Efficacy & Safety of Sofosbuvir/Daclatasvir treatment in COVID-19: A randomized, controlled study

Organizational Data

DRKS-ID:
DRKS00022203
Recruitment Status:
Recruiting ongoing
Date of registration in DRKS:
2020-06-15
Last update in DRKS:
2020-09-29
Registration type:
Prospective

Acronym/abbreviation of the study

No Entry

URL of the study

No Entry

Brief summary in lay language

This study aims to evaluate the efficacy and safety of Sofosbuvir/Daclatasvir versus Hydroxychloroquine (both with the standard care) in patients with 2019-nCoV infection, initially hospitalized to a non-intensive care setting. It is a parallel 3-groups, randomized, open-label, active-controlled clinical study. Ninety patients sufferring from mild up to severe COVID-19 infection will be randomly divided into 3 groups; all will be treated with the standard of care therapy plus an add-on treatment. The Add-on treatment in the first group will be sofosbuvir plus daclatasvir one tablet for each for 10 days duartion. The second group will have hydroxychloroquine as add-on therapy, while the third group will have only the standard of care therapy. The treatment is planned to be escalated according to the disease progression to admission to intensive care unit or mechanical ventilation for any patient from any group in response to his condition. The three groups will be compared for proportions of patients with clinical recovery at day 14 and 21; time to clinical recovery, time to viral negativity in the nose and throat swab; proportions with adverse reactions to therapy and proportion of those who needed mechanical ventilation.

Brief summary in scientific language

This study aims to evaluate the efficacy and safety of Sofosbuvir/Daclatasvir versus Hydroxychloroquine (both with the standard care) in patients with 2019-nCoV infection, initially hospitalized to a non-intensive care setting. It is a parallel 3-groups, randomized, open-label, active-controlled clinical study. Ninety patients sufferring from mild up to severe COVID-19 infection will be randomly divided into 3 groups; all will be treated with the standard of care therapy plus an add-on treatment. The Add-on treatment in the first group will be sofosbuvir plus daclatasvir one tablet for each for 10 days duartion. The second group will have hydroxychloroquine as add-on therapy, while the third group will have only the standard of care therapy. The treatment is planned to be escalated according to the disease progression to admission to intensive care unit or mechanical ventilation for any patient from any group in response to his condition. The three groups will be compared for proportions of patients with clinical recovery at day 14 and 21; time to clinical recovery, time to viral negativity in the nasopharyngeal swab; proportions with adverse reactions to therapy and proportion of those who needed mechanical ventilation.

Health condition or problem studied

Free text:
COVID-19
Free text:
SARS-nCoV-2 infection
Healthy volunteers:
No Entry

Interventions, Observational Groups

Arm 1:
ARM 1 (Experimental): will receive continued standard of care therapy (as per the MOH protocol) together with a daily dose of one Gratisovir (Sofosbuvir) 400 mg tablet combined with one Daktavera (Daclatasvir) 60 mg table, on Day 1 through day 10.
Arm 2:
ARM 2 (Active Comparator): will receive continued standard of care therapy (as the MOH protocol) together with a dose of 4 tablets of Plaquenil (Hydroxychloroquine) 200 mg, on Day 1 followed by 2 tablets daily from day 2 through 5.
Arm 3:
ARM 3 (No Intervention Control): will receive continued standard of care therapy (as per the MOH protocol without Hydroxychloroquine or the direct acting antiviral therapy).

Endpoints

Primary outcome:
1. Proportion of clinical recovery (composite) within 14 & 21 days (Normalization of fever (≤37.2 °C oral), Respiratory rate (≤24/minute on room air), Oxygen saturation (≥94% on room air)), sustained for at least 24 hours (using Exact test with Boot-Strapping). 2. Time to clinical recovery (composite) [Time frame: 21 days after randomization (using Kaplan Meier curve and Cox-regression). 3. Time to viral negativity assessed twice 48 hours apart (log10 viral load assessed by reverse transcription-PCR) during hospital stay (Kaplan Meier curve and Cox-regression). 4. Mean change in Clinical status using 8 point ordinal scale [Day 3 through Day 14, 21 (using Repeated measure Factorial ANOVA test]: 1) Death; 2) Hospitalized, on invasive ventilation or ECMO; 3) Hospitalized, on NIV or HFO2; 4) Hospitalized with oxygen supplement; 5) Hospitalized, not requiring oxygen but need medical care; 6) Hospitalized, not requiring supplemental oxygen or ongoing medical care; 7) Not hospitalized, limitation on activities and/or requiring home oxygen; 8) Not hospitalized with normal activity.
Secondary outcome:
1. Proportion of patients who needed the use of mechanical ventilation during hospital stay [Time Frame: 21 days] (using Exact test with Boot-Strapping). 2. Proportions of Participants with Treatment Emergent Serious Adverse Events Leading to Study Drug Discontinuation (using Exact test with Boot-Strapping).

Study Design

Purpose:
Treatment
Allocation:
Randomized controlled study
Control:
  • Active control (effective treatment of control group)
Phase:
II-III
Study type:
Interventional
Mechanism of allocation concealment:
No Entry
Blinding:
No
Assignment:
Parallel
Sequence generation:
No Entry
Who is blinded:
No Entry

Recruitment

Recruitment Status:
Recruiting ongoing
Reason if recruiting stopped or withdrawn:
No Entry

Recruitment Locations

Recruitment countries:
  • Egypt
Number of study centers:
Multicenter study
Recruitment location(s):
  • Medical center MINISTRY OF HEALTH HOSPITALS CAIRO

Recruitment period and number of participants

Planned study start date:
2020-06-20
Actual study start date:
2020-06-20
Planned study completion date:
No Entry
Actual Study Completion Date:
No Entry
Target Sample Size:
90
Final Sample Size:
No Entry

Inclusion Criteria

Sex:
All
Minimum Age:
18 Years
Maximum Age:
75 Years
Additional Inclusion Criteria:
(1) Subjects or their legal representatives have signed the informed consent form (ICF). (2) Subjects are aged ≥ 18 and ≤ 75; (3) Has laboratory-confirmed Symptomatic COVID-19 (SARS-CoV-2 infection) as determined by polymerase chain reaction (PCR) assay in any specimen collected < 72 hours prior to randomization and any clinical severity category of the following: A. Mild: mild clinical symptoms with no picture of pneumonia in CT, but positive 2019-nCoV2 in throat/nasal swabs. B. Moderate: fever, respiratory symptoms, etc., pneumonia visible in CT. C. Severe (Not Critical): meeting any of the following criteria: (a) Respiratory distress, RR≥30 times/min; (b) Finger oxygen saturation ≤93% in rest state; (c) Arterial partial pressure of oxygen / concentration of fractional inspired oxygen (PaO2/FiO2) ≤400mmHg and > 200mmHg under oxygen inhalation.

Exclusion Criteria

(1) Patients with pneumonia due to other etiology. (2) Critically severe COVID19 ARDS cases Requiring invasive mechanical ventilation at screening; (3) Patients who have severe concomitant illness that affects survival or course of the disease, including uncontrolled malignant tumor, HIV, blood dyscrasia, active bleeding or patients with shock/or multiple organ failure at screening. (4) Pregnant or lactating females. (5) Hypersensitivity or contraindication to any of the experimental drugs used in the study (Prolonged QT syndrome, G6PD deficiency, psoriasis, retinal damage or others). . (6) Patients with decompensated liver cirrhosis or abnormal liver enzyme tests above three times the upper limit values (alanine aminotransferase (ALT) and aspartate aminotransferase (AST); (7) Renal dysfunction (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73m2);

Addresses

Primary Sponsor

Address:
PHARCO CORPORATE
Researcher Sherine Helmy
Amriya, Alexandria, Egypt
21121 Alexandria
Egypt
Telephone:
+201223927561
Fax:
No Entry
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry
Investigator Sponsored/Initiated Trial (IST/IIT):
No

Contact for Scientific Queries

Address:
GREEN CRC
Clinical research consultant Mostafa Yakoot
Green Clinic and Research Centre, Alexandria 21121, Egypt
21121 Alexandria
Egypt
Telephone:
+201223927561
Fax:
+2031339725
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Contact for Public Queries

Address:
GREEN CRC
Clinical research consultant Mostafa Yakoot
Green Clinic and Research Centre, Alexandria 21121, Egypt
21121 Alexandria
Egypt
Telephone:
+201223927561
Fax:
+2031339725
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Sources of Monetary or Material Support

Commercial (pharmaceutical industry, medical engineering industry, etc.)

Address:
Pharco Corporate
Amriya, Alexandria, Egypt
21121 Alexandria
Egypt
Telephone:
+201223927561
Fax:
No Entry
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Ethics Committee

Address Ethics Committee

Address:
Research Ethics Committee, Egypt Ministry of Health and Population
Egypt
Telephone:
No Entry
Fax:
No Entry
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Vote of leading Ethics Committee

Vote of leading Ethics Committee
Date of ethics committee application:
2020-05-11
Ethics committee number:
IRB0000687
Vote of the Ethics Committee:
Approved
Date of the vote:
2020-05-31

Further identification numbers

Other primary registry ID:
No Entry
EudraCT Number:
No Entry
UTN (Universal Trial Number):
U1111-1253-0458
EUDAMED Number:
No Entry

IPD - Individual Participant Data

Do you plan to make participant-related data (IPD) available to other researchers in an anonymized form?:
No
IPD Sharing Plan:
No Entry

Study protocol and other study documents

Study protocols:
No Entry
Study abstract:
No Entry
Other study documents:
No Entry
Background literature:
No Entry
Related DRKS studies:
No Entry

Publication of study results

Planned publication:
No Entry
Publikationen/Studienergebnisse:
No Entry
Date of first publication of study results:
No Entry
DRKS entry published for the first time with results:
No Entry

Basic reporting

Basic Reporting / Results tables:
No Entry
Brief summary of results:
No Entry