Participants With Any Non-serious Adverse Event (AE); Any Serious AE (SAE); Any AEs of Special Interest (AESIs)
Time frame: Up to 45 Days
Change From Baseline in Albumin and Total Protein
Time frame: Baseline and up to 45 days
Change From Baseline in White Blood Cell Count (WBC) and Absolute Neutrophil Count (ANC)
Time frame: Baseline and up to 45 days
Change From Baseline in Total Bilirubin (T. Bilirubin), Creatinine and Direct Bilirubin (D. Bilirubin)
Time frame: Baseline and up to 45 days
Change From Baseline in Alanine Amino Transferase (ALT), Aspartate Amino Transferase (AST) and Alkaline Phosphatase (ALP)
Time frame: Baseline and up to 45 days
Number of Participants With Clinically Significant Abnormality in Electrocardiogram (ECG)
Time frame: Up to 6 days
Maximum Observed Plasma Concentration (Cmax) of Intravenous (IV) DNX
Time frame: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Area Under the Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Concentration (AUC [0-t]) of IV DNX
Time frame: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Time to Reach Cmax (Tmax) of IV DNX
Time frame: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Average Concentration (Cavg) of IV DNX
Time frame: Day 1 pre-dose, Day 3 at pre-dose and 0.5, 1, 1.5, 2, 3, 4, 8 and 12 hours post-dose and Day 5 pre-dose
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Nov 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 31041358Madan A, Chen S, Yates P, Washburn ML, Roberts G, Peat AJ, Tao Y, Parry MF, Barnum O, McClain MT, Roy-Ghanta S. Efficacy and Safety of Danirixin (GSK1325756) Co-administered With Standard-of-Care Antiviral (Oseltamivir): A Phase 2b, Global, Randomized Study of Adults Hospitalized With Influenza. Open Forum Infect Dis. 2019 Apr 3;6(4):ofz163. doi: 10.1093/ofid/ofz163. eCollection 2019 Apr.
Related trials for Virus Diseases
Enrolling by invitation
Personalized Ventilator Settings for Patients on ECMO
Acute Respiratory Distress Syndrome (ARDS), Extracorporeal Membrane Oxygenation
RecruitingObservational study
The Natural History of Severe Viral Infections and Characterization of Immune Defects in Patients Without Known Immunocompromise
EBV, HSV
Active, not recruitingPhase 1
A Phase 1 Study to Evaluate JCXH-108, an mRNA-based Vaccine Against RSV
Respiratory Syncytial Virus (RSV), Infectious Disease
Active, not recruitingObservational study
Profiling Vulnerability and Resilience for Mental Illness Following Viral Infections
Severe Mental Illness, Inflammation
Not yet recruitingPhase 1
A Study to Investigate the Safety and Immunogenicity of mRNA-1469 in African Participants 1 to 65 Years of Age
Ebola-Bundibugyo Virus Disease (Ebola-BDBV)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
GSK Clinical Trials study director
GlaxoSmithKline
8 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Danirixin 15 mg FBE, Danirixin 50 mg FBE and Oseltamivir 75 mg in people with Virus Diseases, run by GlaxoSmithKline at 8 sites in 4 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 16 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 30 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 8 sites in United States, Romania, Russia, Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 2 Jul 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to Clinical Response (TTCR) (time frame: Up to 45 Days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02927431, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Nov 2020; AzTrials last refreshed its copy on 7 Nov 2026.