Clinical Trial Results:
Efficacy and safety of Octagam 10% therapy in COVID-19 patients with severe disease progression
Summary
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EudraCT number |
2020-002482-34 |
Trial protocol |
Outside EU/EEA |
Global end of trial date |
31 Jan 2022
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Results information
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Results version number |
v1(current) |
This version publication date |
31 Jan 2024
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First version publication date |
31 Jan 2024
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
GAM10-10
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT04400058 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Octapharma Pharmazeutika Produktionsges.m.b.H
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Sponsor organisation address |
Oberlaaerstr. 235, Vienna, Austria, 1100
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Public contact |
Clinical Research & Development, Octapharma Pharmazeutika Produktionsges.m.b.H, +43 (1) 610 320, ClinicalRDVienna@groups.octapharma.com
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Scientific contact |
Clinical Research & Development, Octapharma Pharmazeutika Produktionsges.m.b.H, +43 (1) 610 320, ClinicalRDVienna@groups.octapharma.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
31 Jan 2022
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
01 Feb 2021
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Global end of trial reached? |
Yes
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Global end of trial date |
31 Jan 2022
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
GAM10-10 was a randomized, double-blind, placebo-controlled, multicenter, 2-arm adaptive Phase 3 study, designed to evaluate the efficacy and safety of high-dose Octagam 10% therapy in subjects with severe COVID-19. The primary endpoint was stabilization or improvement in modality needed to maintain oxygen supplementation as measured by modality required to maintain oxygen at entry.
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Protection of trial subjects |
The Protocol and amendments, a sample of the subject information and informed consent form and any other materials provided to the subjects for the study, and further requested information, were reviewed and approved by the Independent Ethics Committee (IEC)/Institutional Review Board (IRB) prior to the initiation of the study. The study was approved by the IEC/IRB and the Regulatory Authority before any investigational medicinal product (IMP) was shipped to the study sites and any subject was exposed to a study-related procedure.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
07 Jun 2020
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Long term follow-up planned |
Yes
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Long term follow-up rationale |
Safety, Efficacy, Scientific research | ||
Long term follow-up duration |
12 Months | ||
Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
United States: 126
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Country: Number of subjects enrolled |
Ukraine: 43
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Country: Number of subjects enrolled |
Russian Federation: 38
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Worldwide total number of subjects |
207
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EEA total number of subjects |
0
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
150
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From 65 to 84 years |
56
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85 years and over |
1
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Recruitment
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Recruitment details |
A total of 207 patients were enrolled between June 2020 and February 2021 at 23 sites across the United States, Ukraine and Russia | ||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
A total of 219 patients were screened, with 207 enrolled and randomized into Octagam 10% and placebo arm in 1:1 ratio | ||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Core Study (33 Days)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator | ||||||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Octagam 10% | ||||||||||||||||||||||||||||||
Arm description |
Octagam 10%, 2 g/kg divided by 4 days (0.5 g/kg/day), administered by intravenous infusion over approximately 2 hours per day over 4 consecutive days | ||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Octagam 10%
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection/infusion
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Routes of administration |
Infusion
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Dosage and administration details |
Octagam 10%, 2 g/kg divided by 4 days (0.5 g/kg/day), administered by intravenous infusion over approximately 2 hours per day over 4 consecutive days
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Arm title
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Saline Solution | ||||||||||||||||||||||||||||||
Arm description |
IV saline solution placebo group | ||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Saline Solution
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection/infusion
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Routes of administration |
Infusion
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Dosage and administration details |
Saline Solution administered by intravenous infusion over approximately 2 hours per day over 4 consecutive days
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Period 2
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Period 2 title |
1 Year Follow-Up
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Is this the baseline period? |
No | ||||||||||||||||||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
No
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Arm title
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Octagam 10% | ||||||||||||||||||||||||||||||
Arm description |
Treated with Octagam 10%, in Period 1, no IMP treatment in Period 2 | ||||||||||||||||||||||||||||||
Arm type |
No intervention | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
No investigational medicinal product assigned in this arm
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Arm title
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Saline Solution | ||||||||||||||||||||||||||||||
Arm description |
Treated with IV saline solution placebo group in Period 1, no IMP treatment in Period 2 | ||||||||||||||||||||||||||||||
Arm type |
No intervention | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
No investigational medicinal product assigned in this arm
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Baseline characteristics reporting groups
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Reporting group title |
Core Study (33 Days)
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Octagam 10%
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Reporting group description |
Octagam 10%, 2 g/kg divided by 4 days (0.5 g/kg/day), administered by intravenous infusion over approximately 2 hours per day over 4 consecutive days | ||
Reporting group title |
Saline Solution
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Reporting group description |
IV saline solution placebo group | ||
Reporting group title |
Octagam 10%
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Reporting group description |
Treated with Octagam 10%, in Period 1, no IMP treatment in Period 2 | ||
Reporting group title |
Saline Solution
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Reporting group description |
Treated with IV saline solution placebo group in Period 1, no IMP treatment in Period 2 |
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End point title |
Proportion of Subjects Reaching Stabilization or Improvement in Clinical Status at Day 7 | ||||||||||||||||||
End point description |
Proportion of subjects reaching stabilization or improvement in clinical status at Day 7 on at least one category on a 6-point clinical status scale.
Clinical status categories were be defined as:
1. Hospital discharge or meet discharge criteria (discharge criteria were defined as clinical recovery, i.e. no fever, respiratory rate, oxygen saturation return to normal, and cough relief).
2. Hospitalization, not requiring supplemental oxygen.
3. Hospitalization, requiring supplemental oxygen (but not NIV/HFNC).
4. ICU/hospitalization, requiring NIV/HFNC therapy, as defined by A-a Gradient ≥150mmHg.
5. ICU, requiring Extracorporeal Membrane Oxygenation (ECMO) and/or IMV.
6. Death.
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End point type |
Primary
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End point timeframe |
7 days
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Statistical analysis title |
Subjects with stable or improved clinical status | ||||||||||||||||||
Statistical analysis description |
Proportion of subjects with stable or improved clinical status at Day 7 in Octagam group compared to the placebo group. Clinical status category was based on a 6-point scale. Baseline clinical status was defined as the most recent value prior to treatment.
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Comparison groups |
Octagam 10% v Saline Solution
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Number of subjects included in analysis |
207
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Analysis specification |
Pre-specified
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Analysis type |
superiority [1] | ||||||||||||||||||
P-value |
= 0.386 | ||||||||||||||||||
Method |
Cochran-Mantel-Haenszel | ||||||||||||||||||
Confidence interval |
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Notes [1] - The null hypothesis of no difference in proportion of subjects who reach success in two treatment groups was tested vs. the alternative hypothesis that there that there is a difference between proportions of subjects who reach success in two groups. Hypothesis testing will be performed using Cochran-Mantel-Haenszel (CMH) stratified by age category (≤65 versus >65) at a two-sided 0.05 significance level. |
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End point title |
Length of Hospital Stay (Time to Discharge) | |||||||||||||||
End point description |
Median length of hospital stay in subjects treated with Octagam 10% compared to those that received placebo from randomization through Day 33. Clinical status categories were defined as: Hospital discharge or meet discharge criteria (discharge criteria were defined as clinical recovery, i.e., no fever, respiratory rate, oxygensaturation return to normal, and cough relief.
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End point type |
Secondary
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End point timeframe |
33 days
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No statistical analyses for this end point |
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End point title |
Number of Subjects Reaching Stabilization or Improvement In Clinical Status at Day 14 | ||||||||||||
End point description |
Number of subjects with maintenance or improvement by at least one category on the 6-point clinical status scale on Day 14.
Clinical status categories will be defined as:
1. Hospital discharge or meet discharge criteria (discharge criteria are defined as clinical recovery, i.e. no fever, respiratory rate, oxygen saturation return to normal, and cough relief).
2. Hospitalization, not requiring supplemental oxygen.
3. Hospitalization, requiring supplemental oxygen (but not NIV/HFNC).
4. ICU/hospitalization, requiring NIV/HFNC therapy,as defined by A-a Gradient ≥ 150 mmHg.
5. ICU, requiring Extracorporeal Membrane Oxygenation (ECMO) and/or IMV.
6. Death.
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End point type |
Secondary
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End point timeframe |
14 days
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No statistical analyses for this end point |
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End point title |
Cumulative Duration of Invasive Mechanical Venitlation (IMV) | |||||||||||||||
End point description |
Duration of invasive mechanical ventilation in subjects treated with Octagam 10% compared to placebo from randomization through Day 33
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End point type |
Secondary
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End point timeframe |
33 days
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No statistical analyses for this end point |
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End point title |
Number of Subjects With Severe Disease Progression | ||||||||||||
End point description |
Number of subjects who experienced severe disease progression while treated with Octagam 10% compared to those that received placebo at Day 33. Severe disease progression is defined as subjects requiring extracorporeal membrane oxygenation, mechanical ventilation and/or died through day 33.
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End point type |
Secondary
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End point timeframe |
33 days
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No statistical analyses for this end point |
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End point title |
ICU Stay Length | |||||||||||||||
End point description |
Average length of ICU stay in subjects treated with Octagam 10% compared to those that received placebo from randomization through Day 33.
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End point type |
Secondary
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End point timeframe |
33 days
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No statistical analyses for this end point |
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End point title |
Cumulative Mortality Rate Through Day 33 | ||||||||||||
End point description |
Cumulative mortality in subjects treated with Octagam 10% compared to those that received placebo at Day 33
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End point type |
Secondary
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End point timeframe |
33 days
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No statistical analyses for this end point |
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End point title |
Post Study Health Status, Any Residual Health Effects from COVID-19 or the Study Treatment - 3 Months Post-Study (COVID-19 Subject Questionnaire) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Subjects who completed the core study and entered the registry were administered questionnaires at 3 months asking about their general health. Subjects were asked:
How is your general health?
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
6. Missing
How would you compare your general health now to what it was before you were ill with Covid-19?
1. Much worse
2. Somewhat worse
3. The same
4. Somewhat better
5. Much better
6. Missing
Since last contact, have you?
1. Been hospitalized
2. Sought consultation from a health care professional
3. Experienced deterioration of your health without seeking HCP consultation
4. None of the above
5. Missing
If the above question was not "none of the above", was it in relation to the symptoms?
1. Other
2. Similar to the symptoms experienced during COVID-19 hospitalization
Prior to Covid-19 did you work or go to school full time?
1. Yes
2. No
Do you currently work or go to school full time?
1. Yes
2. No
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End point type |
Post-hoc
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End point timeframe |
3 months post-study
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No statistical analyses for this end point |
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End point title |
Post Study Health Status, Any Residual Health Effects From COVID-19 or the Study Treatment-6 Months Post-Study (COVID-19 Subject Questionnaire) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Subjects who completed the core study and entered the registry were administered questionnaires at 6 months asking about their general health. Subjects were asked:
How is your general health?
1.Poor
2.Fair
3.Good
4.Very Good
5.Excellent
6.Missing
How would you compare your general health now to what it was before you were ill with Covid-19?
1.Much worse
2.Somewhat worse
3.The same
4.Somewhat better
5.Much better
6.Missing
Since last contact, have you?
1.Been hospitalized
2.Sought consultation from a health care professional
3.Experienced deterioration of your health without seeking HCP consultation
4.None of the above
5.Missing
If the above question was not "none of the above", was it in relation to the symptoms?
1.Other
2.Similar to the symptoms experienced during COVID-19 hospitalization
Prior to Covid-19 did you work or go to school full time?
1.Yes
2.No
Do you currently work or go to school full time?
1.Yes
2.No
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End point type |
Post-hoc
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End point timeframe |
6 months post-study
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No statistical analyses for this end point |
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End point title |
Post Study Health Status, Any Residual Health Effects From COVID-19 or the Study Treatment-9 Months Post-Study (COVID-19 Subject Questionnaire) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Subjects who completed the core study and entered the registry were administered questionnaires at 9 months asking about their general health. Subjects were asked:
How is your general health?
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
6. Missing
How would you compare your general health now to what it was before you were ill with Covid-19?
1. Much worse
2. Somewhat worse
3. The same
4. Somewhat better
5. Much better
6. Missing
Since last contact, have you?
1. Been hospitalized
2. Sought consultation from a health care professional
3. Experienced deterioration of your health without seeking HCP consultation
4. None of the above
5. Missing
If the above question was not "none of the above", was it in relation to the symptoms?
1. Other
2. Similar to the symptoms experienced during COVID-19 hospitalization
Prior to Covid-19 did you work or go to school full time?
1. Yes
2. No
Do you currently work or go to school full time?
1. Yes
2. No
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End point type |
Post-hoc
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End point timeframe |
9 months post-study
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No statistical analyses for this end point |
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End point title |
Post Study Health Status, Any Residual Health Effects From COVID-19 or the Study Treatment-12 Months Post-Study (COVID-19 Subject Questionnaire) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Subjects who completed the core study and entered the registry were administered questionnaires at 12 months asking about their general health. Subjects were asked:
How is your general health?
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
6. Missing
How would you compare your general health now to what it was before you were ill with Covid-19?
1. Much worse
2. Somewhat worse
3. The same
4. Somewhat better
5. Much better
6. Missing
Since last contact, have you?
1. Been hospitalized
2. Sought consultation from a health care professional
3. Experienced deterioration of your health without seeking HCP consultation
4. None of the above
5. Missing
If the above question was not "none of the above", was it in relation to the symptoms?
1. Other
2. Similar to the symptoms experienced during COVID-19 hospitalization
Prior to Covid-19 did you work or go to school full time?
1. Yes
2. No
Do you currently work or go to school full time?
1. Yes
2. No
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End point type |
Post-hoc
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End point timeframe |
12 months post-study
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Approximately 33 Days
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Assessment type |
Non-systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
23.0
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Reporting groups
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Reporting group title |
Octagam 10%
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Reporting group description |
Octagam 10%, 2 g/kg divided by 4 days (0.5 g/kg/day), administered by intravenous infusion over approximately 2 hours per day over 4 consecutive days | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Saline Solution
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Reporting group description |
Saline solution placebo group | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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20 May 2020 |
Protocol V3.0 dated 20May2020 |
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08 Jun 2020 |
Protocol v4.0 dated 08Jun2020 |
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01 Jul 2020 |
Protocol V5.0 dated 01Jul2020 |
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04 Aug 2020 |
Protocol V6.0 dated 04Aug2020 |
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18 Sep 2020 |
Protocol V7.0 dated 18Sep2020 |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |