Clinical trial for the treatment of COVID-19 and COVID-like illness in primary care
| ISRCTN | ISRCTN55471843 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN55471843 |
| ClinicalTrials.gov (NCT) | Nil known |
| Clinical Trials Information System (CTIS) | 2022-501707-27-01 |
| Integrated Research Application System (IRAS) | 1008573 |
| Protocol serial number | EU-EcraidPC-1 |
| Sponsor | University Medical Center Utrecht |
| Funder | European Union |
- Submission date
- 03/11/2022
- Registration date
- 21/11/2022
- Last edited
- 13/01/2026
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Infections and Infestations
Plain English summary of protocol
Background and study aims
Most people with COVID-19 and COVID-like illness do not become seriously ill. Some people, however, do go on to have more serious symptoms and may even need to be admitted to hospital. The aim of this study is to investigate the effectiveness and safety of medicinal products to treat COVID-19 and COVID-like illness in adult patients across Europe. This study will investigate whether the medicinal products help patients to recover patients faster, reduce the severity of the symptoms, reduce complications that require treatment in hospital, and prevent spread to family members/housemates.
Who can participate?
Patients aged 18 years or over and experiencing symptoms of a COVID-19 or COVID-like illness, presenting to primary care with COVID-19 and COVID-like-illness in Belgium, France, Germany, Ireland, Poland, Spain and the UK
What does the study involve?
Participants will be randomly allocated to receive either usual care alone or an investigational product, a placebo or a comparator product in addition to usual care.
Participants allocated to the usual care group will receive usual clinical care. Participants allocated to usual care + nitric oxide nasal spray will receive nitric oxide nasal spray (NONS) administered intranasally (into the nose) in addition to usual care, six times per day [two sprays per nostril, equivalent to 0.45 ml volume total per dose (four sprays)], for 7 days.
Participants allocated to usual care + saline nasal spray will receive a saltwater solution administered intranasally in addition to usual care, six times per day [two sprays per nostril, equivalent to 0.45 ml volume total per dose (four sprays)], for 7 days. Participants allocated to the usual care + LTX-109 will receive LTX-109 0.5% weight/weight administered intranasally, three times per day [1 spray per nostril, equivalent to 280uL volume total per dose (2 sprays)] for 3days.
Participants allocated to the usual care + LTX-109-placebo will receive LTX-109 0.0% weight/weight administered intranasally, three times per day [1 spray per nostril, equivalent to 280uL volume total per dose (2 sprays)] for 3days.
The duration of the study for each participant is 3 months. Participants will be monitored daily for their acute symptoms for 28 days with a diary. They will receive a phone call between 28 days and 35 days in case data capture is not complete. Longer-term follow-up will be at 3 months by a phone call or electronic questionnaire. A combined throat/nose swab will be taken at the start of the study and on day 4 for NONS and Saline, and at the start of the study and on days 1, 3 and 5 for LTX-109 and LTX-109-placebo.
What are the possible benefits and risks of participating?
The overall benefits for participants in the intervention group are related to the prevention or treatment effects of the study drug on their COVID-19 or COVID-like illness. Taking part in the study can have possible disadvantages. Participants may experience side effects from the medicinal product. There may be a brief period of discomfort from (self-)taking the combined throat/nose swabs. Taking part in the study will take up some of the time of the participant.
Where is the study run from?
This study is being led by the University Medical Center Utrecht (UMCU) and managed by Ecraid (European Clinical Research Alliance on Infectious Diseases) in the Netherlands. It is a collaboration between the UMCU, the University of Oxford (UK), the University of Antwerp (Belgium), ECRIN (European Clinical Research Infrastructure Network, France) and Ecraid.
When is the study starting and how long is it expected to run for?
December 2021 to December 2025
Who is funding the study?
European Union
Who is the main contact?
1. Dr Alike van der Velden, a.w.vandervelden@umcutrecht.nl
2. Lina Gurskaite, lina.gurskaite@ecraid.eu
Contact information
Principal investigator
Universiteitsweg 100
Utrecht
3584 CG
Netherlands
| Phone | +31 (0)631118081 |
|---|---|
| a.w.vandervelden@umcutrecht.nl |
Public
Heidelberglaan 100
Utrecht
3584 CX
Netherlands
| Phone | +31 (0)631118658 |
|---|---|
| lina.gurskaite@ecraid.eu |
Scientific
Provinciehuis
Archimedeslaan 6
Utrecht
3584 BA
Netherlands
| Phone | +31 (0)6 3111787 |
|---|---|
| jeri.nijland@ecraid.eu |
Scientific
Provinciehuis
Archimedeslaan 6
Utrecht
3584 BA
Netherlands
| Phone | +31 6 5017 7196 |
|---|---|
| chanelle.wigger@ecraid.eu |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Adaptive platform randomized double-blind multicentre trial |
| Secondary study design | Randomised controlled trial |
| Study type | Participant information sheet |
| Scientific title | European Clinical Research Alliance on Infectious Diseases – PRIMary care adaptive platform trial for pandemics and Epidemics |
| Study acronym | ECRAID-Prime |
| Study objectives | Current study objectives as of 13/01/2026: To assess the efficacy of the study IP versus control (Usual Care) or versus a comparator (placebo, or comparator IP) on:↲ 1. Time to first self-report of feeling recovered from symptoms of COVID-19 or COVID-like-illness (for Phase IIb/III type evaluation, as specified in the relevant intervention-specific appendix).↲ 2. Viral clearance, and potentially viral load and/or impact on biomarkers, for example on illness severity or immunological response (for Phase IIa type evaluation as specified in the relevant intervention-specific appendix). Previous study hypothesis as of 23/07/2024: The primary objective(s) of this platform study will be phase-dependent. To assess the efficacy of the study IP versus control on: 1. Time to first self-report of feeling recovered from symptoms of COVID-19 or COVID-like illness (for Phase IIb/III type evaluation, as specified in the relevant intervention-specific appendix). 2. Viral clearance and potential impact on biomarkers, for example on illness severity or immunological response (for Phase IIa type evaluation as specified in the relevant intervention-specific appendix). Previous study hypothesis: To test the safety and efficacy of treatments for patients presenting to primary care with COVID-19 and COVID-like-illness in a Phase II/III type evaluation, with the aim of determining whether treatments should progress to the next phase of evaluation, and evaluate the trial process and procedures to in order to optimize it and enhance recruitment. |
| Ethics approval(s) | Approved 25/05/2024, Federal Agency for Medicines and Health Products (avenue Galilee 5/03, Brussels, 1210, Belgium; +32 (0)25284000; ct.rd@fagg-afmps.be), ref: 2022-501707-27-01 |
| Health condition(s) or problem(s) studied | Reducing illness duration, complications, and possibly transmission of COVID-19 (SARS-CoV-2 infection) and other respiratory pathogens |
| Intervention | Current interventions as of 13/01/2026: Eligible participants will be randomly allocated to receive either an investigational product (IP) or the specified control. Each investigational product has a matching placebo or comparator. Besides this matching placebo or comparator IP, usual care alone can be an additional control arm, this comparison is not double-blind. Participants will be randomised to receive either usual care alone or an investigational product, a placebo or a comparator product in addition to usual care. The ECRAID-Prime trial is a platform trial which means that multiple investigational products for the same illness can be tested simultaneously, and new interventions can be added during the course of the trial in accordance with pre-specified criteria. The names of all treatments of actions, including the control and details of the interventions (dose, duration, how it is administered) are intervention specific and will be described in intervention-specific appendices that will be added to the master protocol. Up to this point three investigational products have been selected. Participants will be randomized to receive either usual care alone or an investigational product, a placebo or a comparator product in addition to usual care. Potential participants can be included if they are eligible to be randomized to at least one investigational product, as well as the usual care arm. A. Usual care arm Participants randomized to the usual care arm will receive usual clinical care according to standard care in the specific country, at the discretion of responsible treating clinicians and according to the participant’s own decisions about self-care for the specific respiratory tract infection. B. Usual care + nitric oxide nasal spray Nitric oxide nasal spray (NONS) is a nitric oxide donor. NONS will be administered intranasally in addition to usual care, six times per day [two sprays per nostril, equivalent to 0.45 ml volume total per dose (four sprays)], for 7 days. C. Usual care + saline nasal spray Saline is a saltwater solution and will be administered intranasally in addition to usual care, six times per day [two sprays per nostril, equivalent to 0.45 ml volume total per dose (four sprays)], for 7 days. D. Usual care + LTX-109 LTX-109 is a broad acting antiviral and antibacterial agent and will be administered intranasally in addition to usual care, three times per day [1 spray per nostril, equivalent to 280uL volume per dose (2 sprays)], for three days. Previous interventions: Eligible participants will be randomly allocated to receive either an investigational product (IP) or the specified control. Each investigational product has a matching placebo or comparator. Besides this matching placebo or comparator IP, usual care alone can be an additional control arm, this comparison is not double-blind. Participants will be randomised to receive either usual care alone or an investigational product, a placebo or a comparator product in addition to usual care. The ECRAID-Prime trial is a platform trial which means that multiple investigational products for the same illness can be tested simultaneously, and new interventions can be added during the course of the trial in accordance with pre-specified criteria. The names of all treatments of actions, including the control and details of the interventions (dose, duration, how it is administered) are intervention specific and will be described in intervention-specific appendices that will be added to the master protocol. Up to this point two investigational products have been selected. Participants will be randomized to receive either usual care alone or an investigational product, a placebo or a comparator product in addition to usual care. Potential participants can be included if they are eligible to be randomized to at least one investigational product, as well as the usual care arm. A. Usual care arm Participants randomized to the usual care arm will receive usual clinical care according to standard care in the specific country, at the discretion of responsible treating clinicians and according to the participant’s own decisions about self-care for the specific respiratory tract infection. B. Usual care + nitric oxide nasal spray Nitric oxide nasal spray (NONS) is a nitric oxide donor. NONS will be administered intranasally in addition to usual care, six times per day [two sprays per nostril, equivalent to 0.45 ml volume total per dose (four sprays)], for 7 days. C. Usual care + saline nasal spray Saline is a saltwater solution and will be administered intranasally in addition to usual care, six times per day [two sprays per nostril, equivalent to 0.45 ml volume total per dose (four sprays)], for 7 days. |
| Intervention type | Other |
| Primary outcome measure(s) |
Current primary outcome measure as of 13/01/2026: |
| Key secondary outcome measure(s) |
Current key secondary outcomes as of 13/01/2026: |
| Completion date | 30/11/2026 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 150 Years |
| Sex | All |
| Target sample size at registration | 1700 |
| Key inclusion criteria | Current key inclusion criteria as of 13/01/2026: In order to be eligible to participate in ECRAID-Prime, a participant must (at least) meet all the following criteria (there can be additional intervention-specific inclusion criteria): 1. Participant is ≥18 years of age on the day of inclusion; if people aged <18 years are suitable for inclusion in the evaluation of an investigational product, then this will be described and justified in the relevant, approved intervention-specific appendix 2. Presence of at least two symptoms suggestive of COVID-19 or COVID-like-illness, one respiratory (cough, sore throat, running or congested nose or sinuses, shortness of breath) and one systemic (fever, feeling feverish, sweats/chills or shivering, low energy or tiredness, headache, muscle, joint or body aches, loss of taste and/or smell) 3. Judged by recruiting a medically qualified clinician or research nurse that the illness is due to COVID-19 or COVID-like illness 4. Onset of symptoms less than x days (x will be specified in the intervention-specific appendix) 5. Willing and able to give informed consent for participation in the study 6. Willing and able to comply with all trial procedures 7. Any additional eligibility criteria relevant to women of child-bearing potential including current pregnancy or breastfeeding will be specified in the intervention-specific appendix Previous key inclusion criteria: In order to be eligible to participate in ECRAID-Prime, a participant must (at least) meet all the following criteria (there can be additional intervention-specific inclusion criteria): 1. Participant is ≥18 years of age on the day of inclusion; if people aged <18 years are suitable for inclusion in the evaluation of an investigational product, then this will be described and justified in the relevant, approved intervention-specific appendix 2. Presence of at least two symptoms suggestive of COVID-19 or COVID-like-illness, one respiratory (cough, sore throat, running or congested nose or sinuses, shortness of breath) and one systemic (fever, feeling feverish, sweats/chills or shivering, low energy or tiredness, headache, muscle, joint or body aches, loss of taste and/or smell) 3. Judged by recruiting a medically qualified clinician or research nurse that the illness is due to COVID-19 or COVID-like illness 4. Onset of symptoms less than 7 days (in case earlier treatment is required for a specific investigational product, this will be specified in the intervention-specific appendix) 5. Willing and able to give informed consent for participation in the study 6. Willing and able to comply with all trial procedures 7. Any additional eligibility criteria relevant to women of child-bearing potential including current pregnancy or breastfeeding will be specified in the intervention-specific appendix |
| Key exclusion criteria | Current key exclusion criteria as of 13/01/2026: A potential participant who meets any of the following criteria will be excluded from participation in ECRAID-Prime (there can be additional intervention-specific exclusion criteria). 1. Requiring admission to the hospital on the day of screening, or inclusion 2. Known allergies or hypersensitivities to any of the components used in the formulation of the investigational product, placebo or the comparator product 3. Any disease, condition, or disorder that precludes participation in the trial, in the opinion of the person checking eligibility and taking consent 4. Any planned major surgery in the next 28 days 5. Currently participating in a trial of an investigational product 6. Any personnel involved in the study Previous key exclusion criteria: A potential participant who meets any of the following criteria will be excluded from participation in ECRAID-Prime (there can be additional intervention-specific exclusion criteria). 1. Requiring admission to the hospital on the day of screening, or inclusion 2. Known allergies or hypersensitivities to any of the components used in the formulation of the investigational product, or the control product 3. Any disease, condition, or disorder that precludes participation in the trial, in the opinion of the person checking eligibility and taking consent 4. Any planned major surgery in the next 28 days 5. Currently participating in a trial of an investigational product |
| Date of first enrolment | 03/10/2024 |
| Date of final enrolment | 31/03/2026 |
Locations
Countries of recruitment
- United Kingdom
- Belgium
- France
- Georgia
- Germany
- Ireland
- Netherlands
- Poland
- Spain
Study participating centres
Radcliffe Observatory Quarter
Woodstock Road
Oxford
OX2 6GG
England
Honiton
EX14 2NY
England
Reading
RG1 5BS
England
Bovey Tracey
TQ13 9QP
England
6 Oxford Road
Banbury
OX16 9AD
England
Oxford
OX4 1XB
England
Coker Close
Bicester
OX26 6AT
England
Kidlington
OX5 2NS
England
Volunteer Way
Faringdon
SN7 7YU
England
Headington
Oxford
OX3 9JA
England
Schilde
2970
Belgium
Kontich
2550
Belgium
Edegem
2650
Belgium
Gössenheim
97780
Germany
Viladecans, Barcelona
08840
Spain
L'Hospitalet de Llobregat, Barcelona
08902
Spain
Sant Vicenç dels Horts, Barcelona
08620
Spain
Tallaght, Dublin 24
D24DH74
Ireland
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan summary | Stored in non-publicly available repository |
| IPD sharing plan | Descriptive metadata will be made fully open through a cohort browser. Controlled access, participant-level data will be made available through a controlled access data platform. Restricted access, participant-level data will be made available to internal partners (e.g., statisticians at participating institutions) within the ECRAID-Prime internal network through the UMCU data warehouse infrastructure. Restricted access participant-level data that includes individual identifiers (e.g., birth date) will not be made openly accessible in line with national, European and international legal, ethical and privacy concerns and to ensure that data sharing complies with the GDPR. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
| Protocol file | version 5.0 | 22/03/2024 | 09/10/2024 | No | No |
| Protocol file | ISA A version 4.0 |
22/03/2024 | 09/10/2024 | No | No |
| Protocol file | ISA B version 4.0 |
22/03/2024 | 09/10/2024 | No | No |
| Protocol file | ISA C version 4.0 |
22/03/2024 | 09/10/2024 | No | No |
| Study website | Study website | 11/11/2025 | 11/11/2025 | No | Yes |
Additional files
Editorial Notes
13/01/2026: The study objectives, interventions, primary and secondary outcomes, key inclusion and exclusion criteria, study centres and a public contact were amended.
09/12/2025: The following changes were made to the study record:
1. The date of final enrolment was changed from 31/12/2025 to 31/03/2026.
2. The completion date was changed from 31/12/2025 to 30/11/2026.
04/11/2024: Georgia was added to the countries of recruitment. Medcapital Gldani and Nuffield Department of Primary Care Health Sciences, University of Oxford were added to the study participating centres.
09/10/2024: The following changes were made to the trial record:
1. Uploaded protocols v4.0 (not peer-reviewed) as additional files.
2. Uploaded protocol v5.0 (not peer-reviewed) as an additional file.
07/10/2024: The following changes were made to the study record:
1. Eudract/CTIS number updated.
2. The recruitment start date was changed from 01/09/2024 to 03/10/2024.
3. The recruitment end date was changed from 01/06/2025 to 31/12/2025.
4. The overall study end date was changed from 30/06/2025 to 31/12/2025.
23/07/2024: The following changes were made:
1. The primary and secondary outcome measures, study hypothesis, ethics approval, contact details were updated.
2. Universitätsklinikum Würzburg, Centre d’Investigation Clinique (CIC) CHU de Limoges, WGC ‘t Spoor, Huisartsenpraktijk Zwaantjes, wijkgezondheidscentrum De Vlier, Huisartsenpraktijk Brig, Huisartsen De Poort, huisartsen Wolvenberg, praktijkhuis de Grote Rivier, Villa Medica, Huisartsengroep Lange Leem, Huisartsenpraktijk Begijnenstraat, Crescent medical centre, Heights medical centre, Main Street Clinic, Moyview Family Practice, Tramore Medical Centre, Akademicka Praktyka Medycyny Rodzinnej Bielska, Medimed, Spółka cywilna SILOE Katarzyna Jachimowicz, Poradnia Lekarza Rodzinnego Joanna Redźko-Baszun, NZOZ „Poradnia Rodzinna” Agnieszka Gosk, Centrum Medyczne Kleosin Wieliczko, Centro de Atencion Primaria Jaume 1, Centro de Atencion Primaria 17 de setembre, Centro de Atencion Primaria Sant Martí de Provençals, Centro de Atencion Primaria Maresme, Equip D'atencio Primaria Barcelona Sardenya S.L.P. were added to the study participating centres.
3. The recruitment start date was changed from 01/06/2024 to 01/09/2024.
4. The recruitment end date was changed from 01/03/2025 to 01/06/2025.
5. The overall study end date was changed from 30/12/2024 to 30/06/2025.
04/03/2024: The recruitment start date was changed from 01/03/2024 to 01/06/2024.
05/12/2023: The following changes were made:
1. The recruitment start date was changed from 01/12/2023 to 01/03/2024.
2. The recruitment end date was changed from 30/12/2024 to 01/03/2025.
31/10/2023: 2 scientific contacts were added.
03/10/2023: The following changes were made to the trial record:
1. The IRAS number was added.
2. The target number of participants was changed from "333 participants per arm (expected +/- 1700 participants in the trial across all arms and all sites)" to "333 participants per arm (expected +/- 1000 participants in the trial across all arms and all sites)".
3. The recruitment start date was changed from 01/10/2023 to 01/12/2023.
03/07/2023: Contact details updated.
06/06/2023: The following changes were made to the study record:
1. The recruitment start date was changed from 01/06/2023 to 01/10/2023.
2. The recruitment end date was changed from 30/08/2024 to 30/12/2024.
3. The overall study end date was changed from 30/11/2024 to 30/12/2024.
4. The intention to publish date was changed from 30/11/2025 to 30/12/2025.
09/05/2023: A contact was removed.
05/04/2023: The recruitment start date was changed from 01/04/2023 to 01/06/2023.
03/02/2023: The following changes were made to the trial record:
1. The primary outcome measure was changed.
2. The secondary outcome measures were changed.
04/01/2023: The following changes were made to the trial record:
1. The primary outcome measure was changed.
2. The secondary outcome measures were changed.
3. The target number of participants was changed from "135 participants per arm (expected +/- 1500 participants in the trial across all arms and all sites)" to "333 participants per arm (expected +/- 1700 participants in the trial across all arms and all sites)".
4. The recruitment start date was changed from 01/01/2023 to 01/04/2023.
11/11/2022: Trial's existence confirmed by European Commission.