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AzTrials

COVID-19Phase 3NCT04280705

Adaptive COVID-19 Treatment Trial (ACTT)

A Phase 3 study testing Remdesivir in people with COVID-19, run by National Institute of Allergy and Infectious Diseases (NIAID) at 60 sites in 10 countries.

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

This study is an adaptive, randomized, double-blind, placebo-controlled trial to evaluate the safety and efficacy of novel therapeutic agents in hospitalized adults diagnosed with COVID-19. The study is a multicenter trial that will be conducted in up to approximately 100 sites globally. Read more about this study

Who is it for?
Ages 18 to 99 years
Conditions the study is for
COVID-19
What is being tested?
Remdesivir
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,062 participants
Where
60 sitesin 10 countries
Study dates
21 Feb 2020to 21 May 2020
Phase
Phase 3
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 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Admitted to a hospital with symptoms suggestive of COVID-19 infection.
  • Subject (or legally authorized representative) provides informed consent prior to initiation of any study procedures.
  • Subject (or legally authorized representative) understands and agrees to comply with planned study procedures.
  • Male or non-pregnant female adult > / = 18 years of age at time of enrollment.
  • Has laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain reaction (PCR) or other commercial or public health assay in any specimen, as documented by either or the following:
  • PCR positive in sample collected < 72 hours prior to randomization; OR

Who cannot join

  • PCR positive in sample collected >/= 72 hours prior to randomization, documented inability to obtain a repeat sample (e.g. due to lack of testing supplies, limited testing capacity, results taking >24 hours, etc.) AND progressive disease suggestive of ongoing SARS-CoV-2 infection.
  • Illness of any duration, and at least one of the following:
  • Radiographic infiltrates by imaging (chest x-ray, CT scan, etc.), OR
  • SpO2 < / = 94% on room air, OR
  • Requiring supplemental oxygen, OR
  • Requiring mechanical ventilation.
Show all 13Show fewer
  • Women of childbearing potential must agree to either abstinence or use at least one primary form of contraception not including hormonal contraception from the time of screening through Day 29.
  • Agrees to not participate in another clinical trial for the treatment of COVID-19 or SARS-CoV-2 through Day 29.
  • Alanine Transaminase (ALT) or Aspartate Transaminase (AST) > 5 times the upper limit of normal.
  • Estimated glomerular filtration rate (eGFR) < 30 ml/min (including patients receiving hemodialysis or hemofiltration).
  • Pregnancy or breast feeding.
  • Anticipated discharge from the hospital or transfer to another hospital which is not a study site within 72 hours.
  • Allergy to any study medication.

Trial locations and contacts

60 sites in 10 countries.

60 sites in 10 countries

United States41 sites
  • University of Maryland School of Medicine - Center for Vaccine Development - Baltimore

    Baltimore, Maryland, 21201-1509

  • Johns Hopkins Hospital - Medicine - Infectious Diseases

    Baltimore, Maryland, 21287-0005

  • Walter Reed National Military Medical Center

    Bethesda, Maryland, 20889

  • National Institutes of Health - Clinical Center, National Institute of Allergy and Infectious Diseases Laboratory Of Immunoregulation, Clinical Research Section

    Bethesda, Maryland, 20892-1504

  • University of Alabama at Birmingham School of Medicine - Infectious Disease

    Birmingham, Alabama, 35233

  • Massachusetts General Hospital - Infectious Diseases

    Boston, Massachusetts, 02114-2621

  • University of Virginia - Acute Care Surgery

    Charlottesville, Virginia, 22908-0816

  • Northwestern Hospital - Infectious Disease

    Chicago, Illinois, 60611-2908

  • University of Illinois at Chicago College of Medicine - Division of Infectious Diseases

    Chicago, Illinois, 60612

  • Emory Vaccine Center - The Hope Clinic

    Decatur, Georgia, 30030-1705

  • Denver Health Division of Hospital Medicine - Main Campus

    Denver, Colorado, 80204

  • Duke Human Vaccine Institute - Duke Vaccine and Trials Unit

    Durham, North Carolina, 27704

  • Brooke Army Medical Center

    Fort Sam Houston, Texas, 78234

  • University of Texas Medical Branch - Division of Infectious Disease

    Galveston, Texas, 77555-0435

  • Penn State Health Milton S. Hershey Medical Center - Division of Infectious Diseases

    Hershey, Pennsylvania, 17033

  • Baylor College of Medicine - Molecular Virology and Microbiology

    Houston, Texas, 77030-3411

  • EvergreenHealth Infectious Disease Service

    Kirkland, Washington, 98034

  • University of California San Diego Health - Jacobs Medical Center

    La Jolla, California, 29037

  • University of California Los Angeles Medical Center - Westwood Clinic

    Los Angeles, California, 90095

  • University of Minnesota Medical Center, Fairview - Infectious Diseases and International Medicine

    Minneapolis, Minnesota, 55455-0341

  • Vanderbilt University Medical Center - Infectious Diseases

    Nashville, Tennessee, 37232-0011

  • Southeast Louisiana Veterans Health Care System - Section of Infectious Diseases

    New Orleans, Louisiana, 70119

  • New York University School of Medicine - Langone Medical Center - Microbiology - Parasitology

    New York, New York, 10016-6402

  • University of Nebraska Medical Center - Infectious Diseases

    Omaha, Nebraska, 68105

  • University of California Irvine Medical Center - Infectious Disease

    Orange, California, 92868-3298

  • VA Palo Alto Health Care System - Infectious Diseases

    Palo Alto, California, 94304-1207

  • Hospital of the University of Pennsylvania - Infectious Diseases

    Philadelphia, Pennsylvania, 19104-4238

  • Naval Medical Center Portsmouth - Infectious Disease Division

    Portsmouth, Virginia, 23708

  • University of Rochester Medical Center - Vaccine Research Unit

    Rochester, New York, 14642-0001

  • University of California Davis Medical Center - Internal Medicine - Infectious Disease

    Sacramento, California, 95817-1460

  • University of Texas Health Science Center at San Antonio - Infectious Diseases

    San Antonio, Texas, 78229-3901

  • Naval Medical Center San Diego - Infectious Disease Clinic

    San Diego, California, 92314

  • University of California San Francisco - Zuckerberg San Francisco General Hospital - Division of Human Immunodeficiency Virus, Infectious Disease, and Global Medicine

    San Francisco, California, 94110-2859

  • The University of Washington - Virology Research Clinic

    Seattle, Washington, 98104

  • Providence Sacred Heart Medical Center

    Spokane, Washington, 99204

  • Saint Louis University - Center for Vaccine Development

    St Louis, Missouri, 63104-1015

  • Stanford University - Stanford Hospital and Clinics - Pediatrics - Infectious Diseases

    Stanford, California, 94305-2200

  • Madigan Army Medical Center - Infectious Disease Clinic

    Tacoma, Washington, 98431

  • Montefiore Medical Center - Infectious Diseases

    The Bronx, New York, 10467-2401

  • Cedars Sinai Medical Center

    West Hollywood, California, 90048-1804

  • University of Massachusetts Medical School - Infectious Diseases and Immunology

    Worcester, Massachusetts, 01655-0002

Other trials in United States

United Kingdom5 sites
  • Royal Sussex County Hospital - Department of Intensive Care Medicine

    East Sussex, Brighton, BN2 5BE

  • John Radcliffe Hospital

    Headington, Oxford, OX3 9DU

  • St. James's University Hospital - Infectious Diseases

    Leeds, West Yorkshire, LS9 7TK

  • Royal Victoria Infirmary - Department of Infectious Diseases

    Level 6, Ward 19, Newcastle Upon Tyne, NE1 4LP

  • Saint Thomas' Hospital - Directorate of Infection

    London, London, City of, SE1 7EH

Other trials in United Kingdom

Germany3 sites
  • Universitatsklinikum Bonn, Medizinische Klinik I - Bereich Infektiologie/HIV der Medizinischen Klinik

    Bonn, North Rhine-Westphalia, 53127

  • Universitatsklinikum Koeln Klinik I fur Innere Medizin Klinisches Studienzentrum fur Infektiologie I

    Cologne, 50937

  • Universitätsklinikum Frankfurt -Medizinische Klinik II - Infektiologie

    Frankfurt, 60590

Other trials in Germany

Greece2 sites
  • Medical School of Athens University - Evangelismos Hospital - Department of Critical Care and Pulmonary Services

    Athens, GR-10675

  • AHEPA University Hospital - 1st Department of Internal Medicine

    Thessaloniki, Central Macedonia, P.O. 54636

Other trials in Greece

Mexico2 sites
  • Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán - Departamento de Infectologia

    Mexico City, 14080

  • Instituto Nacional de Enfermedades Respiratorias (INER) - Ismael Cosío Villegas

    Mexico City, 14080

Other trials in Mexico

South Korea2 sites
  • Seoul National University Bundang Hospital - Division of Infectious Diseases

    Bundang-gu Seongnam-si, Gyeonggi-do, 13620

  • Seoul National University Hospital

    Seoul, Jongno-gu, 03080

Other trials in South Korea

Spain2 sites
  • Hospital Clinic Barcelona, Servicio de Salud Internacional

    Barcelona, Catalonia, 08036

  • Hospital Germans Trias i Pujol - Servei Malalties Infeccioses

    Barcelona, Catalonia, 08916

Other trials in Spain

Denmark1 site
  • University of Copenhagen - Centre of Excellence for Health, Immunity and Infections (CHIP) - Department of Infectious Diseases

    Copenhagen, 2100

Other trials in Denmark

Japan1 site
  • National Center for Global Health and Medicine Hospital - Disease Control and Prevention Center

    Tokyo, 162-8655

Other trials in Japan

Singapore1 site
  • National Centre for Infectious Diseases

    Singapore, 308442

Other trials in Singapore

About this study

Official title: A Multicenter, Adaptive, Randomized Blinded Controlled Trial of the Safety and Efficacy of Investigational Therapeutics for the Treatment of COVID-19 in Hospitalized Adults

This study is an adaptive, randomized, double-blind, placebo-controlled trial to evaluate the safety and efficacy of novel therapeutic agents in hospitalized adults diagnosed with COVID-19. The study is a multicenter trial that will be conducted in up to approximately 100 sites globally. The study will compare different investigational therapeutic agents to a control arm. There will be interim monitoring to introduce new arms and allow early stopping for futility, efficacy, or safety. If one therapy proves to be efficacious, then this treatment may become the control arm for comparison(s) with new experimental treatment(s). Any such change would be accompanied by an updated sample size. Because background standards of supportive care may evolve/improve over time as more is learned about successful management of COVID-19, comparisons of safety and efficacy will be based on data from concurrently randomized subjects. An independent Data and Safety Monitoring Board (DSMB) will actively monitor interim data to make recommendations about early study closure or changes to study arms. To evaluate the clinical efficacy, as assessed by time to recovery, of different investigational therapeutics as compared to the control arm.

Read the detailed description

This study is an adaptive, randomized, double-blind, placebo-controlled trial to evaluate the safety and efficacy of novel therapeutic agents in hospitalized adults diagnosed with COVID-19. The study is a multicenter trial that will be conducted in up to approximately 100 sites globally. The study will compare different investigational therapeutic agents to a control arm. There will be interim monitoring to introduce new arms and allow early stopping for futility, efficacy, or safety. If one therapy proves to be efficacious, then this treatment may become the control arm for comparison(s) with new experimental treatment(s). Any such change would be accompanied by an updated sample size. Because background standards of supportive care may evolve/improve over time as more is learned about successful management of COVID-19, comparisons of safety and efficacy will be based on data from concurrently randomized subjects. An independent Data and Safety Monitoring Board (DSMB) will actively monitor interim data to make recommendations about early study closure or changes to study arms.

The initial sample size is projected to be 572 subjects to achieve 400 subjects with a "recovered" status (per the primary objective). The primary analysis will be based on those subjects enrolled in order to 400 recoveries. An additional analysis of the moderate severity subgroup (those with baseline status of "Hospitalized, requiring supplemental oxygen" or "Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care") is also of public health importance. Hence, enrollment will be permitted until the date of April 20, 2020 to ensure 400 recoveries and provide additional data about this important subgroup. With recent enrollment rates, the total sample size may be 600 to over 800.

Subjects will be assessed daily while hospitalized. If the subjects are discharged from the hospital, they will have a study visit at Days 15, 22, and 29 as an outpatient. For discharged subjects, it is preferred that the Day 15 and 29 visits are in person to obtain safety laboratory tests and OP swab and blood (serum only) samples for secondary research as well as clinical outcome data. However, infection control or other restrictions may limit the ability of the subject to return to the clinic. In this case, Day 15 and 29 visits may be conducted by phone, and only clinical data will be obtained. The Day 22 visit does not have laboratory tests or collection of samples and may also be conducted by phone.

All subjects will undergo a series of efficacy, safety, and laboratory assessments. Safety laboratory tests and blood (serum and plasma) research samples and oropharyngeal (OP) swabs will be obtained on Days 1 (prior to infusion) and Days 3, 5, 8, and 11 (while hospitalized). OP swabs and blood (serum only) plus safety laboratory tests will be collected on Day 15 and 29 (if the subject attends an in-person visit or are still hospitalized).

The primary outcome is time to recovery by Day 29. A key secondary outcome evaluates treatment-related improvements in the 8-point ordinal scale at Day 15. As little is known about the clinical course of COVID-19, a pilot study will be used for a blinded sample size reassessment.

Contacts:

20-0006 Central Contact

Telephone: 1 (301) 7617948

Email: DMIDClinicalTrials@niaid.nih.gov

Conditions
COVID-19
Being tested
Placebo, Remdesivir
Keywords
Adaptive, COVID-19, Efficacy, Multicenter, novel coronavirus, Safety, ACTT
Medical subject headings
COVID-19

What participants receive

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

  • PlaceboOther

    The supplied placebo lyophilized formulation is identical in physical appearance to the active lyophilized formulation and contains the same inactive ingredients. Alternatively, a placebo of normal saline of equal volume may be given if there are limitations on matching placebo supplies.

  • RemdesivirDrug

    Drug Remdesivir is a single diastereomer monophosphoramidate prodrug designed for the intracellular delivery of a modified adenine nucleoside analog GS-441524. In addition to the active ingredient, the lyophilized formulation of Remdesivir contains the following inactive ingredients: water for injection, sulfobutylether beta-cyclodextrin sodium (SBECD), and hydrochloric acid and/or sodium hydroxide.

Study groups in NCT04280705
Study groupRoleWhat they receive
PlaceboPlacebo comparator200 mg of Remdesivir placebo administered intravenously on Day 1, followed by a 100 mg once-daily maintenance dose of Remdesivir placebo while hospitalized for up to a 10 days total course. n=286.
Receives: Other: Placebo
RemdesivirExperimental200 mg of Remdesivir administered intravenously on Day 1, followed by a 100 mg once-daily maintenance dose of Remdesivir while hospitalized for up to a 10 days total course. n=286.
Receives: Drug: Remdesivir

What is being measured

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

  1. Time to Recovery

    Day of recovery is defined as the first day on which the subject satisfies one of the following three categories from the ordinal scale: 1) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 3) Not hospitalized, no limitations on activities.

    Measured: Day 1 through Day 29

  2. Time to Recovery by Race

    Day of recovery is defined as the first day on which the subject satisfies one of the following three categories from the ordinal scale: 1) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 3) Not hospitalized, no limitations on activities.

    Measured: Day 1 through Day 29

  3. Time to Recovery by Ethnicity

    Day of recovery is defined as the first day on which the subject satisfies one of the following three categories from the ordinal scale: 1) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 3) Not hospitalized, no limitations on activities.

    Measured: Day 1 through Day 29

  4. Time to Recovery by Sex

    Day of recovery is defined as the first day on which the subject satisfies one of the following three categories from the ordinal scale: 1) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 3) Not hospitalized, no limitations on activities.

    Measured: Day 1 through Day 29

Secondary outcomes (39)
  1. Change From Baseline in Alanine Transaminase (ALT)

    Blood to evaluate ALT was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  2. Change From Baseline in Aspartate Transaminase (AST)

    Blood to evaluate AST was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  3. Change From Baseline in Creatinine

    Blood to evaluate serum creatinine was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  4. Change From Baseline in Glucose

    Blood to evaluate serum glucose was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  5. Change From Baseline in Hemoglobin

    Blood to evaluate hemoglobin was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  6. Change From Baseline in Platelets

    Blood to evaluate platelets was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  7. Change From Baseline in Prothrombin Time (PT)

    Blood to evaluate PT was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  8. Change From Baseline in Total Bilirubin

    Blood to evaluate total bilirubin was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  9. Change From Baseline in White Blood Cell Count (WBC)

    Blood to evaluate WBC was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  10. Change From Baseline in Neutrophils

    Blood to evaluate neutrophils was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  11. Change From Baseline in Lymphocytes

    Blood to evaluate lymphocytes was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  12. Change From Baseline in Monocytes

    Blood to evaluate monocytes was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  13. Change From Baseline in Basophils

    Blood to evaluate basophils was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  14. Change From Baseline in Eosinophils

    Blood to evaluate eosinophils was collected at Days 1, 3, 5, 8, and 11 while participants were inpatient, and at Days 15 and 29, with the Day 1 assessment serving as baseline. Participants who had been discharged had blood collected if infection control measures allowed for in-person visits after discharge.

    Measured: Days 1, 3, 5, 8, 11, 15 and 29

  15. Change in National Early Warning Score (NEWS) From Baseline

    The NEW score has demonstrated an ability to discriminate patients at risk of poor outcomes. This score is based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness). The NEW Score is being used as an efficacy measure. The minimum score is 0, representing the better outcome, and the maximum value is 19, representing the worse outcome.

    Measured: Days 1, 3, 5, 8, 11, 15, 22, and 29

  16. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 1

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 1

  17. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 3

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 3

  18. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 5

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 5

  19. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 8

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 8

  20. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 11

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 11

  21. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 15

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 15

  22. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 22

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 22

  23. Percentage of Participants at Each Clinical Status Using Ordinal Scale at Day 29

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

    Measured: Day 29

  24. Percentage of Participants Reporting Grade 3 and 4 Clinical and/or Laboratory Adverse Events (AEs)

    Grade 3 AEs are defined as events that interrupt usual activities of daily living, or significantly affects clinical status, or may require intensive therapeutic intervention. Severe events are usually incapacitating. Grade 4 AEs are defined as events that are potentially life threatening.

    Measured: Day 1 through Day 29

  25. Percentage of Participants Reporting Serious Adverse Events (SAEs)

    An SAE is defined as an AE or suspected adverse reaction is considered serious if, in the view of either the investigator or the sponsor, it results in death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect.

    Measured: Day 1 through Day 29

  26. Percentage of Participants Discontinued or Temporarily Suspended From Investigational Therapeutics

    Participants may have been discontinued from investigational therapeutics due to discharge or death. The halting or slowing of the infusion for any reason was collected, as was missed doses in the series of 10 doses.

    Measured: Day 1 through Day 10

  27. Duration of Hospitalization

    Duration of hospitalization was determined two ways. The first includes imputations for participants who died. The second method is restricted to participants who did not die.

    Measured: Day 1 through Day 29

  28. Duration of New Non-invasive Ventilation or High Flow Oxygen Use

    Duration of new non-invasive ventilation or high flow oxygen use was measured in days among participants who were not on non-invasive ventilation or high-flow oxygen use at baseline, determined two ways. The first includes imputations for participants who died. The second method is restricted to participants who did not die

    Measured: Day 1 through Day 29

  29. Duration of New Oxygen Use

    Duration of new oxygen use was measured in days among participants who were not on oxygen at baseline, determined two ways. The first includes imputations for participants who died. The second method is restricted to participants who did not die

    .

    Measured: Day 1 through Day 29

  30. Duration of New Ventilator or Extracorporeal Membrane Oxygenation (ECMO) Use

    Duration of new ventilator or ECMO use was measured in days among participants who were not on a ventilator or ECMO at baseline, determined two ways. The first includes imputations for participants who died. The second method is restricted to participants who did not die

    Measured: Day 1 through Day 29

  31. Percentage of Participants Requiring New Non-invasive Ventilation or High-flow Oxygen Use

    New non-invasive ventilation or high-flow oxygen use was determined as the percentage of subject not on non-invasive ventilation or high-flow oxygen at baseline.

    Measured: Day 1 through Day 29

  32. Percentage of Participants Requiring New Oxygen Use

    The percentage of participants requiring new oxygen use was determined as the percentage of participants not requiring oxygen at baseline

    Measured: Day 1 through Day 29

  33. Percentage of Participants Requiring New Ventilator or Extracorporeal Membrane Oxygenation (ECMO) Use

    The percentage of participants requiring new ventilator or ECMO use was determined as the percentage not on a ventilator or ECMO at baseline

    Measured: Day 1 through Day 29

  34. Mean Change in the Ordinal Scale

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities. A positive change indicates a worsening and a negative change is an improvement.

    Measured: Day 1, 3, 5, 8, 11, 15, 22, and 29

  35. 14-day Participant Mortality

    The mortality rate was determined as the proportion of participants who died by study Day 15.

    Measured: Day 1 through Day 15

  36. 29-day Participant Mortality

    The mortality rate was determined as the proportion of participants who died by study Day 29.

    Measured: Day 1 through Day 29

  37. Time to an Improvement by at Least One Category Using an Ordinal Scale

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities. Time to improvement by at least one category was determined for each participant

    Measured: Day 1 through Day 29

  38. Time to an Improvement of at Least Two Categories Using an Ordinal Scale

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 6) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7) Not hospitalized, limitation on activities and/or requiring home oxygen; 8) Not hospitalized, no limitations on activities. Time to improvement by at least two categories was determined for each participant

    Measured: Day 1 through Day 29

  39. Time to Discharge or to a NEWS of 2 or Less and Maintained for 24 Hours, Whichever Occurs First

    The NEW score has demonstrated an ability to discriminate patients at risk of poor outcomes. This score is based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness). The NEW Score is being used as an efficacy measure. The minimum score is 0, representing the better outcome, and the maximum value is 19, representing the worse outcome. The time to discharge or a NEWS of less than or equal to 2 was determined for each participant.

    Measured: Day 1 through Day 29

Timeline

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

  1. First posted21 Feb 2020
  2. Study start21 Feb 2020
  3. Primary completion21 May 2020
  4. Study completion21 May 2020

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
Double blind
Who is masked
Participant, Investigator
Enrolment
1,062 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04280705
Sponsor's protocol ID
20-0006
Status last verified
Apr 2020
First submitted
20 Feb 2020
Last updated
14 Mar 2022
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Singh K, Rubenstein K, Callier V, Shaw-Saliba K, Rupert A, Dewar R, Laverdure S, Highbarger H, Lallemand P, Huang ML, Jerome KR, Sampoleo R, Mills MG, Greninger AL, Juneja K, Porter D, Benson CA, Dempsey W, El Sahly HM, Focht C, Jilg N, Paules CI, Rapaka RR, Uyeki TM, Clifford Lane H, Beigel J, Dodd LE; Adaptive COVID-19 Treatment Trial (ACTT-1) Study Group Members. SARS-CoV-2 RNA and Nucleocapsid Antigen Are Blood Biomarkers Associated With Severe Disease Outcomes That Improve in Response to Remdesivir. J Infect Dis. 2024 Sep 23;230(3):624-634. doi: 10.1093/infdis/jiae198.

    PubMed 38657001
  • Lin DY, Wang J, Gu Y, Zeng D. Evaluating treatment efficacy in hospitalized COVID-19 patients, with applications to Adaptive COVID-19 Treatment Trials. Clin Trials. 2024 Aug;21(4):500-506. doi: 10.1177/17407745241238443. Epub 2024 Apr 15.

    PubMed 38618926
  • Hedskog C, Rodriguez L, Roychoudhury P, Huang ML, Jerome KR, Hao L, Ireton RC, Li J, Perry JK, Han D, Camus G, Greninger AL, Gale M Jr, Porter DP. Viral Resistance Analyses From the Remdesivir Phase 3 Adaptive COVID-19 Treatment Trial-1 (ACTT-1). J Infect Dis. 2023 Nov 2;228(9):1263-1273. doi: 10.1093/infdis/jiad270.

    PubMed 37466213
  • Grundeis F, Ansems K, Dahms K, Thieme V, Metzendorf MI, Skoetz N, Benstoem C, Mikolajewska A, Griesel M, Fichtner F, Stegemann M. Remdesivir for the treatment of COVID-19. Cochrane Database Syst Rev. 2023 Jan 25;1(1):CD014962. doi: 10.1002/14651858.CD014962.pub2.

    PubMed 36695483
  • Potter GE, Bonnett T, Rubenstein K, Lindholm DA, Rapaka RR, Doernberg SB, Lye DC, Mularski RA, Hynes NA, Kline S, Paules CI, Wolfe CR, Frank MG, Rouphael NG, Deye GA, Sweeney DA, Colombo RE, Davey RT Jr, Mehta AK, Whitaker JA, Castro JG, Amin AN, Colombo CJ, Levine CB, Jain MK, Maves RC, Marconi VC, Grossberg R, Hozayen S, Burgess TH, Atmar RL, Ganesan A, Gomez CA, Benson CA, Lopez de Castilla D, Ahuja N, George SL, Nayak SU, Cohen SH, Lalani T, Short WR, Erdmann N, Tomashek KM, Tebas P. Temporal Improvements in COVID-19 Outcomes for Hospitalized Adults: A Post Hoc Observational Study of Remdesivir Group Participants in the Adaptive COVID-19 Treatment Trial. Ann Intern Med. 2022 Dec;175(12):1716-1727. doi: 10.7326/M22-2116. Epub 2022 Nov 29.

    PubMed 36442063
  • Kreuzberger N, Hirsch C, Chai KL, Tomlinson E, Khosravi Z, Popp M, Neidhardt M, Piechotta V, Salomon S, Valk SJ, Monsef I, Schmaderer C, Wood EM, So-Osman C, Roberts DJ, McQuilten Z, Estcourt LJ, Skoetz N. SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19. Cochrane Database Syst Rev. 2021 Sep 2;9(9):CD013825. doi: 10.1002/14651858.CD013825.pub2.

    PubMed 34473343
  • Ansems K, Grundeis F, Dahms K, Mikolajewska A, Thieme V, Piechotta V, Metzendorf MI, Stegemann M, Benstoem C, Fichtner F. Remdesivir for the treatment of COVID-19. Cochrane Database Syst Rev. 2021 Aug 5;8(8):CD014962. doi: 10.1002/14651858.CD014962.

    PubMed 34350582
  • Sultana J, Crisafulli S, Gabbay F, Lynn E, Shakir S, Trifiro G. Challenges for Drug Repurposing in the COVID-19 Pandemic Era. Front Pharmacol. 2020 Nov 6;11:588654. doi: 10.3389/fphar.2020.588654. eCollection 2020.

    PubMed 33240091
  • Maleszewski JJ, Young PM, Ackerman MJ, Halushka MK. Urgent Need for Studies of the Late Effects of SARS-CoV-2 on the Cardiovascular System. Circulation. 2021 Mar 30;143(13):1271-1273. doi: 10.1161/CIRCULATIONAHA.120.051362. Epub 2020 Sep 24. No abstract available.

    PubMed 32969710
  • Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, Hohmann E, Chu HY, Luetkemeyer A, Kline S, Lopez de Castilla D, Finberg RW, Dierberg K, Tapson V, Hsieh L, Patterson TF, Paredes R, Sweeney DA, Short WR, Touloumi G, Lye DC, Ohmagari N, Oh MD, Ruiz-Palacios GM, Benfield T, Fatkenheuer G, Kortepeter MG, Atmar RL, Creech CB, Lundgren J, Babiker AG, Pett S, Neaton JD, Burgess TH, Bonnett T, Green M, Makowski M, Osinusi A, Nayak S, Lane HC; ACTT-1 Study Group Members. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020 Nov 5;383(19):1813-1826. doi: 10.1056/NEJMoa2007764. Epub 2020 Oct 8.

    PubMed 32445440

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Remdesivir in people with COVID-19, run by National Institute of Allergy and Infectious Diseases (NIAID) at 60 sites in 10 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 6 inclusion and 13 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 14 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 60 sites in United States, United Kingdom, Germany, Greece, Mexico and 5 more countries. 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?

Yes. Results are posted in the registry (first posted 25 Sep 2020). 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 Recovery (time frame: Day 1 through Day 29). The study lists 4 primary outcomes in all. 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 NCT04280705, which also lists 10 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 14 Mar 2022.

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