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COVIDPhase 3NCT04546581

Inpatient Treatment of COVID-19 With Anti-Coronavirus Immunoglobulin (ITAC)

A Phase 3 study testing Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG) and Remdesivir in people with COVID and COVID-19, run by University of Minnesota at 39 sites in 7 countries.

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

This protocol will serve as a platform for assessing treatments for adult patients hospitalized for medical management of COVID-19 without related serious end-organ failure. Trials will involve sites around the world strategically chosen to ensure rapid enrollment. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID, COVID-19, SARS-CoV-2
What is being tested?
Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG) and Remdesivir
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
593 participants
Where
39 sitesin 7 countries
Study dates
8 Oct 2020to 21 May 2021
Phase
Phase 3
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
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • SARS-CoV-2 infection documented by polymerase chain reaction (PCR) or other nucleic acid test (NAT) within 3 days prior to randomization OR documented by NAT more than 3 days prior to randomization AND progressive disease suggestive of ongoing SARS-CoV-2 infection
  • Symptomatic COVID-19 disease
  • Duration of symptoms attributable to COVID-19 ≤ 12 days
  • Requiring inpatient hospital medical care for clinical manifestations of COVID-19 (admission for public health or quarantine only is not included)
  • Willingness to abstain from participation in other COVID-19 treatment trials until after study Day 7
  • Provision of informed consent by participant or legally authorized representative

Who cannot join

  • Prior receipt of SARS-CoV-2 hIVIG or convalescent plasma from a person who recovered from COVID-19 at any time
  • Prior receipt of standard IVIG (not hyperimmune to SARS-CoV-2) within 45 days
  • Current or predicted imminent (within 24 hours) requirement for any of the following:
  • Invasive ventilation
  • Non-invasive ventilation
  • Extracorporeal membrane oxygenation
Show all 15Show fewer
  • Mechanical circulatory support
  • Continuous vasopressor therapy
  • History of allergy to IVIG or plasma products
  • History of selective IgA deficiency with documented presence of anti-IgA antibodies
  • Any medical conditions for which receipt of the required volume of intravenous fluid may be dangerous to the patient (includes New York Association Class III or IV stage heart failure)
  • Any of the following thrombotic or procoagulant disorders:
  • Acute coronary syndromes, cerebrovascular syndromes and pulmonary or deep venous thrombosis within 28 days of randomization
  • History of prothrombin gene mutation 20210, homozygous Factor V Leiden mutations, antithrombin III deficiency, protein C deficiency, protein S deficiency or antiphospholipid syndrome
  • Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the subject or that could prevent, limit, or confound the protocol-specified assessments

Trial locations and contacts

39 sites in 7 countries.

39 sites in 7 countries

United States18 sites
  • Hendrick Medical Center

    Abilene, Texas, 79601

  • National Institutes of Health Clinical Center

    Bethesda, Maryland, 20892

  • Penrose Hospital

    Colorado Springs, Colorado, 80907

  • St. Francis Health Services

    Colorado Springs, Colorado, 80907

  • University of Missouri

    Columbia, Missouri, 65212

  • Ohio Health Research Institute

    Columbus, Ohio, 43215

  • CHRISTUS Spohn Shoreline Hospital

    Corpus Christi, Texas, 78404

  • University of Texas Southwestern Medical Center

    Dallas, Texas, 75235

  • St. Anthony Hospital

    Lakewood, Colorado, 80228

  • Hennepin Healthcare Research Institute/HCMC

    Minneapolis, Minnesota, 55415

  • FirstHealth Moore Regional Hospital

    Pinehurst, North Carolina, 28394

  • CJW Chippenham Medical Center

    Richmond, Virginia, 23225

  • Henrico Doctors' Hospital (HCA)

    Richmond, Virginia, 23229

  • Redmond Regional Medical Center

    Rome, Georgia, 30165

  • Cox Medical Centers

    Springfield, Missouri, 65807

  • Washington VA Medical Center

    Washington D.C., District of Columbia, 20422

  • Saint Anthony North Health Campus

    Westminster, Colorado, 80023

  • University of Massachusetts

    Worcester, Massachusetts, 01665

Other trials in United States

Denmark8 sites
  • Aarhus Universitetshospital, Skejby

    Aarhus

  • Bispebjerg Hospital

    Copenhagen

  • CHIP, Department of Infectious Diseases, Section 2100

    Copenhagen

  • Herlev-Gentofte Hospital

    Hellerup

  • Nordsjællands Hospital, Hillerød

    Hillerød, 3400

  • Hvidovre University Hospital, Department of Infectious Diseases

    Hvidovre

  • Kolding Sygehus

    Kolding

  • Odense University Hospital

    Odense

Other trials in Denmark

Greece5 sites
  • Democritus University of Thrace

    Alexandroupoli, Thrace, 68131

  • 3rd Dept of Medicine, Medical School, NKUA

    Athens, 11527

  • 1st Respiratory Medicine Dept, Athens University Medical School

    Athens

  • Attikon University General Hospital

    Athens

  • Dept. of Critical Care & Pulmonary Medicine, Evangelismos General Hospital

    Athens

Other trials in Greece

Spain4 sites
  • Hospital Universitari Germans Trias i Pujol

    Badalona, Barcelona, 08916

  • Hospital Universitari Vall d'Hebron

    Barcelona, Catalonia, 08035

  • Hospital del Mar

    Barcelona, 08002

  • Hospital Clínic de Barcelona

    Barcelona, 08036

Other trials in Spain

Japan2 sites
  • NCGM

    Tokyo

  • Fujita Health University Hospital

    Toyoake

Other trials in Japan

Nigeria1 site
  • Institute of Human Virology-Nigeria (IHVN)

    Abuja

Other trials in Nigeria

United Kingdom1 site
  • Royal Free Hospital

    London

Other trials in United Kingdom

About this study

Official title: An International Multicenter, Adaptive, Randomized Double-Blind, Placebo-Controlled Trial of the Safety, Tolerability and Efficacy of Anti-Coronavirus Hyperimmune Intravenous Immunoglobulin for the Treatment of Adult Hospitalized Patients at Onset of Clinical Progression of COVID-19

This protocol will serve as a platform for assessing treatments for adult patients hospitalized for medical management of COVID-19 without related serious end-organ failure. Trials will involve sites around the world strategically chosen to ensure rapid enrollment. This trial will compare hyperimmune intravenous immunoglobulin (hIVIG) with matched placebo, when added to standard of care (SOC), for preventing further disease progression and mortality related to COVID-19. SOC will include remdesivir unless it is contraindicated for an individual patient.

Read the detailed description

The primary endpoint of this trial in hospitalized patients is an ordinal outcome based on the patient's clinical status on Day 7. It includes 7 mutually exclusive categories capturing the range of organ dysfunction that may be associated with progression of COVID-19, such as respiratory dysfunction and coagulation-related complications. The ordinal endpoint is defined as follows:

  1. Death
  2. End-organ failure
  3. Life-threatening end-organ dysfunction
  4. Serious end-organ dysfunction
  5. Moderate end-organ dysfunction
  6. Limiting symptoms due to COVID-19
  7. No limiting symptoms due to COVID-19

Secondary endpoints include time to the 3 least favorable categories, time to the 2 most favorable categories, and the pulmonary only and thrombotic only components of the primary ordinal outcome. Mortality, adverse events (AEs), including infusion reactions, and biological correlates of therapeutic activity are also assessed. Because there is no established endpoint for evaluating the clinical efficacy of treatments for COVID-19, other clinically relevant outcomes, including outcomes used in other COVID-19 treatment trials, will be recorded. Thus, the randomized groups (hIVIG + SOC versus placebo + SOC ) can be compared for multiple outcomes, and results can be compared or combined with other trials.

Participants will be randomized (1:1) to a single infusion of hIVIG + SOC or placebo + SOC on the day of randomization (Day 0). Participants taking remdesivir prior to randomization may be enrolled if eligibility criteria are met. Randomized participants who were not taking remdesivir before randomization will start taking remdesivir immediately following the infusion of hIVIG or placebo unless remdesivir is contraindicated. Participants will be followed for 28 days and, if the trial goes to completion, the primary analysis will be completed after all participants are followed for 28 days.

Being tested
Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG), Placebo, Remdesivir
Medical subject headings
COVID-19, Severe Acute Respiratory Syndrome

What participants receive

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

  • Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG)Biological

    Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG) is derived from the plasma of individuals who recover and develop neutralizing antibodies. Participants will receive a single infusion.

  • PlaceboOther

    Participants will receive a single infusion of the placebo (saline).

  • RemdesivirDrug

    Remdesivir will be given to participants in both groups as standard of care (SOC).

Study groups in NCT04546581
Study groupRoleWhat they receive
Intervention GroupExperimentalParticipants in this group will receive the investigational product and standard of care (SOC).
Receives: Biological: Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG); Drug: Remdesivir
Control GroupPlacebo comparatorParticipants in this group will receive a placebo and standard of care (SOC).
Receives: Other: Placebo; Drug: Remdesivir

What is being measured

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

  1. Ordinal Outcome Scale - Day 7

    The primary objective is to compare the clinical status of patients in each group on day 7 of follow-up using the primary ordinal outcome with 7 mutually exclusive categories:

    1. Death 6. End-organ failure 5. Life-threatening end-organ dysfunction 4. Serious end-organ dysfunction 3. Moderate end-organ dysfunction 2. Limiting symptoms due to COVID-19
    2. No limiting symptoms due to COVID-19

    Outcome is reported as the percent of participants in each of 7 categories. Primary ordinal outcome based on the patient's clinical status on Day 7. It includes 7 mutually exclusive categories capturing the range of organ dysfunction that may be associated with progression of COVID-19, such as respiratory dysfunction and coagulation-related complications.

    Minimum value = 1, Maximum value = 7 Higher scores mean a worse outcome

    Measured: 7 days

  2. Primary Safety Outcome - Death, SAE or Grade 3 or 4 Events Through Day 7

    Number of participants with death, SAE or Grade 3 or 4 event through Day 7

    Measured: Through Day 7

Secondary outcomes (3)
  1. N Reaching 3 Least Favorable Categories

    N Reaching 3 least favorable categories of ordinal outcome (Categories 5, 6, 7: life-threatening end organ dysfunction, end organ failure, or death)

    Measured: All of follow-up (through Day 28)

  2. N Reaching 2 Most Favorable Categories

    N Reaching 2 most favorable categories of ordinal outcome (Categories 1 and 2: not requiring oxygen with or without limiting symptoms due to COVID-19)

    Measured: All of follow-up (through Day 28)

  3. N Discharged or in Most Favorable Category

    N discharged from hospital or reaching most favorable ordinal category (category 1: not requiring oxygen and no limiting symptoms due to COVID-19)

    Measured: All of follow-up (through Day 28)

Timeline

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

  1. First posted14 Sep 2020
  2. Study start8 Oct 2020
  3. Primary completion21 May 2021
  4. Study completion21 May 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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
593 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04546581
Sponsor's protocol ID
INSIGHT 013
Status last verified
Mar 2022
First submitted
8 Sep 2020
Last updated
4 Apr 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: A public data set will be made available at the end of the trial

Publications

  • Jha A, Barker D, Lew J, Manoharan V, van Kessel J, Haupt R, Toth D, Frieman M, Falzarano D, Kodihalli S. Efficacy of COVID-HIGIV in animal models of SARS-CoV-2 infection. Sci Rep. 2022 Oct 10;12(1):16956. doi: 10.1038/s41598-022-21223-2.

    PubMed 36216961
  • ITAC (INSIGHT 013) Study Group. Hyperimmune immunoglobulin for hospitalised patients with COVID-19 (ITAC): a double-blind, placebo-controlled, phase 3, randomised trial. Lancet. 2022 Feb 5;399(10324):530-540. doi: 10.1016/S0140-6736(22)00101-5. Epub 2022 Jan 28.

    PubMed 35093205
  • Vandeberg P, Cruz M, Diez JM, Merritt WK, Santos B, Trukawinski S, Wellhouse A, Jose M, Willis T. Production of anti-SARS-CoV-2 hyperimmune globulin from convalescent plasma. Transfusion. 2021 Jun;61(6):1705-1709. doi: 10.1111/trf.16378. Epub 2021 Mar 22.

    PubMed 33715160

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Hyperimmune immunoglobulin to SARS-CoV-2 (hIVIG) and Remdesivir in people with COVID and COVID-19, run by University of Minnesota at 39 sites in 7 countries.

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 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: finished, as of the sponsor's last update on 4 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 39 sites in United States, Denmark, Greece, Spain, Japan and 2 more countries. 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?

Yes. Results are posted in the registry (first posted 4 Apr 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?

Ordinal Outcome Scale - Day 7 (time frame: 7 days). The study lists 2 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 NCT04546581, which also lists 3 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 4 Apr 2022.

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