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    Summary
    EudraCT Number:2020-005227-37
    Sponsor's Protocol Code Number:OLT1177-10
    National Competent Authority:Netherlands - Competent Authority
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2020-12-17
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedNetherlands - Competent Authority
    A.2EudraCT number2020-005227-37
    A.3Full title of the trial
    A Phase 2 Randomized, Double-Blind, Placebo-Controlled Trial of the Safety and Efficacy of Orally Administered Dapansutrile Capsules for the Treatment of Moderate COVID-19 Symptoms and Evidence of Early Cytokine Release Syndrome
    Een fase 2, gerandomiseerde, dubbelblinde, placebo-gecontroleerde studie naar de veiligheid en effectiviteit van oraal toegediende Dapansutrile capsules voor de behandeling van matige COVID-19 symptomen en bewijs van eerste fase van cytokine release syndroom
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    The safety and efficacy of dapansutrile for the treatment of moderate COVID-19 symptoms
    De veiligheid en werkzaamheid van dapansutrile voor behandeling van matige COVID-19 symptomen
    A.3.2Name or abbreviated title of the trial where available
    OLT1177-10
    OLT1177-10
    A.4.1Sponsor's protocol code numberOLT1177-10
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04540120
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorOlatec Therapeutics LLC
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportOlatec Therapeutics LLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationOlatec Therapeutics LLC
    B.5.2Functional name of contact pointClinical Trials Inquiries
    B.5.3 Address:
    B.5.3.1Street Address800 Fifth Avenue, Fl 25D
    B.5.3.2Town/ cityNew York
    B.5.3.3Post code10065
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1833652 8321
    B.5.6E-mailinquiries@olatec.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDapansutrile
    D.3.2Product code OLT1177
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDapansutrile
    D.3.9.1CAS number 54863-37-5
    D.3.9.2Current sponsor codeOLT1177
    D.3.9.3Other descriptive name3-methanesulfonyl-propionitrile
    D.3.9.4EV Substance CodeSUB184700
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    COVID-19, cytokine release syndrome
    COVID-19, cytokine release syndroom
    E.1.1.1Medical condition in easily understood language
    COVID-19, cytokine release syndrome
    COVID-19, cytokine release syndroom
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 23.1
    E.1.2Level PT
    E.1.2Classification code 10084460
    E.1.2Term COVID-19 treatment
    E.1.2System Organ Class 10042613 - Surgical and medical procedures
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to assess the clinical efficacy of dapansutrile versus placebo in subjects presenting with moderate COVID-19 respiratory symptoms and evidence of early cytokine release syndrome.
    Het primaire doel is om de klinische werkzaamheid van dapansutrile versus placebo te beoordelen bij proefpersonen met matige COVID-19-ademhalingssymptomen en aanwijzingen voor een vroeg cytokine-release-syndroom.
    E.2.2Secondary objectives of the trial
    Secondary objectives are to assess:
    • Clinical safety and tolerability of dapansutrile;
    • Proportion of subjects who experience clinical resolution of fever symptoms and shortness of breath at the Day 8, 29 and 45 visits;
    • Time to clinical improvement in fever symptoms and shortness of breath;
    • Proportion of subjects who experience clinical improvement in individual symptoms relevant to COVID 19;
    • Time to recovery of each symptom relevant to COVID-19
    • Proportion of subjects requiring hospitalization, supplemental oxygen, or ventilation or who die before Day 15.
    • Proportion of subjects who have an improvement by Day 15 on the WHO OSCI;
    • Improvement in oxygenation over the course of the study;
    • Changes in Immunological and inflammatory biomarkers;
    • To assess and compare changes in respiratory function.

    Exploratory objectives:
    • Increased knowledge and understanding of the pathogenesis of COVID-19.
    Secundaire doelen voor beoordeling:
    • Klinische veiligheid en verdraagbaarheid van dapansutrile
    • Percentage proefpersonen dat oplossing van koorts en kortademigheid ervaart tijdens de bezoeken op dag 8, 29 en 45
    • Tijd tot klinische verbetering van koorts en kortademigheid
    • Percentage proefpersonen dat klinische verbetering ervaart van individuele symptomen relevant zijn COVID 19
    • Tijd tot het herstellen van alle symptomen relevant voor COVID-19
    • Percentage proefpersonen dat ziekenhuisopname, aanvullende zuurstof of beademing nodig heeft of dat vóór dag 15 overlijdt
    • Percentage proefpersonen met een verbetering in hun score op dag 15 op de WHO OSCI
    • Verbetering van de zuurstofverzadiging
    • Veranderingen in immunologische en inflammatoire biomarkers
    • Beoordelen en vergelijken van veranderingen in respiratoire functie.


    De verkennende doelstelling:
    • Vergroten van kennis en begrip van de pathogenese van COVID-19.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1) Male and female subjects ≥ 18 years of age;
    2) SARS-CoV-2-positive, confirmed by Food and Drug Administration (FDA)- or European Medicines Agency (EMA)-authorized COVID-19 test ≤ 5 days prior to randomization;
    3) Less than or equal to 120 hours from first symptom onset to randomization;
    4) Subjects with moderate COVID-19 consistent with the definition of “moderate” as set forth by the February 2021 FDA Guidance for Industry: COVID-19: Developing Drugs and Biological Products for Treatment or Prevention (FDA, 2021) who at the Screening/Baseline/Day 1 Visit:
    a. have felt feverish within the past 24 hours,
    b. have an SpO2 > 93% on room air at sea level6 when sitting, and
    c. meet at least one of the following criteria:
    i. Respiratory rate: ≥ 20 breaths/minute, when the subject is sitting,
    ii. SpO2: ≤ 96% on room air at sea level6, when the subject is sitting,
    iii. Shortness of breath: with exertion, not requiring oxygen, or
    iv. Heart rate: ≥ 90 beats/minute, when the subject is sitting;
    5) If all of the criteria in Inclusion 4c are met, subject must possess at least one of the following high-risk conditions known to have an underlying increased level of cytokine production; otherwise, at least two of these high-risk conditions must be met:
    a. 70 years or more of age,
    b. Obesity (body mass index [BMI] ≥ 30 kg/m2),
    c. Diabetes (type 1 or 2),
    d. Uncontrolled hypertension, defined as diastolic > 100 mm Hg and/or systolic > 150 mm Hg without any current anti-hypertensive medications. At the time of screening if the patient is on anti-hypertensive medication(s) and diastolic or systolic rates are elevated, patient may be enrolled after consultation with the Medical Monitor,
    e. Known respiratory disease (including asthma or chronic obstructive pulmonary disease [COPD]),
    f. Known heart failure (note: subjects with New York Heart Association Class IV congestive heart failure cannot be enrolled per Exclusion Criterion 4), or
    g. Known coronary disease;
    6) Plasma CRP level must be collected at Screening/Baseline/Day 1 Visit;
    7) Acceptable overall medical condition to be safely enrolled in and complete the study (with specific regard to cardiovascular, renal, and hepatic conditions) in the opinion of the Investigator;
    8) Ability to provide written, informed consent prior to initiation of any study-related procedures, and ability (in the opinion of the Investigator) to understand and comply with all the requirements of the study, which includes abstaining from the use of prohibited medications.
    1) Mannen en vrouwen ≥ 18 jaar;
    2) SARS-CoV-2-positief, bevestigd door een, door de FDA en EMA geautoriseerde, COVID-19 test ≤ 5 dagen vóór randomisatie;
    3) Manifestatie van de eerste symptomen ≤ 120 uur vóór randomisatie;
    4) Proefpersonen met matige COVID-19 in overeenstemming met de definitie van "matig" zoals uiteengezet in de FDA-richtlijnen voor de industrie van februari 2021: COVID-19: ontwikkeling van geneesmiddelen en biologische producten voor behandeling of preventie (FDA, 2021) die bij de screening/baseline /Dag 1 bezoek:
    a. koortsachtig gevoel hebben gehad in de afgelopen 24 uur,
    b. een SpO2 > 93% hadden zittend in kamerlucht op zeeniveau en
    c. voldoen aan ten minste een van de volgende criteria::
    i. Ademhalingsfrequentie: zittend ≥ 20 ademhalingen/minuut,
    ii. SpO2: ≤ 96% zittend in kamerlucht op zeeniveau,
    iii. Kortademig: bij inspanning, geen zuurstof nodig, of
    iv. Hartslag: zittend ≥ 90 slagen/minuut;
    5) Als aan alle criteria in inclusie 4c voldaan is, moet de proefpersoon ten minste een van de volgende risicovolle aandoeningen hebben waarvan bekend is dat ze een onderliggend verhoogd niveau van cytokineproductie hebben; anders moet aan ten minste 2 van deze hoog-risico condities voldaan worden:
    a. 70 jaar of ouder,
    b. Obesitas (body mass index [BMI] ≥ 30 kg/m2),
    c. Diabetes (type 1 of 2),
    d. Ongecontroleerde hypertensie, gedefinieerd als diastolisch > 100 mm Hg en/of systolisch > 150 mm Hg zonder huidige antihypertensiva. Als de proefpersoon op het moment van screening antihypertensiva gebruikt en de diastolische of systolische waarde verhoogd is, kan de proefpersoon worden ingesloten na overleg met de Medical Monitor,
    e. Bekend met luchtwegaandoening (inclusief astma or chronische obstructieve pulmonale ziekte [COPD]),
    f. Bekend met hartfalen (opmerking: proefpersonen met New York Heart Association Class IV congestief hartfalen kunnen niet ingesloten worden per exclusie 4), of
    g. Bekend met hart- en vaatziekten;
    6) Plasma CRP moet worden verzameld bij screening/baseline/dag 1 bezoek;
    7) Acceptabele algehele medische conditie om veilig ingesloten te worden in de studie en deze te voltooien (specifiek rekening houdend met cardiovasculaire, renale en hepatische aandoeningen naar mening van de onderzoeker);
    8) Het vermogen om een schriftelijke toestemmingsverklaring te tekenen voorafgaand aan het starten van onderzoeksgerelateerde procedures, en het vermogen (naar de mening van de onderzoeker) om alle vereisten van het onderzoek te begrijpen en eraan te voldoen, waaronder het onthouden van het gebruik van verboden medicijnen.
    E.4Principal exclusion criteria
    1) Women of childbearing potential, or men whose sexual partner(s) is a woman of childbearing potential, who:
    a. Are or intend to become pregnant (including use of fertility drugs) during the study;
    b. Are nursing (female subjects only);
    c. Are not using an acceptable, highly effective method of contraception until all follow-up procedures are complete.
    2) Evidence of pre-existing or new-onset organ failure (with the exception of those conditions required for enrollment per Inclusion Criterion 5);
    3) Evidence of moderate concurrent nervous system, renal, endocrine, or gastrointestinal disease, unrelated to COVID-19 as determined by the Investigator (with the exception of those conditions required for enrollment per Inclusion Criterion 5);
    4) Evidence of cardiovascular disease with significant arrhythmia, congestive heart failure (New York Heart Association Class IV), unstable angina, cor pulmonale, or symptomatic pericardial effusion, not related to COVID-19 as determined by the Investigator (with the exception of those conditions required for enrollment per Inclusion Criterion 5);
    5) Required use of vasoactive drug support;
    6) History of myocardial infarction in the 6 months prior to the Screening/Baseline/Day 1 Visit;
    7) Evidence of current liver disease, not related to COVID-19 as determined by the investigator;
    8) History or evidence of active tuberculosis (TB) infection at Screening/Baseline/Day 1 Visit or one of the risk factors for tuberculosis such as but not limited or exclusive to:
    a. History of any of the following: residence in a congregate setting (e.g., jail or prison, homeless shelter, or chronic care facility), substance abuse (e.g., injection or non-injection), health-care workers with unprotected exposure to subjects who are at high risk of TB or subjects with TB disease before the identification and correct airborne precautions of the subject
    or
    b. Close contact (i.e., share the same air space in a household or other enclosed environment for a prolonged period [days or weeks, not minutes or hours]) with a person with active pulmonary TB disease within the last 12 months.
    9) History of or currently active primary or secondary immunodeficiency;
    10) Past or present requirement for oxygen (e.g., nasal cannula, proning, mechanical ventilation and/or supplemental oxygen);
    11) Use of any prohibited concomitant medications/therapies or planned use of any concomitant medications/therapies during the Treatment Period, including specifically:
    a. use of ibuprofen or diclofenac
    b. use of colchicine
    c. use of systemic steroids within 30 days of randomization
    d. use of janus kinase (JAK) inhibitors
    e. use of off-label agents (e.g., hydroxychloroquine, remdesivir, dexamethasone) and biologic and oral anti-cytokine agents (e.g., current treatment with adalimumab, infliximab, etanercept, golimumab, certolizumab pegol, tocilizumab, sarilumab, anakinra, canakinumab, rilonacept, baricitinib, tofacitinib, or upadacitinib);
    12) Known history of renal impairment (e.g., calculated glomerular filtration rate [GFR] < 45 mL/min);
    13) Evidence of malignant disease, or malignancies diagnosed within the previous 5 years (except for local basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix uteri that has been excised and cured);
    14) History of infection or known active infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV);
    15) Any other concomitant medical or psychiatric conditions, diseases, or prior surgeries that, in the opinion of the Investigator, would impair the subject from safely participating in the trial and/or completing protocol requirements;
    16) Individuals who have been in a chronic care facility in the past 30 days;
    17) Individuals who are incarcerated;
    18) Participation in any clinical trial and/or use of any investigational product within the immediate 30-day period prior to the Screening/Baseline/Day 1 Visit.
    1) Vrouwen in de vruchtbare leeftijd of mannen waarvan de partner een vrouw is in de vruchtbare leeftijd die:
    a. Van plan zijn zwanger te worden (inclusief gebruik van vruchtbaarheidsmedicatie) tijdens de studie;
    b. Borstvoeding geven (betreft vrouwelijke proefpersonen);
    c. Geen acceptabele, hoog effectieve anticonceptie middelen gebruiken tot alle follow-up procedures voltooid zijn.
    2) Bewijs van een reeds bestaand of nieuw begonnen orgaan falen (met uitzondering van de voorwaarden die vereist zijn voor inclusie volgens inclusiecriterium 5); ;
    3) Bewijs van matige gelijktijdig optredende zenuwstelsel-, nier-, endocriene of gastro-intestinale ziekte, niet gerelateerd aan COVID-19, zoals bepaald door de onderzoeker (met uitzondering van die condities die nodig zijn voor inclusie zoals aangegeven in inclusie criterium 5);
    4) Bewijs van cardiovasculaire ziekte met significante aritmie, congestief hartfalen (New York Heart Association Class IV), instabiele angina, cor pulmonale of symptomatische pericardiale effusie, niet gerelateerd aan COVID-19, zoals bepaald door de onderzoeker (met uitzondering van die condities die nodig zijn voor inclusie zoals aangegeven in inclusie criterium 5;
    5) Vereist gebruik van vasoactieve medicamenteuze ondersteuning;
    6) Medische geschiedenis van myocard infarct in de 6 maanden voor de Screening/Baseline/Dag 1 Visite;
    7) Bewijs van huidige lever ziekten, niet gerelateerd aan COVID-19, zoals bepaald door de de onderzoeker;
    8) Medische geschiedenis of bewijs van actieve tuberculose (tbc) infectie op Screening/Baseline/Dag 1 Visite of één van de of een van de risicofactoren voor tuberculose, zoals maar niet beperkt of exclusief tot:
    a. Medische geschiedenis van het volgende: verblijf in een gemeenschappelijke omgeving (bijv. gevangenis, daklozenopvang of chronische zorginstelling), misbruik van middelen (b.v., injecteerbaar of niet-injecteerbaar), gezondheidswerkers met onbeschermde blootstelling aan patiënten met een hoog risico op tbc of patiënten met tbc vóór de identificatie en correcte voorzorgsmaatregelen van de patiënt
    of
    b. Nauw contact (d.w.z., gedurende langere tijd dezelfde ruimte in een huishouden of een andere gesloten omgeving delen [dagen of weken, niet minuten of uren]) met een persoon met actieve longtuberculose in de afgelopen 12 maanden.
    9) Medische geschiedenis van of huidig actieve primaire of secundaire immunodeficiëntie;
    10) Vroegere of huidige behoefte aan zuurstof (b.v., neuscanule, buikligging, mechanische ventilatie en/of aanvullende zuurstof);
    11) Gebruik van verboden co-medicaties/therapieën of gepland gebruik van co-medicatie/ therapieën tijdens de behandelperiode, inclusief specifiek:
    a. gebruik van ibuprofen of diclofenac
    b. gebruik van colchicine
    c. gebruik van systemische steroïden in de 30 dagen voor randomisatie
    d. gebruik van janus kinase (JAK) remmers
    e. gebruik van off-label middelen (b.v., hydroxychloroquine, remdesivir, dexamethason) en biologicals en orale anti-cytokine middelen (b.v., huidige behandeling met adalimumab, infliximab, etanercept, golimumab, certolizumab pegol, tocilizumab, sarilumab, anakinra, canakinumab, rilonacept, baricitinib, tofacitinib, of upadacitinib);
    12) Medische geschiedenis met nierfunctie stoornis (b.v., berekende glomerulaire filtratie ratio [GFR] < 45 ml/min);
    13) Bewijs van een kwaadaardige ziekte of maligniteiten die in de afgelopen 5 jaar zijn gediagnosticeerd (behalve lokaal basaal- of plaveiselcelcarcinoom van de huid of carcinoom in situ van de baarmoederhals dat is weggesneden en genezen);
    14) Medische geschiedenis van infectie of bekend actieve infectie met het humaan immunodeficiëntie virus (HIV) of , hepatitis B virus (HBV), of hepatitis C virus (HCV);
    15) Alle andere bijkomende medische of psychiatrische aandoeningen, ziekten of eerdere operaties die, naar de mening van de onderzoeker, de proefpersoon zouden verhinderen om veilig deel te nemen aan het onderzoek en/of te voldoen aan de protocolvereisten;
    16) Personen die de afgelopen 30 dagen in een instelling voor chronische zorg zijn geweest;
    17) Personen die in de gevangenis zitten;
    18) Deelname aan een klinisch onderzoek en/of gebruik van een onderzoeksproduct binnen de periode van 30 dagen voorafgaand aan de screening/baseline/dag 1 visite.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint will be the proportion of subjects with complete resolution of fever symptoms (feeling feverish, chills, shivering and/or sweating) and shortness of breath by Day 15.
    Primair eindpunt:
    Het percentage proefpersonen bij wie de koortssymptomen (koortsachtig gevoel, koude rillingen, rillingen en/of zweten) en kortademigheid volledig zijn verdwenen op dag 15.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Day 15
    Dag 15
    E.5.2Secondary end point(s)
    The secondary efficacy-related endpoints will be to compare the dapansutrile and placebo arms by the following measures:
    • WHO Ordinal Scale for Clinical Improvement
    - Clinical status at Day 8, Day 15, and Day 29
    - Mean change from baseline at Day 8, Day 15, and Day 29;
    • Oxygenation
    - Oxygenation-free days from Day 1 through Day 15
    - Incidence and duration of new oxygen use through Day 45;
    • Mechanical ventilation
    - Mechanical ventilator-free days from Day 1 through Day 15
    - Incidence and duration of mechanical ventilation use through Day 45;
    • Hospitalization
    - Duration of hospital stay (days);
    • Mortality
    - Incidence of death through Day 45;
    • Fever
    - Number of days with fever (> 38ᵒC / 100.4ᵒF);
    • Diarrhea
    - Severity and frequency through Day 15;
    • Vomiting
    - Severity and frequency through Day 15;
    • All symptoms relevant to COVID-19
    - Severity and frequency through Day 15;
    • Immunological and inflammatory labs, COVID-19 biomarkers, and cytokine biomarkers
    - Mean change from baseline through Day 15 in the following:
    ALT, AST, Creatinine, C3a, CRP, D-dimer, Ferritin, G-CSF, IL-1β, IL-6, IL-18, IP-10, LDH, Platelets, White blood cell (WBC) count.

    Safety variables collected in the study will be:
    • AEs during the clinical trial;
    • Safety laboratory measures (chemistry, hematology, and urinalysis);
    • Vital signs (pulse, respiratory rate, resting blood pressure, temperature, and oxygen saturation/SpO2).

    The safety endpoints in the study will evaluate the safety of dapansutrile relative to placebo by assessing:
    • Cumulative incidence of SAEs;
    • Cumulative incidence of Grade 3 and Grade 4 AEs;
    • Discontinuation or temporary suspension of participation (for any reason);
    • Changes in white cell count, hemoglobin, platelets, creatinine, glucose, total bilirubin, ALT, and AST over time;
    • Incidence of new infection that occurs during the study, regardless of organism (i.e., viral or non-viral), and including site of infection and source of culture (BALF, tracheal aspirate, sputum, blood, urine, etc.) should be recorded;
    • Incidence of opportunistic infections.

    Exploratory endpoints in the study will evaluate:
    • Association of biomarkers with disease progression, treatment efficacy, and/or adverse events associated with treatment;
    • Increased knowledge and understanding of the pathogenesis of COVID-19.
    Secundaire eindpunten:
    De secundaire eindpunten gerelateerd aan de werkzaamheid, om de dapansutrile en placebo arm te vergelijken, zijn:
    • WHO Ordinal Scale for Clinical Improvement
    - Klinische status op Dag 8, Dag 15 en Dag 29
    - Gemiddelde verandering vanaf baseline op Dag 8, Dag 15 en Dag 29;
    • Zuurstofvoorziening
    - Dagen zonder zuurstofvoorziening van Dag 1 tot en met Dag 15
    - Incidentie en duur van nieuw zuurstofgebruik tot en met dag 45;
    • Mechanische beademing
    - Dagen zonder mechanische behandeling van Dag 1 tot en met Dag 15
    - Incidentie en duur van het gebruik van mechanische beademingIncidence tot en met Dag 45;
    • Ziekenhuisopname
    - Duur van het verblijf in het ziekenhuis (dagen);
    • Sterftecijfer
    - Incidentie van overlijden tot en met Dag 45;
    • Koorts
    - Aantal dagen zonder koorts (> 38ᵒC);
    • Diarree
    - Ernst en frequentie tot en met Dag 15;
    • Braken
    - Ernst en frequentie tot en met Dag 15;
    • Alle symptomen relevant voor COVID-19
    - Ernst en frequentie tot en met Dag 15;
    • Immunologische en inflammatoire labtesten, COVID-19 biomarkers en cytokine biomarkers
    - Gemiddelde verandering vanaf beaseline tot en met Dag 15 voor de volgende parameters:
    ALAT, ASAT, Creatinine, C3a, CRP, D-dimer, Ferritin, G-CSF, IL-1β, IL-6, IL-18, IP-10, LDH, Platelets, White blood cell (WBC) count.

    De volgende variabelen voor veiligheid worden verzameld in de studie:
    • AEs tijdens de klinische trial;
    • Laboratorium testen voor veiligheid (chemie, hematologie en urine analyse);
    • Vitale functies (hartslag, ademhalingsfrequentie, bloeddruk in rust, temperatuur en zuurstofsaturatie/SpO2).

    De eindpunten in deze studie gerelateerd aan de veiligheid van dapansutrile ten opzichte van placebo zijn:
    • Cumulatieve incidentie van SAEs;
    • Cumulatieve incidentie van graad 3 en graad 4 AEs;
    • Beëindiging of tijdelijke opschorting van deelname (ongeacht de reden);
    • Veranderingen in het aantal witte bloedcellen, hemoglobine, trombocyten, kreatinine, glucose, totale bilirubine, ALAT en ASAT in de loop van de tijd;
    • Incidentie van een nieuwe infectie die optreedt tijdens de studie, ongeacht door welk organisme veroorzaakt (d.w.z. viraal of niet-viraal) en inclusief de plaats van de infectie en de bron van de cultuur (BALF, tracheale aspiratie, sputum, bloed, urine, etc.) moeten gedocumenteerd worden;
    • Incidentie van opportunistische infecties.

    De verkennende eindpunten van de studie zullen het volgende evalueren:
    • Associatie van biomarkers met ziekteprogressie, werkzaamheid van de behandeling en/of bijwerkingen die verband houden met de behandeling;
    • Meer kennis en begrip van de pathogenese van COVID-19.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Day 8, day 15, day 29 and day 45
    Dag 8, dag 15, dag 29 en dag 45
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA2
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    United States
    Italy
    Netherlands
    Switzerland
    E.8.7Trial 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
    LVLS
    LPLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days14
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 60
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 20
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state8
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 16
    F.4.2.2In the whole clinical trial 80
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None
    Geen
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-12-17
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-03-03
    P. End of Trial
    P.End of Trial StatusCompleted
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