E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
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 |
• Determine the efficacy of RUX and FOS to reduce the proportion of hospitalised patients progressing from mild to severe COVID-19 pneumonia |
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E.2.2 | Secondary objectives of the trial |
1. Determine the efficacy of RUX or FOS to reduce mortality 2. Determine the efficacy of RUX or FOS to reduce the need for invasive ventilation or ECMO 3. Determine the efficacy of RUX or FOS to reduce the need for non-invasive ventilation 4. Determine the efficacy of RUX or FOS to reduce the proportion of patients suffering significant oxygen desaturation 5. Determine the efficacy of RUX or FOS to reduce the need for renal replacement therapy 6. Determine the efficacy of RUX and FOS to reduce the severity on COVID19 pneumonia [graded by a modified WHO Ordinal Scale] 7. Determine the efficacy of RUX or FOS to reduce the level of inflammatory biomarkers 8. Determine the efficacy of RUX or FOS to reduce duration of hospital admission 9. Evaluate the safety of RUX and FOS for COVID19 pneumonia
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Patients age ≥ 18 years at screening
2. Hospitalisation with COVID-19 pneumonia AND - SARS-CoV2 infection (clinically suspected OR laboratory confirmed) AND - Radiological change consistent with COVID-19 disease
3. Grade 3 or 4 severity (WHO COVID-19 Ordinal Scale)
4. C-reactive protein (CRP) ≥50mg/L
5. Informed consent from patient or professional representative
6. No medical history that might, in the opinion of the responsible clinician, put the patient at significant risk if he/she were to participate in the trial
7. Agreement to abstain from sexual intercourse or use contraception that is >99% effective for all participants of childbearing potential for 42 days
8. For male participants, agreement to abstain from sperm donation for 42 days
9. Non-English speakers will be able to join the study. If patients are unable to understand verbal or written information in English - hospital translation services will be requested at the participating site for the participant where possible. |
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E.4 | Principal exclusion criteria |
1. Requiring either invasive or non-invasive ventilation including continuous positive airway pressure (CPAP) or high flow nasal oxygen at any point before baseline
2. Grade ≥5 severity on the WHO COVID-19 Ordinal Scale
3. O2 saturation < 90% on ≥60% inspired oxygen at baseline
4. In the opinion of the investigator, progression to death is inevitable within the next 24 hours, irrespective of the provision of therapy
5. Known severe allergic reactions to the investigational agents
6. Use of drugs within the preceding 14 days that are known to interact with any study treatment
7. Child Pugh B or C grade hepatic dysfunction
8. End stage renal failure (ESRF)
9. Pregnant or breast feeding
10. Participation in other clinical trials
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is progression from mild to severe COVID-19 pneumonia within 14 days in hospitalised patients. Patients are recruited at a WHO COVID-19 Severity Score of 3 and 4 and the primary endpoint is the comparison of patients whose COVID-19 pneumonia progresses to a severity score 5 on the modified WHO Ordinal Scale. Specifically, the primary endpoint is met when the following are recorded within 14 days:
- Death
- Requirement for invasive ventilation
- Requirement for non-invasive ventilation including CPAP
- O2 saturation < 90% on ≥60% inspired oxygen |
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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) |
1. Determine the efficacy of ruxolitinib or fostamatinib to reduce mortality
2. Determine the efficacy of ruxolitinib or fostamatinib to reduce the need for invasive ventilation and/or extra corporeal membrane oxygenation (ECMO)
3. Determine the efficacy of ruxolitinib or fostamatinib to reduce the need for non-invasive ventilation including continuous positive airway pressure (CPAP) or high flow nasal oxygen
4. Determine the efficacy of ruxolitinib or fostamatinib to reduce the proportion of patients suffering clinically significant oxygen desaturation
5. Determine the efficacy of ruxolitinib or fostamatinib to reduce the need for renal replacement therapy
6. Determine the efficacy of ruxolitinib or fostamatinib to improve the severity of COVID-19 pneumonia on a modified WHO COVID-19 Ordinal Scale
7. Determine the efficacy of ruxolitinib or fostamatinib to reduce blood ferritin, CRP, LDH and D-dimer
8. Determine the efficacy of ruxolitinib or fostamatinib to reduce duration of hospital admission
9. Evaluate the safety of ruxolitinib and fostamatinib for COVID-19 pneumonia |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | 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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | No |
E.8.5.1 | Number of sites anticipated in the EEA | 1 |
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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The end of the scheduled treatment phase is defined as the date of the last Follow-up visit of the last participant. The end of the study is the date of the final data extraction from NHS Digital (anticipated to be 10 years after the last patient is enrolled). |
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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 | 0 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 1 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 7 |
E.8.9.2 | In all countries concerned by the trial days | 1 |