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Treatment of Covid-19 Virus InfectionPhase 2/3NCT04494204

Effect of a Combination of Treatment of Reginmune Capsule and Immunofree Tablets in the Treatment of Mild to Moderate COVID-19 Patients

A Phase 2/3 study testing Immunofree tablets and Reginmune capsule in people with Treatment of Covid-19 Virus Infection, run by PUNEET MITTAL at 3 sites in India.

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

While novel drug discovery and vaccine studies are time taking process, re-purposing old drugs against the COVID-2019 epidemic can help identify treatments, with known pre-clinical, pharmacokinetic, pharmacodynamic, and toxicity profiles, which can rapidly enter Phase 3 or 4 or can be used directly in clinical… Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Treatment of Covid-19 Virus Infection
What is being tested?
Immunofree tablets and Reginmune capsule
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
3 sitesIndia
Study dates
7 Aug 2020to 20 Dec 2020
Phase
Phase 2/3
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 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Gender: Either male or non-pregnant, non-lactating female aged > 18-70
  • Patients with RT-PCR confirmed diagnosis of COVID-19
  • Patients with mild to moderate COVID-19 infection having either one of the following criteria: oPaO2/FiO2:200-300 OR Respiratory rate ? 24/min and SaO2/SpO2 > 90% on room air
  • Subjects willing to give written informed consent
  • Subjects able to take the drug orally and comply with the study protocol
  • Women of child bearing potential must have a negative urine pregnancy test prior to study entry

Who cannot join

  • Patients with persistent vomiting
  • Critically ill patients
  • P/F ratio less than 200 (moderate-severe ARDS)
  • Shock (Requiring Vasopressor to maintain a MAP more than 65 mm of hg or MAP below 65)
  • Patients with known active hepatitis, tuberculosis and definite bacterial or fungal infections
  • Patients with altered mental state
Show all 14Show fewer
  • Patients with multiple organ failure requiring ICU monitoring and treatment
  • Patients with respiratory failure and requiring mechanical ventilation
  • Patients with any concurrent medical condition or uncontrolled, clinically significant systemic disease (e.g. heart failure, hypertension, liver disease, diabetes, anemia etc.) that, in the opinion of investigator precludes the subject's participation in the study or interferes with the interpretation of the study results.
  • Patients with history of serology tests positive for hepatitis B, hepatitis C, or human immunodeficiency virus.
  • Patients who have received specific antiviral drugs ritonavir/lopinavir, or chloroquine, hydroxychloroquine, azithromycin, monoclonal antibodies within 1 week before admission
  • Patient who have participated in another investigational study within 3 months prior to enrollment in this study
  • Investigators, study personnel, sponsor's representatives and their first-degree relatives.
  • Pregnant subjects

Trial locations and contacts

3 sites in 1 country.

India3 sites
  • Lokmanya Hospital

    Pune, Maharashtra, 411033

  • Govt Medical College and Govt General Hospital (Old RIMSGGH)

    Srikakulam, Andhra Pradesh, 532001

  • Parul Institute of Ayurveda and Research Parul University

    Vadodara, Gujarat, 391760

Other trials in India

About this study

Official title: An Open Label, Multicenter, Randomized, Controlled, Clinical Study to Evaluate the Efficacy and Safety of a Combination of Treatment of Reginmune Capsule and Immunofree Tablets Compared With Standard Treatment Protocol in the Treatment of Mild to Moderate COVID-19 Patients.

While novel drug discovery and vaccine studies are time taking process, re-purposing old drugs against the COVID-2019 epidemic can help identify treatments, with known pre-clinical, pharmacokinetic, pharmacodynamic, and toxicity profiles, which can rapidly enter Phase 3 or 4 or can be used directly in clinical settings. Immunofree has many of the herbs which have been evaluated by other trials published for Covid-19 treatment.

The Immunofree tablet of the test product is an Ayurvedic proprietary medicine and is a combination of polyherbal mixture. The components of this formulation are known for their anti-viral and immunomodulatory effects. Also, Reginmune, owing to its immunomodulatory effect might help in easing the symptoms and decrease the viral load.

Read the detailed description

The symptoms of COVID-19 are mainly for respiratory disorders and similar to severe acute respiratory symptoms. The common signs of infection observed in COVID-19 patients include respiratory symptoms, sneezing, fever, cough, shortness of breath and other breathing difficulties. In case of severely infected patients, infection can cause pneumonia, severe acute respiratory syndrome (SARS), kidney failure and even death in many cases. There are many people who had high viral load but do not develop COVID-19 symptoms like coughing or sneezing. Such asymptomatic people serve as hidden carriers of virus and may further contribute in enhanced transmission of virus to other people. In absence of any emergency medicine or complete therapy for COVID-19; the prevention of spread of SARS-CoV2 virus and regulation of infection is the prime step in controlling this epidemic disease, in which the test products can be of immense value.

The test product, Capsule Reginmune is a combination of some phytochemicals, amino acids, vitamins and minerals and a bio-polymer in cellular matrix. The components and their pharmacological activities are as follow:

Echinacea is one of the more popular herbal supplements suggested for boosting immunity. Some respiratory and antiviral research has also been done on Echinacea. Echinacea is not mentioned by the Indian and Chinese Governments however in their guidelines for boosting immunity.

Cats Claw (Uncaria Tomentosa)has shown potent anti-viral and immunomodulatory activity in a recent study. The results demonstrated an in vitro inhibitory activity by both extract and alkaloidal fraction, reducing DENV-Ag+ cell rates in treated monocytes. A multiple microbead immunoassay was applied for cytokine determination (TNF-alpha, IFN-alpha, IL-6 and IL-10) in infected monocyte culture supernatants. The alkaloidal fraction induced a strong immunomodulation: TNF-alpha and IFN-alpha levels were significantly decreased and there was a tendency towards IL-10 modulation. The researchers conclude that the alkaloidal fraction was the most effective in reducing monocyte infection rates and cytokine levels. The antiviral and immunomodulating in vitro effects from U. tomentosa pentacyclic oxindole alkaloids displayed novel properties regarding therapeutic procedures in Dengue Fever and might be further investigated as a promising candidate for clinical application.

Vitamin C: Well accepted to increase immunity and an effective antiviral. However, not many people realize the vast difference in food derived vitamin C and ascorbic acid which is a dead synthesized molecule used to clean pools. Therefore, it is strongly recommended that one should only take food derived Vitamin C.

Zinc: There is some evidence suggesting Zinc can shorten duration of the common cold and one study done in 2010 showing that Zinc had an effect on the older versions of Corona virus. An abundance of evidence has accumulated over the past 50 years to demonstrate the antiviral activity of zinc against a variety of viruses, and via numerous mechanisms. Clinical trial data support the value of zinc in reducing the duration and severity of symptoms of the common cold when administered within 24 hours of the onset of common cold symptoms. However, one must be careful as not all zinc is equally bioavailable and more than 150 mg of Zinc can lead to toxicity.

Copper: A study suggested that copper deficiency may lead to reduction in the number of T cell lymphocytes and impaired host defense against infectious organisms.

L- Lysine: Studies shows L-Lysine supplements may help to boost immunity against certain viral infections.

Aloe Vera: Numerous studies for influenza and herpes has shown that Aloe polysaccharides (APS) extracted from Aloe vera leaves have evident effects on the therapy of virus infection.

Lglutamine: Glutamine is the most abundant and versatile amino acid in the body. Glutamine is currently part of clinical nutritional supplementation protocols and/or recommended for immune suppressed individuals.

L Arginine: Studies have shown that arginine suppressed the growth of HSV-1, concentration dependently and it can boost the activity of T-cells.

L Isoleucine : It has shown to be effective against rotavirus infection. Magnesium Gluconate: It has shown some immunomodulatory effects which was measured by Natural Killer cells activities and phagocytosis.

Sodium Hyaluronate: Hyaluronic acid (HA), one of the main components of extra-cellular matrix and most notably of the fundamental substance of conjunctive tissues, is not an inert structure. Conversely, it displays important biological properties and plays a significant role in crucial physiological processes especially when cellular plasticity is involved such as inflammation, immune reactions, angiogenesis and would healing. It is also strongly involved in neoplastic cells migration and therefore in metastatic spreading of malignant tumors.

The Immunofree tablet of the test product is an Ayurvedic proprietary medicine and is a combination of polyherbal mixture. The components of this formulation are known for their anti-viral and immunomodulatory effects.

Kalmegh also known as Andrographis paniculata has been used in Ayurveda and other herbal traditions for boosting up the immune system. It is believed that the herb has potential antiviral and immunomodulatory properties owing to it containing andrographolide. The following studies are done on it which suggest potential benefit.

Bhumyamalaki: It is also known as Phyllanthus niruri. It seems to exhibit anti-viral anti-inflammatory activity. The following studies for SARS suggest that this may be of benefit.

Glycyrrhiza glabra is also known as licorice, mulethi, etc. It has been used in TCM, Ayurveda and other herbal traditions for lung health and stomach health. It is very alkalizing. It is believed that it has strong antiviral properties and hence this herb is in both Chinese and Indian recommendations. This herb contains glycyrrhizin which showed remarkable qualities in SARS research.

Some reports suggest that strong extracts of this herb are central to the Chinese strategy in Wuhan. The following studies are done on it, which suggest potential benefit.

Tulsi is also known as Ocimum sanctum has been used traditionally in India. It is considered a sacred herb in Ayurveda.Following studies are done on it which suggest potential benefit.

Giloy is also known as Tinospora cordifolia has been used traditionally in Ayurveda as it helps in boosting gut immunity.

Pushkarmool: It is also known as Inula racemosa and it may be an effective herb for flu symptoms. It also supports the normal functioning of the respiratory system.

The drug Pushkarmool has been used in the indigenous system of medicine for a long time. Pushkarmool has been reported in the texts of Ayurveda as possessing Tikta, Katu and Ushna Virya and beneficial for the diseases of heart, throat. It is known to act as an expectorant. It is also used in Ayurveda as an expectorant and resolvent in indurations. Its pharmacological activities include cardioprotective activity, antiallergic activity, antimutagenic and antiapoptotic effects, anti-inflammatory \& analgesic effect, adrenergic beta blocking activity.

Alpinia galanga is also known as rasna, sugandhimool, etc. It has been used inTCM, Ayurveda and other herbal traditions for lung health and the potential to reduce the inflammatory process. It is believed that the herb has antiviral activity in human respiratory syncytial viruses. The following studies are done on it which suggest potential benefit.

Draksha: It is also known as Vitis Vinifera. Studies suggeset that the herb possesses a broad spectrum of pharmacological and therapeutic effects such as antioxidative, anti-inflammatory, and antimicrobial activities.

Haldi is also known as Turmeric, Curcuma longa, etc. Alkaloids derived from turmeric have shown potentially strong inhibitory effects on the neuraminidases from two influenza viral strains. The following studies are done on it which suggest potential benefit.

Haritaki is also known as Terminalia chebula has been used in TCM, Ayurveda, and other herbal traditions for boosting immunity. The herb is also possibly useful for easing the symptoms associated with respiratory illnesses. The following studies are done on it which suggest potential benefit.

Aloe Vera: Studies show that extracts of Aloe Vera may help to inhibit the activity of the virus and support the functioning of the lungs.

Shilajit: It is also known as Asphaltum: It has been used traditionally by the Indian Ayurvedic and Siddha systems of traditional medicine to enhance the quality of life. Studies show that the minerals in Shilajit may also possesses immune boosting activities.

Pippali: It is also known as Piper longum. It has been used traditionally in the Ayurvedic system for lung health. Studies suggest that it may help to improve lung function.

Shaival: It is also known as Asthaxantin. Studies show that it may possess antimicrobial and anti-inflammatory properties.

Damanaka - Also known as Artemisia, has potential anti-malarial properties.

Being tested
Immunofree tablets and Reginmune capsule
Keywords
coronavirus, covid-19, covid, corona, coagulation, immunofree, mgcts, biogetica
Medical subject headings
Coronavirus Infections, COVID-19, Thrombosis

What participants receive

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

  • Immunofree tablets and Reginmune capsuleCombination product

    2 Immunofree tablets thrice a day at an interval of 4-5 hours for 10 days and 1 Reginmune capsule twice a day for 10 days

Study groups in NCT04494204
Study groupRoleWhat they receive
InterventionExperimental2 tablets Immunofree 500 mg tablets thrice a day for 10 days and 1 capsule Reginmune 750 mg twice a day for 10 days
Receives: Combination Product: Immunofree tablets and Reginmune capsule
Comparator AgentActive comparatorAs per standard National Clinical Management Protocol for COVID-19 by Government of India, Ministry of Health and Family Welfare, Directorate General of Health Services, (EMR Division), Version 3, 13.06.20
Receives: Combination Product: Immunofree tablets and Reginmune capsule

What is being measured

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

  1. Time (Days) to clinical improvement from study enrollment

    This includes overall time it takes for negative covid-19 results, improvement based on a customized questionnaire for fever, cough, body ache, loss of taste or smell, or other similar conditions

    Measured: Day 0 - Day 10

Secondary outcomes (6)
  1. Proportion of participants in each group with oxygen saturation more than 94% on room air for more than 24h

    Being an important part, each patient has to be monitored for oxygen saturation level, and this would help us analyze when a subject enters from Mild to moderate stage

    Measured: Day 0, Day 5±1 and Day of discharge i.e Day 10±1

  2. Value of coagulation indicators

    D Dimer levels has to be measured to study the D dimer levels of the patient as most researchers claiming covid-19 to be relative to coagulation. This study will help us identity the same.

    Measured: Day 0, Day 5±1 and Day of discharge i.e Day 10±1

  3. Time to first negative SARS-CoV-2 PCR in NP swab

    via ICMR recognized RT-PCR to identify when a patient is coronavirusfree

    Measured: Day 0, Day 5±1 and Day of discharge i.e Day 10±1

  4. Duration of oxygen therapy

    To identify how long a patient needs oxygen therapy in certain case

    Measured: upto day 10+1

  5. Proportion of participants in each group with need for mechanical ventilation

    This is considered as a part of pharmacovigilance, as how many people enters moderate to severe case, if any

    Measured: upto day 10+1

  6. Duration of hospitalization

    most mild cases that becomes asymptomatic are sent back from hospital and treated at home quarantine. this is to identify when a patient becomes asymptomatic

    Measured: upto day 10+1

Timeline

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

  1. First posted31 Jul 2020
  2. Study start7 Aug 2020
  3. Primary completion1 Dec 2020
  4. Study completion20 Dec 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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
After obtaining the informed consent, patients will be screened by undergoing various assessments and after confirming eligibility, eligible patients will be randomized in the study and assigned either to the test group or control group with Best standard of care as per institutional practice, for 10 days treatment period. Patient will be hospitalized during the treatment period.
Masking
None (open label)
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04494204
Sponsor's protocol ID
MGCTS/20/105
Status last verified
Dec 2020
First submitted
28 Jul 2020
Last updated
22 Dec 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: The trial is meant for pandemic, and any data is fruitful to the society will be shared with researchers only, without compromising personal data of the participant.

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Immunofree tablets and Reginmune capsule in people with Treatment of Covid-19 Virus Infection, run by PUNEET MITTAL at 3 sites in India.

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 14 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 22 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 3 sites in India. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined 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.

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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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 (Days) to clinical improvement from study enrollment (time frame: Day 0 - Day 10). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 22 Dec 2020.

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