Multicenter, Retrospective Study of the Effects of Remdesivir in the Treatment of Severe Covid-19 Infections (REMDECO-19)
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|ClinicalTrials.gov Identifier: NCT04365725|
Recruitment Status : Completed
First Posted : April 28, 2020
Last Update Posted : April 19, 2021
|Condition or disease||Intervention/treatment|
COVID-19 is a respiratory disease caused by a new coronavirus (SARS-CoV-2) and causes significant morbidity and mortality. There is currently no approved treatment for the treatment of patients with COVID-19. Global efforts to evaluate new antivirals and therapeutic strategies to treat COVID-19 have intensified. To quickly propose a first line of defense and fight against the virus in hospitalized patients, the World Health Organization (WHO) relies on already existing drugs, "repositioned", which are immediately available in large quantities and present a good security profile. Remdesivir (GS-5734) is a broad spectrum nucleotide analogue that inhibits RNA-dependent RNA polymerase activity among a diverse group of RNA viruses. Non-clinical and clinical data suggest that remdesivir may be useful for the treatment of COVID-19. WHO has identified remdesivir as a candidate drug of interest to be studied in clinical trials. Compassionate provision of the drug allowed its use before clinical trials began. This retrospective cohort study is designed to analyze the data collected during the routine care of patients who have benefited from this compassionate provision.
The data collected in real life during care will allow a multivariate analysis quickly providing elements of response on a typology of patients and level of progression of the disease for which remdesivir would bring a more or less significant clinical benefit. Multivariate analysis of these data will allow the identification of variables at the initiation of treatment with remdesivir that are potentially predictive of its clinical efficacy.
The period for collecting data collected during treatment for an individual subject is 30 days. The retrospective collection begins on the day before initiation of treatment with remdesivir up to 29 days after. A note of information and of no objection to the collection of data will be sent to the patient. The data collected comes from the patient's medical records. The observations will be entered by investigative doctors and or clinical study technicians.
Statistical analysis will be carried out using SAS 9.3 and / or R software. All the analyzes carried out will follow the recommendations of STROBE for observational studies. A detailed statistical analysis plan will be carried out before basic freezing and data analysis. Quantitative data will be described as the mean and standard deviation or medians and quartiles depending on the distribution of the data. Qualitative data will be described in terms of numbers and percentages. Comparisons of quantitative data will be analyzed using the student or wilcoxon test depending on the test application conditions, and comparisons of categorical variables will be made using the Chi2 or Fisher test, if appropriate. Multivariate models will be produced to explore the factors associated with patient prognosis. The clinical development of patients described on a 7-point ordinal scale will be divided into two in order to create logistic models. The entire process of selecting variables in the models will be described in the analysis plan which will be validated before the database freezes.
|Study Type :||Observational|
|Actual Enrollment :||84 participants|
|Official Title:||Multicenter, Retrospective Study of the Effects of Remdesivir in the Treatment of Severe Covid-19 Infections.|
|Actual Study Start Date :||May 5, 2020|
|Actual Primary Completion Date :||June 12, 2020|
|Actual Study Completion Date :||June 12, 2020|
- Drug: Remdesivir
- Clinical course on Day 15. [ Time Frame: 15 days ]Study the prognostic factors of the clinical course of patients on Day 15 under treatment with remdesivir. Clinical progress will be categorized using a 7-point ordinal scale.
- Clinical course on Day 3. [ Time Frame: 3 days ]Explore the prognostic factors of the clinical course of patients on Day 3
- Clinical course on Day 8 [ Time Frame: 8 days ]Explore the prognostic factors of the clinical course of patients on Day 8
- Clinical course on Day 11. [ Time Frame: 11 days ]Explore the prognostic factors of the clinical course of patients on Day11
- Clinical course on Day 29. [ Time Frame: 29 days ]Explore the prognostic factors of the clinical course of patients on D29.
- Duration of treatment [ Time Frame: 29 days ]Duration of treatment with remdesivir
- Sepsis-related Organ Failure Assessment score [ Time Frame: Day 3, 8, 11, 15 and 29 ]PaO2 / FiO2 and artificial ventilation; platelets; bilirubin; average blood pressure and use of vasoactive drugs; Glasgow score; creatinine.
- Duration without mechanical ventilation [ Time Frame: 29 days ]Duration without mechanical ventilation within 29 days of initiation of treatment with remdesivir
- Mortality [ Time Frame: 29 days ]Mortality at 29 days after initiation of treatment with remdesivir.
- cumulative incidence of grade 3 and 4 adverse events (AEs). [ Time Frame: 29 days ]Evaluate the safety of the treatment with cumulative incidence of grade 3 and 4 adverse events (AEs).
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): NCT04365725
|Paris, France, 75014|
|Principal Investigator:||Jérémie ZERBIT, PharmaD||Assistance Publique - Hôpitaux de Paris|