E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with laboratory confirmed SARS-CoV-2 infection (under RT PCR) who are managed at home or in another out-of-hospital setting. |
Pazienti con diagnosi di laboratorio (attraverso RT-PCR) di SARS-COV-2 gestiti a domicilio o in ambiente extra ospedaliero |
|
E.1.1.1 | Medical condition in easily understood language |
Patients with laboratory confirmed SARS-CoV-2 infection (under RT PCR) who are managed at home or in another out-of-hospital setting. |
Pazienti con diagnosi di laboratorio (attraverso RT-PCR) di SARS-COV-2 gestiti a domicilio o in ambiente extra ospedaliero |
|
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 | 10053983 |
E.1.2 | Term | Corona virus infection |
E.1.2 | System Organ Class | 100000004862 |
|
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 aim of the CONVINCE study is therefore to assess the safety and efficacy of edoxaban and/or colchicine administration in SARS-CoV-2 infected patients who are managed outside the hospital with respect to the occurrence of fatalities, hospitalisation, major vascular thrombotic events or the SARS-CoV-2 clearance rate under RT PCR |
Valutare la sicurezza e l’efficacia della somministrazione di edoxaban e/o colchicina nei pazienti affetti da SARS-CoV-2 gestiti in ambiente extra ospedaliero in merito al numero di decessi, ricoveri ospedalieri, eventi trombotici vascolari maggiori o grado di clearance di SARS-CoV-2 attraverso RT-PCR |
|
E.2.2 | Secondary objectives of the trial |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients >= 18 years old with symptoms compatible with active Coronavirus infection and laboratory confirmed SARS-CoV-2 infection (under RT PCR) who are managed at home or in another out-of-hospital setting. |
Pazienti >= 18 anni con sintomi compatibili con infezione attiva da Coronavirus e diagnosi di laboratorio (attraverso RT-PCR) di SARS-COV-2 gestiti a domicilio o in ambiente extra ospedaliero. |
|
E.4 | Principal exclusion criteria |
• Hepatic disease associated with coagulopathy and clinically relevant bleeding risk, including Child-Pugh C cirrhosis with portal hypertension. • Lesion or condition, if considered to be a significant risk for major bleeding. This may include current or recent gastrointestinal ulceration, presence of malignant neoplasms at high risk of bleeding, recent brain or spinal injury, recent brain, spinal or ophthalmic surgery, recent intracranial haemorrhage, known or suspected oesophageal varices, arteriovenous malformations, vascular aneurysms or major intraspinal or intracerebral vascular abnormalities. • Uncontrolled severe hypertension. • Ongoing or planned treatment with parenteral or oral anticoagulants • Unilateral or bilateral above knee lower extremity amputation. • Inability to take oral medication or otherwise unable or unwilling to undergo/perform study-specified procedures • Have received or will receive an experimental drug or used an experimental medical device within 30 days before the planned start of treatment • Pregnancy or breast-feeding or any plan to become pregnant during the study. Women (and men, for Colchicine group only) with child-bearing potential not using adequate birth control method (note: as adequate method of birth control oral contraception is recommended. If oral contraception is not feasible, both partners should use adequate barrier birth control). • Need for dual anti-platelet therapy consisting of aspirin and an oral P2Y12 inhibitor • Inflammatory bowel disease or chronic diarrhea or neuromuscular disease • Creatinine clearance (CrCl) <15 ml/min • Anticipated use of Hydroxychloroquine • Participation in any other clinical trial • Inability to understand the requirements of the study and to provide informed consent |
• Malattia epatica associata a coagulopatia e rischio di sanguinamento clinicamente rilevante, inclusa cirrosi con ipertensione portale (classe C Child-Pugh) • Lesione o condizione considerata un rischio significativo di sanguinamento maggiore. Può includere ulcerazione gastrointestinale corrente o recente, presenza di neoplasia maligna ad alto rischio di sanguinamento, recente lesione cerebrale o spinale, recente intervento chirurgico cerebrale, spinale o oftalmico, recente emorragia intracranica, varici esofagee note o sospette, malformazioni aterovenose, aneurismi vascolari o anomalie vascolari intraspinali o intracerebrali • Ipertensione severa non controllata • Trattamento in corso o in programma con anticoagulanti per via parenterale o orale • Amputazione dell’arto inferiore sopra il ginocchio unilaterale o bilaterale • Incapacità ad assumere farmaci per via orale o incapacità/indisponibilità ad essere sottoposti alle procedure previste dallo studio • Aver ricevuto o ricevere un farmaco sperimentale o utilizzare un dispositivo medico sperimentale entro 30 giorni prima dell’inizio del previsto trattamento • Donne in gravidanza o in allattamento o che pianificano una gravidanza durante lo studio Le donne (e gli uomini solo per il gruppo della colchicina) in età fertile che non stanno utilizzando un metodo anticoncezionale adeguato (come metodo anticoncezionale adeguato si raccomanda la contraccezione orale; se la contraccezione orale non è fattibile, entrambi i partners dovrebbero usare un adeguato metodo contracettivo a barriera) • Necessità di una doppia terapia anti-piastrinica composta da aspirina e da un inibitore orale P2Y12 • Malattia infiammatoria intestinale o diarrea cronica o malattia neuromuscolare • Clearance della creatinina (CrCl) < 15 ml/min • Impiego previsto di idrossiclorochina • Partecipazione ad un altro studio clinico • Soggetti non in grado di comprendere i requisiti dello studio o di fornire il consenso informato |
|
E.5 End points |
E.5.1 | Primary end point(s) |
This study has 2 co-primary endpoints, one each randomization as follows:
Edoxaban vs. no active treatment Major vascular thrombotic events (MVTE) at 25 (+/-3) days defined as a composite of: • Asymptomatic proximal deep-vein thrombosis • Symptomatic proximal or distal deep-vein thrombosis • Symptomatic pulmonary embolism or thrombosis • Myocardial infarction • Ischemic stroke • non-CNS systemic embolism • Death
Colchicine vs no active treatment The SARS-CoV-2 detection rates at day 14 (+/-3) under RT PCR or freedom from death or hospitalisation |
Questo studio clinico ha due endpoint primari, uno per ogni randomizzazione, come segue: - Edoxaban versus nessun trattamento attivo
Eventi trombotici vascolari maggiori (MVTE) a 25(+/-3) giorno definiti come un composto di: - trombosi venosa profonda asintomatica prossimale - Sintomatica trombosi venosa profonda prossimale o distale - Embolia polmonare sintomatica o trombosi - Infarto Miocardio - Ictus Ischemico - Embolia sistemica del sistema nervoso non centrale - Morte
Colchicina versus nessun trattamento attivo Clearance di SARS-CoV-2 valutata attraverso RT-PCR o assenza di morte o ospedalizzazione a 14 (+/- 3) dalla randomizzazione |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
14 (+/-3) and 25 (+/-3) days |
14 (+/-3) e 25 (+/-3) giorni |
|
E.5.2 | Secondary end point(s) |
The secondary endpoints of the study are the following: 1) Each component of the co-primary endpoints 2) Need for non-invasive or invasive ventilation 3) Need for oxygen therapy 4) Body temperature kinetics 5) Need for analgesics including NSAIDs and/or paracetamol 6) Need for hospitalisation and total days in the hospital 7) Any combination of the above endpoints 8) Each component of the primary endpoint as well as pre-specified composite endpoints at the time all SAEs have come to a resolution 9) Impact of either intervention on coagulation and inflammatory biomarkers including IL-6, CRP, D-dimers, sCD40L, Fibrinogen, Factor X activity and Factor XIa 10) EKG analyses for QT segment measures and for detection of EKC changes associated to myopericarditis. 11) HsTroponin levels 12) Bleeding endpoints according to the Bleeding Academic Research Consortium (BARC) 2, 3 or 5 and ISTH major and clinically relevant non-major bleeding |
Gli endpoint secondari sono: - Componenti individuali di ciascun endpoint primario composito - Necessità di ventilazione non-invasiva o invasiva - Necessità di ossigenoterapia - Andamento della temperatura corporea - Necessità di analgesici inclusi FANS e/o paracetamolo - Necessità di ricovero ospedaliero e totali giorni di degenza ospedaliera - Qualsiasi combinazione degli endpoints soprariportati - Ogni componente dell’Endpoint primario così come gli endpoints compositi prespecificati al momento della risoluzione di tutti i SAEs - Impatto di entrambi gli interventi sui biomarkers della coagulazione e infiammatori tra cui IL-6, CRP, D-Dimero, sCD40L, fibrinogeno, attività del Fattore X e fattore XIa - Analisi elettrocardiografica del tratto QT e dei cambiamenti elettrocardiografici associati a mio-pericardite - Livelli di Troponina Hs - Sanguinamenti BARC 2,3 o 5 e sanguinamenti ISTH maggiori e non maggiori clinicamente rilevanti |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
14 (+/-3) and 25 (+/-3) days; 14 (+/-3) e 25 (+/-3) giorni |
|
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) | Yes |
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 | 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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 14 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 19 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Belgium |
Italy |
Spain |
Switzerland |
|
E.8.7 | Trial has a data monitoring committee | Yes |
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
|
|
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 |