E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Hospitalized patients with COVID-19 |
Pacientes hospitalizados con COVID-19 |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 23.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10051905 |
E.1.2 | Term | Coronavirus infection |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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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 |
Efficacy and safety assessments of BDB-001 for infusion in treating patients with progressive severe COVID-19. |
Evaluación de la eficacia y la seguridad de BDB-001 para perfusión en el tratamiento de pacientes con COVID-19 severa progresiva |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Age: 18-80 years old; Gender: male and/or female. 2. Subject with confirmed severe COVID-19 in less than 5 days who meets any of the following criteria: a. Respiratory distress, RR ≥30 times/min b. In resting state, finger oxygen saturation ≤93% c. Oxygenation Index (PaO2/FiO2)≤300 mmHg (1 mmHg = 0.133kpa) in supine position d. Pulmonary imaging shows lesion progression >50% within 24 – 48 hours. 3. The informed consent signed. |
1. Edad: 18-80 años; Sexo: varones y/o mujeres. 2. Sujeto con COVID-19 severa confirmada en menos de 5 días que cumple cualquiera de los siguientes criterios: a. Dificultad respiratoria, frecuencia respiratoria ≥ 30 respiraciones por minuto b. Saturación de oxígeno periférica en reposo ≤ 93% c. Índice de oxigenación (PaO2/FiO2) ≤ 300 mmHg (1 mmHg = 0,133 kpa) en decúbito supino d. Progresión de las lesiones en las pruebas de diagnóstico por imagen pulmonares >50% en un plazo de 24 a 48 horas. 3. Firma del consentimiento informado. |
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E.4 | Principal exclusion criteria |
1. Subjects already progressed into COVID-19 critically severe type (including respiratory failure requiring mechanical ventilation, or shock, or combined with other organ failure) or sepsis and sepsis shock. 2. History of severe lung disease such as chronic obstructive pulmonary disease (moderate to severe type), lung cancers, tuberculosis; history of severe heart disease: unstable angina pectoris, myocardial infarction, postcardiac surgery, cardiac function ≥grade 3 (NYHA Classification); history of severe liver diseases (e.g. Child-Pugh score ≥grade C); history of severe kidney diseases, such as renal insufficiency (GFR ≤15 mL/min/1.73m2); immune deficiencies or immune- related diseases : including some autoimmune diseases, IgG4-related diseases, allergic alveolitis, vasculitis; malignancies. 3. Clear diagnosis of combined bacterial, fungal infections which would disturb the study results according to the opinion of the investigator 4. Subjects on current treatment with a complement inhibitor such as eculizumab. 5. Subjects with a history of hypersensitivity to any ingredient contained in the study drug 6. A subject has used the following drugs within 2 weeks prior to screening procedures: • Calcineurin inhibitors (e.g., ciclosporin, tacrolimus, etc.) • Immunosuppressant (e.g., everolimus, sirolimus, etc.) • Anti-metabolic drugs (e.g., mycophenolate mofetil, mycophenolate, purine sulphate, etc.) 7. Positive serum pregnancy test at screening in women of child-bearing potential. A woman is considered of childbearing potential, i.e. fertile, following menarche (first menstrual cycle) and until becoming post-menopausal unless permanently sterile: permanent sterilization methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. Women of child-bearing potential must abstain from sexual intercourse or use effective birth control methods for 1 month after their participation in the study ends. Men with a female partner capable of having children must abstain from sexual intercourse or use effective birth control methods for 3 months after their participation in the study ends. Such methods include: • Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal) • Progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable) • Intrauterine device • Intrauterine hormone-releasing system • Bilateral tubal occlusion • Vasectomized partner 8. Any other circumstances that the investigator considers inappropriate for the participation in this study. |
1. Sujetos que ya hayan progresado a COVID-19 severa crítica (con insuficiencia respiratoria que precise ventilación mecánica, o shock, o asociada a otra insuficiencia orgánica) o sepsis y shock séptico; 2. Antecedentes de enfermedad pulmonar severa, como enfermedad pulmonar obstructiva crónica (EPOC) (moderada o severa), cáncer de pulmón, tuberculosis; antecedentes de cardiopatía severa: angina de pecho inestable, infarto de miocardio, cirugía cardiaca previa, clase funcional cardiaca de grado ≥ 3 (clasificación de la NYHA); antecedentes de hepatopatía severa(puntuación de Child Pugh de grado ≥ C); antecedentes de nefropatía severa, como insuficiencia renal (con tasa de filtración glomerular [TFG] ≤ 15 ml/min/1,73 m2); inmunodeficiencias o enfermedades del sistema inmunitario, tales como ciertas enfermedades autoinmunitarias, enfermedades relacionadas con IgG4, alveolitis alérgica, vasculitis; tumores malignos. 3. Diagnóstico claro de infecciones bacterianas o fúngicas asociadas que alterarían los resultados del estudio, a juicio del investigador; 4. Sujetos en tratamiento con ihibidores del complemento tales como ecolizumab 5. Sujectos con historia de hipersensibilidad a cualqueira de los ingredientes del farmaco de estudio 6. Tratamiento con los siguientes medicamentos en las 2 semanas previas a los procedimientos de la selección: • Inhibidores de la calcineurina (p. ej., ciclosporina, tacrólimus, etc.) • Inmunosupresores (p. ej., everólimus, sirólimus, etc.) • Antimetabólicos (p. ej., micofenolato mofetilo, micofenolato, sulfato de purina, etc.) 7. Mujer embarazada o en periodo de lactancia. Prueba de embarazo en suero positiva en el cribado en mujeres en edad fértil. Se considera que una mujer tiene un potencial de procreación, es decir, fértil, después de la menarquia (primer ciclo menstrual) y hasta volverse post menopáusica a menos que sea permanentemente estéril: los métodos de esterilización permanente incluyen histerectomía, salpingectomía bilateral y ooforectomía bilateral. Un estado post menopáusico se define como la ausencia de menstruaciones durante 12 meses sin una causa médica alternativa. Las mujeres en edad fértil deben abstenerse de tener relaciones sexuales o utilizar métodos anticonceptivos efectivos durante 1 mes después de que finalice su participación en el estudio. Los hombres con una pareja capaz de tener hijos deben abstenerse de tener relaciones sexuales o utilizar métodos anticonceptivos efectivos durante 3 meses después de que finalice su participación en el estudio. Entre estos métodos se incluyen: • Anticoncepción hormonal combinada (que contenga estrógeno y progestágeno) asociada a inhibición de la ovulación (oral, intravaginal, transdérmica) • Anticoncepción hormonal que únicamente contenga progestágeno asociada a inhibición de la ovulación (oral, inyectable, implantable) • Dispositivo intrauterino • Sistema intrauterino de liberación hormonal • Ligadura de trompas bilateral • Pareja sometida a vasectomía 8. Cualquier otra circunstancia que el investigador considere inadecuada para la participación en este estudio. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Percentage of patient number (%) achieve recovery [Oxygenation index ≥300mmHg from baseline (day 1 prior to investigational drug administration), in supine position OR discharge from hospital]. |
Porcentaje de pacientes (%) que logren la recuperación [Indice de oxigenación ≥300 mmHg desde el momento basal, (día 1 antes de la administración del fármaco en investigación] en decúbito supino o el alta hospitalaria]. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
days 3, 7, 11, 14. |
dias 3, 7, 11, 14 |
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E.5.2 | Secondary end point(s) |
1. Time for oxygenation index recovery to normal (≥300mmHg) or discharge from hospital based on the record on day 3,7,11,14. 2. Mean change in the oxygenation index 3. Mechanical ventilation time 4. Oxygen therapy 5. Change in inflammation indicators (CRP or IL-6) from baseline. 6. Improvement in body temperature 7. 28-day all-cause mortality rate 8. Mean change from baseline in the clinical improvement ordinal scale recommended by the WHO R&D Blueprint during treatment period. 9. Improvement in the ordinal scale at D3, D7, D11 & D14 |
1. Tiempo hasta la vuelta a la normalidad del índice de oxigenación (≥300 mmHg) o al alta hospitalaria según los registros de los días 3, 7, 11 y 14 2. Cambio medio en el índice de oxigenación 3. Tiempo de ventilación mecánica 4. Oxigenoterapia 5. Cambio de los indicadores de inflamación (proteína C-reactiva o IL-6) respecto al valor basal 6. Mejoría de la temperatura corporal 7. Tasa de mortalidad por cualquier causa a los 28 días 8. Cambio medio desde el inicio en la escala ordinal de mejora clínica recomendada por la OMS durante el período de tratamiento. 9. Mejoría en la escala ordinal los dias 3, 7, 11 y 14 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
days 3, 7, 11, 14 and at the end of the study |
dias 3, 7, 11, 14 y al final del estudio |
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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 | No |
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) | 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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
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 |
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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 | 2 |
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 | 8 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 8 |