COVID-19Phase 2PATCHNCT04329923
The PATCH Trial (Prevention And Treatment of COVID-19 With Hydroxychloroquine)
A Phase 2 study testing Hydroxychloroquine Sulfate 400 mg twice a day, Hydroxychloroquine Sulfate 600 mg twice a day and Hydroxychloroquine Sulfate 600 mg once a day in people with COVID-19, run by Ravi Amaravadi, MD at 1 site in United States.
Trial summary
The PATCH trial (Prevention And Treatment of COVID-19 with Hydroxychloroquine) is funded investigator-initiated trial that includes 3 cohorts. Cohort 1: a double-blind placebo controlled trial of high dose HCQ as a treatment for home bound COVID-19 positive patients; Cohort 2: a randomized study testing different… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- COVID-19
- What is being tested?
- Hydroxychloroquine Sulfate 400 mg twice a day, Hydroxychloroquine Sulfate 600 mg twice a day and Hydroxychloroquine Sulfate 600 mg once a day
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 173 participants
- Where
- 1 siteUnited States
- Study dates
- 9 Apr 2020to 13 Nov 2020
- 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
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years old (Sub-studies 2 and 3)
- Competent and capable to provide informed consent
- Have access to a smart device such as a cell phone, tablet, laptop computer with necessary data/internet accessibility
- Subjects meeting the following criteria by Sub-Study
- Sub-Study 1:
- Age ≥40 years since the risk of prolonged disease that progresses to severe COVID-19 disease increases with age.
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- PCR-positive for the SARS-CoV2 virus
- (Fever, and cough, or Fever and shortness of breath,
- ≤4 days since the first symptoms of COVID-19 and date of testing
- Not taking azithromycin
- Not requiring hospitalization and is sent home for quarantine.
- Must live within 30 miles of HUP or Penn Presbytarian Medical Center to facilitate drop-off of medication
- Must own a working computer, or smartphone and have internet access
- Must be willing to fill out a daily symptom diary
- Must be available for a daily phone call,
- Must take their own temperature twice a day
- Must be willing to report the observed symptoms and development of COVID-19 in the co-inhabitants of the residence at which the quarantine will be served.
- Sub-Study 2 Hospitalized non-ICU service patients.
- PCR-positive for SARS-CoV-2
- Patients admitted to a floor bed at Hospital of the University of Pennsylvania or Penn Presbyterian.
- One or more of the following risk factors for progression to severe disease including: immunocompromising conditions, structural lung disease, hypertension, coronary artery disease, diabetes, age > 60, ferritin > 850, CRP > 6, D-dimer > 1000 Sub-Study 3 Health Care Worker Prevention
- Emergency Medicine or Infectious Disease Team physician or nurse at HUP or PPMC
- ≥20 hours per week of clinical work scheduled in the coming 2 months during the COVID-19 pandemic
- No fever, cough, or shortness of breath in the past 2 weeks
- Willing to report compliance with HCQ in the form of a diary
- Patients must be able to swallow and retain oral medication and must not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels.
Who cannot join
- Prisoners or other detained persons
- Allergy to hydroxychloroquine Pregnant or lactating or positive pregnancy test
- Receiving any treatment drug for 2019-ncov within 14 days prior to screening evaluation (off label, compassionate use or trial related).
- Co-enrollment onto another COVID-19 study is not allowed unless there is approval by the Medical Monitor in consultation with the PI and EM and ID sub-I leaders.
- Known history of retinal disease including but not limited to age related macular degeneration.
- Taking any of the following medications that prolong Qtc:
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- Chlorpromazine.Haloperidol, Droperidol, Quetiapine, Olanzapine. Amisulpride. Thioridazine
- History of interstitial lung disease or chronic pneumonitis unrelated COVID-19.
- Due to risk of disease exacerbation patients with porphyria or psoriasis are ineligible unless the disease is well controlled and they are under the care of a specialist for the disorder who agrees to monitor the patient for exacerbations.
- Patients with serious intercurrent illness that requires active infusional therapy, intense monitoring, or frequent dose adjustments for medication including but not limited to infectious disease, cancer, autoimmune disease, cardiovascular disease.
- Patients who have undergone major abdominal, thoracic, spine or CNS surgery in the last 2 months, or plan to undergo surgery during study participation.
- Patients receiving cytochrome P450 enzyme-inducing anticonvulsant drugs (i.e. phenytoin, carbamazepine, Phenobarbital, primidone or oxcarbazepine) within 4 weeks of the start of the study treatment
- History or evidence of increased cardiovascular risk including any of the following:
- Left ventricular ejection fraction (LVEF) < institutional lower limit of normal. Baseline echocardiogram is not required.
- A QT interval corrected for heart rate using the Frederica formula > 500 msec (Sub-study 2)
- Current clinically significant uncontrolled arrhythmias. Exception: Subjects with controlled atrial fibrillation
- History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within 6 months prior to enrollment
- Current ≥ Class II congestive heart failure as defined by New York Heart Association
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Pennsylvania
Philadelphia, Pennsylvania, 19104
About this study
The PATCH trial (Prevention And Treatment of COVID-19 with Hydroxychloroquine) is funded investigator-initiated trial that includes 3 cohorts. Cohort 1: a double-blind placebo controlled trial of high dose HCQ as a treatment for home bound COVID-19 positive patients; Cohort 2: a randomized study testing different doses of HCQ in hospitalized patients; Cohort 3: a double blind placebo controlled trial of low dose HCQ as a preventative medicine in health care workers.
- Conditions
- COVID-19
- Being tested
- Hydroxychloroquine Sulfate 400 mg twice a day, Hydroxychloroquine Sulfate 600 mg twice a day, Hydroxychloroquine Sulfate 600 mg once a day, Placebo oral tablet
- Medical subject headings
- COVID-19
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Hydroxychloroquine Sulfate 400 mg twice a dayDrug
Also called Plaquenil
Antimalarial compound
Hydroxychloroquine Sulfate 600 mg twice a dayDrug
Also called Plaquenil
Antimalarial compound
Hydroxychloroquine Sulfate 600 mg once a dayDrug
Also called Plaquenil
Antimalarial compound
Placebo oral tabletDrug
Also called Placebo
Placebo
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1 HCQ | Active comparator | COVID-19 PCR+ patients quarantined at home randomized to this arm will be treated with hydroxychloroquine 400 mg twice a day for up to 14 days Receives: Drug: Hydroxychloroquine Sulfate 400 mg twice a day |
| Cohort 1 Placebo | Placebo comparator | COVID-19 PCR+ patients quarantined at home randomized to this arm will be treated with placebo twice a day for up to 14 days. Crossover is allowed if symptoms worsen after 7 days of treatment. Receives: Drug: Placebo oral tablet |
| Cohort 2 HCQ high dose | Experimental | Hospitalized COVID-19 PCR+ patients randomized to this arm will be treated with hydroxychloroquine 600 mg twice a day for up to 14 days Receives: Drug: Hydroxychloroquine Sulfate 600 mg twice a day |
| Cohort 2 HCQ low dose | Active comparator | Hospitalized COVID-19 PCR+ patients randomized to this arm will be treated with hydroxychloroquine 600 mg once a day for up to 7 days Receives: Drug: Hydroxychloroquine Sulfate 600 mg once a day |
| Cohort 3 HCQ | Experimental | Health care workers at high risk of contracting COVID-19 randomized to this arm will be treated with hydroxychloroquine 600 mg once a day for 2 months Receives: Drug: Hydroxychloroquine Sulfate 600 mg once a day |
| Cohort 3 Placebo | Placebo comparator | Health care workers at high risk of contracting COVID-19 randomized to this arm will be treated with placebo for 2 month. Crossover is allowed if subject becomes SARS-CoV2 positive. Receives: Drug: Placebo oral tablet |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to Release From Quarantine Time
Cohort 1 (home quarantined COVID-19 patients): Median time to release from quarantine by meeting the following criteria: 1) No fever for 72 hours 2) improvement in other symptoms and 3) 7 or 10 days (depending on CDC guidance at the time) have elapsed since the beginning of symptom onset.
Measured: until quarantine release or hospitalization
Time to Hospital Discharge
Cohort 2 (hospitalized COVID-19 patients): median number of days until hospital discharge
Measured: until hospital discharge
Number of Health Care Workers Who Developed SARS-COV-2 Infection
Cohort 3 Physicians and nurse prophylaxis: Rate of COVID-19 infection at 2 months
Measured: 2 months
Secondary outcomes (2)
Rate of Housemate Infection
Cohort 1 rate of participant-reported secondary infection of housemates
Measured: until quarantine release, or approximately <20 days
Rate of Hospitalization
Cohort 1 rate of hospitalization
Measured: until quarantine release
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Apr 2020
- Study start9 Apr 2020
- Primary completion11 Nov 2020
- Study completion13 Nov 2020
Why it stopped: Cohort 1: slow accrual Cohort 2: Other studies showed no benefit Cohort 3: Study met pre-specificied futility analysis at planned second interim analysis
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 COVID-19Studies of the same condition, open and under way.
- 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
- Model description
- There are 3 cohorts. All partcipants in of each the cohorts are randomized to one of two arms
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 173 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ravi Amaravadi, MD
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Ravi Amaravadi, MD, University of Pennsylvania
- Investigators
- Ravi Amaravadi, MD, Principal investigator, University of Pennsylvania
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04329923
- Sponsor's protocol ID
- 842838
- Acronym
- PATCH
- Status last verified
- Dec 2020
- First submitted
- 30 Mar 2020
- Last updated
- 10 Dec 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: We will publish our results in a peer-reviewed journal and make available de-identified data for additional analysis
Publications
Abella BS, Jolkovsky EL, Biney BT, Uspal JE, Hyman MC, Frank I, Hensley SE, Gill S, Vogl DT, Maillard I, Babushok DV, Huang AC, Nasta SD, Walsh JC, Wiletyo EP, Gimotty PA, Milone MC, Amaravadi RK; Prevention and Treatment of COVID-19 With Hydroxychloroquine (PATCH) Investigators. Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial. JAMA Intern Med. 2021 Feb 1;181(2):195-202. doi: 10.1001/jamainternmed.2020.6319.
PubMed 33001138
Study at a glance
From the registry record, last updated by the sponsor on 10 Dec 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The PATCH Trial (Prevention And Treatment of COVID-19 With Hydroxychloroquine)
- ClinicalTrials.gov ID
- NCT04329923
- Acronym / sponsor ID
- PATCH / 842838
- Conditions
- COVID-19
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Cohort 1: slow accrual Cohort 2: Other studies showed no benefit Cohort 3: Study met pre-specificied futility analysis at planned second interim analysis
- Enrolment
- 173 participants (actual)
- Lead sponsor
- Ravi Amaravadi, MDUniversity, hospital or other
- Study start
- 9 Apr 2020 (actual)
- Primary completion
- 11 Nov 2020 (actual)
- Study completion
- 13 Nov 2020 (actual)
- First posted
- 1 Apr 2020 (actual)
- Results
- Posted 10 Dec 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The PATCH trial (Prevention And Treatment of COVID-19 with Hydroxychloroquine) is funded investigator-initiated trial that includes 3 cohorts. Cohort 1: a double-blind placebo controlled trial of high dose HCQ as a treatment for home bound COVID-19 positive patients; Cohort 2: a randomized study testing different doses of HCQ in hospitalized patients; Cohort 3: a double blind placebo controlled trial of low dose HCQ as a preventative medicine in health care workers.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 6
- Model description
- There are 3 cohorts. All partcipants in of each the cohorts are randomized to one of two arms
| Arm | Type | Receives |
|---|---|---|
| Cohort 1 HCQ | Active comparator | Drug: Hydroxychloroquine Sulfate 400 mg twice a dayCOVID-19 PCR+ patients quarantined at home randomized to this arm will be treated with hydroxychloroquine 400 mg twice a day for up to 14 days |
| Cohort 1 Placebo | Placebo comparator | Drug: Placebo oral tabletCOVID-19 PCR+ patients quarantined at home randomized to this arm will be treated with placebo twice a day for up to 14 days. Crossover is allowed if symptoms worsen after 7 days of treatment. |
| Cohort 2 HCQ high dose | Experimental | Drug: Hydroxychloroquine Sulfate 600 mg twice a dayHospitalized COVID-19 PCR+ patients randomized to this arm will be treated with hydroxychloroquine 600 mg twice a day for up to 14 days |
| Cohort 2 HCQ low dose | Active comparator | Drug: Hydroxychloroquine Sulfate 600 mg once a dayHospitalized COVID-19 PCR+ patients randomized to this arm will be treated with hydroxychloroquine 600 mg once a day for up to 7 days |
| Cohort 3 HCQ | Experimental | Drug: Hydroxychloroquine Sulfate 600 mg once a dayHealth care workers at high risk of contracting COVID-19 randomized to this arm will be treated with hydroxychloroquine 600 mg once a day for 2 months |
| Cohort 3 Placebo | Placebo comparator | Drug: Placebo oral tabletHealth care workers at high risk of contracting COVID-19 randomized to this arm will be treated with placebo for 2 month. Crossover is allowed if subject becomes SARS-CoV2 positive. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (26 listed)
- Age ≥ 18 years old (Sub-studies 2 and 3)
- Competent and capable to provide informed consent
- Have access to a smart device such as a cell phone, tablet, laptop computer with necessary data/internet accessibility
- Subjects meeting the following criteria by Sub-Study
- Age ≥40 years since the risk of prolonged disease that progresses to severe COVID-19 disease increases with age.
Key exclusion criteria (18 listed)
- Prisoners or other detained persons
- Allergy to hydroxychloroquine Pregnant or lactating or positive pregnancy test
- Receiving any treatment drug for 2019-ncov within 14 days prior to screening evaluation (off label, compassionate use or trial related).
- Co-enrollment onto another COVID-19 study is not allowed unless there is approval by the Medical Monitor in consultation with the PI and EM and ID sub-I leaders.
- Known history of retinal disease including but not limited to age related macular degeneration.
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 |
|---|---|---|
| Hydroxychloroquine Sulfate 400 mg twice a dayAlso: PlaquenilAntimalarial compound | Drug | Cohort 1 HCQ |
| Hydroxychloroquine Sulfate 600 mg twice a dayAlso: PlaquenilAntimalarial compound | Drug | Cohort 2 HCQ high dose |
| Hydroxychloroquine Sulfate 600 mg once a dayAlso: PlaquenilAntimalarial compound | Drug | Cohort 2 HCQ low dose, Cohort 3 HCQ |
| Placebo oral tabletAlso: PlaceboPlacebo | Drug | Cohort 1 Placebo, Cohort 3 Placebo |
Primary outcome
Time to Release From Quarantine Time
Time frame: until quarantine release or hospitalization
Cohort 1 (home quarantined COVID-19 patients): Median time to release from quarantine by meeting the following criteria: 1) No fever for 72 hours 2) improvement in other symptoms and 3) 7 or 10 days (depending on CDC guidance at the time) have elapsed since the beginning of symptom onset.
Time to Hospital Discharge
Time frame: until hospital discharge
Cohort 2 (hospitalized COVID-19 patients): median number of days until hospital discharge
Number of Health Care Workers Who Developed SARS-COV-2 Infection
Time frame: 2 months
Cohort 3 Physicians and nurse prophylaxis: Rate of COVID-19 infection at 2 months
2 secondary outcomes
Rate of Housemate Infection
Time frame: until quarantine release, or approximately <20 days
Rate of Hospitalization
Time frame: until quarantine release
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Dec 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 33001138Abella BS, Jolkovsky EL, Biney BT, Uspal JE, Hyman MC, Frank I, Hensley SE, Gill S, Vogl DT, Maillard I, Babushok DV, Huang AC, Nasta SD, Walsh JC, Wiletyo EP, Gimotty PA, Milone MC, Amaravadi RK; Prevention and Treatment of COVID-19 With Hydroxychloroquine (PATCH) Investigators. Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial. JAMA Intern Med. 2021 Feb 1;181(2):195-202. doi: 10.1001/jamainternmed.2020.6319.
- Individual participant dataSharing planned: Yes. We will publish our results in a peer-reviewed journal and make available de-identified data for additional analysis
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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.
Ravi Amaravadi, MD principal investigator
University of Pennsylvania
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Hydroxychloroquine Sulfate 400 mg twice a day, Hydroxychloroquine Sulfate 600 mg twice a day and Hydroxychloroquine Sulfate 600 mg once a day in people with COVID-19, run by Ravi Amaravadi, MD at 1 site in United States.
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 26 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 10 Dec 2020. 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 United States. 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 10 Dec 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 Release From Quarantine Time (time frame: until quarantine release or hospitalization). The study lists 3 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 NCT04329923, 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 10 Dec 2020.