COUNTER-COVID - Oral imatinib to prevent pulmonary vascular leak in Covid19 – a randomized, double --blind, placebo controlled, clinical trial in patients with severe Covid19 disease
Latest Information Update: 25 Jul 2022
At a glance
- Drugs Imatinib (Primary)
- Indications COVID-19 respiratory infection; Hypoxia; Respiratory insufficiency
- Focus Therapeutic Use
- Acronyms COUNTER-COVID; CounterCovid Study
- 23 Feb 2021 Status changed from recruiting to completed.
- 08 Nov 2020 Planned number of patients changed from 304 to 386.
- 03 Apr 2020 New trial record
Most Recent Events
Trial Overview
Outcome
Purpose
To test whether treatment with oral imatinib reduce disease burden and consumption of medical resources.
Primary Endpoints
Time to liberation from ventilation and supplemental oxygen >48h while being alive during a 28-day period after randomization
Timepoint: 28 days [1]
Other Endpoints
- Secondary efficacy parameters o 28-day mortality o Need for ICU admission o Length of ICU admission o Need for invasive ventilation o Length of invasive ventilation o Days on ventilator o Need for ECMO o Need for non-invasive ventilation o Length of non-invasive ventilation o SpO2 at Day 1,2,3,4,5,7,9 o Fi O2 at Day 1,2,3,4,5,7,9 o SpO2/FiO2 at Day 1,2,3,4,5,7,9 - Safety parameters o Blood cell count Day 0,1,2,3,5,7,9 o Kidney function Day 0,1,2,3,5,7,9 o Liver enzymes Day 0,1,2,3,5,7,9 o NTproBNP at Day 0,1,2,3,5,7,9 o SAEs / AE o ECG at Day 1,3,5,9 - Pharmacokinetics o Study drug plasma levels at 4h, 8h, Day 1,3,5,7,9 o Albumin, AGP1 at Day 0,1,2,3,5,7,9 - Immune responses (subgroups of 50 patients per study arm) o Host response plasma biomarkers on day 0, 5 and 9, and on the first day of any additional interventions (invasive ventilation, CT scanning, bronchoscopy). o Neutrophil RNA sequencing, metabolomics and lipidomics on day 0 and 5 o Phenotypic and functional analysis of whole blood, peripheral blood mononuclear cells and polymorphonuclear leukocytes on day 0 and 5, and on the first day of additional interventions (invasive ventilation, CT scanning, bronchoscopy). - Fibrotic responses (subgroups of 50 patients per study arm) o Fibrotic plasma biomarkers on day 0, 5 and 9, and on the first day of any additional interventions (invasive ventilation, CT scanning, bronchoscopy) Timepoint: 28 days [2]
Diseases Treated
Indication | Qualifiers | Patient Segments |
---|---|---|
COVID-19 respiratory infection | treatment | severe |
Hypoxia | treatment | - |
Respiratory insufficiency | treatment | - |
Subjects
- Subject Type patients
-
Number
Planned: 386
Actual: 385
- Sex male & female
- Age Group 28-93(median 64) years; adult; elderly
Patient Inclusion Criteria
- Age >18 years- Hospital admission with proven SARS2-Covid19 infection- Hypoxemic respiratory failure (SaO2 <94%, PaO2 <9kPa)- Ability to give informed consent.
Patient Exclusion Criteria
- Pre-existing chronic pulmonary disease- Former diagnosis of Interstitial pulmonary disease- Former diagnosis of COPD 4 or FEV1<30%pred- Previous DLCO <45%- Total lung capacity (TLC) < 60% of predicted- Lung cancer with non-surgical treatment in last year- Chronic home oxygen treatment- Pre-existing heart failure with a known left ventricular ejection fraction <40%- Active treatment of hematological or non-hematological cancer with targeted, immuno- or chemotherapy or targeted radiotherpay in the last year- Inability to provide informed consent- Any subject who had received any investigational medication within 1 month prior to the start of this study or who is scheduled to receive another investigational drug during the course of this study- Active liver disease, porphyria or elevations of serums transaminases >5 x ULN (upper limit of normal) or bilirubin > 1.5 x ULN- History or suspicion of inability to cooperate adequately.- White blood count < 4.0^109/l- Hemoglobin < 6.0 mmol/l- Thrombocytes < 100^109/l- Pregnant female subjects- Breastfeeding female subjects- Use of strong Cyp3A4 inductors, including the following drugs: Carbamazepine, efavirenz, enzalutamide, fenobarbital, fenytoine, hypericum, mitotaan, nevirapine, primidon, rifabutine, rifampicine- Concomittant use of chloroquine or hydroxychloroquine.- QTc >500msec at baseline.
Trial Details
Identifiers
Identifier | Owner |
---|---|
EudraCT2020-001236-10 | European Clinical Trials Database |
COVID19 | - |
Trial Dates
-
Initiation Dates
Actual : 31 Mar 2020
-
End Dates
Planned : 30 Sep 2020
Actual : 01 Feb 2021
Other Details
- Design double-blind; multicentre; parallel; prospective; randomised
- Phase of Trial Phase II
- Location Belgium; Netherlands
- Focus Therapeutic Use
Interventions
Drugs | Route | Formulation |
---|---|---|
ImatinibPrimary Drug | Oral | Tablet |
Product Name: Imatinib mesilate Investigational Medicinal Product Trade Name: Imatinib mesilate Name of the Marketing Authorisation Holder: Novartis Country which granted the Marketing Authorisation: Netherlands Investigational Medicinal Product Code: L01XE01 Pharmaceutical Form: Tablet IMP Routes of Administration: Oral use Chemical Origin Active Substance: yes
oral imatinib (800mg loading dose, followed by 400mg daily for 9 days) or placebo on top of standard care
Number Of treatment arms In the trial: 2
Is placebo used in this trial?: yes
Results
Publications
-
Aman J, Duijvelaar E, Botros L, Kianzad A, Schippers J, Smeele P, et al. Late Breaking Abstract - A randomised, double-blind, placebo controlled, clinical trial evaluating imatinib in patients with severe COVID-19. ERS-2021 2021; abstr. N/A.
Available from: URL: https://erj.ersjournals.com/content/58/suppl_65/OA4119 -
De Brabander J, Duijvelaar E, Schippers JR, Smeele PJ, Duitman J, Aman J, et al. Oral Imatinib Reduces Mortality in Hospitalized COVID-19 Patients Through Endothelial Barrier Protection and Immunomodulation. ATS-2022 2022; abstr. N/A.
Available from: URL: https://link.adisinsight.com/Et8c3 -
Duijvelaar E, Vanhove A, Schippers JR, Smeele PJ, de Man FS, Pinto YM, et al. Cardiac Safety of Imatinib for the Treatment of Covid-19: Results from a Randomized, Double Blind, Placebo-Controlled Trial. ATS-2022 2022; abstr. P874.
Available from: URL: https://www.abstractsonline.com/pp8/#!/10476/presentation/8132
Trial Centres
Investigators
Investigator | Centre Name | Trial Centre Country |
---|---|---|
Jurjan Aman
De Boelelaan 1117
show details
Amsterdam Postcode: 1081 HV Netherlands Telephone: +31610738910 j.aman@amsterdamumc.nl |
Amsterdam UMC | Netherlands |
Centres
Centre Name | Location | Trial Centre Country |
---|---|---|
Amsterdam UMC | Amsterdam | Netherlands |
Trial History
Event Date | Event Type | Comment |
---|---|---|
25 Jul 2022 | Other trial event | Last checked against European Clinical Trials Database record. Updated 25 Jul 2022 |
18 May 2022 | Results | Results of pre-specified secondary analysis assessing effects of imatinib on biomarkers and on 28-day mortality presented at the 118th International Conference of the American Thoracic Society Updated 22 Jul 2022 |
18 May 2022 | Results | Results assessing the cardiac safety of treatment with imatinib for 10 days in Covid-19 patients, presented at the 118th International Conference of the American Thoracic Society Updated 22 Jul 2022 |
08 Sep 2021 | Endpoint not met | Primary endpoint has not been met (Time to liberation from ventilation and supplemental oxygen 48h while being alive during a 28-day period after randomization)Results presented at the 31st Annual Congress of the European Respiratory Society Updated 11 Feb 2022 |
08 Sep 2021 | Results | Results presented at the 31st Annual Congress of the European Respiratory Society Updated 09 Feb 2022 |
23 Feb 2021 | Status change - completed | Status changed from recruiting to completed. Updated 23 Feb 2021 |
08 Nov 2020 | Other trial event | Planned number of patients changed from 304 to 386. Updated 09 Nov 2020 |
03 Apr 2020 | New trial record | New trial record Updated 03 Apr 2020 |
References
-
Aman J, Duijvelaar E, Botros L, Kianzad A, Schippers J, Smeele P, et al. Late Breaking Abstract - A randomised, double-blind, placebo controlled, clinical trial evaluating imatinib in patients with severe COVID-19. ERS-2021 2021; abstr. N/A.
Available from: URL: https://erj.ersjournals.com/content/58/suppl_65/OA4119 -
European Clinical Trials Database. Trial-Reg 2023;.
Available from: URL: https://www.clinicaltrialsregister.eu -
De Brabander J, Duijvelaar E, Schippers JR, Smeele PJ, Duitman J, Aman J, et al. Oral Imatinib Reduces Mortality in Hospitalized COVID-19 Patients Through Endothelial Barrier Protection and Immunomodulation. ATS-2022 2022; abstr. N/A.
Available from: URL: https://link.adisinsight.com/Et8c3 -
Duijvelaar E, Vanhove A, Schippers JR, Smeele PJ, de Man FS, Pinto YM, et al. Cardiac Safety of Imatinib for the Treatment of Covid-19: Results from a Randomized, Double Blind, Placebo-Controlled Trial. ATS-2022 2022; abstr. P874.
Available from: URL: https://www.abstractsonline.com/pp8/#!/10476/presentation/8132
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