Phase 2
Completed N=40
Safety, Tolerability, and Treatment Effect of Belnacasan in Patients With COVID-19
Source: ClinicalTrials.gov NCT05164120 ↗Enrolled (actual)
40
Serious AEs
0.0%
Results posted
Sep 2024
Primary outcomePrimary: Safety and Tolerability of Belnacasan — 11; 10; 0; 0 Number of AEs and SAEs
Summary
The purpose of this trial is to assess the safety, tolerability and treatment effect of the orally administered Caspase-1 inhibitor, belnacasan, for the treatment of patients with mild to moderate COVID-19 and to generate proof of concept for future trials.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Safety and Tolerability of Belnacasan |
11; 10; 0; 0 | — |
| SECONDARY Sustained Recovery and Resolution Rates of Common COVID-19 Symptoms |
14; 19; 13; 13; 17; 17 | — |
| SECONDARY Sustained Improvement of Global Impression Rates |
0; 0; 5; 5; 5; 6 | — |
| SECONDARY Time to Sustained Recovery or Resolution of Common COVID-19 Symptoms |
20.6; 15.4 | — |
| SECONDARY Time to Sustained Improvement of Global Impression |
10.5; 13.5 | — |
| SECONDARY Rates of Fever |
1; 0 | — |
| SECONDARY Oxygenation Levels |
-0.01; -0.01 | — |
| SECONDARY Time in Days to Normalization of Fever and Oxygenation Levels. |
4; 7 | — |
| SECONDARY Experiences of COVID-19 Related Deterioration and Mortality |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY The Number of Subjects With COVID-19 Related Deterioration and Mortality Experiences |
0; 0 | — |
| SECONDARY Changes on the WHO 9-Point Ordinal Scale |
3; 6; 8; 8; 14; 13 | — |
| SECONDARY Values on the WHO 9-Point Ordinal Scale |
1.00; 0.94; 0.33; 0.17; 0.00; 0.12 | — |
| SECONDARY Time to Improvement on the WHO 9-Point Ordinal Scale |
9.3; 7.1; 27.2; 19.0 | — |
| SECONDARY Mean Number of Days of Experiencing WHO 9-Point Ordinal Scale Values |
2.9; 2.8; 2.2; 1.7; 3.0; 3.8 | — |
| SECONDARY IL-6 |
17.4; 14.6; 15.1; 11.1; 16.9; 9.7 | — |
| SECONDARY IL-1ra |
37.2; 32.5; 31.2; 26.6; 34.0; 23.2 | — |
| SECONDARY IL-18 |
120.1; 116.0; 82.0; 88.6; 77.0; 81.7 | — |
| SECONDARY TNF-alpha |
131.1; 97.0; 124.5; 97.8; 137.1; 97.8 | — |
| SECONDARY Caspase-1 |
97.2; 115.5; 84.7; 104.4; 69.5; 96.4 | — |
| SECONDARY Gasdermin D |
2.5; 3.5; 4.0; 4.9; 5.0; 5.2 | — |
| SECONDARY G-CSF |
137.2; 147.0; 125.0; 106.6; 121.4; 100.2 | — |
Eligibility Criteria
Inclusion Criteria
- Subject (or legally authorized representative) provides written informed consent prior to the initiation of any study procedures
- Subject understands and agrees to comply with planned study procedures, including using the diary
- Subject agrees to the collection of nasopharyngeal swabs and venous blood per protocol
- Subject is male or non-pregnant female adult ≥18 years of age at time of consent
a. Women with a history of menstruation must agree to use two methods of contraception, at least one of which is highly effective, for the duration of the study as well as to undergo additional pregnancy testing during the study
- Subject has a laboratory confirmed SARS-CoV-2 infection as determined by RT-PCR assay prior to enrollment
- Subject has evidence of either mild or moderate COVID-19 illness of less than 7 days from first onset, with minimal baseline symptom severity based on patient-reported FDA scoring system defined as follows:
- Subject presents with at least two common symptoms of COVID-19 from the following list: Stuffy or runny nose, sore throat, cough, low energy or tiredness, muscle or body ache, headache, chills or shivering, feeling hot or feverish, nausea, vomiting, diarrhea, shortness of breath with exertion (without supplemental oxygen requirement) with a score of 2 or higher, impairment in sense of smell or taste with a score of 1 or higher OR
- Subject presents with any (i.e., at least one) symptom of COVID-19 as defined above AND clinical evidence of moderate COVID-19 as defined by FDA guidance for industry (such as respiratory rate >20 breaths per minute, heart rate >90 beats per minute, with oxygen saturation >93% on room air at sea level)
- Subject presents with high-risk for COVID-19-related inflammation determined by at least one comorbidity, including obesity, diabetes, hypertension, stable heart disease, respiratory disease, and/or non-severe fatty liver disease
- Subject's overall health condition is deemed as suitable to fully and safely participate in this trial as determined by the investigator
Exclusion Criteria
- Any clinical signs indicative of severe or critical COVID-19 as defined by FDA guidance for Industry at the time, including SpO2 2x upper limit of normal, and/or total Bilirubin > upper limit of normal)
- History of malignancy or immunodeficiency within the prior 5 years
- Acute respiratory illness other than COVID-19
- Acute bacterial, viral or fungal infection (including HIV, hepatitis B, hepatitis C)
- While dosed with IP, the taking of prohibited concomitant medication or the ingestion of food that interferes with the IP, including:
- Non-COVID19-related anti-viral medication such as lopinavir, ritonavir, ribavirin, or interferon-1β
- Systemically administered immunosuppressive and anti-inflammatory agents, other than background standard of care for COVID-19 at the time
- Drugs and foods that are potent inhibitors or inducers of CYP3A4 and/or P-gp, as listed in FDA "Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers", including herbal medications such as St. John's Wort within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug
- Any other diseases or medical conditions or concomitant medications that are deemed as not compatible or appropriate for the subject's ability to fully and safely participate in this trial as determined by the investigator
Data sourced from ClinicalTrials.gov (NCT05164120). 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.