Trial record 1 of 1 for:    NCT01227967
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Comparing the Efficacy, Safety, and Tolerability of Combination Antivirals (Amantadine, Ribavirin, Oseltamivir) Versus Oseltamivir for the Treatment of Influenza in Adults at Risk for Complications (IRC003)

This study is currently recruiting participants. (see Contacts and Locations)
Verified September 2016 by National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID) Identifier:
First received: October 22, 2010
Last updated: September 21, 2016
Last verified: September 2016
Seasonal influenza is responsible for many hospitalizations and deaths each year, despite effective antiviral treatments. Some individuals have medical conditions such as heart or lung diseases that make them particularly at risk of severe influenza infections that may result in hospitalization or death. Oseltamivir (Tamiflu) is used most often to treat flu, but there are still many hospitalizations, complications, and deaths even with treatment. This study will evaluate the use of combination antivirals (amantadine, oseltamivir, and ribavirin) compared to oseltamivir alone in the treatment of influenza in an at-risk population.

Condition Intervention Phase
Drug: Amantadine, Ribavirin, Oseltamivir
Drug: Oseltamivir
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized Double-Blind Phase 2 Study Comparing the Efficacy, Safety, and Tolerability of Combination Antivirals (Amantadine, Ribavirin, Oseltamivir Versus Oseltamivir for the Treatment of Influenza in Adults at Risk for Complications

Resource links provided by NLM:

Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Evaluate the reproducibility of virologic samples, comparison between culture and PCR, and the impact of missing data between randomized groups. [ Time Frame: First 50 subjects ]
    The specific measure used for the primary endpoint will be determined by a pilot study of the first 50 subjects randomized which will evaluate the reproducibility of virologic samples, comparison between culture and PCR, and the impact of missing data between randomized groups.

Estimated Enrollment: 1200
Study Start Date: September 2010
Estimated Study Completion Date: September 2016
Estimated Primary Completion Date: September 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Combination Therapy
Amantadine, Ribavirin, Oseltamivir
Drug: Amantadine, Ribavirin, Oseltamivir
One capsule of Oseltamivir 75 mg x 2 - Total dose: 150 mg/day for 5 days; Three capsules of Ribavirin 200 mg for total of 600 mg x 2 - Total dose: 1200 mg/day for 5 days; One capsule of Amantadine 100 mg x 2 Total dose: 200 mg/day for 5 days
Active Comparator: Oseltamivir monotherapy
Drug: Oseltamivir
75 mg x 2 Total dose: 150 mg/day for 5 days

Detailed Description:

Seasonal influenza is responsible for approximately 226,000 excess hospitalizations annually and despite effective antivirals causes significant morbidity and mortality (estimated 24,000-50,000 deaths each year in the United States alone). The influenza virus that emerged in 2009 (A/California/07/2009 H1N1) caused fewer deaths (12,000 flu-related deaths in the U.S) but in contrast to seasonal flu, nearly 90 percent of the deaths with the 2009 H1N1 occurred among people younger than 65 years of age. The CDC has defined an at-risk population that is responsible for the majority of hospitalization and morbidity associated with influenza. This study will evaluate the use of combination antivirals as compared to oseltamivir alone in the treatment of influenza in an at-risk population.

Subjects who meet the CDC definition for being at-risk and that present with an influenza-like illness will be screened for the study. Those subjects with a confirmatory test for influenza (rapid antigen or PCR) will be randomized in a 1:1 manner to receive a blinded study treatment consisting of either the combination of amantadine, oseltamivir, and ribavirin or oseltamivir alone for 5 days. Clinical, virologic, and laboratory assessments on Days 1, 3, 7, 14, and 28 will be used for both safety and efficacy analysis.


- To evaluate the effectiveness of combined treatment with oseltamivir, amantadine, and ribavirin compared with oseltamivir alone for at-risk individuals with confirmed influenza infection.


- Individuals at least 18 years of age who have one or more medical conditions that may cause complications from influenza, and have developed an influenza-like illness.


  • Participants will be screened with a physical examination and medical history, along with blood tests and throat swabs to confirm influenza infection.
  • Eligible participants will be randomly assigned to take either oseltamivir alone (the current standard treatment for influenza) or to take oseltamivir, amantadine, and ribavirin. Participants will have additional blood samples and throat swabs taken at the start of the study, and will be shown how to complete a study diary at home.
  • Participants will receive a study medication kit containing the medication to take at home twice a day for 5 days.
  • Participants will return, with the medication kit, to the clinic on days 1 (the first day after the start of the study), 3, 7, 14, and 28. The first visit may take 2 to 3 hours, but each subsequent visit should take approximately 1 to 2 hours. Additional blood samples and throat swabs will be taken at these visits.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Enrollment (Screening)

  1. Signed informed consent prior to initiation of any study procedures
  2. Age greater than or equal to 18 years of age
  3. Presence of an underlying medical condition(s) that may increase risk of complications from influenza
  4. History of an influenza-like illness defined as:

    • One or more respiratory symptom (cough, sore throat, or nasal symptoms) AND
    • Either
    • Fever (subjective or documented >38 degrees C) OR
    • 1 or more constitutional symptom (headache, malaise, myalgia, sweats/chills or fatigue)
  5. Onset of illness no more than 96 hours before screening defined as when the subject experienced at least one respiratory symptom, constitutional symptom, or fever
  6. Willingness to have samples stored


  1. Signed informed consent
  2. Age greater than or equal to 18 years of age
  3. Presence of a medical condition(s) that have been associated with increased risk of complications from influenza

    • Age 65 years of age or older
    • Asthma
    • Neurological and neuro-developmental conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury) [though still able to provide informed consent per inclusion criteria #1]
    • Chronic lung disease (such as COPD and cystic fibrosis)
    • Heart disease (such as congenital heart disease, congestive heart failure, and coronary artery disease)
    • Blood disorders (excluding genetic causes of anemia, as noted in the exclusion criteria)
    • Endocrine disorders (such as diabetes mellitus)
    • Kidney disorders
    • Liver disorders
    • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
    • Weakened immune system due to disease or medication (such as people with HIV/AIDS, or cancer, chronic steroids or other medications causing immune suppression)
    • BMI ≥ 40
  4. Onset of illness no more than 96 hours before screening defined as when the subject experienced at least one respiratory symptom, constitutional symptom, or fever
  5. Positive test for influenza (either rapid antigen or PCR)

    - Results from influenza testing obtained for clinical indications within 12 hours before screening/enrollment may be used if available. Randomization may proceed in cases of discrepant results (one positive and one negative)

  6. One of the following to avoid pregnancy:

    • Females who are able to become pregnant (i.e., are not postmenopausal, have not undergone surgical sterilization, and are sexually active with men) must agree to use at least 2 effective forms of contraception from the date of informed consent through 6 months after the last dose of study drug. At least one of the methods of contraception should be a barrier method
    • Males who have not undergone surgical sterilization and are sexually active with women must agree to use condoms plus have a partner use at least one additional effective form of contraception from the date of informed consent through 6 months after the last dose of study drug
  7. Willingness to have samples stored


(for Enrollment or Randomization)

  1. Women who are pregnant or breast-feeding, and men whose female partner(s) is pregnant
  2. Inability to take oral medication or a history of gastrointestinal malabsorption that would preclude the use of oral medication.
  3. Hemoglobin < 10 g/dL
  4. WBC < 1.5 times 10(9)/L
  5. Neutrophils < 0.75 x 10(9)/L
  6. Platelets < 50 x 10(9)/L
  7. History of genetic hemoglobinopathy (e.g., thalassemia major or sickle cell anemia) or autoimmune hemolytic anemia
  8. Received more than 2 doses of any antiviral influenza medications since onset of influenza symptoms
  9. Received stavudine (d4T), didanosine (ddI), zidovudine (AZT), or azathioprine within 30 days prior to study entry
  10. Creatinine clearance less than 60 mL/min (estimated by the Cockcroft-Gault equation using serum creatinine)
  11. History of autoimmune hepatitis
  12. Uncompensated liver disease (defined as AST > 3 times site upper limit of normal (ULN), ALT > 3 times ULN, or Direct Bilirubin > 2 times ULN)
  13. Clinical signs of end-stage liver disease including jaundice, coagulopathy, portal hypertension, esophageal varices, ascites, peripheral edema, gastrointestinal bleeding, or encephalopathy
  14. Chronic liver disease categorized as Child-Pugh class C (Child-Pugh score 10-15)
  15. Known hypersensitivity to rimantadine, amantadine, ribavirin, oseltamivir, peramivir, or zanamivir
  16. Received live attenuated virus vaccine (influenza or other) within 3 weeks prior to study entry
  17. Use of any investigational drug within 30 days or 5 half-lives (whichever is longer) prior to study entry
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01227967

Contact: Patient Recruitment and Public Liaison Office (800) 411-1222
Contact: TTY 1-866-411-1010

  Hide Study Locations
United States, Alabama
Simon Williamson Clinic Completed
Birmingham, Alabama, United States, 35211
United States, Arizona
East Valley Family Physicians Recruiting
Chandler, Arizona, United States, 85224
Contact: Kylie Scheideler    480-782-5552   
Thomas Lenzmeier Family Practice Recruiting
Glendale, Arizona, United States, 85308
Contact: Meghan Caldron    623-295-1711   
Central Phoenix Medical Center Recruiting
Phoenix, Arizona, United States, 85020
Contact: Lynn Bessette    602-200-3814   
United States, California
WCCT Global LLC Completed
Costa Mesa, California, United States, 92626
Advanced Rx Clinical Research Recruiting
Garden Grove, California, United States, 92843
Contact: Dianne Huynh    714-554-8080   
Torrance Clinical Research Institute, Inc. Completed
Lomita, California, United States, 90717
University of Southern California Completed
Los Angeles, California, United States, 90033
University of California at San Diego Completed
San Diego, California, United States, 92103
Westlake Medical Research (CA) Completed
Thousand Oaks, California, United States, 91360
Los Angeles BioMedical Research Institute Completed
Torrance, California, United States, 90502
Empire Clinical Research Recruiting
Upland, California, United States, 91786
Contact: Sarah Gordon    909-981-5321   
United States, Colorado
University of Colorado Completed
Aurora, Colorado, United States, 80045
Centennial - IMMUNOe International Research Recruiting
Centennial, Colorado, United States, 80112
Contact: Maureen Collins    303-224-4697   
United States, Florida
University of Florida Recruiting
Gainesville, Florida, United States, 32610
Contact: Robert Shawn Wills    352-265-5911   
Best Quality Research Inc. Completed
Hialeah, Florida, United States, 33016
San Marcus Research Clinic, Inc. Completed
Miami, Florida, United States, 33015
Medical Consulting Center Completed
Miami, Florida, United States, 33125
Suncoast Research Group, LLC Recruiting
Miami, Florida, United States, 33135
Contact: Patricia Flores    305-631-6704   
Contact: Janet Acle    305-631-6704   
University of Miami Completed
Miami, Florida, United States, 33136
DMI Research, Inc. Completed
Pinellas Park, Florida, United States, 33782
United States, Illinois
Northwestern University Completed
Chicago, Illinois, United States, 60611
Sneeze, Wheeze & Itch Associates, LLC Completed
Normal, Illinois, United States, 61761
United States, Iowa
Ridge Family Practice Recruiting
Council Bluffs, Iowa, United States, 51503
Contact: Jan Mitchell    712-352-0423   
University of Iowa Recruiting
Iowa City, Iowa, United States, 52246
Contact: Patricia Winokur    319-384-1735   
United States, Kentucky
Research Integrity, LLC Completed
Owensboro, Kentucky, United States, 42303
United States, Louisiana
Horizon Research Group, of Opelousas, LLC Recruiting
Eunice, Louisiana, United States, 70535
Contact: Rachael Boudreaux    337-457-8841   
Centex Studies Inc. - Dr. Seep Recruiting
Lake Charles, Louisiana, United States, 70601
Contact: Louis Charles    337-244-6374   
United States, Maryland
NIH Clinical Center Active, not recruiting
Bethesda, Maryland, United States, 20892
United States, Massachusetts
Boston Medical Center Completed
Boston, Massachusetts, United States, 02111
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Contact: Josalyn Cho    617-726-1721   
Brigham and Women's Hospital Recruiting
Boston, Massachusetts, United States, 02115
Contact: Guruprasad Jambaulikar, MBBS, MPH    617-525-8466   
UMass Medical School Recruiting
Worcester, Massachusetts, United States, 01655
Contact: Karen Longtine, RN    508-856-6970   
United States, Michigan
Henry Ford Health Systems Completed
Detroit, Michigan, United States, 48202
Bronson Methodist Hospital Recruiting
Kalamazoo, Michigan, United States, 49007
Contact: Gail Massey, RN, BS, CCRP    269-341-8774   
United States, Missouri
West Florissant Internists Completed
Bridgeton, Missouri, United States, 63044
United States, Nebraska
Clinical Research Advantage/ Skyline Medical Center Recruiting
Elkhorn, Nebraska, United States, 68022
Contact: William Patrick Fitzgibbons, M.D.    402-393-2727      
Prairie Fields Family Medicine Recruiting
Freemont, Nebraska, United States, 68025
Contact: Shayla Addison    402-753-6034   
Southwest Family Physicians Completed
Omaha, Nebraska, United States, 68124
United States, New Jersey
New Jersey Medical School Completed
Newark, New Jersey, United States, 07103
United States, New York
James J. Peters, VA Medical Center Completed
Bronx, New York, United States, 10468
Icahn School of Medicine at Mount Sinai Recruiting
New York, New York, United States, 10029
Contact: Judith Aberg, MD    212-824-7714      
University of Rochester Medical Center Completed
Rochester, New York, United States, 14642
United States, North Carolina
University of North Carolina-Chapel Hill Completed
Chapel Hill, North Carolina, United States, 27514
Duke University Recruiting
Durham, North Carolina, United States, 27710
Contact: Cameron Wolfe, MD    919-970-3885   
United States, Ohio
Clinical Research Solutions - Dr. Panuto Recruiting
Middleburg Heights, Ohio, United States, 44130
Contact: Amie Demming    440-340-9010   
United States, Pennsylvania
University of Pennsylvania Recruiting
Philadelphia, Pennsylvania, United States, 19104
Contact: Joseph Quinn    215-349-8092   
University of Pittsburgh Completed
Pittsburgh, Pennsylvania, United States, 15213
Montgomery Medical Recruiting
Smithfield, Pennsylvania, United States, 15478
Contact: Julie Black    724-569-8100 ext 209   
United States, South Dakota
Health Concepts Recruiting
Rapid City, South Dakota, United States, 57702
Contact: Marty Beasley    605-348-4141   
United States, Tennessee
Clinical Research Solutions - Dr. Bart Recruiting
Columbia, Tennessee, United States, 38401
Contact: Beverly Harris    931-255-0177   
Clinical Research Solutions - Dr. Slandzicki Recruiting
Franklin, Tennessee, United States, 37064
Contact: Debra Adamson    615-577-4017   
Clinical Research Solutions - Dr. Hoppers Recruiting
Jackson, Tennessee, United States, 38305
Contact: Amy Arnold    731-431-5027   
Holston Medical Group Completed
Kingsport, Tennessee, United States, 37660
Clinical Research Solutions - Dr. Rowe Recruiting
Nashville, Tennessee, United States, 37211
Contact: Ashley Adamson    615-693-9742   
Clinical Research Solutions - Dr. Dar Recruiting
Smyrna, Tennessee, United States, 37167
Contact: Ashley Adamson    615-577-4017   
United States, Texas
University of Texas Tech Amarillo Recruiting
Amarillo, Texas, United States, 79106
Contact: Irma Cervantes, RN, BSN    806-414-9745   
Family Medicine Associates of Texas Recruiting
Carrollton, Texas, United States, 75010
Contact: Heema Marwah    972-354-1520   
3rd Coast Research Associates Completed
Corpus Christi, Texas, United States, 78413
University of Texas at Houston Completed
Houston, Texas, United States, 77030
Centex Studies Inc. - Dr. Pouzar Recruiting
Houston, Texas, United States, 77062
Contact: Shruti Konda    281-282-0808   
Pioneer Research Solutions, Inc. Completed
Houston, Texas, United States, 77098
Texas Tech HSC Completed
Lubbock, Texas, United States, 79430
Centex Studies Inc. - Dr. Garcia Recruiting
Pharr, Texas, United States, 78577
Contact: Norma Sanchez    956-342-2626   
Village Health Partners Recruiting
Plano, Texas, United States, 75024
Contact: Heema Marwah    972-354-1520   
Endeavor Clinical Trials Recruiting
San Antonio, Texas, United States, 78229
Contact: Diego Ceniceros    210-949-0807   
Bandera Family Healthcare Research Completed
San Antonio, Texas, United States, 78249
United States, Virginia
University of Virginia Completed
Charlottesville, Virginia, United States, 22908
Virginia Commonwealth University Completed
Richmond, Virginia, United States, 23298
Instituto Medico Platense Completed
La Plata, Buenos Aires, Argentina
Hospital Houssay Completed
Vicente Lopez, Provincia de Buenos Aires, Argentina
Centro de Educación Médica e Investigaciónes Clínicas (CEMIC) Completed
Buenos Aires, Argentina
Fundación del Centro de Estudios Infectológicos (FUNCEI) Completed
Buenos Aires, Argentina
Hospital General de Agudos J. M. Ramos Mejía Completed
Buenos Aires, Argentina
Hospital Italiano de Buenos Aires Completed
Buenos Aires, Argentina
Hospital Rawson Completed
Cordoba, Argentina
Instituto Centralizado de Asistencia e Investigación Clínica Integral (CAICI) Completed
Santa Fe, Argentina
Australia, New South Wales
Holdsworth House Med Practice Completed
Darlinghurst, New South Wales, Australia, 2010
Taylor Square Private Clinic Completed
Darlinghurst, New South Wales, Australia, 2010
Westmead Hospital Completed
Westmead, New South Wales, Australia
Australia, Queensland
Royal Brisbane Completed
Herston, Queensland, Australia, 4029
Australia, Victoria
Northside Clinic Completed
Fitzroy North, Victoria, Australia, 3068
The Alfred Hospital Completed
Melbourne, Victoria, Australia, 3004
Royal Melbourne Hospital Completed
Parkville, Victoria, Australia, 3052
Instituto Nacional de Ciencias Médicas y Nutrición (INCMN) Salvador Zubirán Recruiting
México City, Mexico
Contact: Francisco Astudillo, MD    (52-55) 5487-0900 ext 2420      
Contact: Itzel Cruz, MD    (52-55) 5487-0900 ext 2420      
Hospital General y de Alta Especialidad "Dr. Manuel GEA Gonzalez" Completed
Tlalpan, Mexico
Instituto Nacional de Enfermedades Respiratorias (INER) Recruiting
Tlalpan, Mexico
Contact: Javier Romo Garcia, MD    52 (55) 5487-1700 ext 5295      
Contact: Roberto Sanchez, MD    52 (55) 5487-1700 ext 5295      
Siriraj Hospital, Mahidol University Completed
Bangkoknoi, Bangkok, Thailand, 10700
HIV-NAT, The Thai Red Cross AIDS Recruiting
Patumwan, Bangkok, Thailand, 10330
Contact: Anchalee Avihingsanon    +66-26-523-040 ext 107   
Srinagarind Hospital, Khon Kaen University Recruiting
Muang, Khon Kaen, Thailand, 40002
Contact: Ploenchan Chetchotisakd, MD    +66-43-363-168   
Bamrasnaradura Infectious Diseases Institute Recruiting
Muang, Nonthaburi, Thailand, 11000
Contact: Weerawat Manosuthi    +66-25-903-632   
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Study Chair: John Beigel, MD Leidos Biomedical Research, Inc. in support of Clinical Research Section, LIR, NIAID, Natinal Institutes of Health
Study Chair: John Treanor, MD University of Rochester, School of Medicine and Dentistry
  More Information

Additional Information:
Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID) Identifier: NCT01227967     History of Changes
Other Study ID Numbers: 10-I-0210  IRC003 
Study First Received: October 22, 2010
Last Updated: September 21, 2016

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Adaptive Design
At Risk

Additional relevant MeSH terms:
Influenza, Human
Orthomyxoviridae Infections
RNA Virus Infections
Virus Diseases
Respiratory Tract Infections
Respiratory Tract Diseases
Antiviral Agents
Molecular Mechanisms of Pharmacological Action
Anti-Infective Agents
Enzyme Inhibitors
Antiparkinson Agents
Anti-Dyskinesia Agents
Dopamine Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents processed this record on January 19, 2017