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PROLIFIC ChemoprophylaxisTrial (COVID-19)

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ClinicalTrials.gov Identifier: NCT04352933
Recruitment Status : Recruiting
First Posted : April 20, 2020
Last Update Posted : May 13, 2020
Sponsor:
Information provided by (Responsible Party):
Joseph Cheriyan, MD, Cambridge University Hospitals NHS Foundation Trust

Study Description
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Brief Summary:
The number of confirmed cases of COVID-19 infectious disease arising from the SARS-CoV-2 coronavirus is rising substantially and rapidly, with the potential to overwhelm the ability of the entire National Health Service (NHS) to cope with the increased demand. The availability of personal protective equipment is limited and reports of high risk procedures such as aerosol generating procedures (e.g. intubation for the sickest patients) is a source of great concern for infection transmission. Frontline NHS staff with direct patient contact have the highest likelihood of exposure to SARS-CoV-2 and development of COVID-19 disease. Efforts to protect these workers from development of COVID-19, using drugs to prevent the disease, require urgent evaluation.

Condition or disease Intervention/treatment Phase
COVID-19 Drug: Hydroxychloroquine - Daily dosing Drug: Hydroxychloroquine - Weekly Dosing Other: Matched Placebo Hydroxychloroquine Phase 3

Detailed Description:

The number of confirmed cases of COVID-19 infectious disease arising from the SARS-CoV-2 coronavirus is rising substantially and rapidly, with the potential to overwhelm the ability of the entire National Health Service (NHS) to cope with the increased demand. The availability of personal protective equipment is limited and reports of high risk procedures such as aerosol generating procedures (e.g. intubation for the sickest patients) is a source of great concern for infection transmission. Frontline NHS staff with direct patient contact have the highest likelihood of exposure to SARS-CoV-2 and development of COVID-19 disease. Efforts to protect these workers from development of COVID-19, using drugs to prevent the disease, require urgent evaluation.

This trial will be a double-blind, randomized, placebo-controlled trial in a cohort of frontline healthcare workers, who will potentially be exposed to SARS-CoV-2. Eligible participants will be frontline NHS workers aged 18 to 70 years who work in a healthcare setting with direct patient care. Participants will be randomised to one of 3 arms and receive either: (1) Hydroxychloroquine Daily (loading phase: 800mg for first 2 days; maintenance phase: 1 x 200mg tablet every day) + weekly placebo; (2) Hydroxychloroquine weekly (loading phase: 800mg for first 2 days; maintenance phase: 2 x 200mg tablets every 7th day/weekly) + daily placebo, or (3) placebo (daily and weekly).

Participants will be reviewed at an interim visit 6 weeks after baseline and again and the end of the study treatment in 90 days (approximately 3 months) after randomization. Participants will also complete brief questions about their health weekly while on treatment (remotely, via app/web/phone-based interface).

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 1000 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Double-blind
Primary Purpose: Prevention
Official Title: ChemoPROphyLaxIs For covId-19 Infectious Disease (the PROLIFIC Trial)
Actual Study Start Date : May 11, 2020
Estimated Primary Completion Date : October 31, 2020
Estimated Study Completion Date : April 2021

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Hydroxychloroquine - Daily dosing

Hydroxychloroquine Daily (loading phase: 800mg for first 2 days; maintenance phase: 1 x 200mg tablet every day) + weekly placebo, for approximately 90 days.

Route: Oral. Pharmaceutical form: Tablet

 Drug: Hydroxychloroquine - Daily dosing

Active HCQ:

Days 1-2: Loading phase - 400mg (2 x 200mg capsules) taken TWICE A DAY for 2 days Days 3 onwards: Maintenance Phase - 200mg (1 x 200mg capsule) taken ONCE A DAY, every day for 90 days (~3 months),

Matched Placebo HCQ:

Days 3 onwards: Maintenance Phase - 2 capsules taken ONCE A WEEK on the same day each week (every 7th day) for 90 days (~3 months)
Active Comparator: Hydroxychloroquine - Weekly dosing

Hydroxychloroquine weekly (loading phase: 800mg for first 2 days; maintenance phase: 2 x 200mg tablets every 7th day/weekly) + daily placebo, for approximately 90 days.

Route: Oral. Pharmaceutical form: Tablet

 Drug: Hydroxychloroquine - Weekly Dosing

Active HCQ:

Days 1-2: Loading Phase - 400mg (2 x 200mg capsules) taken TWICE A DAY for 2 days Days 3 onwards: Maintenance Phase - 400mg (2 x 200mg capsules) taken ONCE A WEEK on the same day each week (every 7th day) for 90 days (~3 months)

Matched Placebo HCQ:

Days 3 onwards: Maintenance Phase - 1 capsule taken ONCE A DAY for 90 days (~3 months)
Placebo Comparator: Placebo

Placebo arm - 2 tablets twice daily for first 2 days (loading phase), followed by 1 tablet every day for 90 days plus 2 tablets every 7th day, for approximately 90 days.

Route: Oral. Pharmaceutical form: Tablet

 Other: Matched Placebo Hydroxychloroquine

Matched placebo HCQ - daily dosing:

Days 1-2: Loading Phase - 2 capsules taken TWICE A DAY for 2 days Days 3 onwards: Maintenance Phase - 1 capsule taken ONCE A DAY for 90 days (~3 months) Matched placebo HCQ - weekly dosing Days 3 onwards: Maintenance Phase - 2 capsules taken ONCE A WEEK on the same day each week (every 7th day) for 90 days (~3 months)


Outcome Measures
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Primary Outcome Measures :
  1. Time to positive COVID-19 disease [ Time Frame: Assessed up to 90 days ]
    Time taken for incidence of COVID-19 disease between Hydroxychloroquine and placebo arms


Secondary Outcome Measures :
  1. Number of COVID-19 test positive cases [ Time Frame: Assessed up to 90 days ]
    Number of COVID-19 symptoms based on clinical guidelines and test positive infections per study arm

  2. Number of COVID-19 serological test positive cases [ Time Frame: Assessed up to 90 days ]
    Number of test positive COVID-19 serological test positive cases per study arm

  3. Severity of COVID-19 disease between each arm [ Time Frame: Assessed up to 90 days ]
    Severity based on hospitalisation

  4. Number of common COVID-19 complications between each arm [ Time Frame: Assessed up to 90 days ]
    Number of common COVID-19 complications between arms


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

To be included in the trial the participant MUST:

  1. Have given written informed consent to participate
  2. Be aged 18 years to 70 years
  3. Not previously have been diagnosed with COVID-19
  4. Work in a high-risk secondary or tertiary healthcare setting (hospitals accepting COVID-19 patients) with direct patient-facing care

Exclusion Criteria:The presence of any of the following will mean participants are ineligible:

  1. Known COVID-19 positive test at baseline (if available)
  2. Symptomatic for possible COVID-19 at baseline
  3. Known hypersensitivity reaction to HCQ, chloroquine or 4-aminoquinolines
  4. Known retinal disease
  5. Known porphyria
  6. Known chronic kidney disease (CKD; eGFR<30ml/min)
  7. Known epilepsy
  8. Known heart failure or conduction problems
  9. Known significant liver disease (Gilbert's syndrome is permitted)
  10. Known glucose-6-phosphate dehydrogenase (G6PD) deficiency

  11. Currently taking any of the following contraindicated medications:

    1. Digoxin
    2. Chloroquine
    3. Halofantrine
    4. Amiodarone
    5. Moxifloxacin
    6. Cyclosporin
    7. Mefloquine
    8. Praziquantel
    9. Ciprofloxacin
    10. Clarithromycin
    11. Prochlorperazine
    12. Fluconazole
  12. Currently taking hydroxychloroquine or having a clinical indication for taking hydroxychloroquine
  13. Currently breastfeeding
  14. Unable to be followed-up during the trial
  15. Current or future involvement in the active treatment phase of other interventional research studies (excluding observational/non-interventional studies) before study follow-up visit
  16. Not able to use or have access to a modern phone device/web-based technology
  17. Any other clinical reason which may preclude entry in the opinion of the investigator
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04352933


Contacts
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Contact: Ella James, PhD 01223 349762 ella.james@addenbrookes.nhs.uk
Contact: Heike Templin 01223 250874 heike.templin@addenbrookes.nhs.uk

Locations
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United Kingdom
Cambridge University Hospitals NHS Foundation Trust Recruiting
Cambridge, United Kingdom, CB2 0QQ
Sponsors and Collaborators
Cambridge University Hospitals NHS Foundation Trust
Investigators
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Principal Investigator: Joseph Cheriyan, MBCHB, FRCP Cambridge University Hospitals NHS Foundation Trust
More Information
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Responsible Party: Joseph Cheriyan, MD, Dr, Cambridge University Hospitals NHS Foundation Trust
ClinicalTrials.gov Identifier: NCT04352933    
Other Study ID Numbers: PROLIFIC2020 (A095583)
First Posted: April 20, 2020    Key Record Dates
Last Update Posted: May 13, 2020
Last Verified: May 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Joseph Cheriyan, MD, Cambridge University Hospitals NHS Foundation Trust:
SARS-CoV-2
Coronavirus
COVID-19
chemoprophylaxis
Hydroxychloroquine
Additional relevant MeSH terms:
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Hydroxychloroquine
Antimalarials
Antiprotozoal Agents
Antiparasitic Agents
 Anti-Infective Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antirheumatic Agents