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COVID-19Phase 2HITCHNCT04397718

Hormonal Intervention for the Treatment in Veterans With COVID-19 Requiring Hospitalization

A Phase 2 study testing Degarelix and Saline in people with COVID-19, run by VA Office of Research and Development at 14 sites in United States.

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

The purpose of this study is to determine if temporary androgen suppression improves the clinical outcomes of Veterans who are hospitalized to an acute care ward due to COVID-19. Read more about this study

Who is it for?
Ages 18 to 85 years, men only
Conditions the study is for
COVID-19
What is being tested?
Degarelix and Saline
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
96 participants
Where
14 sitesUnited States
Study dates
6 Jul 2020to 8 Jun 2021
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 to 85 years
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male Veterans admitted to a VA hospital.
  • Age > 18
  • Hospitalized on an acute care ward with a diagnosis of COVID-19 contributing to hospitalization.
  • Positive RT-PCR assay for SARS-CoV-2 on a nasopharyngeal swab sample.
  • Severity of illness of level 3, 4 or 5 on the influenza severity scale (see Appendix A) at the time of randomization.
  • The subject (or legally acceptable representative if applicable) must provide written informed consent for the trial.

Who cannot join

  • History of severe hypersensitivity to degarelix or any component of their respective formulation.
  • History of congenital long QT syndrome or known history of prolonged QT interval corrected by the Fridericia correction formula (QTcF) > 500 msec on electrocardiogram performed at screening.
  • Planned discharge within 24 hours of treatment initiation.
  • Subject is planning to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment.
  • Ongoing usage of a Class IA or Class III antiarrhythmic agent. At least 5 half lives must elapse since any prior use of a Class IA or III antiarrhythmic agent prior to administration of study drug.
  • --Baseline electrolyte abnormalities of Grade 3 or higher (based on CTCAE v5.0 criteria). Patients may be included if baseline electrolyte abnormalities are corrected to Grade 2 or lower prior to study drug administration.
Show all 17Show fewer
  • Myocardial infarction in the past 6 months, severe or unstable angina, or New York Heart Association (NYHA) Class III or IV heart disease.
  • Enrollment in another investigational study within 30 days of Day 1.
  • Known psychiatric or substance abuse disorder that would interfere with the requirements of the trial.
  • Child-Pugh Class C liver disease.
  • Use of any of the following hormonal agents within Day 1 of treatment:
  • Androgen receptor antagonists or agonists within 4 weeks,
  • Ketoconazole or abiraterone acetate within 2 weeks,
  • Estrogens or progestins within 2 weeks,
  • Herbal products that contain hormonally active agents within 2 weeks.
  • Unwilling or unable to comply with the study protocol.
  • Any condition, which in the opinion of the investigator, would preclude participation in the trial.

Trial locations and contacts

14 sites in 1 country.

14 sites in 1 country

United States14 sites
  • Brooklyn Campus of the VA NY Harbor Healthcare System, Brooklyn, NY

    Brooklyn, New York, 11209

  • Ralph H. Johnson VA Medical Center, Charleston, SC

    Charleston, South Carolina, 29401-5799

  • VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX

    Dallas, Texas, 75216

  • Michael E. DeBakey VA Medical Center, Houston, TX

    Houston, Texas, 77030

  • Central Arkansas VHS John L. McClellan Memorial Veterans Hospital, Little Rock, AR

    Little Rock, Arkansas, 72205-5484

  • VA Long Beach Healthcare System, Long Beach, CA

    Long Beach, California, 90822

  • VA Greater Los Angeles Healthcare System, West Los Angeles, CA

    Los Angeles, California, 90073

  • Memphis VA Medical Center, Memphis, TN

    Memphis, Tennessee, 38104

  • Miami VA Healthcare System, Miami, FL

    Miami, Florida, 33125

  • Manhattan Campus of the VA NY Harbor Healthcare System, New York, NY

    New York, New York, 10010

  • Philadelphia MultiService Center, Philadelphia, PA

    Philadelphia, Pennsylvania, 19106

  • Phoenix VA Health Care System, Phoenix, AZ

    Phoenix, Arizona, 85012

  • VA Puget Sound Health Care System Seattle Division, Seattle, WA

    Seattle, Washington, 98108

  • St. Louis VA Medical Center John Cochran Division, St. Louis, MO

    St Louis, Missouri, 63106

Other trials in United States

About this study

Official title: Hormonal Intervention for the Treatment in Veterans With COVID-19 Requiring Hospitalization (HITCH): A Multicenter, Phase 2 Randomized Controlled Trial of Best Supportive Care (BSC) vs BSC Plus Degarelix

The purpose of this study is to determine if temporary androgen suppression improves the clinical outcomes of Veterans who are hospitalized to an acute care ward due to COVID-19.

Read the detailed description

A novel coronavirus, now termed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), arose late in 2019. The first confirmed cases occurred in December in Wuhan, Hubei province, China. It now infects people on six continents, spreading person to person. The World Health Organization (WHO) classified it as a global pandemic on March 11, 2020. As of April 6, 2020, there are more than 1.2 million confirmed cases and more than 70,000 deaths attributed to this virus. Every person on Earth, as well as every United States Veteran, is at risk. This is the emergent public health threat of our time.

SARS-CoV-2 is a singled stranded RNA virus related to severe acute respiratory syndrome-related coronavirus (SARS-CoV-1). SARS-CoV-2 is thought to be transmissible largely by respiratory droplets or direct contact, but might also be transmitted through aerosolization. SARS-CoV-2 disease severity ranges from no to minimal symptoms, mildly symptomatic with cough and dyspnea, to severe respiratory distress with multi-organ failure requiring admission to an intensive care unit and emergent ventilator support. Although data are evolving, the severity of illness varies with age, co-existing comorbidities, and biological sex, with older age, people with pre-existing cardiovascular disease, and males manifesting greater disease severity.

A worldwide effort is in place to contain and suppress human-to-human transmission. These public-health strategies aim to slow the rate of spread and reduce the burden on critical care infrastructure. However, there is also a need effective therapeutics. Vaccine trials are underway but potential approvals are at least a year away. Development of new drugs de novo to treat SARS2-CoV-2 will likely take even longer. Thus, the most expedient therapeutic strategy to confront this pandemic will repurpose existing FDA-approved therapeutics. One potential strategy targets viral components directly, using existing antivirals and anti-infectives currently used for other diseases. Such efforts include trials of hydroxychloroquine, remdesivir, and ribavirin. Another strategy involves targeting the human proteins, rather than viral proteins, required for SARS CoV-2 entry and replication.

Conditions
COVID-19
Being tested
Degarelix, Saline
Medical subject headings
COVID-19

What participants receive

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

  • DegarelixDrug

    Degarelix is an FDA-approved drug for prostate cancer

  • SalineOther

    09% Saline

Study groups in NCT04397718
Study groupRoleWhat they receive
Placebo + BSCPlacebo comparatorNo active, only placebo (2 - prefilled syringes containing 3 ml of 0.9% saline) plus best supportive care.
Receives: Other: Saline
Degarelix + BSCExperimentalActive Degarelix (2 - prefilled syringes containing 3 ml of reconstituted Degarelix concentrated to 40mg/ml) plus best supportive care.
Receives: Drug: Degarelix

What is being measured

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

  1. Composite of Mortality, Ongoing Need for Hospitalization, or Mechanical Ventilation at Day 15

    Number of Patients who died, had a ongoing need for hospitalization, or was placed on mechanical ventilation at Day 15.

    Measured: 15 days

Secondary outcomes (7)
  1. Time to Clinical Improvement

    Time to clinical improvement as defined by a decline of 2 categories or more from the baseline modified 7-category ordinal scale of clinical status of hospitalized influenza patients or hospital discharge, whichever comes first. Participants whose condition worsened, who died, or who withdrew from the study without clinical improvement were censored. The 7-categories were defined as: 1: Not hospitalized with resumption of normal activities; 2: Not hospitalized, but unable to resume normal activities; 3: Hospitalization, not requiring supplemental oxygen; 4: Hospitalization, requiring supplemental oxygen; 5: Hospitalization, requiring nasal high-flow oxygen therapy and/or noninvasive mechanical ventilation; 6: Hospitalization, requiring extracorporeal membrane oxygenation and/or invasive mechanical ventilation; 7: Death.

    Measured: Through discharge (an average of 8 days with a maximum of 2.5 months)

  2. Inpatient Mortality

    Number of patients who died during their hospital stay

    Measured: Through discharge (an average of 8 days with a maximum of 2.5 months)

  3. Duration of Hospitalization

    Length of hospital stay (randomization to discharge)

    Measured: Through discharge (an average of 8 days with a maximum of 2.5 months)

  4. Duration of Intubation

    Length of time on mechanical ventilation. Length of mechanical ventilation imputed to maximum length (50 days) for patients who died on mechanical ventilation or who were on mechanical ventilation, but date removed was unknown. Length of mechanical ventilation imputed to 0 for patients never on mechanical ventilation.

    Measured: Through discharge (an average of 8 days with a maximum of 2.5 months)

  5. Time to Normalization of Temperature.

    Length of time for temperature to be less than < 37.5 degree Celsius for 48 hours

    Measured: Through discharge (an average of 8 days with a maximum of 2.5 months)

  6. Maximum Severity of COVID19 Illness.

    Maximum severity score on the modified 7-category ordinal scale of clinical status of hospitalized influenza patients. The 7-categories were defined as: 1: Not hospitalized with resumption of normal activities; 2: Not hospitalized, but unable to resume normal activities; 3: Hospitalization, not requiring supplemental oxygen; 4: Hospitalization, requiring supplemental oxygen; 5: Hospitalization, requiring nasal high-flow oxygen therapy and/or noninvasive mechanical ventilation; 6: Hospitalization, requiring extracorporeal membrane oxygenation and/or invasive mechanical ventilation; 7: Death.

    Measured: Through discharge (an average of 8 days with a maximum of 2.5 months)

  7. Composite of Mortality, Ongoing Need for Hospitalization, or Mechanical Ventilation at Day 30

    Number of Patients who died, had a ongoing need for hospitalization, or was placed on mechanical ventilation at Day 30.

    Measured: 30 days

Timeline

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

  1. First posted21 May 2020
  2. Study start6 Jul 2020
  3. Primary completion8 Jun 2021
  4. Study completion8 Jun 2021

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
96 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04397718
Sponsor's protocol ID
COVID19-8900-15
Acronym
HITCH
Status last verified
Jun 2022
First submitted
14 May 2020
Last updated
6 Jun 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Nickols NG, Mi Z, DeMatt E, Biswas K, Clise CE, Huggins JT, Maraka S, Ambrogini E, Mirsaeidi MS, Levin ER, Becker DJ, Makarov DV, Adorno Febles V, Belligund PM, Al-Ajam M, Muthiah MP, Montgomery RB, Robinson KW, Wong YN, Bedimo RJ, Villareal RC, Aguayo SM, Schoen MW, Goetz MB, Graber CJ, Bhattacharya D, Soo Hoo G, Orshansky G, Norman LE, Tran S, Ghayouri L, Tsai S, Geelhoed M, Rettig MB. Effect of Androgen Suppression on Clinical Outcomes in Hospitalized Men With COVID-19: The HITCH Randomized Clinical Trial. JAMA Netw Open. 2022 Apr 1;5(4):e227852. doi: 10.1001/jamanetworkopen.2022.7852.

    PubMed 35438754
  • Nickols NG, Goetz MB, Graber CJ, Bhattacharya D, Soo Hoo G, Might M, Goldstein DB, Wang X, Ramoni R, Myrie K, Tran S, Ghayouri L, Tsai S, Geelhoed M, Makarov D, Becker DJ, Tsay JC, Diamond M, George A, Al-Ajam M, Belligund P, Montgomery RB, Mostaghel EA, Sulpizio C, Mi Z, Dematt E, Tadalan J, Norman LE, Briones D, Clise CE, Taylor ZW, Huminik JR, Biswas K, Rettig MB. Hormonal intervention for the treatment of veterans with COVID-19 requiring hospitalization (HITCH): a multicenter, phase 2 randomized controlled trial of best supportive care vs best supportive care plus degarelix: study protocol for a randomized controlled trial. Trials. 2021 Jul 5;22(1):431. doi: 10.1186/s13063-021-05389-0.

    PubMed 34225789

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Degarelix and Saline in people with COVID-19, run by VA Office of Research and Development at 14 sites 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 6 inclusion and 17 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 6 Jun 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites 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 6 Jun 2022). 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?

Composite of Mortality, Ongoing Need for Hospitalization, or Mechanical Ventilation at Day 15 (time frame: 15 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 NCT04397718, 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 6 Jun 2022.

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