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Sars-CoV2Phase 3NCT04967430

TOGETHER - Toronto: Trial to Evaluate the Effect of Peginterferon Lambda for the Treatment of COVID-19

A Phase 3 study testing Peginterferon Lambda-1A in people with Sars-CoV2 and Covid19, run by University Health Network, Toronto at 1 site in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Interferon (IFN) lambda is one of the fundamental responses of the innate immune system. Peginterferon lambda is a long-acting form that has been studied extensively in human trials in viral hepatitis, confirming it safety and tolerability. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sars-CoV2, Covid19
What is being tested?
Peginterferon Lambda-1A
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
763 participants
Where
1 siteCanada
Study dates
27 Aug 2021to 30 Jun 2022
Phase
Phase 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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult 18 years of age or older.
  • Symptomatic and within 7 days of symptom onset.
  • High risk for severe disease (as defined by one or more of the following):
  • Age >50
  • Diabetes mellitus requiring therapy
  • Hypertension on medication
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  • BMI >30 kg/m2
  • Cardiovascular disease
  • Asthma requiring chronic controller medication
  • Symptomatic respiratory disease
  • Immunosuppressed patients (to maximum of 10mg prednisone daily +/- other immunosuppressive agents)
  • Documented fever (>38C)
  • One or more of the following symptoms: cough, shortness of breath (SOB), pleuritic chest pain and/or myalgias (to a maximum of 25% of enrollment)
  • Discharged to home isolation.
  • Willing and able to provide informed consent (including by substitute decision maker).
  • Willing and able to follow-up by phone or videoconference.
  • Female patients of childbearing potential and male patients with partners of childbearing potential must agree to use adequate methods of contraception during the study and through 90 days after the last dose of study medication. Female patients of childbearing potential are all those except patients who are surgically sterile, who have medically documented ovarian failure, or who are at least 1 year postmenopausal.

Who cannot join

  • Pregnancy (or positive urine pregnancy test) or lactating.
  • More than 14 days following completion of SARS-CoV-2 vaccition series
  • The following pre-existing medical conditions:
  • Known cirrhosis with any history of decompensation (ascites, variceal bleeding or hepatic encephalopathy)
  • Known chronic kidney disease with estimated creatinine clearance < 30 mL/minute or need for dialysis
  • Uncontrolled severe psychiatric disorder - schizophrenia, bipolar disorder, depression with prior suicidality
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  • Uncontrolled seizures or seizure in the prior 1 month
  • Any other underlying medical (cardiac, liver, renal, neurological, respiratory) or psychiatric condition that in the view of the investigator would preclude use of peginterferon lambda
  • Known alcohol or drug dependence that in the opinion of the investigator would impair study participation.
  • Known prior intolerance to interferon treatment.
  • Enrolment in another clinical trial testing an antiviral agent or receipt of an antiviral agent for COVID-19 in the past 7 days.
  • Use of investigational, off-label therapy for COVID-19, or unproven therapy for COVID-19.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Toronto General Hospital

    Toronto, Ontario, M5G 2C4

Other trials in Canada

About this study

Official title: TOGETHER-Toronto: A Phase III Randomized, Double-blind, Placebo-controlled, Multicenter, Trial to Evaluate the Effect of Peginterferon Lambda for the Treatment of COVID-19

Interferon (IFN) lambda is one of the fundamental responses of the innate immune system. Peginterferon lambda is a long-acting form that has been studied extensively in human trials in viral hepatitis, confirming it safety and tolerability. It is particularly attractive for consideration in the use of acute respiratory illness due to the high expression of the lambda receptor in lung epithelia. We propose to evaluate peginterferon-lambda in ambulatory patients with mild to moderate COVID-19.

Read the detailed description

In this study, individuals who attend an Assessment Centre/Emergency Department to be swabbed for COVID-19 and deemed well enough for home isolation will be informed about the study. There will be two major routes of recruitment. Where feasible, a rapid point-of-care (POC) laminar flow based COVID-19 test (the Abbott PanBio) will be performed and those who do not have a POC test at the assessment centre will be tested by PCR.

Interested participants who contact study staff will be confirmed to have a positive COVID-19 test. Once confirmed will be further screened for eligibility criteria by research study staff. After review, a consent form will be emailed to the participant and informed consent will be obtained through witnessed telephone consent from the participant or a substitute decision maker (SDM). Participants who consent will be randomized to receive a single subcutaneous injection of Peginterferon lambda 180µg or saline placebo.

Patients will be followed remotely with visits. In addition, participants will also attend outpatient clinic for swabs and blood work for routine laboratory and inflammatory markers on Days 7 and 14 with the primary endpoint being the time to SARS-CoV-2 RNA negativity and the proportion with COVID-19 related emergency room assessment >6 hours, hospitalization or death by Day 28. Numerous secondary endpoints will be evaluated as well.

Safety data will be reviewed by the Data Safety and Monitoring Committee after the first 50% of randomized participants complete 14 days of follow-up after treatment.

Conditions
Sars-CoV2, Covid19
Being tested
Peginterferon Lambda-1A, Placebo
Keywords
Peginterferon lambda
Medical subject headings
COVID-19

What participants receive

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

  • Peginterferon Lambda-1ADrug

    Peginterferon lambda is a covalent conjugate of human recombinant non-pegylated IFN lambda (IFN L) and a 20-kDa linear PEG chain.

    Peginterferon lambda Injection is a sterile, nonpyrogenic, ready-to-use solution (0.4 mg/mL) that is clear to opalescent, colorless to pale yellow, and essentially free of particles. Lambda Injection is provided in a 1-mL long Type I glass syringe (0.18 mg/syringe) with a staked 29-gauge, 1/2- inch, thin-walled needle. The syringe has a rigid needle shield and is stoppered with a plunger stopper. Syringes are prefilled with a solution of Peginterferon lambda Injection, mannitol, L-histidine, polysorbate 80, hydrochloric acid, and water for injection; they are intended for a single use at adjustable doses. The syringe is marked with dose indicator lines, which are used as a reference point for administering the correct dose.

  • PlaceboOther

    The placebo will be 0.9% sodium chloride (normal saline) solution. A plastic 1 mL syringe will be prefilled by the study pharmacy. Each syringe will contain 0.5 mL (0.45 mL to match the volume of the Interferon plus 0.05 mL overfill) to allow for needle priming by the unblinded study nurse.

Study groups in NCT04967430
Study groupRoleWhat they receive
TreatmentExperimentalTo receive a dose of peginterferon lambda 180mcg SC at baseline (Day 0).
Receives: Drug: Peginterferon Lambda-1A
PlaceboPlacebo comparatorPatients in this arm will receive a single SC dose of 0.9% sodium chloride (normal saline) solution at baseline (Day 0). A plastic 1 mL syringe will be prefilled by the study pharmacy. Each syringe will contain 0.5 mL (0.45 mL to match the volume of the Interferon plus 0.05 mL overfill) to allow for needle priming by the unblinded study nurse.
Receives: Other: Placebo

What is being measured

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

  1. COVID-19 related urgent care visit, emergency room assessment, hospitalization or death by Day 28 (Primary efficacy endpoint)

    Proportion with COVID-19-related emergency room assessment, hospitalization, or death by Day 28

    Measured: At day 28

  2. SARS-CoV-2 RNA negativity (Primary virological endpoint)

    The time to SARS-CoV-2 RNA negativity.

    Measured: Day 0 to Day 28

  3. Treatment-emergent and treatment-related serious adverse events (Primary safety endpoint)

    The rate of treatment-emergent and treatment-related serious adverse events (SAEs) by Day 28.

    Measured: Day 0 to Day 28

Secondary outcomes (27)
  1. Respiratory symptom resolution (Clinical Outcome #1)

    Time to resolution of respiratory symptoms.

    Measured: Day 0 to Day 28

  2. Hospitalization (Clinical outcome #2)

    Hospitalization for any cause

    Measured: Day 0 to Day 28

  3. Death (Clinical outcome #3)

    Death due to respiratory or cardiovascular causes

    Measured: Day 0 to Day 28

  4. All symptom resolution (Clinical outcome #4)

    Time to resolution of all symptoms (return to usual state of heath).

    Measured: Day 0 to Day 28

  5. Oxygen saturation on room air (Clinical outcome #5)

    Proportion of days with oxygen saturation below 93% on room air by Day 14

    Measured: Day 0 to Day 14

  6. Seeking care from healthcare professional for COVID-19 (Clinical outcome #6)

    Proportion seeking care from primary care provider/walk-in clinic or study healthcare provider for COVID-19.

    Measured: Day 0 - Day 14

  7. Hospital Admission (Clinical outcome #7)

    Duration of hospital admission up to Day 28

    Measured: Day 0 to Day 28

  8. Time to viral negativity (Virologic/immunological outcome #1)

    Time to SARS-CoV-2 RNA negativity.

    Measured: Day 0 to Day 14

  9. Mean log of SARS-CoV-2 RNA (Virologic/immunological outcome #2)

    Difference in mean SARS-CoV-2 RNA in log copies/mL

    Measured: Day 3, 5, 7, 10 and 14

  10. Mean log decline in SARS-CoV-2 RNA (Virologic/immunological outcome #3)

    Difference in mean log decline in SARS-CoV-2 RNA.

    Measured: Day 3, 5, 7, 10 and 14

  11. Negative for SARS-CoV-2 RNA (Virologic/immunological outcome #4)

    Proportion negative for SARS-CoV-2 RNA.

    Measured: Day 3

  12. Negative for SARS-CoV-2 RNA (Virologic/immunological outcome #5)

    Proportion negative for SARS-CoV-2 RNA.

    Measured: Day 7

  13. Negative for SARS-CoV-2 RNA (Virologic/immunological outcome #6)

    Proportion negative for SARS-CoV-2 RNA.

    Measured: Day 14

  14. Proportion with antibodies (Virologic/immunological outcome #7)

    Proportion with SARS-CoV-2 antibodies in blood.

    Measured: Day 0, 7, 14 and 90

  15. Correlation with interferon lambda 4 genotype (Virologic/immunological outcome #8)

    Correlation of response with interferon lambda 4 (IFNL4) genotype.

    Measured: Day 0 to Day 28

  16. Laboratory markers (Virologic/immunological outcome #9)

    Change in hemoglobin over time

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  17. Laboratory markers (Virologic/immunological outcome #10)

    Change in white blood cell count over time

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  18. Laboratory markers (Virologic/immunological outcome #11)

    Change in lymphocyte count over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  19. Laboratory markers (Virologic/immunological outcome #12)

    Change in ALT over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  20. Laboratory markers (Virologic/immunological outcome #13)

    Change in AST over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  21. Laboratory markers (Virologic/immunological outcome #14)

    Change in ALP over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  22. Laboratory markers (Virologic/immunological outcome #15)

    Change in total bilirubin over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  23. Inflammatory markers (Virologic/immunological outcome #16)

    Change in lactate dehydrogenase over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  24. Inflammatory markers (Virologic/immunological outcome #17)

    Change in c-reactive protein over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  25. Inflammatory markers (Virologic/immunological outcome #18)

    Change in D-dimers over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  26. Inflammatory markers (Virologic/immunological outcome #19)

    Change in creatine kinase over time.

    Measured: Day 0 to Day 7 and Day 7 to Day 14.

  27. COVID-19 in household contacts (Transmission outcome #1)

    Confirmed diagnosis of COVID-19 in household contacts.

    Measured: Day 0 to 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 posted19 Jul 2021
  2. Study start27 Aug 2021
  3. Primary completion21 Mar 2022
  4. Study completion30 Jun 2022 (estimated)

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
763 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04967430
Sponsor's protocol ID
JF-12-2020
Other IDs
21-5018
Status last verified
Mar 2022
First submitted
13 Jul 2021
Last updated
5 Apr 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Peginterferon Lambda-1A in people with Sars-CoV2 and Covid19, run by University Health Network, Toronto at 1 site in Canada.

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 17 inclusion and 12 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: status not confirmed, as of the sponsor's last update on 5 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 1 site in Canada. 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?

Results are not available in the source record.

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?

COVID-19 related urgent care visit, emergency room assessment, hospitalization or death by Day 28 (Primary efficacy endpoint) (time frame: At day 28). 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?
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 5 Apr 2022.

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