COVID-19Phase 3NCT05605093
Strategies and Treatments for Respiratory Infections & Viral Emergencies (STRIVE): Shionogi Protease Inhibitor (Ensitrelvir)
A Phase 3 study testing Shionogi Protease Inhibitor (S-217622) in people with COVID-19, run by University of Minnesota at 187 sites in 24 countries.
Trial summary
Treatments are needed to improve outcomes among patients hospitalized for COVID-19, including direct-acting antiviral (DAA) agents to mitigate the pathology driven by ongoing viral replication. 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?
- Shionogi Protease Inhibitor (S-217622)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 602 participants
- Where
- 187 sitesin 24 countries
- Study dates
- 23 Dec 2022to 28 Oct 2025
- Phase
- Phase 3
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
- Age ≥18 years.
- Informed consent for trial participation.
- Hospital admission (or boarding in an emergency department or other area awaiting hospital admission) with signs and/or symptoms of a respiratory infection.
- Confirmation of SARS-CoV2 infection by nucleic acid test (NAT) or equivalent non- NAT test [list of approved tests is in the PIM] collected within the prior 14 days.
- Onset of symptoms attributable to SARS-CoV2 infection occurred within 14 days before randomization.
- Hospitalized for the management of COVID-19, with signs and/or symptoms suggestive of lower respiratory tract infection.
Who cannot join
- The patient is expected to be discharged from the hospital within the next 24 hours.
- Medical condition other than the acute respiratory infection (and its manifestations) that is likely to result in death within 7 days of randomization.
- Use of a strong CYP3A inducer within 14 days prior to enrollment
- Moribund condition, defined as prior cardiac arrest during this hospitalization and life expectancy less than 48 hours of randomization.
- Patient undergoing comfort care measures only such that treatment focuses on end-of- life symptom management over prolongation of life.
- Expected inability or unwillingness to participate in study procedures.
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- In the opinion of the investigator, participation in a trial is not in the best interest of the patient.
- Allergy to investigational agent or vehicle
- Use of a concomitant medication that is contraindicated due to a drug-drug interaction with S-217622
- Moderate to severe hepatic impairment (i.e., Child-Pugh class B or C) or acute liver failure.
- Known estimated glomerular filtration rate (eGRF) \<30 mL/min/1.73m 2
- Continuous renal replacement therapy or chronic dialysis
- Current pregnancy
- Current breastfeeding and unwillingness to defer breastfeeding for 30 days after the last dose of investigational agent.
- Women of child-bearing potential who are unwilling to abstain from sexual intercourse with men or practice appropriate contraception through 30 days from the last dose of the investigational agent.
- Men who are unwilling to abstain from sexual intercourse with women of child- bearing potential or to use barrier contraception through 30 days from the last dose of the investigational agent.
- Inability to take investigational agent in tablet form by mouth.
Trial locations and contacts
187 sites in 24 countries.
187 sites in 24 countries
United States103 sites
Hendrick Medical Center (Site 080-014)
Abilene, Texas, 79601
University of New Mexico Hospital (Site 213-008)
Albuquerque, New Mexico, 87106
VA Ann Arbor Healthcare System (Site 074-028)
Ann Arbor, Michigan, 48105
Rocky Mountain Regional VA Medical Center (Site 074-010)
Aurora, Colorado, 80045
University of Colorado Hospital (Site 204-001)
Aurora, Colorado, 80045
NIH Clinical Center (Site 080-043)
Bethesda, Maryland, 20892
University of Alabama Birmingham University Hospital (Site 213-002)
Birmingham, Alabama, 35233
Massachusetts General Hospital (202-002)
Boston, Massachusetts, 02114
Beth Israel Deaconess Medical Center (Site 202-001)
Boston, Massachusetts, 02215
NYU Brooklyn (301-033)
Brooklyn, New York, 11220
Cooper University Hospital (Site 019-001)
Camden, New Jersey, 08103
Ralph H. Johnson VA Medical Center (Site 074-015)
Charleston, South Carolina, 29401
Medical University of South Carolina (Site 210-002)
Charleston, South Carolina, 29425
University of Virginia Health System, University Hospital (Site 210-003)
Charlottesville, Virginia, 22908
John H. Stroger, Jr. Hospital of Cook County (Site 080-046)
Chicago, Illinois, 60612
University of Illinois at Chicago (Site 008-012)
Chicago, Illinois, 60612
University of Cincinnati Medical Center (Site 207-003)
Cincinnati, Ohio, 45219
Cleveland Clinic Foundation (Site 207-001)
Cleveland, Ohio, 44195
Ohio State University Wexner Medical Center (Site 207-004)
Columbus, Ohio, 43210
CHRISTUS Spohn Shoreline Hospital (Site 080-001)
Corpus Christi, Texas, 78405
Baylor, Scott and White Health (301-003)
Dallas, Texas, 75246
Parkland Health and Hospital Systems (Site 084-002)
Dallas, Texas, 75390
UT Southwestern Medical Center (Site 084-001)
Dallas, Texas, 75390
Public Health Institute at Denver Health (Site 017-004)
Denver, Colorado, 80204
Henry Ford Health System (Site 014-001)
Detroit, Michigan, 48202
Sinai-Grace Hospital (Site 205-005)
Detroit, Michigan, 48235
Duke University Hospital (Site 301-006)
Durham, North Carolina, 27710
New York Presbyterian Queens (003-005)
Flushing, New York, 11355
Lutheran Medical Group (Site 301-010)
Fort Wayne, Indiana, 46804
UCSF Fresno (Site 203-005)
Fresno, California, 93721
University of Florida - Gainesville (Site 201-004)
Gainesville, Florida, 32610
Hackensack Meridian Health (Site 301-030)
Hackensack, New Jersey, 07601
Penn State Health Milton S. Hershey Medical Center (Site 209-002)
Hershey, Pennsylvania, 17033
Houston Methodist Hospital (Site 301-028)
Houston, Texas, 77030
MEDVAMC (Site 074-006)
Houston, Texas, 77030
University of Texas Health Science Center (Site 203-006)
Houston, Texas, 77030
University of Mississippi Medical Center (Site 202-005)
Jackson, Mississippi, 39216
The University of Kansas Hospital (Site 080-044)
Kansas City, Kansas, 66160
Dartmouth-Hitchcock Medical Center (301-024)
Lebanon, New Hampshire, 03756
University of Kentucky (Site 210-004)
Lexington, Kentucky, 40536
VA Loma Linda Healthcare System (Site 074-017)
Loma Linda, California, 92357
MemorialCare Health System (Site 066-003
Long Beach, California, 90806
VA Long Beach Healthcare System (Site 074-026)
Long Beach, California, 90822
Mount Sinai Queens (Site 081-105)
Long Island City, New York, 11102
CHRISTUS Good Shepherd Medical Center (Site 080-031)
Longview, Texas, 75601
Cedars-Sinai Medical Center (Site 208-002)
Los Angeles, California, 90048
Ronald Reagan UCLA Medical Center (Site 203-002)
Los Angeles, California, 90095
William S. Middleton Memorial Veterans Hospital (074-030)
Madison, Wisconsin, 53705
VA Northern California Health Care System (Site 074-023)
Mather, California, 95655
Miami VA Healthcare System (Site 074-003)
Miami, Florida, 33125
Froedtert Memorial Lutheran Hospital (052-001)
Milwaukee, Wisconsin, 53226
NYU Long Island (301-034)
Mineola, New York, 11501
Hennepin Healthcare Research Institute (Site 027-001)
Minneapolis, Minnesota, 55415
M Health Fairview University of Minnesota Medical Center (Site 112-001)
Minneapolis, Minnesota, 55455
University of Minnesota
Minneapolis, Minnesota, 55455
West Virginia University Medicine (301-023)
Morgantown, West Virginia, 26506
Intermountain Medical Center (Site 211-001)
Murray, Utah, 84107
Vanderbilt University Medical Center (Site 212-001)
Nashville, Tennessee, 37212
Yale University (Site 025-001)
New Haven, Connecticut, 06510
New York University Tisch Hospital (Site 301-013)
New York, New York, 10016
Mount Sinai Medical Center (Site 301-012)
New York, New York, 10029
NYC Health + Hospital Harlem (Site 003-003)
New York, New York, 10037
Weill Cornell Clinical Research Unit (065-001)
New York, New York, 10065
New Jersey Medical School Clinical Research Center (028-001)
Newark, New Jersey, 07103
Hoag Memorial Hospital Presbyterian (Site 080-026)
Newport Beach, California, 92663
University of Nebraska Medical Center (Site 080-045)
Omaha, Nebraska, 68198
Orlando VA Medical Center (Site 074-032)
Orlando, Florida, 32827
Veterans Affairs Palo Alto Health Care System (VAPAHCS) (Site 074-005)
Palo Alto, California, 94304
Portland VA Health Care System (074-024)
Portland, Oregon, 97239
St. Lawrence Health System (Site 301-029)
Potsdam, New York, 13676
Rhode Island Hospital (Site 080-036)
Providence, Rhode Island, 02903
The Miriam Hospital (Site 080-039)
Providence, Rhode Island, 02906
Monument Health Rapid City Hospital (Site 213-005)
Rapid City, South Dakota, 57701
Mayo Clinic (Site 054-001)
Rochester, Minnesota, 55905
UC Davis Health (Site 203-004)
Sacramento, California, 95817
Salem VA Medical Center (Site 074-014)
Salem, Virginia, 24153
University of Utah Health (Site 211-002)
Salt Lake City, Utah, 84108
UT Health San Antonio (Site 009-022)
San Antonio, Texas, 78229
VA San Diego Healthcare System (Site 074-016)
San Diego, California, 92161
Zuckerberg San Francisco General Hospital and Trauma Center (Site 213-007)
San Francisco, California, 94110
UCSF Medical Center at Mount Zion (203-007)
San Francisco, California, 94115
San Francisco VAMC (Site 074-002)
San Francisco, California, 94121
University of California San Francisco (Site 203-001)
San Francisco, California, 94143
CHRISTUS - St. Vincent (Site 080-051)
Santa Fe, New Mexico, 87505
Harborview Medical Center (208-001)
Seattle, Washington, 98104
Providence (Sacred Heart) (Site 213-004)
Spokane, Washington, 99204
Baystate Medical Center (Site 201-001)
Springfield, Massachusetts, 01199
Washington University School of Medicine (Site 003-001)
St Louis, Missouri, 63110
Stanford University Hospital & Clinics (Site 203-003)
Stanford, California, 94305
Tampa General Hospital (032-001)
Tampa, Florida, 33606
Lincoln Medical Center (Site 003-016)
The Bronx, New York, 10451
Montefiore Medical Center - Moses Hospital (Site 206-001)
The Bronx, New York, 10467
Montefiore Medical Center - Weiler campus (Site 206-003)
The Bronx, New York, 10467
James J. Peters VAMC (Site 023-003)
The Bronx, New York, 10468
Lundquist Institute for Biomedical Innovation (Site 066-002)
Torrance, California, 90502
Banner University Medical Center Tucson (Site 206-004)
Tucson, Arizona, 85719
Southern Arizona VA Healthcare System (Site 074-009)
Tucson, Arizona, 85723
Carle Foundation Hospital (Site 080-049)
Urbana, Illinois, 61801
Kent County Memorial Hospital (080-048)
Warwick, Rhode Island, 02886
MedStar Health Research Institute/MedStar Washington Hospital Center (Site 009-021)
Washington D.C., District of Columbia, 20010
Washington DC VA Medical Center (Site 009-004)
Washington D.C., District of Columbia, 20422
Wake Forest Baptist Health (Site 210-001)
Winston-Salem, North Carolina, 27157
UMass Chan Medical School (Site 080-007)
Worcester, Massachusetts, 01655
Brazil12 sites
Fundação Universidade Caxias do Sul Hospital Geral (649-218)
Caxias do Sul, Rio Grande do Sul, 95070-561
Sociedade Literária e Caritativa Santo Agostinho - Hospital São José (Site 649-204)
Criciúma, Santa Catarina, 88801-000
Hospital Nereu Ramos (Site 649-210)
Florianópolis, Santa Catarina, 88025-301
Unimed Joinville Cooperativa de Trabalho Médico (Site 649-202)
Joinville, Santa Catarina, 89204-061
Associação Beneficente Hospital Universitário - Universidade de Marília (Site 649-212)
Marília, São Paulo, 17525-160
Hospital de Clínicas de Porto Alegre (649-101)
Porto Alegre, Rio Grande do Sul, 90410
Instituto de Infectologia Emílio Ribas - IIER (Site 649-001)
São Paulo, São Paulo, 01246-000
Real e Benemérita Associação Portuguesa de Beneficência de São Paulo (Site 649-201
São Paulo, São Paulo, 01323-001
Hospital Alemão Oswaldo Cruz (649-215)
São Paulo, São Paulo, 01327-001
Associação Beneficente Síria - HCor (Site 649-203)
São Paulo, São Paulo, 04004-030
Hospital SEPACO (649-207)
São Paulo, São Paulo, 04102-900
Sociedade Beneficente de Senhoras Hospital Sirio-Libanês (Site 649-217)
São Paulo, São Paulo, 05652-900
Denmark10 sites
Aalborg Hospital (Site 625-005)
Aalborg, 9000
Aarhus Universitetshospital, Skejby (625-002)
Aarhus, N, 200
Rigshospitalet, CHIP (Site 625-006)
Copenhagen, 2100
Bispebjerg Hospital (Site 625-013)
Copenhagen, 2400
Herlev/Gentofte Hospital (Site 625-012)
Hellerup, 2900
Nordsjaellands Hospital, Hillerod (Site 625-009)
Hillerød, 3400
Hvidovre University Hospital, Department of Infections Diseases (Site 625-001)
Hvidovre, 2650
Kolding Sygehus, Medicinsk Afdeling (Site 625-011)
Kolding, 6000
Odense University Hospital (Site 625-004)
Odense, 5000
Zealand University Hospital Roskilde (Site 625-010)
Roskilde, 4000
Argentina7 sites
CEMIC (Site 611-021)
Buenos Aires, 1431
Sanatorio Allende (Site 611-030)
Córdoba, Córdoba Province, X5000JHQ
Hospital Rawson (Site 611-012)
Córdoba, 5000
Instituto Medico Platense (Site 611-025)
La Plata, Buenos Aires, B1900AVG
Sanatorio Británico S.A. (611-027)
Rosario, Santa Fe Province, 2000
Sanatorio Medico de Diagnostico y Tratamiento (611-029)
Santa Fe, 3000
Clínica Central S.A. (611-028)
Villa Regina, Río Negro Province, R8336
Spain7 sites
Hospital Universitari Germans Trias i Pujol (626-003)
Badalona, Barcelona, 08916
Hospital del Mar (626-025)
Barcelona, 08003
Hospital Universitari Vall d'Hebron (Site 626-033)
Barcelona, 08035
Hospital Clinic de Barcelona (626-004)
Barcelona, 08036
Hospital General Universitario Gregorio Marañón (Site 626-001)
Madrid, 28017
Hospital Clínico San Carlos (Site 626-017)
Madrid, 28040
Hospital Universitario La Paz (Site 626-012)
Madrid, 28046
Australia5 sites
Austin Health (612-020)
Heidelberg, Victoria, 3084
South Western Sydney Local Health District, Liverpool (Site 612-063)
Liverpool, New South Wales, 2170
The Alfred Hospital (Site 612-017)
Melbourne, Victoria, 3004
St. Vincent's Hospital (Site 612-002)
Sydney, New South Wales, 2010
Westmead Hospital (Site 612-058)
Westmead, New South Wales, 2145
Greece5 sites
Democritus University of Thrace (635-021)
Alexandroupoli, Evros, 68131
Dept of Critical Care and Pulmonary Medicine, Evangelismos General Hospital (635-020)
Athens, Attica, 10676
1st Respiratory Medicine Dept, Athens University Medical School (635-015)
Athens, Attica, 11527
3rd Dept of Medicine, Medical School (635-022)
Athens, Attica, 11527
Attikon University General Hospital (Site 635-009)
Athens, Attica, 12462
Uganda5 sites
MRC/UVRI & LSHTM Uganda Research Unit (634-601)
Entebbe
Gulu Regional Referral Hospital (634-603)
Gulu
St. Francis Hospital, Nsambya (Site 634-607)
Kampala
Lira Regional Referral Hospital (634-605)
Lira
Masaka Regional Referral Hospital (634-606)
Masaka
South Korea4 sites
Seoul St. Mary's Hospital (Site 612-903)
Seocho, Seoul, 06591
Seoul National University Bundang Hospital (Site 612-904)
Seongnam-si, Gyeonggi-do, 13620
Asan Medical Center (612-901)
Seoul, 05505
Chung-Ang University Hospital (Site 612-902)
Seoul, 06973
Germany3 sites
Universitätsklinikum Bonn, Medizinische Klinik I, Immunologische Ambulanz (622-010)
Bonn, 53127
Klinik I für Innere Medizin der Universität zu Köln (Site 622-008)
Cologne, 50937
Johann Wolfgang Goethe Univ. Hosp., Infektionsambulanz CRS (622-001)
Frankfurt, 60590
Japan3 sites
Rinku General Medical Center (Site 612-107)
Osaka, 598-8577
Center Hospital of the National Center for Global Health and Medicine (Site 612-101)
Shinjuku-Ku, Tokyo, 162-8655
Fujita Health University Hospital (Site 612-105)
Toyoake, Aichi-ken, 470-1192
Mexico3 sites
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran (Site 653-001)
Mexico City, Mexico City, 14080
Instituto Nacional de Enfermedades Respiratorias Ismael Cosió Villegas (Site 653-002)
Mexico City, Mexico City, 14080
Hospital General Dr. Aurelio Valdivieso (Site 653-004)
Oaxaca City, OA, 68050
South Africa3 sites
University of Cape Town (UCT) Lung Institute (Site 080-201)
Cape Town, Western Cape, 7925
Durban International Clinical Research Site (WWH) (652-005)
Durban, KwaZulu-Natal, 4013
Greys Hospital (080-202)
Pietermaritzburg, KwaZulu-Natal, 3201
Ukraine3 sites
Central City Clinical Hospital of Ivano-Frankivsk City Council (Site 627-302)
Ivano-Frankivsk, 76018
Treatment and Diagnostic Center ADONIS Plus (627-304)
Kyiv, 02002
Hospital #1 of Zhytomyr City Council (627-303)
Zhytomyr, 1002
United Kingdom3 sites
Royal Free Hospital (634-006)
London, NW3 2QG
Guy's & St. Thomas' NHS Foundation Trust (Site 634-011)
London, SE1 7EH
Royal Victoria Infirmary (Site 634-007)
Newcastle upon Tyne, NE1 4LP
Peru2 sites
Hospital Nacional Hipolito Unanue (651-008)
Lima, 15007
Hospital Nacional Sergio E. Bernales (651-007)
Lima, 15324
Thailand2 sites
Chulalongkorn University and The HIV-NAT (Site 613-001)
Bangkok, 10330
Khon Kaen University, Srinagarind Hospital (Site 613-003)
Khon Kaen, 40002
Georgia1 site
AIDS and Clinical Immunology Research Center (Site 627-201)
Tbilisi, 0159
Nigeria1 site
Institute of Human Virology-Nigeria (IHVN) (Site 612-601)
Abuja, Federal Capital Territory
Puerto Rico1 site
VA Caribbean Health Care (074-033)
San Juan, PR, 00921-3201
About this study
Official title: Strategies and Treatments for Respiratory Infections & Viral Emergencies (STRIVE): Shionogi Protease Inhibitor
Treatments are needed to improve outcomes among patients hospitalized for COVID-19, including direct-acting antiviral (DAA) agents to mitigate the pathology driven by ongoing viral replication. This trial will evaluate S-217622 (ensitrelvir), an anti-SARS-CoV2 3C-like protease inhibitor (PI) developed by Shionogi \&; Co. Ltd.
The study design is a randomized, placebo-controlled, multi-center international clinical trial that will evaluate the clinical efficacy of ensitrelvir when given in addition to standard of care (SOC) for inpatients with COVID-19. The SOC will be determined by local established guidelines and may include additional DAA (e.g., remdesivir) and immunomodulatory treatment strategies. Certain SOC treatments will be pre-specified prior to randomization.
- Conditions
- COVID-19
- Being tested
- Shionogi Protease Inhibitor (S-217622), placebo
- Medical subject headings
- COVID-19
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Shionogi Protease Inhibitor (S-217622)Drug
Also called ensitrelvir
S-217622 (ensitrelvir) is an oral anti-SARS-CoV2 PI that does not require ritonavir co-administration The dose is 375/125 (375 mg on Day 0, followed by 125 mg daily on Days 1-4).
placeboDrug
Placebo is an oral tablet administered once (3 tabs) on Day 0 and once (1 tab) daily on days 1-4, 5-day course.
| Study group | Role | What they receive |
|---|---|---|
| S-217622 (ensitrelvir) plus standard of care (SOC) | Experimental | Study investigational agent (ensitrelvir) will be administered as oral tablets with dosing of 375mg (3 tabs) once on Day 0 and 125mg (1 tab) once daily on Days 1-4. All participants will receive the full 5-day course, including those who are discharged from hospitalization prior to Day 4. Receives: Drug: Shionogi Protease Inhibitor (S-217622) |
| placebo plus standard of care (SOC) | Placebo comparator | Study investigational placebo will be administered as oral tablets with dosing of 375mg (3 tabs) once on Day 0 and 125mg (1 tab) once daily on Days 1-4. All participants will receive the full 5-day course, including those who are discharged from hospitalization prior to Day 4. Receives: Drug: placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants Recovered by Day 60
Number of participants who recovered by Day 60. Recovery was assessed through Day 60 using the Days to Recovery Scale.
Measured: Through Day 60
Secondary outcomes (4)
Mortality
Percentage of participants who died through Day 60
Measured: 60 days post-treatment
A 3-category Ordinal Outcome
A 3-category outcome that represents the participant's status on Day 60. The 3 categories are 1. Recovered on Day 60, 2. Alive, not recovered on Day 60, 3. Died by Day 60"
Measured: 60 days post-treatment
Recovery
Number of participants that recovered, defined as returning to place of residence prior to the onset of COVD-19 illness for 14 consecutive days
Measured: 60 days post-treatment
Percentage of Participants Who Died or Required New Invasive Mechanical Ventilation
Measured: Through Day 60
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Nov 2022
- Study start23 Dec 2022
- Primary completion28 Oct 2025
- Study completion28 Oct 2025
Why it stopped: DSMB closed due to futility.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for COVID-19Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 602 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Minnesota
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Cavan Reilly, PhD, Principal investigator, University of MinnesotaJason Baker, MD, Study chair, University of Minnesota
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05605093
- Sponsor's protocol ID
- S-217622
- Status last verified
- Aug 2026
- First submitted
- 28 Oct 2022
- Last updated
- 24 Sep 2026
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No