Cohort Multiple Randomized Controlled Trials Open-label of Immune Modulatory Drugs and Other Treatments in COVID-19 Patients - Sarilumab Trial - CORIMUNO-19 - SARI
Latest Information Update: 18 Jun 2025
At a glance
- Drugs Sarilumab (Primary)
- Indications COVID 2019 infections; Pneumonia
- Focus Therapeutic Use
- Acronyms CORIMUNO-19-SARI; CORIMUNO-SARI; SARI-2
Most Recent Events
- 12 Jun 2025 The protocol has been amended to change in study time frame.
- 12 Jun 2025 Status changed from active, no longer recruiting to completed.
- 03 Feb 2022 Results of TOCI-2 trial and SARI-2 study analysis published in the European Respiratory Journal
Trial Overview
Purpose
The overall objective of the study is to determine the therapeutic effect and tolerance of Sarilumab in patients with moderate, severe pneumonia or critical pneumonia associated with Coronavirus disease 2019 (COVID-19). Sarilumab is a human IgG1 monoclonal antibody that binds specifically to both soluble and membrane-bound IL-6Rs (sIL-6Rα and mIL-6Rα) and has been shown to inhibit IL-6-mediated signaling through these receptors. The study has a cohort multiple Randomized Controlled Trials (cmRCT) design. Randomization will occur prior to offering Sarilumab administration to patients enrolled in the CORIMUNO-19 cohort. Sarilumab will be administered to consenting adult patients hospitalized with COVID-19 either diagnosed with moderate or severe pneumonia requiring no mechanical ventilation or critical pneumonia requiring mechanical ventilation. Patients who will chose not to receive Sarilumab will receive standard of care. Outcomes of Sarilumab-treated patients will be compared with outcomes of standard of care-treated patients as well as with outcomes of patients treated with other immune modulators.
Primary Endpoints
Percentage of Participants With WHO Clinical Progression Scale > 5 at Day 4 -- Severe COVID Population (WHO Clinical Progression Scale =5 at Baseline)
description: Percentage of participants who has died or needed non-invasive or mechanical ventilation
by day 4 (WHO clinical progression scale > 5). A patient with new do-not-resuscitate
order at day 4 will be considered as with a score > 5.
WHO progression scale:
Uninfected; non viral RNA detected: 0 Asymptomatic; viral RNA detected: 1 Symptomatic;
Independent: 2 Symptomatic; Assistance needed: 3 Hospitalized; No oxygen therapy: 4
Hospitalized; oxygen by mask or nasal prongs: 5 Hospitalized; oxygen by NIV or High flow:
6 Intubation and Mechanical ventilation, pO2/FIO2≥150 OR SpO2/FIO2≥200: 7 Mechanical
ventilation, (pO2/FIO2<150 OR SpO2/FIO2<200) OR vasopressors (norepinephrine >0.3
microg/kg/min): 8 Mechanical ventilation, pO2/FIO2<150 AND vasopressors (norepinephrine
>0.3 microg/kg/min), OR Dialysis OR ECMO: 9 Dead: 10
time_frame: 4 days
Percentage of Participants With Non-invasive Ventilation, Mechanical Ventilation or Death at Day 14 (WHO Clinical Progression Scale =5 at Baseline)
description: Survival without needs of ventilator utilization (including non invasive ventilation and
high flow) at day 14. Percentage of non-invasive ventilation, mechanical ventilation or
death. Thus, events considered are needing ventilator utilization (mechanical or
non-invasive ventilation including high flow oxygen), or death. New do-not-resuscitate
(DNR) order (if given after the inclusion of the patient) will be considered as an event
at the date of the DNR.
time_frame: Day 1 to Day 14
Percentage of Participants With no Improvement in WHO Clinical Progression Scale at Day 4 -- Critical COVID Population ( WHO Clinical Progression Scale >5 at Baseline)
description: Results are presented as the percentage not improved, so that an effective treatment
would be associated with a decrease in percentage
Scale:
Uninfected; non viral RNA detected: 0 Asymptomatic; viral RNA detected: 1 Symptomatic;
Independent: 2 Symptomatic; Assistance needed: 3 Hospitalized; No oxygen therapy: 4
Hospitalized; oxygen by mask or nasal prongs: 5 Hospitalized; oxygen by NIV or High flow:
6 Intubation and Mechanical ventilation, pO2/FIO2≥150 OR SpO2/FIO2≥200: 7 Mechanical
ventilation, (pO2/FIO2<150 OR SpO2/FIO2<200) OR vasopressors (norepinephrine >0.3
microg/kg/min): 8 Mechanical ventilation, pO2/FIO2<150 AND vasopressors (norepinephrine
>0.3 microg/kg/min), OR Dialysis OR ECMO: 9
time_frame: 4 days
Cumulative Incidence (Percentage of Participants) With Successful Tracheal Extubation at Day 14 -- Critical COVID Population (WHO Clinical Progression Scale >5 at Baseline)
description: Cumulative incidence of successful tracheal extubation (defined as duration extubation >
48h) at day 14 if patients have been intubated before day 14 ; or removal of Non Invasive
Ventilation or high flow (for > 48h) if they were included under oxygen by Non Invasive
Ventilation or High flow (score 6) and remained without intubation. Death or new
do-not-resuscitate order (if given after the inclusion of the patient) will be considered
as a competing event.
time_frame: Day 1 to Day 14
Other Endpoints
Percentage of Participants Surviving (Overall Survival)
description: Percentage of participants surviving at 14, 28 and 90 days
time_frame: 14, 28 and 90 days
WHO Progression Scale
description: WHO progression scale:
Uninfected; non viral RNA detected: 0 Asymptomatic; viral RNA detected: 1 Symptomatic;
Independent: 2 Symptomatic; Assistance needed: 3 Hospitalized; No oxygen therapy: 4
Hospitalized; oxygen by mask or nasal prongs: 5 Hospitalized; oxygen by NIV or High flow:
6 Intubation and Mechanical ventilation, pO2/FIO2≥150 OR SpO2/FIO2≥200: 7 Mechanical
ventilation, (pO2/FIO2<150 OR SpO2/FIO2<200) OR vasopressors (norepinephrine >0.3
microg/kg/min): 8 Mechanical ventilation, pO2/FIO2<150 AND vasopressors (norepinephrine
>0.3 microg/kg/min), OR Dialysis OR ECMO: 9 Dead: 10
time_frame: 4, 7 and 14 days
Mean of Ventilator Free-days at Day 28 -- Critical COVID Population (WHO-clinical Progression Scale >5 at Baseline)
description: 28-day ventilator free-days
time_frame: 28 days
Cumulative Incidence (Percentage of Participants) of Oxygen Supply Independency
description: Time to oxygen supply independency
time_frame: 28, 90 days
Cumulative Incidence (Percentage of Participants) of Discharge From Hospital
description: Time to discharge from hospital
time_frame: 28, 90 days
Cumulative Incidence (Percentage of Participants) of Intensive Care Unit Discharge -- Critical COVID Population (WHO Clinical Progression Scale >5 at Baseline)
description: Time to discharge from Intensive Care Unit
time_frame: 28, 90 days
PaO2/FiO2 Ratio -- Critical COVID Population (WHO-CPS >5)
description: evolution of PaO2/FiO2 ratio PaO2 is partial pressure of arterial oxygen expressed in
mmHg. FiO2 is fraction of inspired oxygen (for instance, 0.33 for 33% oxygen) with no
units.
PaO2/FiO2 ratio is expressed in mmHg.
time_frame: day 1 to day 14 [1]
Diseases Treated
Indication | Qualifiers | Patient Segments |
---|---|---|
COVID 2019 infections | treatment | - |
Pneumonia | treatment | moderate, severe |
Biomarker
NCT Number | Biomarker Name | Biomarker Function |
---|---|---|
NCT04324073 | IQ motif containing GTPase activating protein 1 | Brief Title, Official Title |
secretion associated Ras related GTPase 1A | Brief Title, Official Title |
Subjects
- Subject Type patients
-
Number
Planned: 240
Actual: 239
- Sex male & female
- Age Group ≥ 18 years; adult
Patient Inclusion Criteria
1. Patients included in the CORIMUNO-19 cohort 2. Patients belonging to one of the 2 following groups: - Group 1: patients not requiring Intensive Care Unit at admission with moderate and severe pneumopathy according to the OMS Criteria of severity of COVID pneumopathy. Moderate cases : Cases meeting all of the following criteria: - Showing fever and respiratory symptoms with radiological findings of pneumonia. - Requiring between 3L/min and 5L/min of oxygen to maintain SpO2 >97% Severe cases Cases meeting any of the following criteria: - Respiratory distress (???30 breaths/ min); - Oxygen saturation≤93% at rest in ambient air; or Oxygen saturation ≤97 % with O2 > 5L/min. - PaO2/FiO2???300mmHg - Group 2: patients requiring Intensive Care Unit based on Criteria of severity of COVID pneumopathy. - Respiratory failure and requiring mechanical ventilation - No do-not-resuscitate order (DNR order).
Patient Exclusion Criteria
- Patients with exclusion criteria to the CORIMUNO-19 cohort. - Known hypersensitivity to Sarilumab or to any of their excipients. - Pregnancy - Current documented bacterial infection - Patient with any of following laboratory results out of the ranges detailed below at screening should be discussed depending of the medication: - Absolute neutrophil count (ANC) ≤ 1.0 x 109/L - Haemoglobin level: no limitation - Platelets (PLT) < 50 G /L - SGOT or SGPT > 5N
Trial Details
Identifiers
Identifier | Owner |
---|---|
NCT04324073 | ClinicalTrials.gov: US National Institutes of Health |
APHP200375-2 | - |
Trial Dates
-
Initiation Dates
Planned : 26 Mar 2020
Actual : 27 Mar 2020
-
Primary Completion Dates
Planned : 27 Mar 2021
Actual : 21 Apr 2020
-
End Dates
Planned : 31 Dec 2021
Actual : 24 Sep 2020
Other Details
- Design multicentre; open; parallel; prospective; randomised
- Phase of Trial Phase II/III
- Location France
- Focus Therapeutic Use
Interventions
Drugs | Route | Formulation | Target |
---|---|---|---|
Sarilumab Primary Drug
|
Intravenous | Infusion | Interleukin 6 receptor |
SARILUMAB -- Critical COVID population (WHO Clinical Progression Scale >5 at baseline)
Sarilumab (an IV dose of 400 mg of sarilumab in a 1 hour-infusion at Day 1). Administration of Sarilumab fixed dose on day 3 was recommended and left to the treating physician Drug: Sarilumab( (an IV dose of 400 mg of sarilumab in a 1 hour-infusion at D1 )
SARILUMAB -- Severe COVID population (WHO Clinical Progression Scale =5 at baseline)
Sarilumab (an IV dose of 400 mg of sarilumab in a 1 hour-infusion at Day 1). Administration of Sarilumab fixed dose on day 3 was recommended and left to the treating physician Drug: Sarilumab( (an IV dose of 400 mg of sarilumab in a 1 hour-infusion at D1 )
Standard of care -- Severe COVID population (WHO Clinical Progression Scale =5 at baseline)
Usual care was provided at the discretion of the clinicians
Standard of care -- Critical COVID population (WHO Clinical Progression Scale >5)
Usual care was provided at the discretion of the clinicians
Results
Publications
-
Hermine O, Mariette X, Porcher R, Resche-Rigon M, Tharaux PL, Ravaud P. Effect of Interleukin-6 Receptor Antagonists in Critically Ill Adult Patients with COVID-19 Pneumonia: two Randomised Controlled Trials of the CORIMUNO-19 Collaborative Group. . Eur-Respir-J 2022;.
PubMed | CrossRef Fulltext
Trial Centres
Investigators
Investigator | Centre Name | Trial Centre Country |
---|---|---|
Matthieu RESCHE-RIGON, MD PhD
685740240 Ext: +33 matthieu.resche-rigon@u-paris.fr
show details
|
-
|
|
matthieu resche-rigon, MD-PhD
685740240 +33 matthieu.resche-rigon@u-paris.fr
show details
|
NECKER Hospital | France |
Olivier HERMINE, MD-PhD
603707920 Ext: +33 ohermine@gmail.com
show details
|
-
|
|
Xavier Mariette, MD-PHD | Kremlin Bicetre hospital APHP | France |
Centres
Centre Name | Location | Trial Centre Country |
---|---|---|
- |
-
|
-
|
Assistance Publique - Hôpitaux de Paris |
-
|
-
|
Cochin Aphp | Paris, Ile De France | France |
HEGP | Paris, Ile De France | France |
Kremlin Bicetre hospital APHP | Le Kremlin-Bicêtre, Ile De France | France |
NECKER Hospital | Paris | France |
Trial History
Event Date | Event Type | Comment |
---|---|---|
18 Jun 2025 | Other trial event | Last checked against the ClinicalTrials.gov record. Updated 18 Jun 2025 |
12 Jun 2025 | Protocol amendment | The protocol has been amended to change in study time frame. Updated 18 Jun 2025 |
12 Jun 2025 | Status change - completed | Status changed from active, no longer recruiting to completed. Updated 18 Jun 2025 |
07 Mar 2022 | Other trial event | According to ClinicalTrials.gov, the recruitment status of this study is unknown because the information has not been verified recently (last verified Mar 2020). Updated 07 Mar 2022 |
03 Feb 2022 | Results | Results of TOCI-2 trial and SARI-2 study analysis published in the European Respiratory Journal Updated 11 Feb 2022 |
15 Apr 2020 | Biomarker Update | Biomarkers information updated Updated 04 Nov 2021 |
14 Apr 2020 | Status change - active, no longer recruiting | Status changed from recruiting to active, no longer recruiting. Updated 16 Apr 2020 |
31 Mar 2020 | Other trial event | Planned number of patients changed from 180 to 240. Updated 03 Apr 2020 |
31 Mar 2020 | Other trial event | Planned primary completion date changed from 26 Mar 2021 to 27 Mar 2021. Updated 03 Apr 2020 |
31 Mar 2020 | Status change - recruiting | Status changed from not yet recruiting to recruiting. Updated 03 Apr 2020 |
30 Mar 2020 | New trial record | New trial record Updated 30 Mar 2020 |
References
-
ClinicalTrials.gov: US National Institutes of Health. Trial-Reg 2024;.
Available from: URL: http://clinicaltrials.gov -
Hermine O, Mariette X, Porcher R, Resche-Rigon M, Tharaux PL, Ravaud P. Effect of Interleukin-6 Receptor Antagonists in Critically Ill Adult Patients with COVID-19 Pneumonia: two Randomised Controlled Trials of the CORIMUNO-19 Collaborative Group. . Eur-Respir-J 2022;.
PubMed | CrossRef Fulltext
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