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Efficacy and Safety of Ambervin® and Standard Therapy in Hospitalized Patients With COVID-19

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.
 
ClinicalTrials.gov Identifier: NCT05656495
Recruitment Status : Completed
First Posted : December 19, 2022
Last Update Posted : December 21, 2022
Sponsor:
Information provided by (Responsible Party):
Promomed, LLC

Brief Summary:
This is open-labe randomized multicenter comparative Phase III study conducted in 8 medical facilities. The objective of the study is to assess the efficacy, safety and tolerability of Ambervin for intramuscular and inhaled administration in complex therapy COVID-19 compared with the Standard of care (SOC) in hospitalized patients with moderate COVID-19.

Condition or disease Intervention/treatment Phase
COVID-19 Drug: Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate intramuscularly Drug: Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate inhaled Drug: Standard of care Phase 3

Detailed Description:
Upon signing the informed consent form and screening, 313 eligible patients hospitalized with COVID-19 were randomized at a 1:1:1 ratio to receive either Ambervin intramuscular 1mg 1 times a day for 10 days or Ambervin inhaled 10mg 1 times a day for 10 days or SOC.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 313 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open Randomized Multicenter Comparative Study to Evaluate the Efficacy, Safety and Tolerability of the Use of Ambervin® for Intramuscular Administration and for Inhalation in Patients Hospitalized With COVID-19
Actual Study Start Date : February 28, 2022
Actual Primary Completion Date : November 22, 2022
Actual Study Completion Date : November 22, 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Ambervin intramuscularly
Arm 1 (n=104) receives the study drug Ambervin for intramuscularly administration 1 mg 1 time per day. The course of treatment is 10 days.
Drug: Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate intramuscularly
lyophilizate for preparation of solution for intramuscular administration 1 mg 1 time per day for 10 days
Other Name: Ambervin intramuscularly

Experimental: Ambervin inhaled
Arm 2 (n=105) receives the study drug Ambervin for inhalation administration 10 mg 1 time per day. The course of treatment is 10 days.
Drug: Tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine succinate inhaled
lyophilizate for preparation of solution for inhalation administration 10 mg 1 time per day for 10 days
Other Name: Ambervin inhaled

Active Comparator: Standard of care
Arm 3 (n=104) patients receive standard therapy prescribed in accordance with the recommended treatment regimens included in the InterimGuidelines for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19) approved by the Russian Ministry of Health by decision of the investigator and taking into account the availability of drugs at the study site
Drug: Standard of care
The administration of 'StandardTherapy' drugs was done according to the regimen recommended in the 'COVID-19TreatmentGuidelines'(current version)




Primary Outcome Measures :
  1. Prevalence of patients with category 0-1 as per categorical ordinal clinical improvement WHO scale [ Time Frame: From baseline to Visit 4 (days 14-15) ]
    The proportion of patients with category 0-1 as per the categorical ordinal clinical improvement scale


Secondary Outcome Measures :
  1. Prevalence of patients with clinical status less than 4 points on the categorical ordinal WHO scale of clinical improvement [ Time Frame: From baseline to Visit 3 (days 11-12) and 4 (days 14-15) ]
    The proportion of patients with clinical status less than 4 points on the categorical ordinal WHO scale of clinical improvement

  2. Frequency of improvement in clinical status on a categorical ordinal WHO scale of clinical improvement of 2 or more categories [ Time Frame: From baseline to Visit 3 (days 11-12) and 4 (days 14-15) ]
    The proportion of patients with clinical status on a categorical ordinal WHO scale of clinical improvement of 2 or more categories

  3. Time to improve clinical status on a categorical ordinal scale of clinical improvement by ≥ 1 point. [ Time Frame: From baseline to Visit 6 (study completion, day 28±1) ]
    Number of days to improve clinical status on a categorical ordinal scale of clinical improvement by ≥ 1 point.

  4. Prevalence of patients eligible for discharge to continue outpatient treatment according to BMR [ Time Frame: From baseline to Visit 2 (days 6-7), 3 (days 11-12) ]
    The proportion of patients eligible for discharge to continue outpatient treatment according to current Cuidelines

  5. Prevalence of patients with RR < 22/min [ Time Frame: From baseline to Visit 2 (days 6-7), 3 (days 11-12) ]
    The proportion of patients with RR < 22/min

  6. Prevalence of patients with CRP level < 10 mg/l [ Time Frame: From baseline to Visit 2 (days 6-7), 3 (days 11-12) ]
    The proportion of patients with CRP level < 10 mg/l

  7. Prevalence of patients with blood lymphocytes > 1.2 x 10(9)/L [ Time Frame: From baseline to Visit 2 (days 6-7), 3 (days 11-12) ]
    The proportion of patients with blood lymphocytes > 1.2 x 10(9)/L

  8. Assessment of the degree of lung damage according to CT [ Time Frame: From baseline to Visit 4 (days 14-15) ]
    The degree of lung damage according to CT

  9. Prevalence of patients with SpO2 ≥ 95% on 2 consecutive days [ Time Frame: From baseline to Visit 2 (days 6-7), 3 (days 11-12), 4 (days 14-15) ]
    The proportion of patients with SpO2 ≥ 95% on 2 consecutive days

  10. The frequency of transfer of patients to the intensive care unit and intensive care [ Time Frame: From baseline to Visit 6 (study completion, day 28±1) ]
    The proportion of patients transferred to the intensive care unit and intensive care

  11. The frequency of cases of the use of high flow oxygen therapy, non-invasive and invasive ventilation of lung, ECMO [ Time Frame: From baseline to Visit 6 (study completion, day 28±1) ]
    The proportion of patients who used high flow oxygen therapy, non-invasive and invasive ventilation of lung, ECMO

  12. The frequency of cases of ARDS [ Time Frame: From baseline to Visit 6 (study completion, day 28±1) ]
    The proportion of patients with ARDS

  13. The frequency of patients with a fatal outcome [ Time Frame: From baseline to Visit 6 (study completion, day 28±1) ]
    The proportion of patients with a fatal outcome



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 to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Availability of the Informed Consent Form of thePatient Information Leaflet (PIL) signed and dated bypatient.
  2. Men and women aged 18 to 80 years inclusive at thetime of signing the Informed Consent Form in PIL.
  3. Confirmed case of COVID-19 at the time ofscreening based on SARS-CoV-2 RNA test usingnucleic acid amplification (NAA) method. It isacceptable to include a patient with a presumptiveCOVID-19 diagnosis prior to receiving the results ofSARS-CoV-2 RNA test made at the screening stage.
  4. Hospital admission due to COVID-19.
  5. Moderate severity infection with SARS-CoV-2: Clinical signs (the presence of at least 2 of the following criteria):

    • body temperature > 38 °C;
    • RR > 22/min;
    • CT pattern typical of a viral lesion
    • shortness of breath on exertion;
    • SpO2 < 95%;
    • Serum CRP > 10 mg/L.
  6. Lesion volume is minimal or moderate; CT 1-2.
  7. Patient's consent to use reliable contraceptive methods through out the study and within 1 month for women and 3 months for men after its completion. Reliable means of contraception are: sexualabstinence, use of condom in combination withspermicide.

Women incapable of childbearing may also participate inthe study (with past history of: hysterectomy, tubal ligation,infertility, menopause for more than 2 years), as well asmen with infertility or a history of vasectomy

Exclusion Criteria:

  1. Hypersensitivity to components of the study drug.
  2. Impossibility of CT procedure (for example, gypsumdressing or metal structures in the field of imaging).
  3. Obstacles or inability to perform intramuscular injections and / or inhalations
  4. Arterial hypotension (a decrease in blood pressure (BP) below 100/60 mm Hg) at the time of screening and / or a history of hypotensive crises.
  5. The need for the use of drugs from the list of prohibited therapies.
  6. Availability of criteria for severe and extremely severe disease at the time of screening
  7. Presence within 6 months prior to screening of a probable or confirmed case of moderate COVID-19
  8. History of presumptive or confirmed COVID-19 caseof moderate, severe and extremely severe course ofthe disease.
  9. Vaccination less than 4 weeks prior to screening.
  10. The need for treatment in the intensive care unit at the time of screening.
  11. Impaired liver function (AST and/or ALT ≥ 2 UNLand/or total bilirubin ≥ 1.5 UNL) at the time ofscreening.
  12. Renal impairment (GFR < 60 ml/min) at the time of screening.
  13. Positive testing for HIV, syphilis, hepatitis B and/or C.
  14. Chronic heart failure FC III-IV according to New York Heart Association (NYHA) functional classification.
  15. Malignancies in the past medical history.
  16. Alcohol, pharmacological and/or drug addiction in the past medical history and/or at the time of screening.
  17. Epilepsy in history.
  18. Schizophrenia, schizoaffective disorder, bipolardisorder, or other history of mental pathology orsuspicion of their presence at the time of screening.
  19. Severe, decompensated or unstable somatic diseases (any disease or condition that threaten thepatient's life or impair the patient's prognosis, and also make it impossible for him/her to participate in the clinical study).
  20. Any history data that the investigating physician believes could lead to complication in the interpretation of the study results or create an additional risk to the patient as a result of his/her participation in the study.
  21. Patient's unwillingness or inability to comply with procedures of the Study Protocol (in the opinion of physician investigator).
  22. Pregnant or nursing women or women planning pregnancy.
  23. Participation in another clinical study for 3 monthsprior to inclusion in the study.
  24. Other conditions that, according to the physicianinvestigator, prevent the patient from being includedin the study.

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): NCT05656495


Locations
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Russian Federation
Budgetary institution of the Chuvash Republic "Emergency Hospital"
Cheboksary, Russian Federation
City clinical Hospital №24
Moscow, Russian Federation
Infectious Clinical Hospital No.1
Moscow, Russian Federation
State Budgetary Healthcare Institution City Clinical Hospital named after S. I. Spasokukotskiy of Moscow Healthcare Department
Moscow, Russian Federation
Regional Clinical Hospital
Ryazan, Russian Federation
Ryazan State Medical University named after academician I.P. Pavlov of Ministry of Health of the Russian Federation
Ryazan, Russian Federation
Ogarev Mordova State University of Ministry of Health of the Russian Federation
Saransk, Russian Federation
City Hospital No. 40 Kurortny District
Sestroretsk, Russian Federation
Regional State Budget Healthcare Institution "Clinical hospital No. 1"
Smolensk, Russian Federation
Voronezh Regional Clinical Hospital No.1
Voronezh, Russian Federation
Sponsors and Collaborators
Promomed, LLC
Investigators
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Principal Investigator: Dmitriy Pushkar Moscow State Clinical Hospital №50
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Responsible Party: Promomed, LLC
ClinicalTrials.gov Identifier: NCT05656495    
Other Study ID Numbers: AMB-112021
First Posted: December 19, 2022    Key Record Dates
Last Update Posted: December 21, 2022
Last Verified: December 2022
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 Promomed, LLC:
SARS-CoV-2
Ambervin
Additional relevant MeSH terms:
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COVID-19
Respiratory Tract Infections
Infections
Pneumonia, Viral
Pneumonia
Virus Diseases
Coronavirus Infections
Coronaviridae Infections
Nidovirales Infections
RNA Virus Infections
Lung Diseases
Respiratory Tract Diseases