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Phase 2 N=40 Randomized Triple-blind Treatment

Safety and Efficacy of Dupilumab for Treatment of Hospitalized COVID-19 Patients

COVID-19

Enrolled (actual)
40
Serious AEs
42.5%
Results posted
Nov 2023
Primary outcome: Primary: Day 28 Ventilator Free Survival — 0.79; 0.86 proportion of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Dupilumab (Biological); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
University of Virginia
Primary completion
Apr 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Day 28 Ventilator Free Survival
0.79; 0.86
PRIMARY
Follow up Study 1 Year Outcome: Pulmonary Function Testing- Oxygen Diffusion and 6 Minute Walk Testing
0.30; 1.0
SECONDARY
Proportion of Patients With Eosinophilia
0.26; 0.048
SECONDARY
Cumulative Incidence of Grade 3 and 4 Clinical Adverse Events, Serious Adverse Events (SAEs) or Death
58; 29
SECONDARY
SARS-CoV-2 Variants
100; 94
SECONDARY
Change in Plasma Total Immunoglobulin E (IgE) Levels
17.5; 16.3
SECONDARY
Change in C-reactive Protein (CRP)
5.5; 8.9
SECONDARY
Change in Ferritin
384; 545
SECONDARY
Duration of Hospitalization
6; 6
SECONDARY
Day 60 All Cause Mortality
11; 24
SECONDARY
Day 28 All-cause Mortality Rate
5; 14
SECONDARY
Day 60 Ventilator Free Survival
0.90; 0.76
SECONDARY
Percentage of Patients Needing Extracorporeal Membrane Oxygenation (ECMO)
0; 0
SECONDARY
Percentage of Patients Needing Renal Replacement Therapy
11; 10
SECONDARY
Percentage of Patients Needing Vasopressors
21; 19
SECONDARY
Follow Up Study 1 Year Outcome: All-cause Mortality at 1 Year
16; 38
SECONDARY
Follow-up Study 1 Year Outcome: Differences in High Resolution Computed Tomography (HRCT) Chest Scan Appearance Post Recovery
80; 67
SECONDARY
Follow-up Study 1 Year Outcome: Conduct a 6 Minute Walk Testing
0.10; 0.50
SECONDARY
Follow up Study 1 Year Outcome: Pulmonary Function Testing- Abnormal Spirometry
30; 67
SECONDARY
Follow-up Study 1 Year Outcome: Assess Neurocognitive Function Using the MOCA
0.90; 0.83

Summary

This is a randomized, double-blind, placebo-controlled, superiority phase IIa trial to assess the safety and efficacy of dupilumab use in hospitalized patients with moderate to severe COVID-19 infection. Subsequently, we conducted a 1 year follow up study to investigate the occurrence of Post COVID conditions (PCC) in our study population through assessment of pulmonary function, symptoms, neurocognition and immune biomarkers to observe for any treatment group differences.

Eligibility Criteria

Inclusion Criteria

  • Male or female 18 years of age or older at the time of enrollment.
  • Patients hospitalized with a positive RT-PCR for SARS-CoV-2 within the last 14 days, with illness duration within the last 14 days, and evidence of moderate to severe COVID-19 infection as defined by NIH COVID-19 Severity Categorization (8):
  • Moderate illness: Individuals who show evidence of lower respiratory disease during clinical assessment or imaging and who have saturation of oxygen SpO2≥ 94% on room air at sea level.
  • Severe illness: Individuals who have SpO2 30 breaths/min, or lung infiltrates >50%.
  • Patient and/or legally authorized representative is willing and able to provide written informed consent and comply with all protocol requirements.
  • Patients with hematologic malignancies or solid tumors are eligible.
  • Patients with autoimmune disorders are eligible.
  • Patients with immunodeficiency and organ or stem cell transplant recipients are eligible.
  • Patients with acute or chronic renal injury/failure are eligible.
  • Patients with neutropenia/lymphopenia are eligible.
  • Patients with elevated liver function tests are eligible.
  • Women who are not taking contraception are eligible.
  • Patients who are currently or have recently received steroids and/or remdesivir are eligible.
  • Patient agrees to not participate in another clinical trial for the treatment of COVID-19 through end of study period.

Exclusion Criteria

  • Patients who do not require inpatient admission for COVID-19 infection.
  • Patients who require invasive mechanical ventilation at time of enrollment.
  • A pre-existing condition or use of a medication that, in the opinion of the site investigator, may place the individual at a substantially increased risk due to study participation.
  • Pregnancy or breast feeding (lactating women who agree to discard breast milk from day 1 until two weeks after the last study product is given are not excluded).
  • Allergy to Dupilumab or its excipients.
  • Received any of the following in the two weeks prior to screening as treatment of COVID-19:
  • small molecule tyrosine kinase inhibitors (e.g. imatinib, gefitinib, acalabrutinib, etc.);
  • monoclonal antibodies targeting cytokines (e.g., TNF inhibitors, anti-interleukin-1 [IL-1], anti-IL-6 [or sarilumab], etc.);
  • monoclonal antibodies targeting T-cells or B-cells as treatment for COVID-19;
  • Any other immunomodulatory (other than steroids) medications within 5 half-lives or 30 days prior to randomization.
  • Current acute parasitic helminth infection or history of chronic parasitic infection.
  • History of ocular scleritis, uveitis, keratitis or recent (<6 months) eye injury (chemical or traumatic), infection or vascular occlusion.
  • Have received any live vaccine (that is, live attenuated) within 4 weeks before screening, or intend to receive a live vaccine (or live attenuated) during the study. Note: Use of non-live (inactivated) vaccinations is allowed for all subjects.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04920916). 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.

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