A Study to Evaluate the Efficacy and Safety of Pirfenidone With Novel Coronavirus Infection

This study is a multi-center, randomized, open, blank-controlled, multi-stage clinical study. As there are no effective treatments, the project team will evaluate possible treatments (including but not limited to Pirfenidone) based on actual conditions. Ketone, Pirfenidone, lopinavir / ritonavir, remdesivir, single / polyclonal antibodies against coronavirus), explore the most effective treatment options.

The first phase will assess the efficacy and safety of approximately 147 (primarily estimated) hospitalized adult patients diagnosed with Wuhan new coronavirus infection in the pirfenidone-treated group compared to standard treatment.

Patients with influenza within 14 days of onset of symptoms were screened and randomly assigned as soon as possible after screening (within 4 day). Patients will be allocated in a 1: 1 ratio and divided into the pirfenidone treatment group or the standard treatment group only. Patients who do not meet the inclusion and exclusion criteria are only allowed to be re-screened once, provided that the time from onset of symptoms to randomization remains within 14days.

This study planned to randomize approximately 147 adult subjects. They will be stratified according to whether the onset time is ≤ 14 days and randomly divided into groups of 1: 1, receiving standard treatment or pirfenidone orally 3 times a day, 2 tablets each time. The course is 4 weeks or more. Subjects and all research center staff were not blinded.

Study selection criteria: (1) Age ≥ 18 years. (2) Clinically diagnosed patients with new type of coronavirus pneumonia include: on the basis of meeting the criteria for suspected cases, one of the following pathogenic evidence: ① real-time fluorescent RT-PCR of respiratory specimens or blood specimens for detection of new coronavirus nucleic acid; Respiratory or blood specimens are genetically sequenced and highly homologous to known new coronaviruses. (3) The time interval between the suspected neocoronary pneumonia pneumonia case and the random enrollment is determined within 4 days to 7 days according to the history symptoms and chest CT imaging. Cough, diarrhea, or other related symptoms can be used. The imaging changes are mainly based on chest CT.

Study exclusion criteria: (1) AST and ALT> 1.5 x ULN at visit 1; (2) bilirubin> 1.5 x ULN at visit 1; (3) Cockcroft-Gault formula at visit 1 Calculated creatinine clearance rate <30 mL / min; (4) patients with potential chronic liver disease (Child Pugh A, B or C liver injury; (5) previous treatment with nidanib or pirfenidone; Screening visit (Visit 1) 1 month or 6 half-life (whichever is greater) received other research drug treatment; (7) Based on ATS / ERS / JRS / ALAT 2011 guidelines (P11-07084) IPF diagnosis; (8) Obvious pulmonary hypertension (PAH) defined by any of the following standards: ① Clinical / echocardiographic evidence of previously obvious right heart failure; ② Medical history including right heart catheter showing a heart index ≤ 2l / min / m2; ③ required Parenteral administration of epoprostenol / treprostinil for the treatment of PAH; (9) other clinically significant pulmonary abnormalities considered by the investigator; (10) major extrapulmonary physiological limitations (such as chest wall deformities, large amounts Pleural effusion); (11) cardiovascular disease, any of the following diseases: ① severe hypertension within 6 months of visit 1, treatment Uncontrollable (≥160 / 100 mmHg); ② myocardial infarction within 6 months of visit 1; ③ unstable angina within 6 months of visit 1; (12) history of severe central nervous system (CNS) events; (13) Known allergies to the test drug; (14) Other diseases that may interfere with the testing process or judged by the investigator may interfere with the trial participation or may put the patient at risk when participating in the trial; (15) pregnancy, Women who are breastfeeding or planning a pregnancy; (16) Patients are unable to understand or follow the test procedures, including completing the questionnaires themselves without help.

Study design primary and secondary endpoints Main endpoints: (1) Absolute changes in baseline lesion area, finger pulse oxygen, and blood gas from baseline at 4 weeks of chest CT images; (2) Total score of King's Interstitial Lung Disease Short Questionnaire (K-BILD) at Week 4 Absolute change from baseline.

Secondary end point: Time to death within 4 weeks due to respiratory causes; time to disease progression or death within 4 weeks; recovery of blood routine lymphocytes at week 4; and blood inflammation indicators at week 4 ( IL-8, etc.); at week 4, absolute changes in viral nucleic acid from baseline; at week 4, pulmonary fibrosis survival symptoms dyspnea scores absolute changes from baseline; at week 4, pulmonary fibrosis survival Symptoms of cough scores are absolute changes from baseline.