E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Acute respiratory distress syndrome (ARDS) in patients affected by COVID-19 |
Síndrome de Distrés Respiratorio agudo en pacientes afectados por COVID-19 |
|
E.1.1.1 | Medical condition in easily understood language |
Acute respiratory distress syndrome (ARDS) in patients affected by COVID-19 |
Síndrome de Distrés Respiratorio agudo en pacientes afectados por COVID-19 |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10001052 |
E.1.2 | Term | Acute respiratory distress syndrome |
E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal disorders |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of dexamethasone in reducing overall mortality. |
Evaluar la eficacia de la dexametasona en reducir la mortalidad global. |
|
E.2.2 | Secondary objectives of the trial |
-To evaluate the efficacy of dexamethasone in increasing by the number of ventilator-free days days (VFDs) at 28 days. |
-Evaluar la eficacia de la dexametasona en la duración de la ventilación mecánica (medida como nº de días libres de ventilación mecánica en 28 días. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
To be eligible for inclusion into this study (Day 0), each patient must fulfil the following inclusion criteria during screening and prior to the enrolment into the study:
a. Age >=18 years old b. Patients must have acute onset of ARDS, as defined by the American-European Consensus Conference (AECC) criteria for ARDS: i. Having an initiating clinical condition (pneumonia, aspiration, inhalation injury, sepsis, trauma, acute pancreatitis, etc.). ii. bilateral infiltrates on frontal chest radiograph iii. absence of left atrial hypertension, a pulmonary capillary wedge pressure (PCWP) less than 18 mm Hg, or no clinical signs of left heart failure iv. severe hypoxemia (a PaO2/FIO2 <=200 mm Hg, regardless of FIO2 or positive end-expiratory pressure (PEEP) c. Be intubated and mechanically ventilated d. to have a positive reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for COVID-19 in a respiratory tract sample; e. Have provided signed written informed consent from the patient or the patient's personal legal representative. |
Para ser elegible para inclusión en el estudio (Día 0), cada paciente debe cumplir los siguientes criterios de inclusión durante el screening y antes de considerarlo incluido:
a. Edad >=18 años b. Pacientes deben tener un episodio agudo de ARDS, definido según los criterios de ARDS de la Conferencia de Consenso Americana-Europea (AECC): i. Tener una causa clínica del ARDS (neumonía, sepsis, traumatismo, aspiración, inhalación de tóxico, politransfusión, post-operado de trasplante de órganos o enfermedades neoplásicas, pancreatitis aguda, etc.). ii. Infiltrados pulmonares bilaterales en la radiografía de tórax iii. Ausencia de hipertensión auricular izquierda, presión capilar pulmonar <18 mmHg, o ausencia de signos de fracaso ventricular izquierdo. iv. Hipoxemia grave (una PaO2/FiO2 <=200 mmHg, independientemente de la FiO2 y del nivel de PEEP. c. Estar intubado y ventilado mecánicamente. d. Dar positivo por COVID-19 en una muestra del tracto respiratorio por RT-PCR d. Haber obtenido el consentimiento informado del paciente o de su representante legal. |
|
E.4 | Principal exclusion criteria |
o be eligible for inclusion into this study (Day 0), each patient must not have any of the following exclusion criteria during screening and prior to the enrolment into the study:
a. Be a woman known to be pregnant or lactating b. Patients with a known contraindication to corticosteroids, c. A decision by a physician that involvement in the trial is not in the patient’s best interest, |
Para ser elegible de ser incluido en este estudio (Día 0), cada paciente no debe tener ninguno de los siguientes criterios de exclusión durante el screening y antes de ser incluido en el estudio:
a. Mujer embarazada o en periodo de lactancia b. Pacientes con contraindicación conocida a corticoesteroides c. Que su médico considere que su participación en el ensayo no sea conveniente |
|
E.5 End points |
E.5.1 | Primary end point(s) |
All-cause hospital mortality |
Mortalidad hospitalaria por cualquier causa |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
At hospital discharge |
Al alta hospitalaria |
|
E.5.2 | Secondary end point(s) |
-Number of ventilator free-days (VFDs) at Day 28 (defined as days alive and free from mechanical ventilation at day 28 after intubation. For subjects ventilated >=28 days and for subjects who die, VFD is 0. -Mortality at ICU and at Day 28 -Duration (in days) on mechanical ventilation -Length of stay (in days) in the hospital for survivors -Time (in days) from treatment initiation to death -Proportions with viral RNA detection over time. |
-Número de días libres de ventilación mecánica (VFDs) a Día 28 (definido como los días en que el paciente está vivo y libre de la ventilación mecánica dentro de los 28 días después de la intubación). Para pacientes ventilados >=28 días o que fallecen, el valor de VFD es 0. -Mortalidad en la UCI y a los 28 días -Duración (días) con ventilación mecánica -Estancia (en días) hospitalaria de los supervivientes -Tiempo (en días) desde el inicio del tratamiento hasta la muerte -Porporciones con RNA viral detectado a lo largo del tiempo |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
At hospital discharge |
Al alta hospitalaria |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Tratamiento convencional pero sin dexametasona |
Normal treatment but without dexamethasone |
|
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
LVLS However, there will be an interim analysis for testing efficacy and futility when the first 100 patients have been randomized and followed up until hospital discharge. An absolute difference in hospital mortality <20% (at a p>0.025) will justify stopping the trial. |
LVLS Sin embargo, se hará un análisis intermedio cuando se los primeros 100 pacientes se hayan randomizado y seguido hasta su alta hospitalaria. Una diferencia absoluta en la mortalidad hospitalaria >20% (con una p<0.025) justificará parar el ensayo |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |