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COVID-19 PneumoniaPhase 3BESTNCT04305106

Bevacizumab in Patients With Severe Covid-19

A Phase 3 study testing Bevacizumab in people with COVID-19 Pneumonia, run by Qilu Hospital of Shandong University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The novel coronavirus (SARS-CoV-2) is a new strain of coronavirus found in human in 2019, which causes epidemic worldwide. Novel coronavirus disease (COVID-19) causes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in patients with severe COVID-19. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID-19 Pneumonia
What is being tested?
Bevacizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
588 participants
Where
1 siteChina
Study dates
12 Jan 2023to 31 Dec 2023
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

  • Age: ≥18 years old, both genders;
  • Confirmed COVID-19 diagnosis (any body fluid tested positive for SARS-CoV-2 nucleic acid by PCR, or positive for SARS-CoV-2 antigen);
  • Respiratory rate ≥ 30 times/min, partial pressure of oxygen (PaO2)/ fraction of inspiration O2 (FiO2)≤ 300mmHg (1mmHg = 0.133kPa), or SpO2 ≤ 93% at rest without supplemental oxygen;
  • Article (3) above is newly appeared within 7 days;
  • Chest radiography or computed tomography shows bilateral chest infiltrates.

Who cannot join

  • Unable to obtain informed consent.
  • Physician with more than 5 years of clinical experience determines that death was inevitable within 24 hours.
  • Severe hepatic dysfunction (Child Pugh score ≥ C, or AST> 5 times the upper limit); Severe renal dysfunction (estimated glomerular filtration rate ≤ 30mL/ min/1.73 m2) or receive continuous renal replacement therapy, hemodialysis, or peritoneal dialysis.
  • Uncontrolled hypertension (sitting systolic blood pressure> 160mmHg, or diastolic blood pressure>100mmHg); previous history of hypertension crisis or hypertensive encephalopathy.
  • Poorly controlled heart diseases, such as NYHA class II and above cardiac insufficiency, unstable angina pectoris, myocardial infarction within 1 year before enrollment, supraventricular or ventricular arrhythmia need treatment or intervention.
  • Severe or above chronic obstructive pulmonary disease (GOLD grade, FEV1/FVC < 0.5).
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  • Hereditary bleeding tendency or coagulopathy;
  • Arterial/venous thromboembolic events within 6 months before enrollment, such as ischemic stroke, transient ischemic attack, deep venous thrombosis, pulmonary embolism, etc. Severe vascular disease (including aneurysms or arterial thrombosis requiring surgery) within 6 months before enrollment.
  • Unhealed wounds, active gastric ulcers or fractures. Gastrointestinal perforation, gastrointestinal fistula, abdominal abscess, visceral fistula formation within 6 months before enrollment. Major surgery (including preoperative Chest biopsy) or major trauma (such as a fracture) within 28 days before enrollment. May have surgery during the trial.
  • Severe, active bleeding such as hemoptysis, gastrointestinal bleeding, central nervous system bleeding, and nosebleeds within 1 month before enrollment.
  • Malignant tumors within 5 years before enrollment.
  • Allergic to bevacizumab or its components.
  • Active tuberculosis, uncontrollable infection, untreated active hepatitis or HIV-positive patients.
  • Pregnant and lactating women and those planning to get pregnant.
  • Participated in other clinical trials, not considered suitable for this study by the researchers.

Trial locations and contacts

1 site in 1 country.

Jiaojiao Pang, Dr contact

18560089129

jiaojiaopang@126.com

China1 site, 1 recruiting
  • Qilu Hospital of Shandong University

    Jinan, Shandong, 250012

    Jiaojiao Pang, Dr, +86 18560089129, jiaojiaopang@126.com

    Recruiting

Other trials in China

About this study

Official title: The Efficacy and Safety of Bevacizumab in Patients With Severe Covid-19: a Multicenter, Randomized, Double-blind, Parallel-group, Placebo-controlled Trial

The novel coronavirus (SARS-CoV-2) is a new strain of coronavirus found in human in 2019, which causes epidemic worldwide. Novel coronavirus disease (COVID-19) causes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in patients with severe COVID-19. Pulmonary edema is the key detrimental feature of ALI/ARDS. Autopsy of patients died from COVID-19 reported that, pulmonary mucus exudation was more severe and obvious than SARS infection. Pulmonary CT scanning and pathological findings also suggest that pulmonary edema caused by inflammatory exudation is a distinguished feature of COVID-19. Vascular endothelial growth factor (VEGF), also known as vascular permeability factor (VPF), is known as the most potent factor to increase vascular permeability, with the induction effect 50,000 times stronger than histamine. Bevacizumab is an anti-VEGF recombinant humanized monoclonal antibody, which has been used in anti-tumor treatment since 2004, with considerable reliability and clinical safety. This trial will provide high level evidence to answer whether bevacizumab is efficacy and safe medication for patients with severe COVID-19.

Read the detailed description

Evident increase of VEGF levels in serum has been displayed on novel pneumonia patients. The investigators also conducted a pilot study of 93 patients with severe COVID-19 that confirmed the significantly elevated level of plasma and serum VEGF.

At the beginning of 2020, the investigators proposed the concept of using anti-VEGF treatment for patients with severe COVID-19 and conducted a pilot study (NCT04275414). Among the 27 enrolled participants treated with bevacizumab, it was found that the clinical recovery status, PaO2/FiO2, and pulmonary exudation on imaging were significantly improved than the external controls in the same center during the same period. This provides good preliminary basis for this RCT.

Being tested
Bevacizumab, Placebo, Standard care

What participants receive

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

  • BevacizumabDrug

    Also called Recombinant anti-VEGF humanized monoclonal antibody injection

    Bevacizumab (7.5mg/kg BW) + Saline (100ml) Bevacizumab will be administered in a single dose with no less than 90 minutes of intravenous infusion under ECG monitoring.

  • PlaceboOther

    Also called Inactive excipient

    Placebo (7.5mg/kg BW) + Saline (100ml) The placebo drug will be administered in a single dose with no less than 90 minutes of intravenous infusion under ECG monitoring.

  • Standard careOther

    Standard care, including prophylactic doses of low molecular weight heparin or unfractionated heparin without contraindications, and therapeutic doses of anticoagulants with the evidence of thrombosis risk or occurrence.

Study groups in NCT04305106
Study groupRoleWhat they receive
BevacizumabExperimentalBevacizumab 7.5mg/kg body weight, intravenous drip, single-dose administration, and standard of care, including prophylactic doses of low molecular weight heparin or unfractionated heparin without contraindications, and therapeutic doses of anticoagulants with the evidence of thrombosis risk or occurrence.
Receives: Drug: Bevacizumab; Other: Standard care
PlaceboPlacebo comparatorPlacebo (inactive excipient) 7.5mg/kg body weight, intravenous drip, single-dose administration, and standard of care, including prophylactic doses of low molecular weight heparin or unfractionated heparin without contraindications, and therapeutic doses of anticoagulants with the evidence of thrombosis risk or occurrence.
Receives: Other: Placebo; Other: Standard care

What is being measured

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

  1. The time from randomization to clinical improvement

    The time from randomization to an improvement of two points (from the status at randomization) on a seven-category ordinal scale or live discharge from the hospital, whichever comes first.

    Measured: 28 days

Secondary outcomes (11)
  1. Intubation rate

    Intubation rate

    Measured: From date of randomization until the date of discharge, up to 28 days

  2. Duration of mechanical ventilation (days)

    Days of mechanical ventilation

    Measured: From date of randomization until the date of discharge, up to 28 days

  3. Duration of non-invasive ventilator or nasal high flow oxygen inhalation

    Days of non-invasive ventilator or nasal high flow oxygen inhalation

    Measured: From date of randomization until the date of discharge, up to 28 days

  4. All-cause mortality

    All-cause mortality

    Measured: From date of randomization until the date of discharge, up to 60 days

  5. Time to reach level 1 on the seven-category ordinal scale

    Days from randomization to the clinical status of reaching level 1 on the seven--category ordinal scale

    Measured: up to 60 days

  6. PaO2/FiO2 level

    The ratio of partial pressure of oxygen to fraction of inspiration O2

    Measured: day 1, day 3, day 7 and day 14 after randomization, or before discharge

  7. Improvement of pulmonary lesions

    The change of volumes of pulmonary exudation shown on CT compared to baseline

    Measured: day 7 and day 14 after randomization, or before discharge

  8. Improvement of lymphocyte count

    The change of the level of lymphocyte count compared to baseline

    Measured: day 7 and day 14 after randomization, or before discharge

  9. Improvement of CRP

    The change of the level of C-reactive protein compared to baseline

    Measured: day 7 and day 14 after randomization, or before discharge

  10. Improvement of LDH

    The change of the level of lactate dehydrogenase compared to baseline

    Measured: day 7 and day 14 after randomization, or before discharge

  11. SAE, AE

    Serious adverse event, adverse event

    Measured: From date of randomization until the date of discharge, up to 28 days

Timeline

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

  1. First posted12 Mar 2020
  2. Study start12 Jan 2023
  3. Primary completion30 Nov 2023 (estimated)
  4. Study completion31 Dec 2023 (estimated)

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
588 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04305106
Sponsor's protocol ID
QLEmer
Acronym
BEST
Status last verified
Jan 2023
First submitted
9 Mar 2020
Last updated
27 Jun 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: We will share the study protocol, SAP, ICF, CSR and analytic code on the day of article publication.

Publications

  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.

    PubMed 31986264
  • Pang J, Xu F, Aondio G, Li Y, Fumagalli A, Lu M, Valmadre G, Wei J, Bian Y, Canesi M, Damiani G, Zhang Y, Yu D, Chen J, Ji X, Sui W, Wang B, Wu S, Kovacs A, Revera M, Wang H, Jing X, Zhang Y, Chen Y, Cao Y. Efficacy and tolerability of bevacizumab in patients with severe Covid-19. Nat Commun. 2021 Feb 5;12(1):814. doi: 10.1038/s41467-021-21085-8.

    PubMed 33547300

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Bevacizumab in people with COVID-19 Pneumonia, run by Qilu Hospital of Shandong University at 1 site in China.

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 5 inclusion and 15 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: status not confirmed, as of the sponsor's last update on 27 Jun 2023. 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 China. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Jiaojiao Pang, Dr (18560089129, jiaojiaopang@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The time from randomization to clinical improvement (time frame: 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 NCT04305106, which also lists 2 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 27 Jun 2023; AzTrials last refreshed its copy on 6 Nov 2026.

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