E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Novel coronavirus pneumonia (COVID-19) |
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E.1.1.1 | Medical condition in easily understood language |
Novel coronavirus pneumonia (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 | LLT |
E.1.2 | Classification code | 10084383 |
E.1.2 | Term | Novel COVID-19-infected pneumonia |
E.1.2 | System Organ Class | 100000004862 |
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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 |
Assess efficacy and safety of Montelukast as add on treatment to the novel coronavirus pneumonia (COVID-19) |
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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. Admitted to a hospital with a diagnosis of moderate or severe COVID-19 pneumonia defined as: a. moderate cases: showing fever and respiratory symptoms with radiological findings of pneumonia; b. severe cases meeting any of the following criteria: i) respiratory distress (≧30 breaths/ min); ii) oxygen saturation≤93% at rest without oxygen inhalation; iii) PaO2/FiO2(fraction of inspired oxygen)≤300mmHg; iv) with chest imaging that showed obvious lesion progression within 24-48 hours >50% shall be managed as severe cases 2. Subject, or legally authorized representative, provides written informed consent prior to the initiation of any study procedures. 3. Understands and agrees to comply with planned study procedures. 4. Agrees to the collection of oropharyngeal swabs. 5. Male or non-pregnant female adult > / = 18 years of age at the time of enrollment. 6. Has laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain reaction (PCR) or other commercial or public health assay in any specimen collected < 72 hours prior to randomization. Note, 72 hours is not necessarily time from initial diagnosis. If > / = 72 hours since positive PCR, the PCR may be repeated to assess eligibility. 7. Women of childbearing potential must agree to either abstinence or use at least one primary form of contraception not including hormonal contraception from the time of screening through Day 29.
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E.4 | Principal exclusion criteria |
1. Admitted to a hospital with a diagnosis of critical type of COVID-19 pneumonia defined as any of the follow: i) requiring mechanical ventilation, ii) extracorporeal life support (ECMO, ECCO2R, RRT); iii) shock, iv) multiple organ dysfunction syndrome. Patients who are participating in another drug clinical trials. 2. Requiring dialysis. 3. Pregnancy or breast feeding. 4. Allergy to any study medication. 5. Severe basic diseases that affect survival, including uncontrolled malignant tumors that have metastasized and cannot be removed, blood diseases, cachexia, active bleeding, severe malnutrition, HIV, etc.; 6. Pulmonary tumors caused by obstructive pneumonia, severe interstitial fibrosis, alveolar proteinosis, allergic alveolitis. 7. Continued use of immunosuppressive agents or organ transplants in the last 6 months. 8. Expected deaths within 48 hours. 9. Clinicians judge inappropriate.
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E.5 End points |
E.5.1 | Primary end point(s) |
Improvement of COVID-19 disease status defined by the percentage of subjects reporting each severity rating on an 8-point ordinal scale [Time Frame: Day 29] The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 6) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7) Not hospitalized, limitation on activities and/or requiring home oxygen; 8) Not hospitalized, no limitations on activities.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Time Frame: Day 1 through Day 29 |
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E.5.2 | Secondary end point(s) |
1. Change from baseline in alanine transaminase (ALT), aspartate transaminase (AST) [Time Frame: Day 1 through Day 29], creatinine, glucose, hemoglobin, platelets, prothrombin time (PT), total bilirubin, and white blood cell count with differential [Time Frame: Day 1 through Day 29] 2. Change in National Early Warning Score (NEWS) from baseline [Time Frame: Day 1 through Day 29]. The NEW score has demonstrated an ability to discriminate patients at risk of poor outcomes. This score is based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness). The NEW Score is being used as an efficacy measure, available at https://www.mdcalc.com/national-early-warning-score-news 3. Clinical status using an ordinal scale [Time Frame: Day 3 through Day 29] a. The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 6) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7) Not hospitalized, limitation on activities and/or requiring home oxygen; 8) Not hospitalized, no limitations on activities. 4. Cumulative incidence of Grade 3 and 4 adverse events (AEs) [Time Frame: Day 1 through Day 29] a. Grade 3 AEs are defined as events that interrupt usual activities of daily living, or significantly affects clinical status, or may require intensive therapeutic intervention. Severe events are usually incapacitating. b. Grade 4 AEs are defined as events that are potentially life threatening. 5. Cumulative incidence of serious adverse events (SAEs) [Time Frame: Day 1 through Day 29] a. An SAE is defined as an AE or suspected adverse reaction is considered serious is, in the view of either the investigator or the sponsor, if results in death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect. 6. Duration of hospitalization, of new non-invasive ventilation or high flow oxygen use, duration of new oxygen use, duration of new ventilator or extracorporeal membrane oxygenation (ECMO) use, incidence of new non-invasive ventilation or high flow oxygen use, incidence of new oxygen use, incidence of new ventilator or extracorporeal membrane oxygenation (ECMO) use, number of non-invasive ventilation/high flow oxygen free days and number of oxygenation free days [Time Frame: Day 1 to Day 29] 7. Subject 28-day mortality [Time Frame: Day 1 through Day 29]. Date and cause of death (if applicable). 8. Time to discharge or to a National Early Warning Score (NEWS) of </= 2 and maintained for 24 hours, whichever occurs first [ Time Frame: Day 1 through Day 29]. The NEW score has demonstrated an ability to discriminate patients at risk of poor outcomes. This score is based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness). The NEW Score is being used as an efficacy measure.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Time Frame: Day 1 through Day 29 |
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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) | 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 | No |
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
| 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 | |
E.8.9.1 | In the Member State concerned days | |