Phase 2
Completed N=100
Study to Evaluate the Safety and Efficacy of High Dose Intravenous Immune Globulin (IVIG) Plus Standard Medical Treatment (SMT) Versus SMT Alone in Participants in Intensive Care Unit (ICU) With Coronavirus Disease (COVID-19)
Source: ClinicalTrials.gov NCT04480424 ↗Enrolled (actual)
100
Serious AEs
50.0%
Results posted
Oct 2022
Primary outcomePrimary: All-Cause Mortality Rate Through Day 29 — 28.0; 32.0 Percentage of participants — p=0.8275
Summary
The purpose of the study is to determine if a high dose of Intravenous Immune Globulin (IVIG) plus Standard Medical Treatment (SMT) can reduce all-cause mortality versus SMT alone in hospitalized participants with COVID-19 requiring admission to the ICU through Day 29.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY All-Cause Mortality Rate Through Day 29 |
28.0; 32.0 | 0.8275 |
| SECONDARY Percentage of Participants With Actual Intensive Care Unit (ICU) Discharge Time |
64; 62 | 0.8599 |
| SECONDARY Duration of Mechanical Ventilation |
11.22; 8.64 | 0.2626 |
| SECONDARY Percentage of Participants With Actual Hospital Discharge Time |
62; 56 | 0.6854 |
| SECONDARY Duration of Any Oxygen Use From Day 1 Through Day 29 |
23.00; 23.02 | 0.9917 |
| SECONDARY Mean Change From Baseline in Ordinal Scale |
-0.12; -0.17 | 0.7557 |
| SECONDARY Absolute Change From Baseline in Ordinal Scale at Day 29 |
1.05; 0.65 | 0.0922 |
| SECONDARY Percentage of Participants in Each Severity Category of the 7-Point Ordinal Scale |
18.2; 27.3; 31.8; 15.9; 11.4; 18.2 | — |
| SECONDARY Percentage of Participants Who Develop Acute Respiratory Distress Syndrome (ARDS) |
94.0; 96.0; 93.9; 94.0; 79.4; 61.3 | — |
| SECONDARY Percentage of Participants Who Develop ARDS Distributed by Severity |
4.0; 4.0; 50.0; 58.0; 40.0; 34.0 | — |
| SECONDARY Change From Baseline in Sequential Organ Failure Assessment (SOFA) Score at Day 5, Day 15, and Day 29 |
0.34; -0.07; 0.20; 0.30; -0.87; -0.95 | 0.3611 |
| SECONDARY Change From Baseline in National Early Warning Score (NEWS) |
-2.56; -2.62 | 0.9366 |
| SECONDARY Percentage of Participants Achieving Clinical Response: NEWS ≤ 2 Maintained for 24 Hours |
32.9; 28.2 | — |
Eligibility Criteria
Inclusion Criteria
- Hospitalized male or female subjects of ≥ 18 years of age at time of Screening who are being treated in the ICU for COVID-19 for not longer than 48 hours or for whom a decision has been made that COVID-19 disease severity warrants ICU admission.
- Has laboratory-confirmed novel coronavirus {SARS-CoV-2} infection as determined by qualitative polymerase chain reaction (PCR) (reverse transcriptase [RT]-PCR), or other United States Food and Drug Administration (FDA)-approved diagnostic assay for COVID-19 in any specimen during the current hospital admission prior to randomization.
- Illness (symptoms of COVID-19 of any duration requiring ICU level care), and the following:
- Radiographic infiltrates by imaging (chest X-Ray, computerized tomography (CT) scan, etc.), and
- Requiring mechanical ventilation and/or supplemental oxygen.
- Any one of the following related to COVID-19: i. Ferritin > 400 nanogram per milliliter (ng/mL), ii. Lactate dehydrogenase (LDH) > 300 units per liter (U/L), iii. D-Dimers > reference range, or iv. C-reactive protein (CRP) > 40 milligram per liter (mg/L).
- Subject provides informed consent prior to initiation of any study procedures.
Exclusion Criteria
- Clinical evidence of any significant acute or chronic disease or pathophysiologic manifestations (eg, complications of COVID-19 standard medical treatments) that, in the opinion of the investigator, may place the subject at undue medical risk.
- The subject has had a known (documented) serious anaphylactic reaction to blood, any blood-derived or plasma product or a past history of any hypersensitivity reactions to commercial immunoglobulin.
- A medical condition in which the infusion of additional fluid is contraindicated.
- Shock that is unresponsive to fluid challenge and/or multiple vasopressors and accompanied by multiorgan failure considered by the Principal Investigator not able to be reversed.
- Subjects with known (documented) thrombotic complications to polyclonal IVIG therapy in the past.
- Subjects with current or prior myocardial infarction, stroke, deep vein thrombosis, or thromboembolic event (within the past 12 months) or who have a history of thromboembolic events of unknown etiology.
- Subjects with limitations of therapeutic effort.
- Female subjects who are pregnant or of child-bearing potential with a positive test for pregnancy blood or urine human chorionic gonadotropin (HCG)-based assay at Screening/Baseline.
- Subjects participating in another interventional clinical trial with investigational medical product or device.
- Known history of prothrombin gene mutation 20210, homozygous Factor V Leiden mutations, antithrombin III deficiency, protein C deficiency, protein S deficiency or antiphospholipid syndrome.
- Presence of malignancy (either new diagnosis of malignancy or known residual disease) within the past 12 months.
- Creatinine at Screening is ≥ 4 mg/dL (or subject is dependent on dialysis/renal replacement therapy).
- Known Immunoglobulin A (IgA) deficiency with anti-IgA serum antibodies.
- Uncontrolled hypertension at the time of Screening (systolic blood pressure > 200 mm Hg) or refractory severe hypotension with sustained systolic blood pressure < 90 mm Hg unresponsive to vasopressors.
Data sourced from ClinicalTrials.gov (NCT04480424). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.