Clinical Trial Results:
A Phase II, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Antiviral Activity, Safety, Pharmacokinetics, and Efficacy of RO7496998 (AT-527) in Non-Hospitalized Adult Patients with Mild or Moderate COVID-19
Summary
|
|
EudraCT number |
2020-005366-34 |
Trial protocol |
IE BG ES LV GR LT |
Global end of trial date |
13 Oct 2021
|
Results information
|
|
Results version number |
v1(current) |
This version publication date |
04 Oct 2022
|
First version publication date |
04 Oct 2022
|
Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
|
|||
Trial identification
|
|||
Sponsor protocol code |
WV43042
|
||
Additional study identifiers
|
|||
ISRCTN number |
- | ||
US NCT number |
NCT04709835 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
|
|||
Sponsor organisation name |
F. Hoffmann-La Roche AG
|
||
Sponsor organisation address |
Grenzacherstrasse 124, Basel, Switzerland, CH-4070
|
||
Public contact |
F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
|
||
Scientific contact |
F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
|
||
Paediatric regulatory details
|
|||
Is trial part of an agreed paediatric investigation plan (PIP) |
No
|
||
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
|
||
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
|
||
Results analysis stage
|
|||
Analysis stage |
Final
|
||
Date of interim/final analysis |
13 Oct 2021
|
||
Is this the analysis of the primary completion data? |
No
|
||
Global end of trial reached? |
Yes
|
||
Global end of trial date |
13 Oct 2021
|
||
Was the trial ended prematurely? |
No
|
||
General information about the trial
|
|||
Main objective of the trial |
The main objective of this Phase II, randomized, double-blind, placebo-controlled study was to evaluate the antiviral activity of selected dose regimens of AT-527 compared with placebo in non-hospitalized adult participants with mild or moderate COVID-19.
|
||
Protection of trial subjects |
All study subjects were required to read and sign an Informed Consent Form.
|
||
Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
03 Feb 2021
|
||
Long term follow-up planned |
No
|
||
Independent data monitoring committee (IDMC) involvement? |
No
|
||
Population of trial subjects
|
|||
Number of subjects enrolled per country |
|||
Country: Number of subjects enrolled |
Canada: 1
|
||
Country: Number of subjects enrolled |
Spain: 15
|
||
Country: Number of subjects enrolled |
United Kingdom: 76
|
||
Country: Number of subjects enrolled |
Greece: 4
|
||
Country: Number of subjects enrolled |
Ireland: 1
|
||
Country: Number of subjects enrolled |
Latvia: 3
|
||
Worldwide total number of subjects |
100
|
||
EEA total number of subjects |
23
|
||
Number of subjects enrolled per age group |
|||
In utero |
0
|
||
Preterm newborn - gestational age < 37 wk |
0
|
||
Newborns (0-27 days) |
0
|
||
Infants and toddlers (28 days-23 months) |
0
|
||
Children (2-11 years) |
0
|
||
Adolescents (12-17 years) |
0
|
||
Adults (18-64 years) |
97
|
||
From 65 to 84 years |
3
|
||
85 years and over |
0
|
|
|||||||||||||||||||||
Recruitment
|
|||||||||||||||||||||
Recruitment details |
The study enrolled 104 participants at sites in the United Kingdom, Spain, Greece, Latvia, Ireland and Canada. | ||||||||||||||||||||
Pre-assignment
|
|||||||||||||||||||||
Screening details |
The study enrolled 104 non-hospitalized adult participants with mild or moderate COVID-19. Four enrolled participants were not treated and are not included in the Results. | ||||||||||||||||||||
Period 1
|
|||||||||||||||||||||
Period 1 title |
Overall Study (overall period)
|
||||||||||||||||||||
Is this the baseline period? |
Yes | ||||||||||||||||||||
Allocation method |
Randomised - controlled
|
||||||||||||||||||||
Blinding used |
Double blind | ||||||||||||||||||||
Roles blinded |
Investigator, Carer, Subject | ||||||||||||||||||||
Arms
|
|||||||||||||||||||||
Are arms mutually exclusive |
Yes
|
||||||||||||||||||||
Arm title
|
Pooled Placebo | ||||||||||||||||||||
Arm description |
Participants received placebo matched to 550 mg or 1100 mg AT-527 twice a day (BID) on Days 1-5. | ||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||
Investigational medicinal product name |
Placebo
|
||||||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||||||
Other name |
|||||||||||||||||||||
Pharmaceutical forms |
Tablet
|
||||||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||||||
Dosage and administration details |
The dose and regimen of the placebo matched that of the respective AT-527 comparator arm.
|
||||||||||||||||||||
Arm title
|
AT-527 550 mg (1x550 mg) | ||||||||||||||||||||
Arm description |
Participants received 550 mg AT-527 (1x550 mg) twice a day (BID) on Days 1-5. | ||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||
Investigational medicinal product name |
AT-527
|
||||||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||||||
Other name |
RO7496998
|
||||||||||||||||||||
Pharmaceutical forms |
Tablet
|
||||||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||||||
Dosage and administration details |
Participants received 550 mg AT-527 (1x550 mg) twice a day (BID) on Days 1-5.
|
||||||||||||||||||||
Arm title
|
AT-527 1100 mg (4x275 mg) | ||||||||||||||||||||
Arm description |
Participants received 1100 mg AT-527 (4x275 mg) twice a day (BID) on Days 1-5. | ||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||
Investigational medicinal product name |
AT-527
|
||||||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||||||
Other name |
RO7496998
|
||||||||||||||||||||
Pharmaceutical forms |
Tablet
|
||||||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||||||
Dosage and administration details |
Participants received 1100 mg AT-527 (4x275 mg) twice a day (BID) on Days 1-5.
|
||||||||||||||||||||
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Baseline characteristics reporting groups
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Pooled Placebo
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Participants received placebo matched to 550 mg or 1100 mg AT-527 twice a day (BID) on Days 1-5. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
AT-527 550 mg (1x550 mg)
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Participants received 550 mg AT-527 (1x550 mg) twice a day (BID) on Days 1-5. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
AT-527 1100 mg (4x275 mg)
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Participants received 1100 mg AT-527 (4x275 mg) twice a day (BID) on Days 1-5. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
End points reporting groups
|
|||
Reporting group title |
Pooled Placebo
|
||
Reporting group description |
Participants received placebo matched to 550 mg or 1100 mg AT-527 twice a day (BID) on Days 1-5. | ||
Reporting group title |
AT-527 550 mg (1x550 mg)
|
||
Reporting group description |
Participants received 550 mg AT-527 (1x550 mg) twice a day (BID) on Days 1-5. | ||
Reporting group title |
AT-527 1100 mg (4x275 mg)
|
||
Reporting group description |
Participants received 1100 mg AT-527 (4x275 mg) twice a day (BID) on Days 1-5. | ||
Subject analysis set title |
Placebo Matched to AT-527 550 mg
|
||
Subject analysis set type |
Sub-group analysis | ||
Subject analysis set description |
Participants received placebo matched to 550 mg AT-527 twice a day (BID) on Days 1-5.
|
|
||||||||||||||||||||||
End point title |
Change from Baseline in the Amount of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Virus RNA for AT-527 550 mg and Matched Placebo [1] | |||||||||||||||||||||
End point description |
SARS-CoV-2 virus RNA was measured by reverse-transcription polymerase chain reaction (RT-PCR) from nasopharyngeal (NP) swabs. The change from baseline was estimated from an ANCOVA model with baseline viral load as a covariate. Reported here is the adjusted mean change from baseline. A negative change from baseline indicates an improvement. The modified ITT infected (mITTi) population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization. Here, n indicates the number of participants analyzed at each time point.
|
|||||||||||||||||||||
End point type |
Primary
|
|||||||||||||||||||||
End point timeframe |
Baseline, Day 3, Day 5, Day 7
|
|||||||||||||||||||||
Notes [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: Results are reported for the arms as indicated in the endpoint title. The other arms are reported in the co-primary endpoint. |
||||||||||||||||||||||
|
||||||||||||||||||||||
Statistical analysis title |
Day 3 | |||||||||||||||||||||
Comparison groups |
AT-527 550 mg (1x550 mg) v Placebo Matched to AT-527 550 mg
|
|||||||||||||||||||||
Number of subjects included in analysis |
60
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority [2] | |||||||||||||||||||||
P-value |
= 0.7144 | |||||||||||||||||||||
Method |
ANCOVA | |||||||||||||||||||||
Parameter type |
Difference in Adjusted Means | |||||||||||||||||||||
Point estimate |
-0.11
|
|||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
level |
80% | |||||||||||||||||||||
sides |
2-sided
|
|||||||||||||||||||||
lower limit |
-0.49 | |||||||||||||||||||||
upper limit |
0.27 | |||||||||||||||||||||
Variability estimate |
Standard error of the mean
|
|||||||||||||||||||||
Dispersion value |
0.292
|
|||||||||||||||||||||
Notes [2] - A difference in adjusted means of <0 favors RO7496998 (AT-527). |
||||||||||||||||||||||
Statistical analysis title |
Day 5 | |||||||||||||||||||||
Comparison groups |
AT-527 550 mg (1x550 mg) v Placebo Matched to AT-527 550 mg
|
|||||||||||||||||||||
Number of subjects included in analysis |
60
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority [3] | |||||||||||||||||||||
P-value |
= 0.3373 | |||||||||||||||||||||
Method |
ANCOVA | |||||||||||||||||||||
Parameter type |
Difference in Adjusted Means | |||||||||||||||||||||
Point estimate |
0.32
|
|||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
level |
80% | |||||||||||||||||||||
sides |
2-sided
|
|||||||||||||||||||||
lower limit |
-0.11 | |||||||||||||||||||||
upper limit |
0.74 | |||||||||||||||||||||
Variability estimate |
Standard error of the mean
|
|||||||||||||||||||||
Dispersion value |
0.327
|
|||||||||||||||||||||
Notes [3] - A difference in adjusted means of <0 favors RO7496998 (AT-527). |
||||||||||||||||||||||
Statistical analysis title |
Day 7 | |||||||||||||||||||||
Comparison groups |
AT-527 550 mg (1x550 mg) v Placebo Matched to AT-527 550 mg
|
|||||||||||||||||||||
Number of subjects included in analysis |
60
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority [4] | |||||||||||||||||||||
P-value |
= 0.426 | |||||||||||||||||||||
Method |
ANCOVA | |||||||||||||||||||||
Parameter type |
Difference in Adjusted Means | |||||||||||||||||||||
Point estimate |
-0.25
|
|||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
level |
80% | |||||||||||||||||||||
sides |
2-sided
|
|||||||||||||||||||||
lower limit |
-0.66 | |||||||||||||||||||||
upper limit |
0.16 | |||||||||||||||||||||
Variability estimate |
Standard error of the mean
|
|||||||||||||||||||||
Dispersion value |
0.315
|
|||||||||||||||||||||
Notes [4] - A difference in adjusted means of <0 favors RO7496998 (AT-527). |
|
||||||||||||||||||||||
End point title |
Change from Baseline in the Amount of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Virus RNA for AT-527 1100 mg and Pooled Placebo [5] | |||||||||||||||||||||
End point description |
SARS-CoV-2 virus RNA was measured by reverse-transcription polymerase chain reaction (RT-PCR) from NP swabs. The change from baseline was estimated from an ANCOVA model with baseline viral load as a covariate. Reported here is the adjusted mean change from baseline. A negative change from baseline indicates an improvement. The modified ITT infected (mITTi) population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization. Here, n indicates the number of participants analyzed at each time point.
|
|||||||||||||||||||||
End point type |
Primary
|
|||||||||||||||||||||
End point timeframe |
Baseline, Day 3, Day 5, Day 7
|
|||||||||||||||||||||
Notes [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: Results are reported for the arms as indicated in the endpoint title. The other arms are reported in the co-primary endpoint. |
||||||||||||||||||||||
|
||||||||||||||||||||||
Statistical analysis title |
Day 3 | |||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
|||||||||||||||||||||
Number of subjects included in analysis |
70
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority [6] | |||||||||||||||||||||
P-value |
= 0.7351 | |||||||||||||||||||||
Method |
ANCOVA | |||||||||||||||||||||
Parameter type |
Difference in Adjusted Means | |||||||||||||||||||||
Point estimate |
-0.1
|
|||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
level |
80% | |||||||||||||||||||||
sides |
2-sided
|
|||||||||||||||||||||
lower limit |
-0.48 | |||||||||||||||||||||
upper limit |
0.28 | |||||||||||||||||||||
Variability estimate |
Standard error of the mean
|
|||||||||||||||||||||
Dispersion value |
0.294
|
|||||||||||||||||||||
Notes [6] - A difference in adjusted means of <0 favors RO7496998 (AT-527). |
||||||||||||||||||||||
Statistical analysis title |
Day 5 | |||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
|||||||||||||||||||||
Number of subjects included in analysis |
70
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority [7] | |||||||||||||||||||||
P-value |
= 0.7524 | |||||||||||||||||||||
Method |
ANCOVA | |||||||||||||||||||||
Parameter type |
Difference in Adjusted Means | |||||||||||||||||||||
Point estimate |
-0.1
|
|||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
level |
80% | |||||||||||||||||||||
sides |
2-sided
|
|||||||||||||||||||||
lower limit |
-0.5 | |||||||||||||||||||||
upper limit |
0.3 | |||||||||||||||||||||
Variability estimate |
Standard error of the mean
|
|||||||||||||||||||||
Dispersion value |
0.31
|
|||||||||||||||||||||
Notes [7] - A difference in adjusted means of <0 favors RO7496998 (AT-527). |
||||||||||||||||||||||
Statistical analysis title |
Day 7 | |||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
|||||||||||||||||||||
Number of subjects included in analysis |
70
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority [8] | |||||||||||||||||||||
P-value |
= 0.8083 | |||||||||||||||||||||
Method |
ANCOVA | |||||||||||||||||||||
Parameter type |
Difference in Adjusted Means | |||||||||||||||||||||
Point estimate |
-0.08
|
|||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
level |
80% | |||||||||||||||||||||
sides |
2-sided
|
|||||||||||||||||||||
lower limit |
-0.48 | |||||||||||||||||||||
upper limit |
0.33 | |||||||||||||||||||||
Variability estimate |
Standard error of the mean
|
|||||||||||||||||||||
Dispersion value |
0.314
|
|||||||||||||||||||||
Notes [8] - A difference in adjusted means of <0 favors RO7496998 (AT-527). |
|
|||||||||||||||||
End point title |
Time to Cessation of SARS-CoV-2 Viral Shedding | ||||||||||||||||
End point description |
Time to cessation of viral shedding was defined as the time between the initiation of any study treatment and the first time when a negative or below the limit of detection RT-PCR test result was obtained. RT-PCR was measured from NP swabs. Median, 25th and 75th percentiles were estimated from the Kaplan-Meier curve. The mITTi population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization. "99999" indicates that the value was not estimable due to low number of participants with events.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to Day 7
|
||||||||||||||||
|
|||||||||||||||||
Statistical analysis title |
Placebo versus AT-527 550 mg | ||||||||||||||||
Statistical analysis description |
Hazard ratio (80% CI) was estimated with a Cox proportional hazards model (unadjusted).
|
||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 550 mg (1x550 mg)
|
||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||
Analysis type |
|||||||||||||||||
Method |
|||||||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||||||
Point estimate |
0.96
|
||||||||||||||||
Confidence interval |
|||||||||||||||||
level |
80% | ||||||||||||||||
sides |
2-sided
|
||||||||||||||||
lower limit |
0.53 | ||||||||||||||||
upper limit |
1.74 | ||||||||||||||||
Statistical analysis title |
Placebo versus AT-527 1100 mg | ||||||||||||||||
Statistical analysis description |
Hazard ratio (80% CI) was estimated with a Cox proportional hazards model (unadjusted).
|
||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||
Analysis type |
|||||||||||||||||
Method |
|||||||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||||||
Point estimate |
1.33
|
||||||||||||||||
Confidence interval |
|||||||||||||||||
level |
80% | ||||||||||||||||
sides |
2-sided
|
||||||||||||||||
lower limit |
0.76 | ||||||||||||||||
upper limit |
2.32 |
|
|||||||||||||||||
End point title |
Time to Sustained Non-Detectable SARS-CoV-2 Virus RNA | ||||||||||||||||
End point description |
Time to sustained non-detectable SARS-CoV-2 virus RNA was defined as the time between the initiation of any study treatment and first time when a negative or below the limit of detection test result by RT-PCR is obtained after which no positive test above or equal to the limit of detection was reported. RT-PCR was measured from NP swabs. Median, 25th and 75th percentiles were estimated from the Kaplan-Meier curve. The mITTi population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization. "99999" indicates that the value was not estimable due to low number of participants with events.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to Day 7
|
||||||||||||||||
|
|||||||||||||||||
Statistical analysis title |
Placebo versus AT-527 550 mg | ||||||||||||||||
Statistical analysis description |
Hazard ratio (80% CI) was estimated with a Cox proportional hazards model (unadjusted).
|
||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 550 mg (1x550 mg)
|
||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||
Analysis type |
|||||||||||||||||
Method |
|||||||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||||||
Point estimate |
0.86
|
||||||||||||||||
Confidence interval |
|||||||||||||||||
level |
80% | ||||||||||||||||
sides |
2-sided
|
||||||||||||||||
lower limit |
0.44 | ||||||||||||||||
upper limit |
1.7 | ||||||||||||||||
Statistical analysis title |
Placebo versus AT-527 1100 mg | ||||||||||||||||
Statistical analysis description |
Hazard ratio (80% CI) was estimated with a Cox proportional hazards model (unadjusted).
|
||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||
Analysis type |
|||||||||||||||||
Method |
|||||||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||||||
Point estimate |
1.06
|
||||||||||||||||
Confidence interval |
|||||||||||||||||
level |
80% | ||||||||||||||||
sides |
2-sided
|
||||||||||||||||
lower limit |
0.56 | ||||||||||||||||
upper limit |
2.03 |
|
|||||||||||||||||||||||||||||||||
End point title |
Percentage of Participants Positive for SARS-CoV-2 Virus RNA at Specified Timepoints | ||||||||||||||||||||||||||||||||
End point description |
Reported here is the percentage of participants with a positive virus RNA by RT-PCR test result above or equal to the limit of quantification (LOQ). RT-PCR was measured from NP swabs. The mITTi population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization. Here, n indicates the number of participants analyzed at each time point.
|
||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||
End point timeframe |
Baseline, Day 3, Day 5, Day 7
|
||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
Statistical analysis title |
Day 3 Placebo versus AT-527 550 mg | ||||||||||||||||||||||||||||||||
Statistical analysis description |
Confidence interval estimated with the Farrington-Manning method.
|
||||||||||||||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 550 mg (1x550 mg)
|
||||||||||||||||||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||||||||||||||
Analysis type |
|||||||||||||||||||||||||||||||||
Method |
|||||||||||||||||||||||||||||||||
Parameter type |
Difference in Percentage of Positivity | ||||||||||||||||||||||||||||||||
Point estimate |
5
|
||||||||||||||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||||||||||||||
level |
80% | ||||||||||||||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||||||||||||||
lower limit |
-0.16 | ||||||||||||||||||||||||||||||||
upper limit |
10.16 | ||||||||||||||||||||||||||||||||
Statistical analysis title |
Day 3 Placebo versus AT-527 1100 mg | ||||||||||||||||||||||||||||||||
Statistical analysis description |
Confidence interval estimated with the Farrington-Manning method.
|
||||||||||||||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
||||||||||||||||||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||||||||||||||
Analysis type |
|||||||||||||||||||||||||||||||||
Method |
|||||||||||||||||||||||||||||||||
Parameter type |
Difference in Percentage of Positivity | ||||||||||||||||||||||||||||||||
Point estimate |
-1.9
|
||||||||||||||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||||||||||||||
level |
80% | ||||||||||||||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||||||||||||||
lower limit |
-9.2 | ||||||||||||||||||||||||||||||||
upper limit |
5.41 | ||||||||||||||||||||||||||||||||
Statistical analysis title |
Day 5 Placebo versus AT-527 550 mg | ||||||||||||||||||||||||||||||||
Statistical analysis description |
Confidence interval estimated with the Farrington-Manning method.
|
||||||||||||||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 550 mg (1x550 mg)
|
||||||||||||||||||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||||||||||||||
Analysis type |
|||||||||||||||||||||||||||||||||
Method |
|||||||||||||||||||||||||||||||||
Parameter type |
Difference in Percentage of Positivity | ||||||||||||||||||||||||||||||||
Point estimate |
5.79
|
||||||||||||||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||||||||||||||
level |
80% | ||||||||||||||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||||||||||||||
lower limit |
-4.82 | ||||||||||||||||||||||||||||||||
upper limit |
16.4 | ||||||||||||||||||||||||||||||||
Statistical analysis title |
Day 5 Placebo versus AT-527 1100 mg | ||||||||||||||||||||||||||||||||
Statistical analysis description |
Confidence interval estimated with the Farrington-Manning method.
|
||||||||||||||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
||||||||||||||||||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||||||||||||||
Analysis type |
|||||||||||||||||||||||||||||||||
Method |
|||||||||||||||||||||||||||||||||
Parameter type |
Difference in Percentage of Positivity | ||||||||||||||||||||||||||||||||
Point estimate |
-0.88
|
||||||||||||||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||||||||||||||
level |
80% | ||||||||||||||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||||||||||||||
lower limit |
-12.4 | ||||||||||||||||||||||||||||||||
upper limit |
10.65 | ||||||||||||||||||||||||||||||||
Statistical analysis title |
Day 7 Placebo versus AT-527 550 mg | ||||||||||||||||||||||||||||||||
Statistical analysis description |
Confidence interval estimated with the Farrington-Manning method.
|
||||||||||||||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 550 mg (1x550 mg)
|
||||||||||||||||||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||||||||||||||
Analysis type |
|||||||||||||||||||||||||||||||||
Method |
|||||||||||||||||||||||||||||||||
Parameter type |
Difference in Percentage of Positivity | ||||||||||||||||||||||||||||||||
Point estimate |
2.39
|
||||||||||||||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||||||||||||||
level |
80% | ||||||||||||||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||||||||||||||
lower limit |
-10.64 | ||||||||||||||||||||||||||||||||
upper limit |
15.42 | ||||||||||||||||||||||||||||||||
Statistical analysis title |
Day 7 Placebo versus AT-527 1100 mg | ||||||||||||||||||||||||||||||||
Statistical analysis description |
Confidence interval estimated with the Farrington-Manning method.
|
||||||||||||||||||||||||||||||||
Comparison groups |
Pooled Placebo v AT-527 1100 mg (4x275 mg)
|
||||||||||||||||||||||||||||||||
Number of subjects included in analysis |
70
|
||||||||||||||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||||||||||||||
Analysis type |
|||||||||||||||||||||||||||||||||
Method |
|||||||||||||||||||||||||||||||||
Parameter type |
Difference in Percentage of Positivity | ||||||||||||||||||||||||||||||||
Point estimate |
-0.26
|
||||||||||||||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||||||||||||||
level |
80% | ||||||||||||||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||||||||||||||
lower limit |
-13.39 | ||||||||||||||||||||||||||||||||
upper limit |
12.88 |
|
|||||||||||||||||
End point title |
Area Under the Curve (AUC) in the Amount of SARS-CoV-2 Virus RNA | ||||||||||||||||
End point description |
AUC is the amount of SARS-CoV-2 virus RNA from baseline to the last sample timepoint and was calculated using the trapezoidal method. RT-PCR was measured from NP swabs. The mITTi population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Baseline, Day 3, Day 5, Day 7
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Time to Alleviation or Improvement of COVID-19 Symptoms (21.5 hours) | ||||||||||||||||
End point description |
COVID-19 symptoms were evaluated using the first 12 items in the COVID-19 Symptom Diary, which included the following 12 items: nasal congestion or runny nose, sore throat, cough, shortness of breath, muscle or body aches, fatigue, headache, chills/sweats, feeling hot or feverish, nausea, vomiting, and diarrhea. The symptoms were scored on the 4-point Likert scale (0=none, 1=mild, 2=moderate, 3=severe). Time to alleviation or improvement is defined as the length of time taken from start of treatment to the point at which all of the following three criteria are met and maintained for a concurrent duration of at least 21.5 hours: "new" symptoms with a score of 0 or 1; "pre- existing and worsened due to COVID-19" symptoms with at least a single category improvement from baseline; "pre-existing and not worsened due to COVID-19" symptoms remaining the same or at least a single category improvement from baseline. mITTi population was analyzed for this endpoint.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 28 Days
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Time to Alleviation or Improvement of COVID-19 Symptoms (43 hours) | ||||||||||||||||
End point description |
COVID-19 symptoms were evaluated using the first 12 items in the COVID-19 Symptom Diary, which included the following 12 items: nasal congestion or runny nose, sore throat, cough, shortness of breath, muscle or body aches, fatigue, headache, chills/sweats, feeling hot or feverish, nausea, vomiting, and diarrhea. The symptoms were scored on the 4-point Likert scale (0=none, 1=mild, 2=moderate, 3=severe). Time to alleviation or improvement is defined as the length of time taken from start of treatment to the point at which all of the following three criteria are met and maintained for a concurrent duration of at least 43 hours: "new" symptoms with a score of 0 or 1; "pre- existing and worsened due to COVID-19" symptoms with at least a single category improvement from baseline; "pre-existing and not worsened due to COVID-19" symptoms remaining the same or at least a single category improvement from baseline. mITTi population was analyzed for this endpoint.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 28 Days
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Time to Alleviation of COVID-19 Symptoms (21.5 hours) | ||||||||||||||||
End point description |
COVID-19 symptoms were evaluated using the first 12 items in the COVID-19 Symptom Diary, which included the following 12 items: nasal congestion or runny nose, sore throat, cough, shortness of breath, muscle or body aches, fatigue, headache, chills/sweats, feeling hot or feverish, nausea, vomiting, and diarrhea. The symptoms were scored on the 4-point Likert scale (0=none, 1=mild, 2=moderate, 3=severe). Time to alleviation of COVID-19 symptoms is defined as the length of time taken from start of treatment to the point at which the following criterion is met and maintained for at least 21.5 hours: Score of 0 or 1 on Items 1-12 of the COVID-19 Symptom Diary, regardless of if the symptom is pre-existing or new. mITTi population was analyzed for this endpoint.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 28 Days
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Time to Alleviation of COVID-19 Symptoms (43 hours) | ||||||||||||||||
End point description |
COVID-19 symptoms were evaluated using the first 12 items in the COVID-19 Symptom Diary, which included the following 12 items: nasal congestion or runny nose, sore throat, cough, shortness of breath, muscle or body aches, fatigue, headache, chills/sweats, feeling hot or feverish, nausea, vomiting, and diarrhea. The symptoms were scored on the 4-point Likert scale (0=none, 1=mild, 2=moderate, 3=severe). Time to alleviation of COVID-19 symptoms is defined as the length of time taken from start of treatment to the point at which the following criterion is met and maintained for at least 43 hours: Score of 0 or 1 on Items 1-12 of the COVID-19 Symptom Diary, regardless of if the symptom is pre-existing or new. mITTi population was analyzed for this endpoint.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 28 Days
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Duration of Fever | ||||||||||||||||
End point description |
Duration of fever was defined as the time from start of treatment to return to an afebrile state (temperature ≤ 37.5°C) maintained for at least 21.5 hours. The mITTi population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 28 Days
|
||||||||||||||||
|
|||||||||||||||||
Notes [9] - Only participants who had a fever (temperature > 37.5 degrees Celsius) at baseline are included. [10] - Only participants who had a fever (temperature > 37.5 degrees Celsius) at baseline are included. [11] - Only participants who had a fever (temperature > 37.5 degrees Celsius) at baseline are included. |
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Percentage of Participants with COVID-19 Related Complications | ||||||||||||||||
End point description |
COVID-19 related complications include death, hospitalization, radiologically confirmed pneumonia, acute respiratory failure, sepsis, coagulopathy, pericarditis, myocarditis, and cardiac failure. The mITTi population was defined as all participants randomized in the study who received any amount of study drug and had at least one positive SARS-CoV-2 RT-PCR test result above or equal to the limit of quantification (LOQ) during the study, with participants grouped according to the treatment assignment at randomization.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 33 Days
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point title |
Time to Alleviation of an Individual Symptom | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
The COVID-19 Symptom Diary included 14 items: nasal congestion or runny nose, sore throat, cough, shortness of breath, muscle or body aches, fatigue, headache, chills/sweats, feeling hot or feverish, nausea, vomiting, diarrhea, sense of smell over the past 7 days, sense of taste over the past 7 days. The severity of items 1-12 was recorded on a 4-point Likert scale (none=0, mild=1, moderate=2, severe=3). Items 13-14 were recorded on a 3-point Likert scale (same as usual=0, less than usual=1, no sense=2). Time to alleviation: the time from the start of treatment to the point at which the following criterion was met and maintained for at least 21.5 hours: score of 0 or 1 for Items 1-12; score of 0 for Items 13-14. mITTi population: only participants with a baseline score of > 1 for Items 1 - 12 or > 0 for Items 13 - 14 were included in the analysis. Here, "n" is the number of participants analyzed for the individual symptom. "99999": not estimable due to low number of events.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Up to 28 Days
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||
End point title |
Percentage of Participants with Adverse Events (AEs) | ||||||||||||||||
End point description |
An AE is any untoward medical occurrence in a clinical investigation subject administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any of the following: any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the medicinal product, any new disease or exacerbation of an existing disease, recurrence of an intermittent medical condition not present at baseline or related to a protocol-mandated intervention. Safety population consisted of all participants who received any amount of study drug and were grouped according to the treatment that the participants actually received rather than the treatment assigned at randomization.
|
||||||||||||||||
End point type |
Secondary
|
||||||||||||||||
End point timeframe |
Up to 33 Days
|
||||||||||||||||
|
|||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point title |
Plasma Concentrations of AT-511, AT-551, AT-229 and AT-273 for Participants Treated with 550 mg AT-527 [12] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
AT-511 is the free base form of AT-527. Its major metabolites are AT-551, AT-229, and AT-273. The pharmacokinetic-evaluable population consisted of all participants randomized into the study who had at least one post-dose drug concentration measurement at a scheduled visit timepoint. Here, n indicates the number of participants analyzed at each time point.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Day 1: pre-dose, 1 hour, 3 hours; Day 3: pre-dose; Day 5: pre-dose, 3 hours, 48 hours
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Notes [12] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: Results are presented for the arm as indicated in the endpoint title. Plasma concentrations were only evaluated in the arms treated with AT-527. |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point title |
Plasma Concentrations of AT-511, AT-551, AT-229 and AT-273 for Participants Treated with 1100 mg AT-527 [13] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
AT-511 is the free base form of AT-527. Its major metabolites are AT-551, AT-229, and AT-273. The pharmacokinetic-evaluable population consisted of all participants randomized into the study who had at least one post-dose drug concentration measurement at a scheduled visit timepoint. Here, n indicates the number of participants analyzed at each time point.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Day 1: pre-dose, 1 hour, 4 hours; Day 3: pre-dose; Day 5: pre-dose, 1 hour, 4 hours, 48 hours
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Notes [13] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: Results are presented for the arm as indicated in the endpoint title. Plasma concentrations were only evaluated in the arms treated with AT-527. |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
Up to 33 days
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse event reporting additional description |
Safety Population consisted of all participants who received any amount of study drug and were grouped according to the treatment that the participants actually received rather than the treatment assigned at randomization.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
24.1
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Pooled Placebo
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Participants received placebo matched to 550 mg or 1100 mg AT-527 twice a day (BID) on Days 1-5. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
AT-527 1100 mg (4x275 mg)
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Participants received 1100 mg AT-527 (4x275 mg) twice a day (BID) on Days 1-5. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
AT-527 550 mg (1x550 mg)
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Participants received 550 mg AT-527 (1x550 mg) twice a day (BID) on Days 1-5. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
||
10 Dec 2020 |
The purpose of amendment version 2 was primarily to remove the use of historical severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) test results for eligibility assessment and to clarify the timing of safety data required for dose-selection decision making. |
||
05 Feb 2021 |
The purpose of country-specific amendment version 3 was to incorporate changes requested by the Irish Health Products Regulatory Authority. |
||
24 Feb 2021 |
The purpose of amendment version 4 was primarily to broaden the patient population by allowing all subjects with mild or moderate COVID-19 to be enrolled, not only those considered
otherwise healthy, and to enable Cohorts B-E to be conducted in an outpatient setting. The parameters for the dose selection decision were also modified. |
||
13 May 2021 |
The purpose of amendment version 5 was primarily to incorporate additional secondary efficacy endpoints and updated information related to cautionary therapies. |
||
17 Sep 2021 |
The purpose of amendment version 6 was primarily to enable further evaluation of the antiviral efficacy and safety of RO7496998 (AT-527) using the dose regimen selected from previous cohorts. No patients were enrolled under this protocol
version as the study closed after recruitment of Cohort A and Cohort B. |
||
Interruptions (globally) |
|||
Were there any global interruptions to the trial? No | |||
Limitations and caveats |
|||
Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |