An adaptive randomised placebo controlled phase II trial of antivirals for COVID-19 infection (VIRCO): A structured summary of a study protocol for a randomised controlled trial
Oct 14, 2020Trials
A randomized placebo-controlled trial testing antiviral drugs for COVID-19 infection
The study aims to recruit 190 people to assess the efficacy of favipiravir compared to placebo.
The primary objective is to evaluate time to within 14 days of randomisation.
Secondary objectives include assessing safety and clinical benefits measured by the .
The trial design is a multi-centre, triple-blind, randomised, placebo-controlled phase II study.
Participants must be aged 18 or older and have confirmed SARS-CoV-2 infection within the past 5 days.
The study includes both hospitalised patients and those in the community who meet eligibility criteria.
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OBJECTIVES: Primary objective: To determine the efficacy of a candidate antiviral on time to compared to standard of care within 14 days of randomisation Secondary objectives: • To determine the safety of the antiviral • To determine the clinical benefit of the antiviral over placebo according to the • To determine the clinical benefit of the antiviral over placebo on time to resolution of clinical symptoms • To determine the effect of the antiviral over placebo on biomarkers of inflammation and immune activation TRIAL DESIGN: This is a multi-centre, triple-blind, randomised placebo controlled phase II, 2-arm trial with parallel-group design with allocation ratio 1:1.
PARTICIPANTS: Inclusion Criteria: • Provision of informed consent by the participant • Age ≥18 years • Confirmed SARS-CoV-2 by nucleic acid testing in the past 5 days • COVID-19 related symptom initiation within 5 days • Female patients of childbearing potential must have a negative pregnancy test at Screening. Female patients of childbearing potential and fertile male patients who are sexually active with a female of childbearing potential must use highly effective methods of contraception throughout the study and for 1 week following the last dose of study treatment.
EXCLUSION CRITERIA: • Known allergy to the study medication • Is on another clinical trial investigating an antiviral treatment for COVID-19 • Pregnancy • Patients with severe hepatic dysfunction equivalent to Grade C in the Child-Pugh classification • Patients with renal impairment requiring dialysis • Is deemed by the Investigator to be ineligible for any reason Participants will be recruited from, and the study visits will take place at Alfred Hospital, Monash Health, Austin Health in Victoria, Australia for hospitalised participants as well as recruitment in the community in participants homes for eligible people not requiring hospitalisation.
INTERVENTION AND COMPARATOR: The first candidate antiviral is favipiravir Arm 1: Favipiravir 1800 mg favipiravir BD on Day 1 followed by 800 mg BD favipiravir for the next 13 days. Arm 2: Placebo MAIN OUTCOMES: Primary outcome: Time to virological cure as defined by 2 successive throat (or combined nose/throat) swabs negative for SARS-CoV-2 by nucleic acid testing during the 14 days after enrolment.
RANDOMISATION: Randomisation performed at the Alfred Hospital Clinical Trials Pharmacy using computer generated block-randomisation lists with 6 participants per block. Within each block half of the participants will be randomised to the candidate antiviral and the other half to placebo. Randomisation is stratified by study site, with participants enrolled in the community considered as a study site.
BLINDING (MASKING): Study participants, study investigators and the study statistician will be blinded to treatment allocation.
NUMBERS TO BE RANDOMISED (SAMPLE SIZE): The study aims to recruit 190 people (95/arm) with the first candidate antiviral favipiravir TRIAL STATUS: Protocol version 2.0 Dated 31-Jul-2020. Recruitment will take place between July 2020 and December 2020.
TRIAL REGISTRATION: clinicaltrials.gov NCT04445467 First posted 24-Jun-2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
Key numbers
190
Participants to be Randomised
95 participants in each treatment arm.
14 days
Treatment Duration
Time frame for measuring primary outcome.
Full Text
What this is
This protocol outlines a phase II trial assessing the antiviral favipiravir for COVID-19.
The primary objective is to evaluate the efficacy of favipiravir on time to .
Secondary objectives include safety assessments and clinical benefits compared to placebo.
Essence
The trial aims to determine if favipiravir can accelerate in COVID-19 patients compared to a placebo.
Key takeaways
The trial will enroll 190 participants, with 95 receiving favipiravir and 95 receiving placebo. Participants must provide informed consent and meet specific inclusion criteria.
Primary outcome measures include time to , defined as two negative SARS-CoV-2 tests within 14 days post-enrollment.
The study will also assess safety and clinical benefits using the and resolution of symptoms.
Caveats
The trial's findings will depend on participant adherence to the protocol and accurate reporting of outcomes.
Exclusion criteria may limit generalizability to broader COVID-19 populations, particularly those with severe comorbidities.
Definitions
virological cure: Achieving two successive negative tests for SARS-CoV-2 by nucleic acid testing.
WHO 7-point ordinal scale: A scale used to assess clinical status in COVID-19 patients, ranging from asymptomatic to death.
