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SepsisPhase 3LOVITNCT03680274

Lessening Organ Dysfunction With VITamin C

A Phase 3 study testing Vitamin C in people with Sepsis and Vitamin C, run by Université de Sherbrooke at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

LOVIT is a multicentre concealed-allocation parallel-group blinded randomized controlled trial to ascertain the effect of high-dose intravenous vitamin C compared to placebo on mortality or persistent organ dysfunction at 28 days in septic intensive care unit patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sepsis, Vitamin C, Intensive Care Unit
What is being tested?
Vitamin C
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
872 participants
Where
1 siteCanada
Study dates
8 Nov 2018to 24 Jan 2022
Phase
Phase 3
Are there results?
None posted in the registry

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

  • Admitted to the intensive care unit with proven or suspected infection as the main diagnosis;
  • Currently treated with a continuous IV infusion of vasopressors (norepinephrine, epinephrine, vasopressin, dopamine, phenylephrine).

Who cannot join

  • > 24 hours of intensive care unit admission;
  • Known Glucose-6-phosphate dehydrogenase (G6PD) deficiency;
  • Pregnancy;
  • Known allergy to vitamin C;
  • Known kidney stones within the past 1 year;
  • Received any intravenous vitamin C during this hospitalization unless incorporated in parenteral nutrition;
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  • Expected death or withdrawal of life-sustaining treatments within 48 hours;
  • Previously enrolled in this study;
  • Previously enrolled in a trial with which co-enrolment is not allowed.
  • The LOVIT trial has broad eligibility criteria and includes patients with a primary diagnosis of sepsis of any cause (including sepsis caused by viral pathogens as COVID-19).

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Research Center of the CHUS

    Sherbrooke, Quebec, J1H 5N4

Other trials in Canada

About this study

Official title: Lessening Organ Dysfunction With VITamin C (LOVIT)

LOVIT is a multicentre concealed-allocation parallel-group blinded randomized controlled trial to ascertain the effect of high-dose intravenous vitamin C compared to placebo on mortality or persistent organ dysfunction at 28 days in septic intensive care unit patients. Patients with COVID-19 are considered eligible for this study.

Read the detailed description

Background. The burden of sepsis is increasing worldwide. It is the cause of 8 million global deaths each year. Currently, treatment options are limited to antimicrobials and supportive care such as intravenous fluids, vasopressors, mechanical ventilation, and renal replacement therapy. In the absence of effective therapies specifically targeting the dysregulated immune response, prolonged use of these life-sustaining therapies can be debilitating. A growing body of evidence suggesting that vitamin C, an inexpensive and readily available intervention, is potentially lifesaving in sepsis. Intravenous vitamin C may be the first therapy to mitigate the dysregulated cascade of events that leads to sepsis. If proven effective, vitamin C could be used worldwide and drastically change outcomes in high- and low-income settings alike.

Objectives. To determine whether intravenous vitamin C, compared to placebo, reduces mortality and morbidity in sepsis (induced by bacterial and viral pathogens (as COVID-19)), and compare clinical and biochemical measures of organ dysfunction, and health-related quality of life (HRQoL) at 6 months. To ascertain the volume of distribution, clearance, and plasma concentration over a course of 96 hours of intravenous vitamin C 50 mg/kg of weight every 6 hours or matching placebo (pharmacokinetic (PK) substudy).

Methods. Patients will be randomly assigned to vitamin C (intravenous, 50 mg/kg every 6h) or placebo (0.9% NaCl or dextrose 5% in water) for 96 hours. Study personnel at the clinical sites will document the composite of death or persistent organ dysfunction at day 28. Daily assessments will occur for organ function, on days 1, 3, 7 for inflammation, infection, and endothelial injury biomarkers, at baseline for vitamin C level, and at 6 months for mortality and HRQoL. The LOVIT Trial will be conducted in adult general Canadian and international intensive care units. For the PK substudy: Blood samples will be drawn around the 8th dose at time 0 and then after administration at times 1h, 2h, 4h and 6h (the 6h level will be immediately prior to the next dose). The PK substudy will be conducted with 100 participants in 3 of the 25 participating centers.

Relevance. In the context of increasing off-label use of vitamin C for sepsis and ongoing trials of vitamin C bundled with other pharmacological interventions, the LOVIT Trial will constitute a rigorous assessment of the effect of vitamin C monotherapy on patient-important outcomes.

Being tested
Vitamin C, Control
Medical subject headings
Sepsis, COVID-19, Coronavirus Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Vitamin CDrug

    Also called Ascorbic acid

    Intravenous vitamin C administered in bolus doses of 50 mg/kg mixed in a 50-mL solution of either dextrose 5% in water (D5W) or normal saline (0.9% NaCl), during 30 to 60 minutes, every 6 hours for 96 hours (i.e. 200 mg/kg/day and 16 doses in total).

  • ControlOther

    Dextrose 5% in water (D5W) or normal saline (0.9% NaCl) in a volume to match the vitamin C.

Study groups in NCT03680274
Study groupRoleWhat they receive
Vitamin CExperimentalVitamin C: 50 mg/kg every 6 hours for 96 hours.
Receives: Drug: Vitamin C
ControlPlacebo comparatorDextrose 5% in water (D5W) or normal saline (0.9% NaCl) in a volume to match the vitamin C.
Receives: Other: Control

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of deceased participants or with persistent organ dysfunction

    Defined as death or dependency on mechanical ventilation, renal replacement, or vasopressors

    Measured: Both assessed at 28 days

Secondary outcomes (14)
  1. Number of participants with persistent organ dysfunction-free days in intensive care unit

    Persistent organ dysfunction-free days in intensive care unit

    Measured: Up to day 28

  2. Number of participants deceased at 6 months

    Mortality at 6 months

    Measured: 6 months

  3. Score of health related quality of life in 6-month survivors

    Assessed by the questionnaire EuroQol-5D (EQ-5D-5L). The EQ-5D-5L essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).

    The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.

    The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'.

    Measured: 6 months

  4. Global tissue dysoxia

    Assessed by serum lactate concentration

    Measured: Days 1, 3, 7

  5. Organ function (including renal function)

    Assessed by the Sequential Organ Failure Assessment (SOFA) score. Used to track a person's status during the stay in an intensive care unit to determine the extent of a person's organ function or rate of failure. The score is based on 6 different sub-scores, one each for the respiratory (PaO2/FiO2 mmHg), cardiovascular (mean arterial pressure OR administration of vasopressors required), hepatic (liver bilirubin (mg/dl) [μmol/L]), coagulation (platelets×103/µl), renal (kidneys creatinine (mg/dl) [μmol/L] (or urine output)) and neurological (Glasgow coma scale). The sub-score of each system ranges from 0 (best) to +4 (worst).

    Measured: Days 1, 2, 3, 4, 7, 10, 14, 28

  6. Rate of inflammation

    Assessed by interleukin-1 beta (IL-1ß), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP).

    Measured: Days 1, 3, 7

  7. Rate of infection

    Assessed by procalcitonin (PCT)

    Measured: Days 1, 3, 7

  8. Rate of endothelial injury

    Assessed by thrombomodulin (TM) and angiopoietin-2 (ANG-2)

    Measured: Days 1, 3, 7

  9. Occurrence of stage 3 acute kidney injury

    Assessed by KDIGO (Kidney Disease: Improving Global Outcomes) criteria

    Measured: Up to day 28

  10. Acute hemolysis

    • clinician judgment of hemolysis, as recorded in the chart, OR
    • hemoglobin drop of at least 25 g/L within 24 hours of a dose of investigational product PLUS 2 of the following:
    • reticulocyte count >2 times upper limit of normal at clinical site lab;
    • haptoglobin < lower limit of normal at clinical site lab;
    • indirect (unconjugated) bilirubin >2 times upper limit of normal at clinical site lab;
    • Lactate dehydrogenase (LDH) >2 times upper limit of normal at clinical site lab.

    Severe hemolysis:

    • hemoglobin < 75 g/L AND at least 2 of the above criteria AND requires 2 units of packed red blood cells

    Measured: Up to day 28

  11. Hypoglycemia

    Core lab-validated glucose level of less than 3.8 mmol/L

    Measured: During the time participants receive the 16 doses of the investigational product and the 7 days following the last dose

  12. Vitamin C volume of distribution

    Assessed by chromatography-tandem mass spectrometry

    Measured: 8th dose of vitamin C at time 0 (immediately prior to the dose) and then after administration at times 1 hour, 2 hours, 4 hours and 6 hours (Pharmacokynetic substudy)

  13. Vitamin C clearance

    Assessed by chromatography-tandem mass spectrometry

    Measured: 8th dose of vitamin C at time 0 (immediately prior to the dose) and then after administration at times 1 hour, 2 hours, 4 hours and 6 hours (Pharmacokynetic substudy)

  14. Vitamin C plasma concentration

    Assessed by chromatography-tandem mass spectrometry

    Measured: 8th dose of vitamin C at time 0 (immediately prior to the dose) and then after administration at times 1 hour, 2 hours, 4 hours and 6 hours (Pharmacokynetic substudy)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Sep 2018
  2. Study start8 Nov 2018
  3. Primary completion15 Aug 2021
  4. Study completion24 Jan 2022

Resources

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
872 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03680274
Sponsor's protocol ID
MP-31-2019-2945
Acronym
LOVIT
Status last verified
Mar 2022
First submitted
19 Sep 2018
Last updated
4 Apr 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data collected during the LOVIT trial will be shared with researchers who provide a detailed and methodologically sound proposal, with specific aims. Data sharing will be for the purposes of medical research, with specific data elements provided to answer the research questions in the proposal, and under the auspices of the consent under which the data were originally gathered.

Publications

  • Muller MM, Pinto R, Lamontagne F, Adhikari NKJ, Del Sorbo L; Lessening Organ Dysfunction With Vitamin C (LOVIT) Investigators. Vitamin C Does Not Affect Platelet Counts in Patients With Sepsis: A Post hoc Analysis of the Lessening Organ Dysfunction With Vitamin C Randomized Trial. Crit Care Explor. 2025 Sep 5;7(9):e1310. doi: 10.1097/CCE.0000000000001310. eCollection 2025 Sep.

    PubMed 40927646
  • Rynne J, Mosavie M, Masse MH, Menard J, Battista MC, Maslove DM, Del Sorbo L, St-Arnaud C, DAragon F, Fox-Robichaud A, Charbonney E, Adhikari NKJ, Lamontagne F, Shankar-Hari M; LOVIT Investigators, the Canadian Critical Care Trials Group. Sepsis subtypes and differential treatment response to vitamin C: biological sub-study of the LOVIT trial. Intensive Care Med. 2025 Jan;51(1):82-93. doi: 10.1007/s00134-024-07733-9. Epub 2025 Jan 7.

    PubMed 39774855
  • Lamontagne F, Masse MH, Menard J, Sprague S, Pinto R, Heyland DK, Cook DJ, Battista MC, Day AG, Guyatt GH, Kanji S, Parke R, McGuinness SP, Tirupakuzhi Vijayaraghavan BK, Annane D, Cohen D, Arabi YM, Bolduc B, Marinoff N, Rochwerg B, Millen T, Meade MO, Hand L, Watpool I, Porteous R, Young PJ, D'Aragon F, Belley-Cote EP, Carbonneau E, Clarke F, Maslove DM, Hunt M, Chasse M, Lebrasseur M, Lauzier F, Mehta S, Quiroz-Martinez H, Rewa OG, Charbonney E, Seely AJE, Kutsogiannis DJ, LeBlanc R, Mekontso-Dessap A, Mele TS, Turgeon AF, Wood G, Kohli SS, Shahin J, Twardowski P, Adhikari NKJ; LOVIT Investigators and the Canadian Critical Care Trials Group. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. N Engl J Med. 2022 Jun 23;386(25):2387-2398. doi: 10.1056/NEJMoa2200644. Epub 2022 Jun 15.

    PubMed 35704292
  • Lachance O, Goyer F, Adhikari NKJ, Masse MH, Bilodeau JF, Lamontagne F, Leclair MA. High-dose vitamin-C induced prolonged factitious hyperglycemia in a peritoneal dialysis patient: a case report. J Med Case Rep. 2021 May 21;15(1):297. doi: 10.1186/s13256-021-02869-4.

    PubMed 34020705
  • Masse MH, Menard J, Sprague S, Battista MC, Cook DJ, Guyatt GH, Heyland DK, Kanji S, Pinto R, Day AG, Cohen D, Annane D, McGuinness S, Parke R, Carr A, Arabi Y, Vijayaraghavan BKT, D'Aragon F, Carbonneau E, Maslove D, Hunt M, Rochwerg B, Millen T, Chasse M, Lebrasseur M, Archambault P, Deblois E, Drouin C, Lellouche F, Lizotte P, Watpool I, Porteous R, Clarke F, Marinoff N, Belley-Cote E, Bolduc B, Walker S, Iazzetta J, Adhikari NKJ, Lamontagne F; Canadian Critical Care Trials Group. Lessening Organ dysfunction with VITamin C (LOVIT): protocol for a randomized controlled trial. Trials. 2020 Jan 8;21(1):42. doi: 10.1186/s13063-019-3834-1.

    PubMed 31915072

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Vitamin C in people with Sepsis and Vitamin C, run by Université de Sherbrooke at 1 site in Canada.

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 2 inclusion and 10 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: finished, as of the sponsor's last update on 4 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Number of deceased participants or with persistent organ dysfunction (time frame: Both assessed at 28 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 NCT03680274, which also lists 5 linked publications.

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 4 Apr 2022; AzTrials last refreshed its copy on 29 Oct 2026.

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