Phase 2
N=40
Safety and Efficacy of Dupilumab for Treatment of Hospitalized COVID-19 Patients
COVID-19
Bottom Line
View on ClinicalTrials.gov: NCT04920916 ↗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
| Outcome | Result | p-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.
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.