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Post EUA study of Itolizumab in COVID-19
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Revisión de 19 Julio 2023 - 3:23pm
Post EUA study of Itolizumab in COVID-19
General information
Section to complete general information about the trial: scientific and public title, protocol identifiers, sponsors and Source(s) of Monetary or Material Support.
Scientific title:
Observational study post Emergency Use Authorization (EUA) of the anti-CD6 monoclonal antibody itolizumab in the treatment of moderate, severe and critical patients with SARS-CoV-2 pneumonia (COVID-19)
Secondary indentifying numbers:
IIC RD-EC 180
Issuing authority of the secondary identifying numbers:
Center of Molecular Immunology (CIM)
Primary sponsor:
Center of Molecular Immunology (CIM)
Secondary sponsor:
Not applicable
Source(s) of monetary or material support:
Center of Molecular Immunology (CIM), Cuban Ministry of Public Health (MINSAP)
Authorization for beginning
Section to complete information about the regulatory approval of clinical trial: regulatory agency name, approval date and reference number in the agency.
Regulatory instance to authorize the initiation of the study:
Trials notification
Regulatory instance:
Center for State Control of Drugs, Medical Devices and Equipment (CECMED)
Notification date :
23/09/2020
Reference number:
In process
Principal investigator
Section to complete information about Email address, telephone number and postal address of the Principal Investigator.
First name:
Carlos
Last name:
Hidalgo Mesa
Medical Specialty :
Second Degree Specialist in Internal Medicine
Affiliation:
"Comandante Manuel Fajardo Rivero" Military Hospital
Postal address:
Dos Gallardos corner Nueva, Cultural Complex “Abel Santamaria”, reparto Osvaldo Herrera
City:
Santa Clara
País:
Cuba
Zip Code:
50100
Telephone:
+53-42206061
Email address:
carlitos.villaclara@gmail.com
Clinical sites to participate
Section to complete the data related to the clinical sites involved in the trial: site and responsible investigator for every site.
Countries of recruitment:
Cuba
Clinical sites:
Havana, Teaching Surgical Clinical Hospital Dr. Salvador Allende
Havana, Julio Trigo Hospital
Pinar del Rio, Leon Cuervo Rubio Hospital
Matanzas, Mario Munnoz Military Hospital
Matanzas, Faustino Perez Hospital
Camaguey, Octavio de la Concepcion Military Hospital
Holguin, Fermin Valdez Military Hospital
Holguin, Lucia Inniguez Hospital
Santiago de Cuba, Joaquin Castillo Duany Military Hospital
Recruitment status
Section to complete information about the recruitment status and the date of first enrolment subject
Recruitment status:
Complete
Date of first enrollment:
13/09/2020
Health condition and Intervention
Section to complete information about the primary medical condition(s) or problem(s) studied and, a characteristics of the intervention(s).
Health condition(s) or Problem(s) studied:
Pneumonia by SARS-CoV-2
Health condition(s) code:
COVID-19
SARS-CoV-2
Intervention(s):
Humanized monoclonal antibody Itolizumab: Treatment protocol for COVID-19 approved by MINSAP+ MAb Itolizumab. The patient will receive two doses of the MAb Itolizumab, 200 mg each, diluted to 200 mL of saline solution, separated by 72 hours, intravenously, with a slow infusion rate, not greater than 30 drops per minute, which means administer the product in approximately 2-3 hours.
Intervention code:
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Administration, Intravenous
Intervention keyword:
Itolizumab
Outcomes and Timepoint
Section to complete information about primary and secondary outcomes including. It includes the metric or method of measurement used and, the time point for every outcome.
Primary outcome(s):
Reduction of lung function decline (Rate of patients without the need to increase FiO2 to maintain stable SO2 and without the need for intubation and/or Rate of patients with decreased positive end-expiratory pressure (PPEP) values) . Measurement time: 7 days
Key secondary outcomes:
1. Oro-tracheal intubation rate (Rate of patients requiring intubation). Measurement time: 7 days. 2. Rate of non-invasive or invasive mechanical ventilation when respiratory failure occurs, or failure of non-invasive mechanical ventilation (Rate of patients requiring non-invasive mechanical ventilation (NIMV), Rate of patients requiring invasive mechanical ventilation, Rate of patients with NIMV failure). Measurement time: before, 48, 72, 120 and 168 hours after administering itolizumab 3. Duration time of mechanical ventilation or time until weaning (Time elapsed from the start date of mechanical ventilation to the date of weaning ). Measurement time: until withdrawal of mechanical ventilation 4. Rate of deceased patients (proportion of deceased patients out of the total number of patients included 14 days after being included or once discharged from hospital). Measurement time: 14 days after treatment. 5. Serum concentrations of IL1, IL6 and TNF alpha (reported in pg/ml according to the reference values of the commercial kits used). Measurement time: at the beginning, 48, 96 and 168 hours after itolizumab administration. 6. HSH Score (Temperature, visceromegaly, cytopenias, triglycerides, fibrinogen, ferritin, AAT (TGO). Measurement time: 48, 96 and 168 hours after itolizumab administration. 7. C-reactive protein, and absolute count of lymphocytes (positive or negative, qualitative variable) Measurement time: pre, 48 hours, 72, 120 and 168 8. Adverse events related to treatment (according to causality and intensity) Measurement time: pre before administration of the antibody, during and after while the patient is hospitalized 9. Hospitalization time (days in hospital from the date of receiving treatment with Itolizumab until discharge or death in hospital) Measurement time: At discharge or death
Selection criterias
Section to complete information about the inclusion and exclusion criteria for participant selection, including age and gender.
Gender:
Male/Female
Minimum age:
18 years
Maximum age:
None
Inclusion criteria:
1. Any gender and skin color 2. Age equal to or greater than 18 years 3. SARS-CoV-2 infection diagnosed by RT-PCR or positive rapid test for COVID 19 4. Confirmed multifocal interstitial pneumonia 5. Need for oxygen therapy to maintain SO2>93% 6. Worsening of lung involvement, defined as one of the following criteria: o Worsening of oxygen saturation >3 percentage points • decrease in PaO2 >10%, • with stable FiO2 in the last 24h. • Need to increase FiO2 in order to maintain stable SO2 • new need for mechanical installation in the last 24 hours. • Increase in the number and/or extension of the pulmonary areas of consolidation. 7. Expresses the voluntariness of the patient, family member or impartial witness. 8. Alternatively, itolizumab may be used in patients in whom macrophage activation syndrome is suspected, according to the following criteria: • Need for oxygen therapy not less than 6L/min plus one of the following conditions: o Wheezing or gasping for breath (cannot quickly count to 20 after taking a deep breath). o Respiratory rate greater than 22 breaths per minute with oxygen therapy at 6L/min PO2. o Partial pressure of arterial oxygen <65 mm Hg. o Worsening of the radiological image. o Fever ≥38ºC. o Reduction of the initial values of hemoglobin, platelets or neutrophils or Hb<90 g/L, platelets<100 x109/L, neutrophils<1 x109/L or leukocytes <4 x109/L. o Decreased erythrocyte sedimentation rate in disagreement with CRP (low erythrocyte sedimentation rate and CRP increased or unchanged). o Increase in the initial value of triglycerides or triglycerides greater than 3 mmol/L. o Increase in the initial value of ferritin from 500 ng/ml or absolute value of ferritin ≥ 2000 ng/ml. o Transaminase aspartate-aminotransferase ≥30 IU/L. o Increased D-dimer o Fibrinogen < 2.5 g/L 9. Appearance of neurological manifestations
Exclusion criteria:
Pregnant or lactating women.
Type of population:
Adults
Type of participant:
Patients
Study design
Section to complete information about the characteristics of the study design.
Type study:
Observational
Purpose:
Treatment
Allocation:
N/A: single arm study
Masking:
Open
Control group:
Uncontrolled
Study design:
Single group
Phase:
N/A
Target sample size:
Open
Contact for public queries
Section to complete information about Email address, telephone number and postal address of the contact who will respond to general queries, including information about current recruitment status
First Name:
Mayra
Last Name:
Ramos Suzarte
Specialty:
PhD. in Health Science. Biochemestry
Affiliation:
Center of Molecular Immunology (CIM)
Postal Address:
216 and 15, Atabey, Playa
City:
Havana
País:
Cuba
Zip Code:
11600
Telephone:
+53-72143146
Email :
mayra@cim.sld.cu
Contact for scientific queries
Section to complete information about Email address, telephone number and postal address of the contact who will respond to scientific queries.
First Name:
Mayra
Last Name:
Ramos Suzarte
Specialty:
PhD Health Science. Biochemestry
Affiliation:
Center of Molecular Immunology (CIM)
Postal Address:
216 and 15. Atabey. Playa
City:
Havana
País:
Cuba
Zip Code:
11600
Telephone:
+53-72143146
Email :
mayra@cim.sld.cu
Data Sharing
Section to complete the data related to the data sharing plan.
Data sharing plan:
No
Research Ethics Committees
Section to complete the data related to the review ethics committees.
Name of Research Ethics Committees:
Institute of Tropical Medicine "Pedro Kouri"
Status of evaluation:
Approved
Status of evaluation date of Ethic Committee:
27/03/2020
Postal address of Ethic Committee :
Autopista Novia del Mediodía 6 1/2 entre Autopista Nacional y Carretera Central CP. 11 400. La Habana. Cuba
Telephone:
+53-72020430 al 44
Correo electrónico:
daniel@ipk.sld.cu
About study completion
Section to complete the data related to the study completion.
Final enrolment number:
249
Study completion date:
30/04/2021
Date of available results:
10/09/2021
Date of first publication:
01/07/2022
Registration and Update
Section to complete information about the name of Primary Registry, date of registration and the unique ID number assigned by the registry (RPCEC).
Primary registry:
RPCEC
Unique ID number:
RPCEC00000402
Date of Registration in Primary Registry:
21/03/2022
Record Verification Date:
2022/03/31
Next update date:
2023/03/31
Link to the spanish version:
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