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    Clinical Trial Results:
    A Phase 2b, Randomized, Double-Blind, Placebo-Controlled Multi-Center Study Evaluating Antiviral Effects, Pharmacokinetics, Safety, and Tolerability of GS-5806 in Hospitalized Adults with Respiratory Syncytial Virus (RSV) Infection

    Summary
    EudraCT number
    2014-002137-58
    Trial protocol
    GB   BE   IT   NL  
    Global end of trial date
    12 Apr 2017

    Results information
    Results version number
    v2(current)
    This version publication date
    18 May 2019
    First version publication date
    12 Apr 2018
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Adding text to “Limitations and Caveats” section

    Trial information

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    Trial identification
    Sponsor protocol code
    GS-US-218-1227
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02135614
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Gilead Sciences
    Sponsor organisation address
    333 Lakeside Drive, Foster City, CA, United States, 94404
    Public contact
    Gilead Clinical Study Information Center, Gilead Sciences, GileadClinicalTrials@gilead.com
    Scientific contact
    Gilead Clinical Study Information Center, Gilead Sciences, GileadClinicalTrials@gilead.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    12 Apr 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    27 Mar 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    12 Apr 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study is to evaluate the effects of presatovir (GS-5806) on respiratory syncytial virus (RSV) viral load in RSV-positive adults who have been hospitalized with acute respiratory infectious symptoms.
    Protection of trial subjects
    The protocol and consent/assent forms were submitted by each investigator to a duly constituted Independent Ethics Committee (IEC) or Institutional Review Board (IRB) for review and approval before study initiation. All revisions to the consent/assent forms (if applicable) after initial IEC/IRB approval were submitted by the investigator to the IEC/IRB for review and approval before implementation in accordance with regulatory requirements. This study was conducted in accordance with recognized international scientific and ethical standards, including but not limited to the International Conference on Harmonization guideline for Good Clinical Practice (ICH GCP) and the original principles embodied in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    09 Jun 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 3
    Country: Number of subjects enrolled
    Poland: 6
    Country: Number of subjects enrolled
    United Kingdom: 6
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    France: 35
    Country: Number of subjects enrolled
    Italy: 1
    Country: Number of subjects enrolled
    Israel: 58
    Country: Number of subjects enrolled
    United States: 29
    Country: Number of subjects enrolled
    New Zealand: 18
    Country: Number of subjects enrolled
    Australia: 16
    Country: Number of subjects enrolled
    Korea, Republic of: 16
    Worldwide total number of subjects
    189
    EEA total number of subjects
    52
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    73
    From 65 to 84 years
    98
    85 years and over
    18

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were enrolled at study sites in Australia, Europe, Asia, New Zealand, and the United States. The first participant was screened on 09 June 2014. The last study visit occurred on 12 April 2017.

    Pre-assignment
    Screening details
    833 participants were screened.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Presatovir
    Arm description
    Single dose of presatovir
    Arm type
    Experimental

    Investigational medicinal product name
    Presatovir
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Single dose of presatovir 200 mg (4 x 50 mg tablets)

    Arm title
    Placebo
    Arm description
    Single dose of placebo
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Single dose of placebo

    Number of subjects in period 1 [1]
    Presatovir Placebo
    Started
    92
    94
    Completed
    86
    90
    Not completed
    6
    4
         Adverse event, serious fatal
    1
    -
         Adverse event, non-fatal
    -
    1
         Withdrew consent
    2
    2
         Lost to follow-up
    3
    -
         Investigator's discretion
    -
    1
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: 3 participants (Presatovir = 2; Placebo = 1) who were enrolled but not treated are not included in the subject disposition table.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Presatovir
    Reporting group description
    Single dose of presatovir

    Reporting group title
    Placebo
    Reporting group description
    Single dose of placebo

    Reporting group values
    Presatovir Placebo Total
    Number of subjects
    92 94 186
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    69.4 ± 14.24 65.9 ± 13.87 -
    Gender categorical
    Units: Subjects
        Female
    50 52 102
        Male
    42 42 84
    Race
    Units: Subjects
        American Indian or Alaska Native
    0 1 1
        Asian
    6 11 17
        Black or African American
    5 7 12
        Native Hawaiian or Pacific Islander
    0 2 2
        White
    72 69 141
        Other
    2 2 4
        Not Permitted
    7 2 9
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    0 1 1
        Not Hispanic or Latino
    85 91 176
        Not Permitted
    7 2 9
    Stratification Factor: Disease Status
    Units: Subjects
        Asthma
    22 22 44
        Chronic Obstructive Pulmonary Disease
    27 30 57
        No Chronic Airways or Lung Disease
    31 31 62
        Other Chronic Airways or Lung Disease
    12 11 23
    Nasal Viral Load
    Units: log10 copies/mL
        arithmetic mean (standard deviation)
    5.58 ± 2.104 5.07 ± 2.528 -
    Flu-PRO score
    Flu-PRO Score was calculated as the mean of 38 individual scores. Individual scores ranged from 0 (no symptoms) to 4 (worst symptoms).
    Units: units on a scale
        arithmetic mean (standard deviation)
    1.11 ± 0.553 1.04 ± 0.566 -

    End points

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    End points reporting groups
    Reporting group title
    Presatovir
    Reporting group description
    Single dose of presatovir

    Reporting group title
    Placebo
    Reporting group description
    Single dose of placebo

    Primary: Time-Weighted Average Change in Respiratory Syncytial Viral (RSV) Load From Baseline to Day 5

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    End point title
    Time-Weighted Average Change in Respiratory Syncytial Viral (RSV) Load From Baseline to Day 5
    End point description
    The time-weighted average change, often referred to as the DAVG, provides the average viral burden change from baseline. The mean values presented were calculated using the ANCOVA model and are adjusted for baseline value and stratification factor. The Evaluable Analysis Set included all randomized participants who received at least 1 dose of study medication, had an RSV viral load greater than lower limit of quantification (LLOQ) of the RT-qPCR assay in the Day 1 nasal-swab sample, and had a minimum of 3 quantifiable samples (including baseline) within a 5 day period.
    End point type
    Primary
    End point timeframe
    Baseline to Day 5
    End point values
    Presatovir Placebo
    Number of subjects analysed
    80
    74
    Units: log10 copies/mL
        arithmetic mean (standard error)
    -0.77 ± 0.113
    -0.89 ± 0.118
    Statistical analysis title
    Statistical Analysis - Presatovir vs Placebo
    Comparison groups
    Placebo v Presatovir
    Number of subjects included in analysis
    154
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.46 [1]
    Method
    ANCOVA
    Parameter type
    Treatment difference
    Point estimate
    0.12
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.2
         upper limit
    0.43
    Notes
    [1] - P-value was calculated from the ANCOVA model including baseline values, Clinical Frailty Scale (CFS) score, and stratification factor as covariates.

    Secondary: Time-weighted Average Change in the Flu-PRO Score From Baseline to Day 5

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    End point title
    Time-weighted Average Change in the Flu-PRO Score From Baseline to Day 5
    End point description
    The Flu-PRO is a patient-reported outcome questionnaire utilized as a standardized method for evaluating symptoms of influenza. Flu-PRO Score was calculated as the mean of 38 individual scores. Individual scores ranged from 0 (no symptoms) to 4 (worst symptoms). The mean values presented were calculated using the ANCOVA model and are adjusted for baseline value and stratification factor. Participants in the Evaluable Analysis Set with available data were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline to Day 5
    End point values
    Presatovir Placebo
    Number of subjects analysed
    79
    74
    Units: units on a scale
        arithmetic mean (standard error)
    -0.27 ± 0.029
    -0.35 ± 0.030
    Statistical analysis title
    Statistical Analysis - Presatovir vs Placebo
    Comparison groups
    Presatovir v Placebo
    Number of subjects included in analysis
    153
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.046 [2]
    Method
    ANCOVA
    Parameter type
    Treatment difference
    Point estimate
    0.08
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0
         upper limit
    0.16
    Notes
    [2] - P-value was calculated from the ANCOVA model including the baseline value, CFS score and stratification factor as covariates.

    Secondary: Number of Hospitalization-Free Days Following Presatovir Administration

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    End point title
    Number of Hospitalization-Free Days Following Presatovir Administration
    End point description
    The Evaluable Analysis Set included all randomized participants who received at least 1 dose of study medication, had an RSV viral load greater than lower limit of quantification (LLOQ) of the RT-qPCR assay in the Day 1 nasal-swab sample, and had a minimum of 3 quantifiable samples (including baseline) within a 5 day period.
    End point type
    Secondary
    End point timeframe
    Up to Day 28
    End point values
    Presatovir Placebo
    Number of subjects analysed
    80
    74
    Units: days
        median (inter-quartile range (Q1-Q3))
    25 (20 to 27)
    25 (20 to 27)
    Statistical analysis title
    Statistical Analysis - Presatovir vs Placebo
    Comparison groups
    Presatovir v Placebo
    Number of subjects included in analysis
    154
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.39 [3]
    Method
    Negative Binomial Model
    Confidence interval
    Notes
    [3] - P-value was calculated from the negative binomial model with the stratification factor as covariate.

    Secondary: Rate of Unplanned Medical Encounters

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    End point title
    Rate of Unplanned Medical Encounters
    End point description
    The adjusted rate of unplanned medical encounters (clinic visits, emergency room visits, urgent care visits, and rehospitalizations) related to a respiratory illness after initial hospital discharge through Day 28 will be assessed. Event rate was calculated as the total number of unplanned medical encounters divided by the total number of participants. The mean values presented were adjusted for stratification factor. The Evaluable Analysis Set included all randomized participants who received at least 1 dose of study medication, had an RSV viral load greater than lower limit of quantification (LLOQ) of the RT-qPCR assay in the Day 1 nasal-swab sample, and had a minimum of 3 quantifiable samples (including baseline) within a 5 day period.
    End point type
    Secondary
    End point timeframe
    Up to Day 28
    End point values
    Presatovir Placebo
    Number of subjects analysed
    80
    74
    Units: encounters per participant
        number (confidence interval 95%)
    0.226 (0.133 to 0.384)
    0.066 (0.029 to 0.150)
    Statistical analysis title
    Statistical Analysis - Presatovir vs Placebo
    Comparison groups
    Presatovir v Placebo
    Number of subjects included in analysis
    154
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.004 [4]
    Method
    Negative Binomial Model
    Confidence interval
    Notes
    [4] - P-value from the negative binomial model comparing the rate ratio between treatment groups, adjusted for the stratification factor.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to Day 28
    Adverse event reporting additional description
    Safety Analysis Set: all participants who received 1 dose of study drug.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.0
    Reporting groups
    Reporting group title
    Presatovir
    Reporting group description
    Single dose of presatovir

    Reporting group title
    Placebo
    Reporting group description
    Single dose of placebo

    Serious adverse events
    Presatovir Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 92 (8.70%)
    13 / 94 (13.83%)
         number of deaths (all causes)
    2
    0
         number of deaths resulting from adverse events
    Investigations
    Troponin increased
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac failure congestive
         subjects affected / exposed
    2 / 92 (2.17%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Angle closure glaucoma
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Prostatitis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 92 (1.09%)
    2 / 94 (2.13%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute respiratory distress syndrome
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cough
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary congestion
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Cellulitis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infective exacerbation of chronic obstructive airways disease
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Influenza
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 94 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Device malfunction
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 94 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Presatovir Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    34 / 92 (36.96%)
    31 / 94 (32.98%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    5 / 92 (5.43%)
    2 / 94 (2.13%)
         occurrences all number
    5
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    8 / 92 (8.70%)
    5 / 94 (5.32%)
         occurrences all number
    8
    5
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    5 / 92 (5.43%)
    1 / 94 (1.06%)
         occurrences all number
    5
    1
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    4 / 92 (4.35%)
    9 / 94 (9.57%)
         occurrences all number
    4
    9
    Diarrhoea
         subjects affected / exposed
    5 / 92 (5.43%)
    7 / 94 (7.45%)
         occurrences all number
    5
    7
    Constipation
         subjects affected / exposed
    4 / 92 (4.35%)
    5 / 94 (5.32%)
         occurrences all number
    4
    5
    Vomiting
         subjects affected / exposed
    2 / 92 (2.17%)
    6 / 94 (6.38%)
         occurrences all number
    2
    6
    Abdominal pain
         subjects affected / exposed
    5 / 92 (5.43%)
    2 / 94 (2.13%)
         occurrences all number
    5
    2
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    6 / 92 (6.52%)
    3 / 94 (3.19%)
         occurrences all number
    6
    3
    Epistaxis
         subjects affected / exposed
    2 / 92 (2.17%)
    5 / 94 (5.32%)
         occurrences all number
    2
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Mar 2014
    ● Added South Korea to the planned study centers and clarified which European countries had been selected to participate ● Clarified PK sampling time points on Days 1, 3, and 5 ● Corrected the title of the Frailty Index to the Clinical Frailty Scale (CFS) ● Added an exclusion criterion for subjects requiring > 50% O2 when awake at screening ● Added an exclusion criteria for subjects scoring > 7 on the CFS at baseline ● Added RSV antibody titer blood draws at baseline and Day 14 ● Added viral-coinfection testing at baseline, and clarified that RSV and influenza sampling and testing at screening was to follow local laboratory procedures ● Clarified the exclusion criteria for chronic systemic immunosuppressive agents and the exclusion criteria related to pneumonia ● Deleted the exclusion criteria related to life-expectancy and to heart failure ● Removed the Clinical Symptom Score assessment and the European Quality of Life 5-Dimension utility measure (EQ5D-5L) questionnaire ● Modified the Flu-PRO secondary endpoint from AUC of change in score from baseline to Day 7 to daily average change in the Flu-PRO score from baseline to Day 5, and updated the Secondary Analysis sections accordingly ● Updated the Interim Analysis section to allow for an earlier assessment of futility and allow for study termination at a higher conditional power threshold ● Modified the primary endpoint from the AUC of log10 viral load from Day 1 to Day 7 to the daily average change in log10 viral load from Day 1 to Day 5, and updated the assumptions used in the sample size calculation ● Deleted the total number of intensive care unit (ICU) transfers exploratory endpoint
    05 Aug 2014
    ● Modification of contraceptive requirements ● Addition of phototoxicity text to the dosage and administration information ● Addition of text to address potential for drug-drug interactions (DDI) to the prior and concomitant medication information ● Addition of the EudraCT Number and the ClinicalTrials.gov Identifier ● Updated the terminology of relevant endpoints from daily averages to time-weighted averages as this term, along with difference between time-weighted average post-baseline and baseline (DAVG), is often used in literature. The definitions and calculations of the endpoints remained the same.
    29 Aug 2014
    ● Updated the list of countries in which study centers were planned ● Modified inclusion criteria to allow hospitalizations due to respiratory or non-respiratory reasons and to clarify that either upper or lower respiratory tract symptoms were acceptable, instead of requiring both ● Expanded exclusion criterion related to prednisone use to include similar corticosteroids ● Removed exclusion criteria related to history of bleeding disorder and to arrhythmia ● Replaced exclusion criterion for HIV/AIDS and hepatitis B or C status with a criterion excluding cluster determinant 4 (CD4) counts indicative of immunocompromised subjects ● Modified exclusion criterion related to bacteremia and fungemia ● Replaced exclusion criteria related to cerebrovascular accident or stroke, and admission for trauma or planned and emergent surgeries with a broader exclusion criterion to exclude subjects with unstable medical conditions ● Modified exclusionary laboratory values for relevance in the elderly patient population ● Clarified the 2-part consent process ● Clarified the use of admissions records to support enrollment and baseline data ● Added telephone visit as an option for Day 28 ● Administrative change to relocate collection of demographic information from baseline visit (Day 1) to screening (Day −1) in order to align with electronic data capture (EDC) requirements ● Administrative changes to Section 7.0 Adverse Events including rewording and reformatting for clarity ● Administrative change to update the sponsor address to the address of Gilead’s main headquarters ● Administrative change updating the primary medical monitor to Seth Toback, MD
    17 Nov 2015
    ● Added summary of the definitive embryo-fetal development study ● Added a section for ongoing clinical studies ● Completely revised the study design section for clarity ● Removed food-effect and phototoxicity wording from study drug dosing requirements ● Added End of Study and Post Study Care sections to the protocol ● Increased the number of study centers where the study was planned and added Hong Kong as a study location ● Clarified inclusion criterion for number of symptom days ● Added exclusion criterion for Middle East Respiratory Syndrome coronavirus (MERS-CoV) and other coronavirus coinfection ● Added moderate cytochrome P450 enzyme (CYP) inducers to the concomitant and prohibited medications ● Added recent historical evidence of pleural effusion and arterial blood pH to medical history requirements ● Added the option for home visits at Days 2, 3, 5, 7, and 14 ● Added Day 21 visit ● Updated Flu-PRO instructions ● Added the EQ5D-5L ● Standardized O2 saturation procedure across protocols ● Added Supplemental Oxygen Use Diary ● Added an ECG to Day 14 and updated ECG before dosing at baseline to a mandatory requirement ● Added requirement for collection of clinical data related to cardiac testing ● Added troponin blood draws before and after dosing at baseline and added an additional troponin blood draw at Day 14 ● Updated exploratory analyses based on the addition of the EQ5D-5L questionnaire. Analysis methods for other endpoints were also updated to include stratification factors in the model. ● Administrative change of all instances of GS-5806 to presatovir, excluding the study title ● Corrected typographical error in the EudraCT Number ● Administrative clarification that subjects could be discharged 30 minutes after dosing but were still required to complete all after dosing procedures ● Administrative addition of text regarding the Eligibility Criteria electronic case report form (eCRF) based off the new protocol template

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    An unplanned review of unblinded clinical trial data was performed in this study that was not prospectively specified in the protocol. There was no impact on the overall integrity or conclusions of the study.
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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