Study to assess the safety and effectiveness of remdesivir in people with moderate COVID-19
ISRCTN | ISRCTN85762140 |
---|---|
DOI | https://doi.org/10.1186/ISRCTN85762140 |
EudraCT/CTIS number | 2020-000842-32 |
IRAS number | 282026 |
ClinicalTrials.gov number | NCT04292730 |
Secondary identifying numbers | GS-US-540-5774, IRAS 282026, CPMS 45459 |
- Submission date
- 02/11/2020
- Registration date
- 03/11/2020
- Last edited
- 30/11/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Infections and Infestations
Plain English summary of protocol
Background and study aims
The purpose of this study is to test a new medicine, remdesivir (RDV) for people with COVID-19.
There are no approved medications to treat COVID-19, a new disease caused by a virus called SARS-CoV-2 that was just identified in late 2019. COVID-19 can cause many symptoms. The symptoms can range from mild to very severe and sometimes can lead to death.
The purpose of this study is to see if RDV can improve the health of people with moderate COVID-19.
Who can participate?
Persons 12 years of age or older who have SARS-CoV-2 infection less than 4 days before joining the study, and are in hospital.
What does the study involve?
Part A was randomized and open-label (patients know what medication they are getting and for how long, doctors and study staff also know):
The researchers used a computer program to randomly choose the treatment each participant took. This helped make sure the treatments were chosen fairly. Participants had an equal chance of receiving RDV for 5 days, receiving RDV for 10 days or for not receiving RDV at all. In all treatment arms, participants still received standard of care treatment.
Part B was also open-label. Participants who qualified for the study and decided to join received RDV by injections directly into the vein. Participants were randomized to one of the following treatment groups:
1. Standard of care treatment together with RDV 200mg on Day 1 and then RDV 100mg on Days 2, 3, 4 and 5
2. Standard of care treatment together with RDV 200mg on Day 1 and then RDV 100mg on Days 2, 3, 4, 5, 6, 7, 8, 9 and 10
3. Standard of care treatment and no RDV
Part B Extension Treatment Group – For participants enrolled when Part A is completed, they received standard of care treatment together with RDV 200mg on Day 1 and then RDV 100mg on Days 2, 3, 4, 5, 6, 7, 8, 9, 10. The treatment may have been reduced to a total of 5 days based on the results from Part A.
What are the possible benefits and risks of participating?
Possible benefits: Participants may not get any benefit from taking part in this study. Studies are a way for doctors to see if a drug is useful in treating a disease. Taking part in this study may help us know more about how to treat people with COVID-19 in the future.
Possible risks: All medicines could potentially cause side effects in some people. Increases in levels of liver enzymes have been seen in some people who have taken RDV, which may be a sign of inflammation or damage to the cells in the liver.
Where is the study run from?
The study was run from Gilead Sciences, Inc. (USA) and took place at 133 centres globally.
When is the study starting and how long is it expected to run for?
February 2020 to June 2020
Who is funding the study?
Gilead Sciences, Inc. (USA)
Who is the main contact?
GileadClinicalTrials@gilead.com
Contact information
Scientific
333 Lakeside Drive
Foster City
California
94404
United States of America
Phone | +1 646-351-9642 |
---|---|
Devi.SenGupta@gilead.com |
Study information
Study design | Phase 3 randomized open-label multi-center study |
---|---|
Primary study design | Interventional |
Secondary study design | Randomised parallel trial |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
Scientific title | A phase 3 randomized study to evaluate the safety and antiviral activity of remdesivir (GS-5734™) in participants with moderate COVID-19 compared to standard of care treatment |
Study objectives | The odds of improvement for the RDV 5-day treatment group (Treatment Group 1) or 10-day treatment group (Treatment Group 2) is different from the odds of improvement for SOC treatment group (Treatment Group 3) with respect to clinical status assessed by a 7-point ordinal scale on Day 11. |
Ethics approval(s) | Approved 25/03/2020, North East - Tyne & Wear South Research Ethics Committee (HRA Jarrow, Room 001, Jarrow Business Centre, Rolling Mill Road, Jarrow, NE32 3DT, UK; +44 (0)207 1048084; nrescommittee.northeast-tyneandwearsouth@nhs.net), ref: 20/NE/0105 |
Health condition(s) or problem(s) studied | COVID-19 (SARS-CoV-2 infection) |
Intervention | The study was conducted in two parts. In Part A, approximately 600 participants who met all eligibility criteria were randomized via an interactive web response system (IWRS) in 1:1:1 ratio into one of the following treatment groups: Treatment Group 1: continued SOC therapy together with intravenous (IV) RDV 200 mg on Day 1 followed by IV RDV 100 mg on Days 2, 3, 4, and 5 Treatment Group 2: continued SOC therapy together with IV RDV 200 mg on Day 1 followed by IV RDV 100 mg on Days 2, 3, 4, 5, 6, 7, 8, 9, and 10 Treatment Group 3: continued SOC therapy Part B began enrollment after enrollment to Part A is complete. In Part B, an additional approximately 1,000 participants who met all of the eligibility criteria received: Extension Treatment Group: continued standard of care therapy together with IV RDV 200 mg on Day 1 followed by IV RDV 100 mg on Days 2, 3, 4, 5, 6, 7, 8, 9, and 10 Based on the results from Part A, or if treatment for 5 days is selected in a study of more severe disease, all participants in the Extension Treatment Group and all new participants will be reassigned to receive treatment for a total of 5 days. National and local regulatory authorities will be informed. All participants were followed-up for 28 days. |
Intervention type | Drug |
Pharmaceutical study type(s) | |
Phase | Phase III |
Drug / device / biological / vaccine name(s) | Remdesivir (RDV) |
Primary outcome measure | The Odds of Ratio for Improvement on a 7-point Ordinal Scale (The ordinal scale is an assessment of the clinical status on a given day. Each day, the worst score from the previous day will be recorded. The scale is as follows: 1. Death 2. Hospitalized, on invasive mechanical ventilation or Extracorporeal Membrane Oxygenation (ECMO) 3. Hospitalized, on non-invasive ventilation or high flow oxygen devices 4. Hospitalized, requiring low flow supplemental oxygen 5. Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (coronavirus (COVID-19) related or otherwise) 6. Hospitalized, not requiring supplemental oxygen - no longer required ongoing medical care (other than per protocol Remdesivir administration 7. Not hospitalized.) The ordinal scale was recorded each day from Baseline until discharge or Day14, any change in category from Day 14 to discharge (or Day28) was also recorded. |
Secondary outcome measures | Adverse Events were recorded from patient medical records from the time of consent up to Day 28 (+/-5 days). Serious adverse events were reported up to 30 days of last dose and after the protocol defined follow-up period if deemed relevant to the use of study drug |
Overall study start date | 11/02/2020 |
Completion date | 26/06/2020 |
Eligibility
Participant type(s) | Patient |
---|---|
Age group | Mixed |
Lower age limit | 12 Years |
Sex | Both |
Target number of participants | 1,600 |
Total final enrolment | 1113 |
Key inclusion criteria | 1. Willing and able to provide written informed consent, or with a legal representative who can provide informed consent, or enrolled under ICH E6(R2) 4.8.15 emergency use provisions as deemed necessary by the investigator (participants ≥18 years of age), or willing and able to provide assent (participants ≥12 and <18 years of age, where locally and nationally approved) prior to performing study procedures. For participants ≥12 and <18 years of age, a parent or legal guardian willing and able to provide written informed consent prior to performing study procedures 2. Aged ≥18 years (at all sites), or aged ≥12 and <18 years of age weighing ≥40 kg (where permitted according to local law and approved nationally and by the relevant institutional review board [IRB] or independent ethics committee [IEC]) 3. SARS-CoV-2 infection confirmed by PCR test ≤4 days before randomization 4. Currently hospitalized and requiring medical care for COVID-19 5. SpO2 >94% on room air at screening 6. Radiographic evidence of pulmonary infiltrates 7. Men and women of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception |
Key exclusion criteria | 1. Participation in any other clinical trial of an experimental treatment for COVID-19 2. Concurrent treatment or planned concurrent treatment with other agents with actual or possible direct acting antiviral activity against SARS-CoV-2 3. Requiring mechanical ventilation at screening 4. ALT or AST >5 x ULN Note: if per local practice only ALT is routinely measured, exclusion criteria will be evaluated on ALT alone 5. Creatinine clearance <50 mL/min using the Cockcroft-Gault formula for participants ≥18 years of age and Schwartz Formula for participants <18 years of age 6. Positive pregnancy test 7. Breastfeeding woman 8. Known hypersensitivity to the study drug, the metabolites, or formulation excipient |
Date of first enrolment | 15/03/2020 |
Date of final enrolment | 29/05/2020 |
Locations
Countries of recruitment
- England
- France
- Germany
- Hong Kong
- Italy
- Japan
- Korea, South
- Netherlands
- Scotland
- Singapore
- Spain
- Sweden
- Switzerland
- Taiwan
- United Kingdom
- United States of America
Study participating centres
Kowloon
N.T.
Hong Kong
Nagoya, Aichi
464-8547
Japan
Yokohama-shi, Kanagawa
221-0855
Japan
Seoul
2053
Korea, South
Seoul
4564
Korea, South
NUHS Tower Block
119228
Singapore
169856
Singapore
308442
Singapore
Service des maladies infectieuses et tropicales
Bordeaux
33075
France
Service des Maladies Infectieuses et Tropicales
Paris
75010
France
Düsseldorf
40225
Germany
Leipzig,Sachsen
4129
Germany
I. Medizinische Klinik und Poliklinik, Hamburg
20246
Germany
Klinik für Innere Medizin I
Kiel
24105
Germany
Berlin
13353
Germany
II. Medizinische Klinik und Poliklinik der TU München
München, Bayern
81675
Germany
München, Bayern
80804
Germany
UOC malattie Infettive I
Pavia
27100
Italy
Isituto Scientifico Universitario San Raffaele
Milano
20132
Italy
U.O. di Malattie Infettive
Brescia
25123
Italy
Unità Operativa Malattie Infettive E Tropicali
Padova, Veneto
35128
Italy
Piacenza, Emilia-Romagna
29100
Italy
Torino, Piemonte
10149
Italy
Dipartimento di Scienze Biomediche e Cliniche L. Sacco
Milano, Lombardia
20157
Italy
Lombardia
20122
Italy
Parma
43100
Italy
Roma
00149
Italy
Cremona, Lombardia
26100
Italy
24127
Italy
Amsterdam, Noord-Holland
1105 AZ
Netherlands
Leiden
2333 ZA
Netherlands
15006
Spain
28046
Spain
L'Hospitalet de Llobregat
Barcelona
8907
Spain
Servicio de Enfermedades Infecciosas
Pabellon A, 2ª planta
Malaga
29010
Spain
Valencia
46026
Spain
Sevilla
41013
Spain
Unidad enfermedades infecciosas, Barakaldo
48903
Spain
Madrid
28040
Spain
28041
Spain
Madrid
28034
Spain
Madrid
28805
Spain
Badalona, Barcelona
8036
Spain
SE-141 86
Sweden
Infektionskliniken
Malmö
SE-20502
Sweden
Ticino (it)
6900
Switzerland
Geneve
1205
Switzerland
Klinik für Infektiologie und Spitalhygiene
Zürich, Zürich (de)
8091
Switzerland
London
NW3 5NU
United Kingdom
London
NW1 2BU
United Kingdom
London
W2 1NY
United Kingdom
Crownhill
Plymouth
PL6 8DH
United Kingdom
Sheffield
S10 2JF
United Kingdom
Edinburgh
EH16 4SA
United Kingdom
Glasgow
G51 4TF
United Kingdom
Cottingham
HU16 5JQ
United Kingdom
Denmark Hill
London
SE5 9RS
United Kingdom
Liverpool
L7 8XP
United Kingdom
Crumpsall
Manchester
M8 5RB
United Kingdom
Harrow
London
HA1 3UJ
United Kingdom
New York
10029
United States of America
10019
United States of America
1003
United States of America
Eureka, California
95501
United States of America
Suite 300
Richland, Washington
99352
United States of America
Mission Viejo
California
92691
United States of America
Minneapolis, Minnesota
55415
United States of America
Hackensack, New Jersey
7601
United States of America
Detroit, Michigan
48202
United States of America
Bronx, New York
10468
United States of America
Orange, California
92868
United States of America
Denver, Colorado
80262
United States of America
Suite 1001, Spokane
Washington
99204
United States of America
Philadelphia, Pennsylvania
19122
United States of America
Philadelphia, Pennsylvania
19104
United States of America
Suite 440, Everett
Washington
98201
United States of America
New Orleans
Louisiana
70112
United States of America
Seattle, Washington
98122
United States of America
Dallas, Texas
75246
United States of America
Fort Worth, TX
76104
United States of America
Temple, TX
76508
United States of America
Santa Rosa, California
95403
United States of America
TX Medical Flagship
Houston, Texas
77030
United States of America
Emerson Hall
Suite 421, Indianapolis
Indiana
46077
United States of America
Denver, Colorado
80220
United States of America
1st Floor, Santa Monica
90404
United States of America
Columbia, South Carolina
29203
United States of America
Greenville, SC
29605
United States of America
Cleveland, Ohio
44106
United States of America
Chicago, Illinois
60612
United States of America
Iowa City, Iowa
52242
United States of America
2nd Floor
Dallas, TX
75235
United States of America
Silver Spring, Maryland
20910
United States of America
Ann Arbor, Michigan
48109
United States of America
Falls Church, Virginia
22042
United States of America
Sacramento, California
95816
United States of America
Bronx, New York
10461
United States of America
San Francisco, California
94109
United States of America
Manhasset, New York
11030
United States of America
New Hyde Park, NY
11040
United States of America
Seattle, Washington
98101
United States of America
Tacoma, Washington
98405
United States of America
Pavillion III
Suite 268, Dallas, Texas
75203
United States of America
New York
10065
United States of America
Division of Infectious Disease
Brigham and Women's Hospital
Boston, Massachusetts
2115
United States of America
Berkeley, California
94705
United States of America
2205
United States of America
Portland, Oregon
97227
United States of America
Chicago, Illinois
60637
United States of America
New Brunswick, NJ
08901
United States of America
Danbury, Connecticut
6810
United States of America
Milstein Hospital
Fourth Floor, New York
10032
United States of America
New Haven, Connecticut
06510-3220
United States of America
Boston, Massachusetts
2111
United States of America
Portland, Oregon
97225
United States of America
Paterson, New Jersey
7503
United States of America
Rochester, Minnesota
55905
United States of America
Newport Beach, California
92663
United States of America
Richmond, Virginia
23298
United States of America
Portland, Maine
4102
United States of America
Suite 143, Chicago, Illinois
60612
United States of America
Mountain View, California
94040
United States of America
Oakland, California
94611
United States of America
94115
United States of America
95051
United States of America
95119
United States of America
94080
United States of America
Boston, Massachusetts
2215
United States of America
Stanford, California
94305
United States of America
Providence, Rhode Island
2906
United States of America
Durham, North Carolina
27710
United States of America
Lebanon, New Hampshire
3766
United States of America
Sponsor information
Industry
333 Lakeside Drive
Foster City
California
94404
United States of America
Phone | +1-833-445-3230 |
---|---|
GileadClinicalTrials@gilead.com | |
Website | http://www.gilead.com/ |
https://ror.org/056546b03 |
Funders
Funder type
Industry
Government organisation / For-profit companies (industry)
- Alternative name(s)
- Gilead, Gilead Sciences, Inc.
- Location
- United States of America
Results and Publications
Intention to publish date | 01/06/2021 |
---|---|
Individual participant data (IPD) Intention to share | Yes |
IPD sharing plan summary | Available on request |
Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal. A redacted version of the latest protocol and statistical analysis plan, will be available on ClinicalTrials.gov when results are submitted https://clinicaltrials.gov/ct2/show/NCT04292730) |
IPD sharing plan | The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Gilead Sciences shares anonymized individual patient data upon request or as required by law or regulation with qualified external researchers based on submitted curriculum vitae and reflecting non conflict of interest. The request proposal must also include a statistician. Approval of such requests is at Gilead Science’s discretion and is dependent on the nature of the request, the merit of the research proposed, the availability of the data, and the intended use of the data. Data requests should be sent to datarequest@gilead.com . Data will become available 18 months after study completion and will be accessible in a secured external environment. More information on Gilead’s data sharing policy can be found here: https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy . |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
---|---|---|---|---|---|
Basic results | No | No | |||
Results article | 15/09/2020 | 25/03/2021 | Yes | No | |
Protocol (other) | V2.0 | 29/04/2020 | 30/11/2022 | No | No |
Statistical Analysis Plan | v1.0 | 26/06/2020 | 30/11/2022 | No | No |
HRA research summary | 28/06/2023 | No | No |
Editorial Notes
30/11/2022: Protocol and statistical analysis plan added.
25/03/2021: The following changes have been made:
1. Publication reference added.
2. A basic results link has been added.
03/11/2020: Trial’s existence confirmed by North East - Tyne & Wear South Research Ethics Committee.