Survival TRial Using CytoKines in COVID-19 (STRUCK Trial)

  • STATUS
    Recruiting
  • days left to enroll
    37
  • participants needed
    60
  • sponsor
    University of Sao Paulo
Updated on 27 January 2021

Summary

Currently, there are few approved treatments for COVID-19, antiretroviral (remdesivir) and corticoids. With about 15% of COVID-19 patients suffering from severe disease health system will be overwhelmed. Treatments approaches to inhibit viral replication (antiretroviral and extended spectrum antiviral drugs), such as Remdesivir and Hydroxychloroquine are being used. In severe cases, by CT scans investigators are able to observe that these patients seem to be dying with fibrosis and lung vasculitis. It is hypothesised that targeting vasculitis and lung inflammation secondary to the viral infection may help patients' survival (reducing mortality) and/or decrease time in mechanical ventilators. It is proposed a 4-arm trial, converted to 2 after interim analysis (60 patients for the initial phase, sample size recalculation after initial analysis and 2 arms beyond). In initial phase, IL-6 indirect inhibitor (colchicine), in first arm; IL-17 inhibitor, an innovative target never tested (at this moment) in COVID-19 severe patients, in second study arm. Both approaches (indirect IL-6 and Il-17) are related to modulation of inflammatory immune response. Finally, in third arm, IL-2 low dose. This cytokine was identified as Treg upregulation. Treg levels decrease in hepatitis C virus (HCV) associated vasculitis and increase in vasculitis resolution. In fourth arm, control group, standard of care. Initially, for the first 60 included patients, the study will comprise 4 arms (15 patients per arm, randomization ratio 1:1:1:1). An interim effectiveness and safety analysis at this point will guide the selection of one single treatment strategy (adaptative study) to be carried on after that, comparatively with the control group. The multi-site trial planned enrollment duration of 4-6 months and for each participant will be approximately 4 weeks. This trial will bring complementary data to the global effort in COVID-19 cases resolution.

Details
Condition COVID19
Treatment aldesleukin, colchicine, Standard of Care (SOC), Ixekizumab
Clinical Study IdentifierNCT04724629
SponsorUniversity of Sao Paulo
Last Modified on27 January 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Positive result in the quantitative real-time PCR (qPCR) test for SARS-CoV-2 in the respiratory tract
Pneumonia confirmed by chest imaging and
Respiratory rate 24 IRPM (for adults) or
O2 saturation <93% or
No improvement in O2 saturation, despite oxygen supply or
Arterial hypotension; or
Changes in capillary filling time; or
Changes in the level of consciousness; or
Oliguria
IMPORTANT: The presence of increased respiratory rate or desaturation (items
a" and "b") are criteria for hospital admission. Items "c" to "g" are
considered criteria for ICU admission
Following the recommendations of The So Paulo State Health Secretariat
resolution SS-28 of 03-Mar-2020, prepared by the Hospital das Clnicas of
Medical School-USP

Exclusion Criteria

Age <18 years
Refuse to sign the Informed Consent Form
Patient's decision that their involvement is not in their interest
Severe known liver disease (eg cirrhosis, with aminotransferase levels> 5 times the reference value limit)
Pregnancy or breastfeeding period
Severe bacterial infection
Severe diarrhea
Diverticulitis or intestinal perforation
Infection known as HIV
Presence of one of the following uncontrolled or unstable cardiovascular diseases: stroke, ECG confirmed acute ischemia or myocardial infarction and / or clinically significant dysrhythmia; Known history of gastrointestinal bleeding, uncontrolled peptic ulcer or uncontrolled duodenal ulcer
Known history of hemophilia or other bleeding disorders
History of organ transplantation, congenital immunodeficiency
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