Effectiveness of Interleukin-6 Receptor Inhibitors in the Management of Patients With Severe SARS-CoV-2 Pneumonia: An Open-Label, Multicenter Sequential and Cluster Randomized Trial
Latest Information Update: 04 Nov 2021
At a glance
- Drugs Sarilumab (Primary) ; Tocilizumab (Primary) ; Tocilizumab (Primary)
- Indications COVID-19 pneumonia; COVID-19 respiratory infection; SARS-CoV-2 acute respiratory disease
- Focus Therapeutic Use
- Acronyms TOCIVID
- 08 Oct 2020 Status changed from recruiting to discontinued due to changed clinical conditions and too few patients available.
- 05 Apr 2020 Status changed from not yet recruiting to recruiting.
- 01 Apr 2020 Planned initiation date changed from 25 Mar 2020 to 4 Apr 2020.
Most Recent Events
Trial Overview
Purpose
To compare the effect of either one of three IL-6 inhibitor administrations, relative to the standard of care, on time to independence from supplementary oxygen therapy, measured in days from baseline to day 28, in patients with severe SARS-CoV-2 pneumonia.
Comments
According to ClinicalTrials.gov, this study has been terminated due to changed clinical conditions and too few patients available.
Primary Endpoints
Time to independence from supplementary oxygen therapy
time_frame: days from enrolment up 28 days
Other Endpoints
Number of deaths
time_frame: 28 days from enrolment
Days out of hospital and alive
time_frame: 28 days from enrolment
Ventilator free days alive and out of hospital
time_frame: 28 days from enrolment
C-reactive protein (CRP) level
description: Measured from standard blood test
time_frame: baseline
time_frame: peak during hospitalisation, up to 28 days
time_frame: 14 days
time_frame: 28 days
Number of participants with serious adverse events
description: Measured as occurrence of any serious adverse events
time_frame: During treatment, up to 28 days [1]
Diseases Treated
Indication | Qualifiers | Patient Segments |
---|---|---|
COVID-19 pneumonia | treatment | severe |
COVID-19 respiratory infection | treatment | - |
SARS-CoV-2 acute respiratory disease | treatment | - |
Biomarker
NCT Number | Biomarker Name | Biomarker Function |
---|---|---|
NCT04322773 | C-reactive protein (CRP) | Eligibility Criteria, Outcome Measure |
D-dimer | Eligibility Criteria | |
Ferritin | Eligibility Criteria | |
interleukin 6 receptor | Official Title |
Subjects
- Subject Type patients
-
Number
Planned: 200
Actual: 20
- Sex male & female
- Age Group ≥ 18 years; adult; elderly
Patient Inclusion Criteria
- SARS-CoV-2 infection confirmed by real time-PCR and - Positive imaging: consolidation, ground glass opacities, or bilateral pulmonary infiltration either by CT-scan or chest x-ray; and - Need of oxygen therapy to maintain SO2>94% OR FiO2/PaO2 > 20 and at least two of the following laboratory measures: - CRP level >70 mg/L - CRP level ≥ 40 mg/L and doubled within 48 hours (without other confirmed infectious or non-infectious course), - Lactatdehydrogenase > 250 U/L, - thrombocytopenia < 120.000 x 10E9/L, - lymphocyte count < 0.6 x 10E9/L, - D-dimer > 1 ug/mL, - serum ferritin > 300 ug/mL
Patient Exclusion Criteria
- pregnancy suspected or confirmed, - severe heart failure, - suspected or confirmed bacterial infection, - current solid or hematological malignancy, - neutropenia, - ALAT elevation more than three times the laboratory upper limit, - ASA class 5 (after COVID19 admission) or higher at inclusion (prior admission), - severe chronic obstructive pulmonary disease or heart failure (NYHA class II or higher), - pregnant or lactating women, - current treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs)/immunosuppressive agents including IL-6 inhibitors, or with Janus kinase inhibitors (JAKi) in the past 30 days or plans to receive during the study period, - current use of chronic oral corticosteroids in a dose higher than prednisone 10 mg or equivalent per day, - previous or active tuberculosis (TB), - HIV infection regardless of immunological status, hepatitis, - evidence of recent (30 days) invasive bacterial or fungal infections, - patients who have received immunosuppressive antibody therapy within the past 5 months, including intravenous immunoglobulin or plans to receive during the study period, - IV drug abuse, - history of inflammatory bowel disease, - diverticulitis, - ulcer, - perforated gastrointestinal tract, - participation in any clinical research study evaluating an investigational product (IP) or therapy within 3 months and less than five half-lives of IP prior inclusion to the study, - any physical examination findings and/or history of any illness that, in the opinion of the study investigator, might confound the results of the study or pose an additional risk to the patient by their participation in the study, - inability to give informed consent.
Trial Details
Identifiers
Identifier | Owner |
---|---|
NCT04322773 | ClinicalTrials.gov: US National Institutes of Health |
EudraCT2020-001275-32 | European Clinical Trials Database |
APPI2CV2020-01 | - |
Trial Dates
-
Initiation Dates
Planned : 04 Apr 2020
Actual : 05 Apr 2020
-
Primary Completion Dates
Planned : 01 Jun 2021
Actual : 08 Oct 2020
-
End Dates
Planned : 01 Jun 2021
Actual : 08 Oct 2020
Other Details
- Design multicentre; open; prospective; randomised; sequential
- Phase of Trial Phase II
- Location Denmark
- Focus Therapeutic Use
Interventions
Drugs | Route | Formulation |
---|---|---|
SarilumabPrimary Drug | Subcutaneous | Injection |
TocilizumabPrimary Drug | Intravenous | Infusion |
TocilizumabPrimary Drug | Subcutaneous | Injection |
Roactemra iv
Single dose treatment with 400 mg tocilizumab intravensously
Drug: RoActemra iv (single dose treatment with tocilizumab 400 mg intravenously) Other Name: tocilizumab 400 mg
Other: Standard medical care (management as usual)
Roactemra sc
Single dose treatment with 2 x 162 mg tocilizumab subcutaneously
Drug: RoActemra sc (single dose treatment with tocilizumab 2 x 162 mg subcutaneously) Other Name: tocilizumab 2 x 162 mg
Other: Standard medical care (management as usual)
Kevzara sc
Single dose treatment with 1 x 200 mg sarilumab subcutaneously
Drug: Kevzara sc (single dose treatment with sarilumab 1 x 200 mg subcutaneously) Other Name: sarilumab 1 x 200 mg
Other: Standard medical care (management as usual)
Standard care
Management as usual
Other: Standard medical care (management as usual)
Trial Centres
Investigators
Investigator | Centre Name | Trial Centre Country |
---|---|---|
Lars Erik Kristensen, PhD
0045 38164157
show details
lars.erik.kristensen@regionh.dk |
Bispebjerg-Frederiksberg Hospital | Denmark |
Line Rustad
0045 38164158
show details
line.rustad@regionh.dk |
Bispebjerg-Frederiksberg Hospital | Denmark |
Centres
Centre Name | Location | Trial Centre Country |
---|---|---|
Bispebjerg-Frederiksberg Hospital | Copenhagen | Denmark |
Lars Erik Kristensen |
-
|
-
|
Marius Henriksen |
-
|
-
|
Trial History
Event Date | Event Type | Comment |
---|---|---|
09 Nov 2020 | Other trial event | Last checked against European Clinical Trials Database record. Updated 09 Nov 2020 |
12 Oct 2020 | Other trial event | Last checked against the ClinicalTrials.gov record. Updated 12 Oct 2020 |
09 Oct 2020 | Biomarker Update | Biomarkers information updated Updated 04 Nov 2021 |
08 Oct 2020 | Status change - discontinued | Status changed from recruiting to discontinued due to changed clinical conditions and too few patients available. Updated 12 Oct 2020 |
07 Apr 2020 | Other trial event | New source identified and integrated(European Clinical Trials Database:EudraCT2020-001275-32). Updated 07 Apr 2020 |
05 Apr 2020 | Status change - recruiting | Status changed from not yet recruiting to recruiting. Updated 08 Apr 2020 |
01 Apr 2020 | Other trial event | Planned initiation date changed from 25 Mar 2020 to 4 Apr 2020. Updated 06 Apr 2020 |
31 Mar 2020 | New trial record | New trial record Updated 31 Mar 2020 |
References
-
ClinicalTrials.gov: US National Institutes of Health. Trial-Reg 2023;.
Available from: URL: http://clinicaltrials.gov -
European Clinical Trials Database. Trial-Reg 2023;.
Available from: URL: https://www.clinicaltrialsregister.eu
Adis International Ltd. Part of Springer Science+Business Media
© Springer Nature Switzerland AG