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COVID-19Phase 2NEREIDANCT05705167

Plitidepsin Versus Control in Immunocompromised Adult Participants With Symptomatic COVID-19 Requiring Hospital Care (NEREIDA)

A Phase 2 study testing Plitidepsin in people with COVID-19, run by PharmaMar at 44 sites in 11 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 primary objective of this study is to evaluate efficacy of plitidepsin in pre-specified groups of immunocompromised patients with symptomatic COVID-19 requiring hospital care versus control in terms of mortality. 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?
Plitidepsin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
37 participants
Where
44 sitesin 11 countries
Study dates
19 Apr 2023to 19 Apr 2024
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

  • Signed informed consent obtained prior to initiation of any study-specific procedures and study treatment.
  • Participant aged ≥18 years.
  • Participant diagnosed COVID-19, with the following characteristics:
  • A regulatory-approved test, collected no more than 3 days prior to study randomisation, with either a Ct value ≤30 or a positive antigen test.
  • Presence of any of the selected signs/symptom listed in the COVID-19 signs/symptoms checklist within the last 24 hours.
  • Participant already admitted or requiring hospital care for symptomatic COVID-19, for which at least one antiviral has failed or cannot be used (i.e., contraindication, absence of labelled indication, guidelines or drug unavailability), after a minimum washout period of 24 hours for small molecules (e.g., remdesivir, molnupiravir, nirmaltrevir, ritonavir) and 5 days for antiviral monoclonal antibodies (e.g., tixagevimab + cilgavimab) or convalescent plasma.
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  • Adequate bone marrow, liver, kidney, and metabolic function, defined by the following tests performed at local laboratory:
  • Absolute neutrophil count ≥500/mm^3 (0.5 x 109/L).
  • Platelet count ≥ 50 000/mm3 (50 x 109/L).
  • Alanine transaminase (ALT) ≤3 x upper limit of normal (ULN) (≤5 x ULN if preexistent liver involvement by the underlying disease).
  • Serum bilirubin ≤1.5 x ULN (or direct bilirubin <1.5 x ULN when total bilirubin is above ULN).
  • Estimated glomerular filtration rate ≥30 mL/min (CKD-EPI Creatinine Equation [2021]).
  • Females of child-bearing potential must have a negative serum or urine pregnancy test by local laboratory at screening and must be non-lactating.
  • Females of child-bearing potential and fertile males with partners of child-bearing potential must use contraceptive methods as specified in the protocol.
  • Group-specific inclusion criteria:
  • Group 1 - Patients receiving, within the last 30 days, immune-suppressive therapy due to haematopoietic or organ transplantation.
  • Group 2 - Participants receiving B-cell depleting therapies within the last 6 months (with the exception of CAR-T cell therapy for which time restriction is not applicable).
  • Group 3 - Participants receiving, within the last 30 days, other immune-suppressive therapies.
  • Group 4 - Other situations with immunodeficiency.
  • Primary immune deficiencies.
  • Human immunodeficiency virus (HIV) infection, with CD4^+ T lymphocyte < 200 cells/μL in the last month.
  • Radiation therapy within the last 3 months- requires documentation of ALC < 500 cells/μL.
  • Haematological neoplasia or myelodysplasia not currently receiving any therapy.
  • Other situations with a documentation of ALC < 500 cells/μL.

Who cannot join

  • Evidence of critical illness.
  • Any of the following cardiac conditions or risk factors:
  • Cardiac infarction or cardiac surgery episode within the last month.
  • History of known congenital QT prolongation.
  • Known structural cardiomyopathy with abnormal left ventricular ejection fraction (LVEF) (<50%).
  • Current clinical evidence of heart failure or acute cardiac ischaemia (New York Heart Association (NYHA) class III-IV).
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  • Hypersensitivity to the active ingredient or any of the excipients (mannitol, macrogolglycerol hydroxystearate, and ethanol) or contraindication to receive dexamethasone, antihistamine H1/H2, or anti-serotoninergic 5HT3 agents.
  • Females who are pregnant or breast-feeding.
  • Females and males with partners of child-bearing potential who are not using at least 1 protocol-specified method of contraception.
  • Any situation currently requiring increasing needs of immune-suppressive agents.
  • Any other clinically significant medical condition or laboratory abnormality that, in the opinion of the investigator, would jeopardise the safety of the participant or potentially impact on participant compliance or the safety/efficacy observations in the study.
  • Participation in another clinical study involving an investigational drug within 30 days prior to screening.

Trial locations and contacts

44 sites in 11 countries.

44 sites in 11 countries

Spain18 sites
  • Hospital Germans Trias i Pujol

    Badalona, Barcelona, 08916

  • Hospital del Mar - Parc de Salut Mar

    Barcelona, 08003

  • Vall d'Hebron Institut de Recerca

    Barcelona, 08035

  • Hospital Clinic de Barcelona

    Barcelona, 08036

  • Hospital San Pedro de Alcantara

    Cáceres, 10003

  • Hospital Universitario de La Princesa

    Madrid, 28006

  • Hospital General Universitario Gregorio Marañón

    Madrid, 28007

  • MD Anderson Cancer Center Madrid

    Madrid, 28033

  • Hospital Universitario Ramón y Cajal

    Madrid, 28034

  • Hospital Clínico San Carlos

    Madrid, 28040

  • Hospital Universitario Fundación Jiménez Díaz

    Madrid, 28040

  • Hospital Universitario 12 de Octubre

    Madrid, 28041

  • Hospital Universitario HM Sanchinarro

    Madrid, 28050

  • Hospital Regional Universitario de Málaga - Hospital General

    Málaga, 29010

  • Hospital Universitario Quirónsalud Madrid

    Pozuelo de Alarcón, Madrid, 28223

  • Complejo Asistencial Universitario de Salamanca - Hospital Clínico

    Salamanca, 37007

  • Hospital Alvaro Cunqueiro - Clinico Universitario Vigo

    Vigo, Pontevedra, 36213

  • Hospital Universitario Miguel Servet

    Zaragoza, 50009

Other trials in Spain

Greece6 sites
  • General Hospital of Athens Evangelismos

    Athens, Attica, 10676

  • Laiko General Hospital of Athens

    Athens, Attica, 11527

  • Alexandra General Hospital

    Athens, Attica, 11528

  • University General Hospital Attikon

    Athens, Attica, 124 62

  • General Hospital for Thoracic Diseases Sotiria

    Athens, 11527

  • University Hospital of Ioannina

    Ioannina, Epirus, 45500

Other trials in Greece

France5 sites
  • Centre Hospitalier de la Côte Basque

    Bayonne, Pyrénées-Atlantiques, 64109

  • Hôpitaux Civils de Colmar - Centre Hospitalier Louis Pasteur

    Colmar, Grand Est, 68024

  • Cancer Research Centre of Lyon

    Lyon, Auvergne-Rhône-Alpes, 69373

  • Les Hôpitaux Universitaires de Strasbourg

    Strasbourg, 67091

  • Centre Hospitalier Régional Universitaire de Tours

    Tours, Indre-et-Loire, 37044

Other trials in France

Portugal4 sites
  • Hospital da Senhora da Oliveira - Guimarães

    Guimarães, Braga District, 4835-044

  • Centro Hospitalar Universitário Lisboa Norte, E.P.E - Hospital De Santa Maria

    Lisbon, Lisbon District, 1649-035

  • Hospital Pedro Hispano

    Senhora da Hora, 4464-513

  • Centro Hospitalar de Vila Nova de Gaia/Espinho

    Vila Nova de Gaia, 4434-502

Other trials in Portugal

Georgia3 sites
  • The First University Clinic of the Tbilisi State Medical University

    Tbilisi, 0141

  • Ltd Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic

    Tbilisi, 0144

  • Academician Vakhtang Bochorishvili Clinic

    Tbilisi, 4600

Other trials in Georgia

Italy2 sites
  • Ente Ospedaliero Ospedali Galliera

    Genova, 16128

  • IRCCS Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani

    Roma, Rome, 00149

Other trials in Italy

United Kingdom2 sites
  • University College London Hospitals NHS Foundation Trust

    London, NW1 2BU

  • The Newcastle Upon Tyne Hospitals NHS Foundation Trust

    Newcastle upon Tyne, England, NE1 4LP

Other trials in United Kingdom

Belgium1 site
  • Universitair Ziekenhuis Leuven - Campus Gasthuisberg

    Leuven, Flemish Brabant, 3000

Other trials in Belgium

Hungary1 site
  • Országos Korányi Pulmonológiai Intézet

    Budapest, 1121

Other trials in Hungary

Israel1 site
  • Sheba Medical Center Hospital - Tel Hashomer

    Ramat Gan, Tel Aviv, 52621

Other trials in Israel

Poland1 site
  • Wojewódzki Specjalistyczny Szpital im. Dr. Władysława Biegańskiego

    Lodz, Lódzkie, 91-347

Other trials in Poland

About this study

Official title: A Multicentre, Open Label, Randomised, Controlled, Basket, Pragmatic, Phase II, Clinical and Translational Study to Determine the Efficacy and Safety of Plitidepsin Versus Control in Immunocompromised Adult Patients With Symptomatic COVID-19 Requiring Hospital Care

The primary objective of this study is to evaluate efficacy of plitidepsin in pre-specified groups of immunocompromised patients with symptomatic COVID-19 requiring hospital care versus control in terms of mortality.

Conditions
COVID-19
Being tested
Plitidepsin
Keywords
COVID-19, Plitidepsin
Medical subject headings
COVID-19

What participants receive

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

  • PlitidepsinDrug

    IV infusion over 60-minutes

Study groups in NCT05705167
Study groupRoleWhat they receive
Plitidepsin 2.5 mgExperimentalBest standard care (as per applicable local, institutional, national, supranational COVID-19 treatment guidelines) and plitidepsin (administered as a 60-minute intravenous (IV) infusion, every 24 hours for 3 consecutive days, at a dose of 2.5 mg) will be administered to participants of the following groups: * Group 1 - Participants receiving immune-suppression due to haematopoietic or organ transplantation. * Group 2 - Participants receiving B-cell depleting therapies. * Group 3 - Participants receiving other immune-suppressive therapies. * Group 4 - Other situations with immune deficiencies.
Receives: Drug: Plitidepsin
ControlNo interventionBest standard care (as per applicable local, institutional, national, supranational COVID-19 treatment guidelines) ± other regulatory-approved antiviral (if clinically indicated) will be administered to participants of the following groups: * Group 1 - Participants receiving immune-suppression due to haematopoietic or organ transplantation. * Group 2 - Participants receiving B-cell depleting therapies. * Group 3 - Participants receiving other immune-suppressive therapies.

What is being measured

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

  1. One-month All-cause Mortality Rate

    In the event of the participant initiating another non-protocol therapy, 1-month all-cause mortality rate was evaluated regardless of initiation of new non-protocol therapy.

    Measured: Day 1 to Day 30 (±2)

Secondary outcomes (7)
  1. Time to Confirmed Negativisation in SARS-CoV-2 Antigen Test or Real Time Polymerase Chain Reaction (RT-PCR) Cycle Threshold (Ct) > 30

    Time to confirmed negativisation in SARS-CoV antigen test or RT-PCR Ct>30 was calculated as time from randomisation to the corresponding event using Kaplan-Meier (KM) estimates. Participants with no available data for any time to event efficacy endpoint were censored at time 0, end of study (Day 60 ±3), or date of early study termination. Also, participants who had not achieved the time to event endpoint were censored at the last valid assessment.

    Measured: Day 1 to Day 60 (±3)

  2. Time to Sustained End of COVID-related Hospital Care

    Time to sustained end of COVID-related hospital care from the time of randomisation was calculated as time from randomisation to the corresponding event using KM estimates. Participants with no available data for any time to event efficacy endpoint were censored at time 0, end of study (Day 60 ±3), or date of early study termination. Also, participants who had not achieved the time to event endpoint were censored at the last valid assessment.

    Measured: Day 1 to Day 60 (±3)

  3. Time to Sustained Improvement and Resolution of Selected COVID-19 Signs/Symptoms

    Time to sustained improvement and resolution of all targeted COVID-19 signs/symptoms was calculated as time from randomisation to the corresponding event using KM estimates. Corresponding events were defined as the event occurring on the first of 4 consecutive days when all symptoms scored as National Cancer Institute (NCI)-Common Terminology Criteria for Adverse Events (CTCAE) v5.0; category of moderate-severe intensity, or requiring medical intervention, or limiting instrumental activity of daily living are scored as mild or absent AND all symptoms scored mild or 0 (absent) at study entry are scored as 0. Participants with no available data for any time to event efficacy endpoint were censored at time 0, end of study (Day 60 ±3), or date of early study termination. Also, participants who had not achieved the time to event endpoint were censored at the last valid assessment.

    Measured: Day 1 to Day 60 (±3)

  4. Number of Participants in Each Category of the World Health Organization (WHO) Clinical Progression Scale (CPS)

    Distribution of participants according to their clinical status by the 11-category WHO CPS:

    • Uninfected; no viral ribonucleic acid (RNA) detected
    • Asymptomatic; viral RNA detected
    • Symptomatic; independent
    • Symptomatic; assistance needed
    • Hospitalised; no oxygen therapy
    • Hospitalised; oxygen by mask or nasal prongs
    • Hospitalised; oxygen by non-invasive ventilation (NIV) or high flow
    • Intubation and mechanical ventilation
    • Mechanical ventilation or vasopressors
    • Mechanical ventilation and vasopressors, dialysis, or extracorporeal membrane oxygenation (ECMO) OR
    • Death.

    Measured: Days 4 (±1), 8 (±1), 15 (±1), 30 (±2), and 60 (±3)

  5. Number of Participants Requiring Oxygen Therapy

    The maximum number of participants requiring oxygen therapy on any day during each visit window is reported.

    Measured: Days 4 (±1), 8 (±1), 15 (±1), 30 (±2), and 60 (±3)

  6. Time to Sustained Discontinuation of Oxygen Supplementation

    Time to sustained discontinuation is calculated as time from randomisation to the corresponding event using KM estimates. Corresponding events were defined as discontinuation of oxygen supplementation for at least 7 days. Participants with no available data for any time to event efficacy endpoint were censored at time 0, end of study (Day 60 ±3), or date of early study termination. Also, participants who had not achieved the time to event endpoint were censored at the last valid assessment.

    Measured: Day 1 to Day 60 (±3)

  7. Number of Participants Who Experience a Treatment-emergent Adverse Event (TEAE)

    Frequency of the following events (all-cause and treatment-related) are included:

    • TEAEs
    • TEAEs ≥ grade 3 according to the NCI CTCAE v5.0
    • TEAEs of special interest
    • Serious TEAEs
    • Serious adverse reactions (SARs)
    • AEs leading to treatment discontinuation
    • Deaths (related to COVID-19/all)

    Clinically relevant/significant changes from Baseline in laboratory parameters and vital signs were reported as AEs.

    Measured: Day 1 to Day 60 (±3)

Timeline

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

  1. First posted30 Jan 2023
  2. Study start19 Apr 2023
  3. Primary completion19 Mar 2024
  4. Study completion19 Apr 2024

Why it stopped: Significant difficulties in the recruitment of participants.

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
None (open label)
Enrolment
37 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05705167
Sponsor's protocol ID
AV-APL-B-002-22
Other IDs
2022-002489-34
Acronym
NEREIDA
Status last verified
Sep 2024
First submitted
21 Dec 2022
Last updated
2 Dec 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Landete P, Caliman-Sturdza OA, Lopez-Martin JA, Preotescu L, Luca MC, Kotanidou A, Villares P, Iglesias SP, Guisado-Vasco P, Saiz-Lou EM, Del Carmen Farinas-Alvarez M, de Lucas EM, Perez-Alba E, Cisneros JM, Estrada V, Hidalgo-Tenorio C, Poulakou G, Torralba M, Fortun J, Garcia-Ocana P, Lemaignen A, Marcos-Martin M, Molina M, Paredes R, Perez-Rodriguez MT, Raev D, Ryan P, Meira F, Gomez J, Torres N, Lopez-Mendoza D, Jimeno J, Varona JF. A Phase III Randomized Controlled Trial of Plitidepsin, a Marine-Derived Compound, in Hospitalized Adults With Moderate COVID-19. Clin Infect Dis. 2024 Oct 15;79(4):910-919. doi: 10.1093/cid/ciae227.

    PubMed 39182994

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Plitidepsin in people with COVID-19, run by PharmaMar at 44 sites in 11 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 24 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: stopped early, as of the sponsor's last update on 2 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 44 sites in Spain, Greece, France, Portugal, Georgia and 6 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. 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 2 Dec 2024). 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?

One-month All-cause Mortality Rate (time frame: Day 1 to Day 30 (±2)). 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 NCT05705167, which also lists 1 linked publication.

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 2 Dec 2024.

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