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COVID-19Phase 2NCT04547140

Study to Evaluate the Safety and Efficacy of Liquid Alpha1-Proteinase Inhibitor (Human) in Hospitalized Participants With Coronavirus Disease (COVID-19)

A Phase 2 study testing Liquid Alpha1-Proteinase Inhibitor (Human) and Standard Medical Treatment in people with COVID-19, run by Grifols Therapeutics LLC at 20 sites in 5 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of the study is to determine if Liquid Alpha1-Proteinase Inhibitor (Human) (Liquid Alpha1-PI) plus SMT can reduce the proportion of participants dying or requiring intensive care unit (ICU) admission on or before Day 29 or who are dependent on high flow oxygen devices or invasive mechanical ventilation on… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID-19
What is being tested?
Liquid Alpha1-Proteinase Inhibitor (Human) and Standard Medical Treatment
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
57 participants
Where
20 sitesin 5 countries
Study dates
29 Jan 2021to 28 Jan 2022
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
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Hospitalized male or female participant ≥ 18 years of age at time of screening who is being treated for COVID-19. Participants must be screened within 48 hours (≤ 48 hours) of hospital admission.
  • Has laboratory-confirmed novel coronavirus {SARS-CoV-2} infection as determined by qualitative polymerase chain reaction (PCR) (reverse transcriptase [RT]-PCR), or other commercial or public health assay approved by regulatory authorities as a diagnostic test for COVID-19 in any specimen during the current hospital admission OR 96 hours prior to the hospital admission date and prior to randomization (the SARS-CoV-2 test results must be performed by a hospital laboratory and the documentation available).
  • COVID-19 illness (symptoms) of any duration, including both of the following: a) Radiographic infiltrates by imaging (chest X-Ray, computed tomography (CT) scan, etc.) and/or clinical assessment (evidence of rales/crackles on exam) with peripheral oxygen saturation by pulse oximetry (SpO2) <94% on room air; b) Any one of the following related to COVID-19: i. Ferritin > 400 nanogram per milliliter (ng/mL), ii. lactate dehydrogenase (LDH) > 300 units per liter (U/L), iii. D-Dimers > reference range, or iv. C-reactive protein (CRP) > 40 milligram per liter (mg/L).
  • Participant provides informed consent prior to initiation of any study procedures.
  • Female participants of childbearing potential (and males with female partners of childbearing potential) must agree to use of acceptable contraception methods during study (example, oral, injectable, or implanted hormonal methods of contraception, placement of an intrauterine device or intrauterine system, condom or occlusive cap with spermicidal foam/gel/film/cream/suppository, male sterilization, or true abstinence) throughout the study.

Who cannot join

  • Participants requiring invasive mechanical ventilation or ICU admission or with partial pressure of arterial oxygen/ fraction of inspired oxygen (PaO2/FIO2) ≤ 150 mmHg (i.e., arterial oxygen in millimeter of mercury (mmHg) divided by fraction inspired oxygen concentration [example, 0.21 for room air]).
  • Clinical evidence of any significant acute or chronic disease that, in the opinion of the investigator, may place the participant at undue medical risk.
  • The participant has had a known serious anaphylactic reaction to blood, any blood-derived or plasma product, or known selective immunoglobulin A (IgA) deficiency with anti-IgA antibodies.
  • A medical condition in which the infusion of additional fluid is contraindicated (example, decompensated congestive heart failure or renal failure with fluid overload). This includes currently uncontrolled congestive heart failure New York Heart Association Class III or IV stage heart failure.
  • Shock that is unresponsive to fluid challenge and/or multiple vasopressors and accompanied by multiorgan failure considered not able to be reversed by the Principal Investigator.
  • Known alpha-1 antitrypsin deficiency for which the participant is already receiving alpha1-proteinase inhibitor augmentation therapy.
Show all 22Show fewer
  • Women who are pregnant or breastfeeding. Female participants of child-bearing potential must have a negative test for pregnancy blood or urine human chorionic gonadotropin (HCG)-based assay at screening/baseline visit.
  • Participants for whom there is limitation of therapeutic effort such as "Do not resuscitate" status.
  • Currently participating in another interventional clinical trial with investigational medical product or device.
  • Participants previously requiring long-term oxygen therapy (home oxygen therapy).
  • History (within the last 2 years) of myocardial infarction, unstable angina, stroke or transient ischemic attacks, pulmonary embolism or deep venous thrombosis.
  • Participant has medical condition (other than COVID-19) that is projected to limit lifespan to ≤ 1 year.
  • Systolic blood pressure < 100 mm Hg or > 160 mm Hg (uncontrolled hypertension) at the time of Screening.
  • Alanine aminotransferase (ALT) ≥ 2 times the upper limit of normal (ULN).
  • Any elevation of total bilirubin at the time of Screening.
  • Estimated glomerular filtration rate (eGFR) < 45 mL/min (or participant is dependent on dialysis/renal replacement therapy) at the time of Screening. eGFR is calculated by the Cockcroft-Gault equation.
  • Hemoglobin < 10 g/dL at the time of Screening.
  • Absolute neutrophil count < 1000/mm^3 at the time of Screening.
  • Platelet count < 75,000/mm^3 at the time of Screening.
  • Participant has history of drug or alcohol abuse within the past 24 months.
  • Participant is unwilling to commit to follow-up visits.
  • Known history of prothrombin gene mutation 20210, homozygous Factor V Leiden mutations, antithrombin III deficiency, protein C deficiency, protein S deficiency or antiphospholipid syndrome.

Trial locations and contacts

20 sites in 5 countries.

20 sites in 5 countries

United States10 sites
  • Birmingham VA

    Birmingham, Alabama, 35233

  • Hannibal Clinic

    Hannibal, Missouri, 63401

  • Kansas City VA

    Kansas City, Missouri, 64128

  • Sparrow Hospital

    Lansing, Michigan, 48912

  • Memphis VA

    Memphis, Tennessee, 38104

  • University of Miami Hospital

    Miami, Florida, 33125

  • Columbia University Medical Center

    New York, New York, 10032

  • CHI Health Center

    Omaha, Nebraska, 68102

  • St. Joseph's Hospital

    Phoenix, Arizona, 85013

  • University of Utah

    Salt Lake City, Utah, 84108

Other trials in United States

Brazil6 sites
  • AngioCor Blumenau

    Blumenau, Santa Catarina, 89020-430

  • Hospital Dia do Pulmão

    Blumenau, 89030-101

  • Universidade Estadual São Paulo - Campus de Botucatu

    Botucatu, São Paulo, 18618-686

  • Sociedade Literaria e Caritativa Santo Agostinho

    Criciúma, Santa Catarina, 88811-500

  • Hospital Alemao Oswaldo Cruz

    São Paulo, 01327-001

  • Universidade Federal de Sao Paulo

    São Paulo, 04037-002

Other trials in Brazil

Chile2 sites
  • Hospital Padre Hurtado

    Santiago, 8860000

  • Hospital Carlos Van Buren

    Valparaíso, 2340000

Other trials in Chile

Colombia1 site
  • Fundación Oftalmológica de Santander

    Bucaramanga, Santander Department

Other trials in Colombia

Mexico1 site
  • Unidad Medica para la Salud Integral

    San Nicolás de los Garza, 66465

Other trials in Mexico

About this study

Official title: A Multicenter, Randomized, Double-blind, Placebo-Controlled, Parallel Group Study to Evaluate the Safety and Efficacy of Liquid Alpha1-Proteinase Inhibitor (Human) Plus Standard Medical Treatment (SMT) Versus Placebo Plus SMT in Hospitalized Subjects With COVID-19

The purpose of the study is to determine if Liquid Alpha1-Proteinase Inhibitor (Human) (Liquid Alpha1-PI) plus SMT can reduce the proportion of participants dying or requiring intensive care unit (ICU) admission on or before Day 29 or who are dependent on high flow oxygen devices or invasive mechanical ventilation on Day 29 versus placebo plus SMT in hospitalized participants with COVID-19.

Conditions
COVID-19
Being tested
Liquid Alpha1-Proteinase Inhibitor (Human), Placebo, Standard Medical Treatment
Keywords
Coronavirus Disease, Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2
Medical subject headings
COVID-19

What participants receive

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

  • Liquid Alpha1-Proteinase Inhibitor (Human)Biological

    Also called Alpha1-proteinase inhibitor

    Intravenous infusion 120 mg/kg

  • PlaceboDrug

    Also called 0.9% Normal Saline

    Intravenous infusion

  • Standard Medical TreatmentDrug

    SMT

Study groups in NCT04547140
Study groupRoleWhat they receive
Liquid Alpha1-Proteinase Inhibitor + Standard Medical TreatmentExperimentalParticipants received the first intravenous (IV) infusion of liquid alpha1-proteinase inhibitor (human) 120 milligrams per kilogram (mg/kg), based on body weight on Day 1, followed by second liquid alpha1-proteinase inhibitor (human) dose of 120 mg/kg based on body weight, on Day 8 (second dose was not mandatory and was given at the principal investigator's [PI] discretion). Participants also received all standard of care interventions while hospitalized, from Day 1 to Day 29.
Receives: Biological: Liquid Alpha1-Proteinase Inhibitor (Human); Drug: Standard Medical Treatment
Placebo + Standard Medical TreatmentPlacebo comparatorParticipants received IV infusions of 0.9% normal saline of commensurate volume to that of liquid alpha1-proteinase inhibitor as placebo on Day 1 and Day 8 (Day 8 was not mandatory and was given at the PI's discretion). Participants also received all standard of care interventions while hospitalized, from Day 1 to Day 29.
Receives: Drug: Placebo; Drug: Standard Medical Treatment

What is being measured

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

  1. Percentage of Participants Dying or Requiring Intensive Care Unit (ICU) Admission

    Measured: Up to Day 29

  2. Percentage of Participants Who Are Dependent on High Flow Oxygen Devices or Invasive Mechanical Ventilation

    Measured: Day 29

Secondary outcomes (13)
  1. Change From Baseline in National Early Warning Score (NEWS)

    NEWS is clinical scoring developed to improve detection of deterioration in ill participant. It is based on 7 clinical parameters: Respiration rate, oxygen saturation, supplemental oxygen, systolic blood pressure (BP), pulse rate, level of consciousness, and temperature. A score of 0 and 2 was allocated to supplemental oxygen, 0 and 3 for level of consciousness and score of 0, 1, 2 and 3 for remaining parameters (i.e. respiration rate, oxygen saturation, systolic BP, pulse rate and temperature) where 0 = normal health condition to 3 = worst health condition; Higher scores indicated more severity. All scores were summed to get an aggregate score. Aggregate NEWS score ranged from 0 to 20, with higher scores indicating more severity/higher risk.

    Measured: Baseline, Days 15 and 29

  2. Time to Clinical Response as Assessed by NEWS Score ≤ 2 Maintained for 24 Hours

    Time to clinical response was reported at 50th percentile in days.

    Measured: Up to Day 29

  3. Time to Hospital Discharge

    Time to hospital discharge is defined as duration of hospitalization from Day 1 through Day 29.

    Measured: Up to Day 29

  4. Duration of ICU Stay

    Duration of ICU stay in days is analyzed for participants admitted to ICU post randomization.

    Measured: Up to Day 29

  5. Duration of Any Oxygen Use

    Measured: Up to Day 30

  6. Duration of Mechanical Ventilation

    Duration of Mechanical Ventilation is analyzed for participants requiring mechanical ventilation post randomization.

    Measured: Up to Day 29

  7. Mean Change From Baseline in Ordinal Scale

    The ordinal scale is a 7-point scale ranging from 1 to 7 used to measure clinical status based on the following points: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. Higher score indicated no severe illness. Mean change in Ordinal scale was evaluated by fitting a linear mixed-effects model for repeated measures (MMRM).

    Measured: Baseline, Days 15 and 29

  8. Absolute Change From Baseline in Ordinal Scale

    The ordinal scale is a 7-point scale ranging from 1 to 7 used to measure clinical status based on the following points: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or ECMO; 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. Higher score indicated no severe illness.

    Measured: Baseline, Days 15 and 29

  9. Percentage of Participants in Each Severity Category of the 7-point Ordinal Scale

    The ordinal scale is a 7-point scale ranging from 1 to 7 used to measure clinical status based on the following points: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or ECMO 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. The percentages are rounded off to the single decimal point.

    Measured: Day 15 and Day 29

  10. Time to Sustained Normalization of Temperature

    Time to sustained normalization of temperature was reported at 50th percentile in days.

    Measured: Up to Day 29

  11. Percentage of Participants Who Experienced Sustained Normalization of Fever

    Normalization of fever is defined as temperature < 36.6 °C armpit, < 37.2 °C oral, or < 37.8 °C rectal sustained for at least 24 hours.

    Measured: Up to Day 29

  12. Number of Participants Who Develop Acute Respiratory Distress Syndrome (ARDS)

    ARDS was defined based on Berlin criteria (chest imaging, origin of edema, oxygenation).

    Measured: Up to Day 29

  13. Time to Clinical Progression

    Time to clinical progression is defined as the time to death, mechanical ventilation, or ICU admission. Time to clinical progression was reported at 50th percentile in days.

    Measured: Up to Day 29

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 start29 Jan 2021
  3. Primary completion13 Dec 2021
  4. Study completion28 Jan 2022

Why it stopped: Study Stopped for Futility

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
57 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04547140
Sponsor's protocol ID
GC2006
Status last verified
Mar 2023
First submitted
10 Sep 2020
Last updated
22 Mar 2023
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Liquid Alpha1-Proteinase Inhibitor (Human) and Standard Medical Treatment in people with COVID-19, run by Grifols Therapeutics LLC at 20 sites in 5 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 5 inclusion and 22 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 22 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in United States, Brazil, Chile, Colombia, Mexico. 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 22 Mar 2023). 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?

Percentage of Participants Dying or Requiring Intensive Care Unit (ICU) Admission (time frame: Up to Day 29). 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?
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 Mar 2023.

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