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A Study to Assess Pulsed Inhaled Nitric Oxide vs Placebo in Subjects With Mild or Moderate COVID-19 (COViNOX)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT04421508
Recruitment Status : Terminated (Futility)
First Posted : June 9, 2020
Last Update Posted : April 28, 2021
Information provided by (Responsible Party):
Bellerophon ( Bellerophon Pulse Technologies )

Brief Summary:
A randomized, double-blind, placebo-controlled study to assess the efficacy and safety of pulsed inhaled iNO compared to placebo in subjects with COVID-19.

Condition or disease Intervention/treatment Phase
COVID-19 Coronavirus Coronavirus Infection Combination Product: INOpulse Combination Product: Placebo Phase 3

Detailed Description:
This is a randomized, double-blind, placebo-controlled study to assess the efficacy and safety of pulsed iNO compared to placebo in subjects with COVID-19 who are hospitalized and require supplemental oxygen without assisted ventilation. Subjects will be randomized to receive placebo or iNO125 mcg/kg ideal body weight (IBW)/hour 24 hours daily up to 14 days or until resolution or discharge.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 191 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of Pulsed, Inhaled Nitric Oxide (iNO) Versus Placebo in Subjects With Mild or Moderate Coronavirus (COVID-19)
Actual Study Start Date : July 12, 2020
Actual Primary Completion Date : December 28, 2020
Actual Study Completion Date : January 22, 2021

Arm Intervention/treatment
Active Comparator: Inhaled Nitric Oxide (iNO)
Pulsed inhaled iNO 125 mcg/kg IBW/hour
Combination Product: INOpulse
Subjects will be treated by means of an INOpulse device using an INOpulse nasal cannula.

Sham Comparator: Placebo
Pulsed inhaled N2, 99.999% gas
Combination Product: Placebo
Subjects will be treated by means of an INOpulse device using an INOpulse nasal cannula.

Primary Outcome Measures :
  1. The proportion of subjects who died or had respiratory failure [ Time Frame: Through Day 28 ]

Secondary Outcome Measures :
  1. Clinical status using National Institute of Allergy and Infectious Diseases (NIAID) 8-point ordinal scale [ Time Frame: Day 7, 14, 28 and day of discharge ]
    The assessment of clinical status at the first assessment of a study day. The scale is: 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 supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 6) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7) Not hospitalized, limitation on activities and/or requiring home oxygen; 8) Not hospitalized, no limitations on activities.

  2. Proportion of subject to recover, defined as return to room air or baseline O2, or discharged alive [ Time Frame: Through Day 28 ]
  3. Proportion of subjects discharged alive from hospital [ Time Frame: Through Day 28 ]
  4. Duration of Hospitalization [ Time Frame: Through Day 28 ]
  5. Mortality - all cause and cardiopulmonary [ Time Frame: Through Day 28 ]
  6. Proportion of subjects with a negative conversion of reverse transcription polymerase chain reaction (RT-PCR) from a nasopharyngeal swab [ Time Frame: Through Day 28 ]

Other Outcome Measures:
  1. Proportion of subjects with adverse events leading to study drug discontinuation [ Time Frame: Through Day 28 ]

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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

Inclusion Criteria:

  • Signed informed consent
  • At least 18 years old
  • Subjects must be hospitalized and have the following:

    • proven or high suspicion of SARS-CoV-2 infection and,
    • requiring oxygen supplementation defined as:
    • SpO2 ≤ 92% regardless of supplemental oxygen (ie on room air or on oxygen), or
    • SpO2 ≥ 92% on supplemental O2 and in the opinion of the Investigator it is not safe to decrease or remove the supplemental oxygen
    • require supplemental oxygen of no more than 10 L/minute, and
    • radiologic suspected or proven COVID-19 pneumonitis (chest x-ray or CT scan)
  • Female subjects must have a negative pregnancy test
  • Willing and able to comply with the treatment schedule and study procedures

Exclusion Criteria:

  • Participating in another clinical trial of an investigational treatment for COVID-19
  • Methemoglobin > 3%
  • Evidence of severe multi organ failure
  • Use of assisted ventilation prior to initiation of iNO
  • Pregnancy or positive pregnancy test pre-dose
  • Open tracheostomy
  • Chronic use of a nitric oxide donor agent such as nitroglycerin or drugs known to increase methemoglobin such as lidocaine, prilocaine, benzocaine, nitroprusside, isosorbide, or dapsone at screening
  • History or clinical evidence of systolic heart failure, left ventricular dysfunction (LVEF <40%)
  • Subjects reporting massive hemoptysis associated with the current illness or with radiologically proven pulmonary embolus

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 identifier (NCT number): NCT04421508

Show Show 17 study locations
Sponsors and Collaborators
Bellerophon Pulse Technologies
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Study Director: Edward Parsley, DO Bellerophon Pulse Technologies
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Responsible Party: Bellerophon Pulse Technologies Identifier: NCT04421508    
Other Study ID Numbers: PULSE-CVD19-001
First Posted: June 9, 2020    Key Record Dates
Last Update Posted: April 28, 2021
Last Verified: April 2021

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Bellerophon ( Bellerophon Pulse Technologies ):
Severe Acute Respiratory Syndrome (SARS) Pneumonia
Severe Acute Respiratory Syndrome Coronavirus 2
pulsed inhaled nitric oxide
inhaled nitric oxide
portable pulsed inhaled nitric oxide
nitric oxide
Additional relevant MeSH terms:
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Coronavirus Infections
Respiratory Tract Infections
Pneumonia, Viral
Virus Diseases
Coronaviridae Infections
Nidovirales Infections
RNA Virus Infections
Lung Diseases
Respiratory Tract Diseases