E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Acute Respiratory Distress Syndrome (ARDS) due to SARS-CoV-2 infection. |
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E.1.1.1 | Medical condition in easily understood language |
Lung disease caused by corona virus infection. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
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 |
The primary objective is to assess the impact of AMY-101 on the time needed for clinical improvement of the patients. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to assess the safety, further measures of clinical efficacy and PK/PD of AMY-101 in patients. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Hospitalized adult (age ≥ 18), of any gender, with confirmed SARSCoV-2 infection with an oxygen saturation (SaO2) of 94% or less while they were breathing ambient air, or a ratio of the partial pressure of oxygen (PaO2) to the fraction of inspired oxygen (FiO2) of less than 300 mm Hg. 2.Diagnosed with SARS-CoV-2 infection, according to the following criteria: −Demonstration of SARS-CoV-2 RNAemia in nasopharyngeal swap or bronchio-alveolar lavage (BAL) (the test that will be used for SARSCoV-2 RNAemia is certified with the CE mark and will be used within the scope of its intended purpose) −Pneumonia confirmed by chest imaging (ultrasound, X-ray, CT, etc.) 3.Dated and signed informed consent from patient. |
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E.4 | Principal exclusion criteria |
1.Demonstrated or suspected uncontrolled systemic severe infection, such as sepsis (e.g.: positive blood culture, or procalcitonin ≥0.25 μg/L) 2.Demonstrated local extrapulmonary abscess 3.Chemotherapy for less than 3 months 4.Use of other investigational drug within 4 weeks or a period of 5 half-lives duration prior to Day1 (whichever is longer) 5.Ongoing participation in any other therapeutic clinical trial XML File Identifier: UMHQJ2DEWA4np0qWjAkTqsbNM4k= Page 8/15 01/08/2020 6.Hypersensitivity to the active substance or any of the ingredients of the IMP or placebo 7.Pregnancy 8.Age <18. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The time to clinical improvement, defined as the time from randomization to an improvement of two points or more (from the status at randomization) on a seven-category ordinal scale or live discharge from the hospital, whichever came first: Seven-category ordinal scale („Cao-Scale" in accordance to Cao B et al. NEJM 2020): −1: not hospitalized with resumption of normal activities; −2: not hospitalized, but unable to resume normal activities; −3: hospitalized, not requiring supplemental oxygen; −4: hospitalized, requiring supplemental oxygen; −5: hospitalized, requiring nasal high-flow oxygen therapy, noninvasive mechanical ventilation, or both; −6: hospitalized, requiring ECMO, invasive mechanical ventilation, or both; and −7: death |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Secondary endpoints will include data regarding safety, tolerability, efficacy and PK of AMY-101. Specifically, the following assessments will be made: o Efficacy: −Rate of patients surviving on day 28. −Rate of patients requiring invasive mechanical ventilation due to worsening of ARDS within 14 days after inclusion in the study −Rate of patients requiring non-invasive mechanical ventilation (NIV) due to worsening of ARDS within 14 days after inclusion in the study −Changes in PaO2 and PaO2/FIO2 from day 1 to day 7 −Changes in respiratory rate from day 1 to day 7 −Changes in quick Sequential Organ Failure Assessment Score (qSOFA: respiratory rate, systolic blood pressure, Glasgow Coma Scale (GCS) per day (up to day 14 or up to the day of discharge, in case of discharge earlier than day 14). −Changes in maximal and minimal cardiovascular parameters (RR, HR) per day −Changes in biomarkers of inflammation (CBC, CRP, Ferritin, Procalcitonin, etc) on day 1, 2, 3, 4, 5, 7, 10, 14 or up to the day of discharge, in case of discharge earlier than day 14. −Length of stay in ICU −Duration of hospitalization o Safety: −All severe adverse events −All adverse events −All infectious events −Anti-drug antibodies on day 0 and 14 (or on day 0 and on day of discharge, in case of discharge earlier than day 14) o PK/PD (on day 1, 2, 3, 4, 5, 7, 10, 14 or up to day of discharge, in case of discharge earlier than day 14): −AMY-101 plasma level −Biomarkers of complement activity (C3, C3a, C5a, sC5b-9 −Biomarkers of cytokine release syndrome (e.g., IL-1, IL-6, IL-12) −Biomarkers of lung damage (Club Cell protein CC16). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Daily evaluation (or as indicated for each specific endpoint). |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | Yes |
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 | Yes |
E.8.2.3 | Other | No |
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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 16 |
E.8.9.1 | In the Member State concerned days | |