E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Mild or moderate COVID-19 (Coronavirus Disease 19), not requiring hospitalization |
COVID-19 (Malattia da Coronavirus 19) lieve o moderata, che non richiede ospedalizzazione |
|
E.1.1.1 | Medical condition in easily understood language |
Mild or moderate COVID-19 (Coronavirus Disease 19), not requiring hospitalization |
COVID-19 (Malattia da Coronavirus 19) lieve o moderata, che non richiede ospedalizzazione |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 23.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10053983 |
E.1.2 | Term | Corona virus infection |
E.1.2 | System Organ Class | 100000004862 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10070255 |
E.1.2 | Term | Coronavirus test positive |
E.1.2 | System Organ Class | 10022891 - Investigations |
|
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 |
Identify the most suitable therapeutic scheme to reduce the risk of disease progression towards respiratory failure in paucisymptomatic patients affected by SARS-CoV-2 infection treated at home |
Identificare lo schema terapeutico dei pazienti paucisintomatici con infezione da SARS-CoV-2 trattati a domicilio più idoneo a ridurre il rischio di progressione della malattia verso l’insufficienza respiratoria |
|
E.2.2 | Secondary objectives of the trial |
• Assess the frequency of hospitalizations in the 3 treatment arms • Evaluate the frequency of nasopharyngeal swab positive patients at the end of the experimental treatment in the 3 treatment arms • Compare safety and tolerability associated with therapeutic regimens proposed in paucisymptomatic patients with SARS-CoV-2 infection treated at home; for patients on treatment with heparins, evaluate the onset of vascular disorders |
• Valutare la frequenza delle ospedalizzazioni nei 3 bracci di trattamento • Valutare la frequenza di pazienti positivi al tampone naso-faringeo alla fine del trattamento sperimentale nei 3 bracci di trattamento • Confrontare sicurezza e tollerabilità associate agli schemi terapeutici proposti in pazienti con infezione da SARS-CoV-2 paucisintomatici trattati a domicilio; per i pazienti con trattamento eparinico, valutare l'insorgenza di disordini vascolari |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Age from 35 to 80 years 2. Confirmed SARS-CoV-2 infection, (evidence of infection obtained by COVID-19 swab test prior to consent signing is accepted) 3. Patients with mild / moderate symptoms with at least fever and / or painful manifestations such as headache, muscle aches, sore throat, and in addition vomiting and/or diarrhea. 4. Signing informed consent 5. For female patients: statement of menopausal status or absence of pregnancy |
1. Età compresa tra 35 e 80 anni 2. Infezione confermata da SARS-CoV-2 (Allegato 1), (si accetta evidenza di infezione ottenuta con tampone precedente la firma del consenso) 3. Pazienti con sintomatologia lieve/moderata (vedere Allegato 3 del protocollo per le definizioni), con almeno febbre e/o manifestazioni dolorose come mal di testa, dolori muscolari, mal di gola a cui possono aggiungersi vomito e/o diarrea 4. Firma del consenso informato 5. Per le pazienti di sesso femminile: dichiarazione di stato menopausale o assenza di gravidanza |
|
E.4 | Principal exclusion criteria |
1. Age less than 35 years old 2. 80 years old in the year of enrollment 3. Clinical condition requiring steroid therapy 4. Mechanical ventilation needed 5. Pregnancy and breastfeeding 6. Severe electrolyte imbalances 7. History of ventricular cardiac arrhythmias 8. Known renal insufficiency (CcCl <30 mL / min or patient on CCRT, haemodialysis or peritoneal dialysis) 9. Oncological, haemato-oncological, haematological and / or hepatic disease 10. Retinal disease, or hearing loss 11. Mental illness 12. Skin disorders (including skin rash, dermatitis, psoriasis) 13. Patients already on anticoagulant treatment with high / low molecular weight heparins or other parenteral anticoagulants 14. Patients at high venous thromboembolic risk according to the Padua score already on prophylaxis with low molecular weight heparin or unfractionated heparin 15. Patients with indications for treatment with oral anticoagulants 16. Patients on chronic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) 17. Patients being treated with antivirals 18. Patients treated with monoclonal antibodies with direct action on cytokines 19. Patients being treated with chloroquine / hydroxychloroquine 20. Intolerance to study drugs 21. Immunosuppressive therapy in progress or in the last month. 22. Patients with severe hepatocellular insufficiency 23. Patients with ulcerative colitis or Crohn's disease 24. Patients with increased bleeding risk: • Congenital and acquired haemorrhagic diseases • Thrombocytopenia (<25,000 / mm3) • Bleeding in progress • Previous heparin thrombocytopenia 25. Women of childbearing age who do not use contraceptives 26. Participation in other interventional or observational clinical trials |
1. Età inferiore 35 anni (compiuti) 2. Età superiore a 80 anni (anche se non compiuti) 3. Quadro clinico che richiede terapia steroidea 4. Necessità di ventilazione meccanica 5. Gravidanza e allattamento 6. Presenza di gravi scompensi elettrolitici 7. Storia di aritmie cardiache ventricolari 8. Insufficienza renale nota (CcCl <30 mL/min o paziente in CCRT, emodialisi o dialisi peritoneale) 9. Malattia oncologica, emato-oncologica, ematologica e/o epatica 10. Malattia retinica, o perdita dell'udito 11. Malattia mentale 12. Disturbi della pelle (inclusi rash cutaneo, dermatite, psoriasi) 13. Pazienti già in trattamento anticoagulante 14. Pazienti ad elevato rischio tromboembolico venoso secondo il Padua score (Allegato7) già in profilassi con eparina a basso peso molecolare o eparina non frazionata 15. Pazienti con indicazioni al trattamento con anticoagulanti orali 16. Pazienti in trattamento cronico con farmaci antinfiammatori non steroidei (FANS) 17. Pazienti in trattamento con antivirali 18. Pazienti in trattamento con anticorpi monoclonali con azione diretta su citochine 19. Pazienti in trattamento con clorochina/idrossiclorochina 20. Intolleranza ai farmaci in studio 21. Terapia immunosoppressiva in corso o nell’ultimo mese. 22. Pazienti con grave insufficienza epatocellulare 23. Pazienti affetti da colite ulcerosa o da morbo di Crohn 24. Pazienti con aumentato rischio emorragico: • Malattie emorragiche congenite e acquisite • Piastrinopenia (<25.000/mm3) • Emorragia in atto • Precedente piastrinopenia da eparina 25. Donne in età fertile che non fanno uso di contraccettivi 26. Partecipazione ad altri studi clinici interventistici e/o osservazionali |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Percentage of patients with worsening of disease symptoms and signs 5-10 (±2) days after initiation of therapy (baseline), i.e. transition from mild to moderate or severe or critical disease, or from moderate to severe disease criticism. |
Percentuale di pazienti che a 5 e 10 (±2) giorni dall’inizio della terapia farmacologica (basale) presenta sintomi e segni di malattia peggiorati rispetto a quelli registrati al basale, ovvero che transitano da malattia lieve a moderata o severa o critica, oppure da malattia moderata a severa o critica |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
5 and 10 (±2) days |
5 e 10 (±2) giorni |
|
E.5.2 | Secondary end point(s) |
• Percentage of patients hospitalized within 5 and 10 (±2) days of the start of therapy (baseline) in the 3 treatment arms; • Percentage of patients positive for nasopharyngeal swab at 10 (± 2) days from the start of treatment; • Grade 2-5 treatment-related adverse events (moderate, severe, very severe related events and deaths), serious adverse events or treatment discontinuation due to toxicity in the 3 treatment arms (safety and tolerability) |
• Percentuale di pazienti ospedalizzati entro 5 e 10 (±2) giorni dall’inizio della terapia farmacologica (basale) nei 3 bracci di trattamento; • Percentuale di pazienti positivi al tampone naso-faringeo a 10 (±2) giorni dall’inizio del trattamento; • Eventi avversi correlati ai trattamenti di grado 2-5 (eventi correlati moderati, severi, molto severi e decessi), eventi avversi seri o interruzioni del trattamento dovute a tossicità nei 3 bracci di trattamento (sicurezza e tollerabilità) |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
5 and 10 (±2) days; 10 (±2) days; 15 days |
5 e 10 (±2) giorni; 10 (±2) giorni; 15 giorni |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Adattivo, multi-braccio, multi-stadio, randomizzato a grappolo |
Adaptive, multi-arm, multi-stage, cluster randomised |
|
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Paracetamolo in monoterapia |
Paracetamol alone, not in combination with other IMPs |
|
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
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
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 | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |