E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Coronavirus disease 2019 (COVID-19) |
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E.1.1.1 | Medical condition in easily understood language |
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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.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 23.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10084510 |
E.1.2 | Term | Coronavirus infections |
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 |
Phase 1: • To evaluate the safety and tolerability of REGN10933+REGN10987 (REGN-COV2) compared to placebo • To evaluate the virologic efficacy of REGN-COV2 compared to placebo in reducing viral shedding of SARS CoV 2 Phase 2: • To evaluate the virologic efficacy of REGN-COV2 compared to placebo in reducing viral shedding of SARS CoV 2 • To evaluate the clinical efficacy of REGN-COV2 compared to placebo in improving clinical status Phase 3: • To evaluate and confirm the clinical efficacy of REGN-COV2 compared to placebo in improving clinical status. |
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E.2.2 | Secondary objectives of the trial |
Phase 1: • Evaluate additional indicators of virologic efficacy of REGN-COV2 vs placebo • Estimate the clinical efficacy of REGN-COV2 vs placebo in improving clinical outcomes • Compare RT-qPCR results acquired with different sample types • Characterize the PK profiles of REGN10933 and REGN10987 in serum • Assess the immunogenicity of REGN10933 and REGN10987 Phase 2: • Evaluate additional indicators of virologic efficacy of REGN-COV2 vs placebo • Evaluate additional indicators of clinical efficacy of REGN-COV2 vs placebo • Evaluate the safety and tolerability of REGN-COV2 vs placebo • Characterize the concentrations of REGN10933 and REGN10987 in serum • Assess the immunogenicity of REGN10933 and REGN10987 Phase 3: • Evaluate the clinical efficacy of REGN-COV2 vs placebo • Evaluate the safety and tolerability of REGN-COV2 vs placebo • Characterize the concentrations of REGN10933 and REGN10987 in serum • Assess the immunogenicity of REGN10933 and REGN10987 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Key Inclusion Criteria: •Has SARS-CoV-2-positive antigen or molecular diagnostic test (by validated SARS-CoV-2 antigen, RT-PCR, or other molecular diagnostic assay, using an appropriate sample such as NP, nasal, oropharyngeal [OP], or saliva) ≤72 hours prior to randomization and no alternative explanation for current clinical condition. A historical record of positive result from test conducted ≤72 hours prior to randomization is acceptable. •Has symptoms consistent with COVID-19, as determined by investigator, with onset ≤10 days before randomization •Hospitalized for COVID-19 illness for ≤72 hours with at least 1 of the following at randomization; patients meeting more than one criterion will be categorized in the most severely affected category: a. Cohort 1A: With COVID-19 symptoms but not requiring supplemental oxygen b. Cohort 1: Maintains O2 saturation >93% on low-flow oxygen as defined in the protocol c.Cohort 2: High-intensity oxygen therapy without mechanical ventilation as defined in the protocol d.Cohort 3: On mechanical ventilation NOTE: Other protocol defined inclusion criteria apply |
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E.4 | Principal exclusion criteria |
Key Exclusion Criteria: •Phase 1 only: Patients maintaining O2 saturation >94% on room air •In the opinion of the investigator, unlikely to survive for >48 hours from screening •Receiving extracorporeal membrane oxygenation (ECMO) •Has new-onset stroke or seizure disorder during hospitalization •Initiated on renal replacement therapy due to COVID-19 NOTE: Other protocol defined exclusion criteria apply |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Proportion of patients with treatment-emergent Serious Adverse Events (SAEs) (Primary: Ph 1: C1 Secondary: Ph 1: C1, Ph 2: C1A, C1, C2, C3) 2. Proportion of patients with infusion-related reactions (Primary: Ph 1:C1, Secondary: Ph 2: C1A, C1, C2, C3) 3. Proportion of patients with hypersensitivity reactions (Primary: Ph 1:C1, Secondary: Ph 2: C1A, C1, C2, C3) 4.Time-weighted average change from baseline in viral shedding as measured by quantitative reverse transcription polymerase chain reaction (RT-qPCR) in nasopharyngeal (NP) swab samples (Ph 1:C1, Ph 2: C1A, C1, C2, C3) 5. Proportion of patients with at least 1-point improvement on a 7-Point Ordinal Scale in clinical status (Primary: Ph 2: C1A, C1, C2, C3, Ph 3:C1, C2, C3 Secondary: Ph 1:C1, Ph 2: C1A, C1, C2, C3)
7-point Ordinal Scale: - Death; - Hospitalized, requiring invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); - Hospitalized, requiring non-invasive ventilation or high flow oxygen devices; - Hospitalized, requiring supplemental oxygen; - Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise) - Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care - Not hospitalized |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Through Day 169 (Primary: Ph.1: Up to Day 169, Secondary: Ph.1: Up to Day 29, Ph.2: Up to Day 29 and 57) 2. Through Day 4 3. Through Day 29 4. Baseline up to Day 22 5. From Day 1 up to Day 29 (Primary: Ph 2: C1A and C1, Ph3: C1: Day 8, Ph. 2: C2 and C3, Ph.3: C2 and C3: Day 22, Secondary: Ph. 1: Day 8 and Day 29, Ph. 2: Day 29) |
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E.5.2 | Secondary end point(s) |
1.Time-weighted average change from baseline in viral shedding as measured by RT-qPCR in saliva samples (Ph 1: C1) 2.Time-weighted average change from baseline in viral shedding as measured by RT-qPCR in nasal samples (Ph 1: C1) 3.Time to negative RT-qPCR in all tested samples with no subsequent positive RT-qPCR in any tested samples (Ph 1: C1) 4.Time to negative RT-qPCR in NP swabs with no subsequent positive RT-qPCR (Ph 2: C1A, C1, C2, C3) 5.Change from baseline in viral shedding as measured by RT-qPCR in NP swabs (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 6.Time-weighted average change in viral shedding (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 7.Change from baseline in viral shedding as measured by RT-qPCR in saliva samples (Ph1:C1) 8.Change from baseline in viral shedding as measured by RT-qPCR in nasal swabs(Ph 1: C1) 9.Correlation of RT-qPCR results over time between different sample types (Ph 1: C1) 10.Concordance of RT-qPCR results over time between different sample types (Ph 1: C1) 11.Proportion of patients with at least 2-point improvement on a 7-Point Ordinal Scale in clinical status (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 12.Time to no longer requiring oxygen supplementation (Ph 1: C1 Ph 2: C1, C2, C3) 13.Number of days of supplemental oxygen use (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 14.Proportion of patients initiating high-intensity oxygen therapy (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 15.Number of days of high-intensity oxygen therapy (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 16.Proportion of patients initiating mechanical ventilation (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 17.Number of days of mechanical ventilation (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 18.Number of Ventilator-free days (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 19.Number of days of hospitalization (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 20.Proportion of patients re-admitted to hospital after discharge through the end of study (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 21.Proportion of patients admitted into an intensive care unit (ICU) (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 22.Days of ICU stay (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 23.Number of deaths due to any cause (All-Cause Mortality) (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 24.Overall Survival (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 25.Serum concentration of REGN10933 over time (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 26.Serum concentration of REGN10987 over time (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 27.Incidence of anti-drug antibodies (ADA) to REGN10933 (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 28.Incidence of ADA to REGN10987 (Ph 1: C1 Ph 2: C1A, C1, C2, C3) 29.Assessment of PK parameter: Cmax of REGN10933 (Ph1) 30.Assessment of PK parameter: Cmax of REGN10987 (Ph1) 31.Assessment of PK parameter: Cmax-to-dose ratio (Cmax/dose) for REGN10933 (Ph1) 32.Assessment of PK parameter: Cmax-to-dose ratio (Cmax/dose) for REGN10987 (Ph1) 33.Assessment of PK parameter: Time to Cmax (tmax) for REGN10933 (Ph1) 34.Assessment of PK parameter: Time to Cmax (tmax) for REGN10987 (Ph1) 35.Assessment of PK parameter: AUC computed from time zero to the time of the last positive concentration (AUClast) for REGN10933 (Ph1) 36.Assessment of PK parameter: AUC computed from time zero to AUClast for REGN10987 (Ph1) 37.Assessment of PK parameter: AUC from time zero extrapolated to infinity (AUCinf) for REGN10933(Ph1) 38.Assessment of PK parameter: AUC from time zero extrapolated to AUCinf for REGN10987 (Ph1) 39.Assessment of PK parameter: AUCinf-to-dose ratio (AUCinf/dose) of REGN10933 (Ph1) 40.Assessment of PK parameter: AUCinf-to-dose ratio (AUCinf/dose) of REGN10987 (Ph1) 41.Assessment of PK parameter: Observed t1/2 of REGN10933 (Ph1) 42.Assessment of PK parameter: Observed t1/2 of REGN10987 (Ph1) 43.Assessment of PK parameter: CL for REGN10933 (Ph1) 44.Assessment of PK parameter: CL of REGN10987 (Ph1) 45.Assessment of PK parameter: Vss of REGN10933 (Ph1) 46.Assessment of PK parameter: Vss of REGN10987 (Ph1) 47.Assessment of PK parameter: Mean residence time (MRT) of REGN10933 (Ph1) 48.Assessment of PK parameter: MRT of REGN10987(Ph1) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1.Baseline up to Day 22 2.Baseline up to Day 22 3.Through Day 29 4.Through Day 29 5 - 8.Baseline up to Day 29 9.Up to Day 29 10.Up to Day 29 11.From Day 1 up to Day 29 12.Through Day 29 13.Through Day 29 14.Up to Day 29 or hospital discharge 15.Through Day 29 16.Up to Day 29 or hospital discharge 17-19.Through Day 29 20.Ph 1:Through Day 169 Ph 2:Through Day 57 21.Up to Day 29 22.Up to Day 29 23.Ph 1:Through Day 29 and Day 169 Ph 2:Through Day 29 and Day 57 24.Ph 1:Through Day 169 Ph 2:Through Day 57 25-28.Phase 1:Through Day 169 Phase 2:Through Day 29 29.-48.Through day 169 |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.1.1 | First administration to humans | Yes |
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) | 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 | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
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 | Yes |
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.8.5 | 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 | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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 |
Brazil |
Chile |
Mexico |
United States |
Romania |
Moldova, Republic of |
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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
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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 | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 14 |