A Phase 4 interventional study of Anaferon for Children in Influenza and Acute Respiratory Viral Infections, sponsored by Materia Medica Holding. Completed at 27 sites in 3 countries. Open to participants aged 3 Years to 12 Years. Per ClinicalTrials.gov, last updated 2019-07-12.
Sponsored by Materia Medica Holding · Phase 4, Interventional, and Treatment
The purpose of this study is:
The study will enroll outpatient subjects of both sexes aged 3-12 years with clinical manifestations of influenza/Acute Respiratory Viral Infections (ARVI), including fever
≥ 38.0°С having an appointment with a doctor within the first day after the illness onset.
Тhe physician will collect medical history information, perform an objective examination, record the concomitant therapy, and obtain nasal swab specimens for a rapid diagnostic influenza test. If the swab is positive, the doctor shall obtain swab specimens from the nasal cavity and oropharynx (nasopharyngeal swab) for a subsequent real time reverse transcription-polymerase chain reaction (RT-PCR) to determine the viral load of influenza A and/or B virus. If the swab is negative for influenza the doctor shall collect a nasopharyngeal swab for a subsequent PCR test for other respiratory viruses.
If inclusion criteria are met and exclusion criteria are absent at visit 1 (Day 1), the patient will be enrolled in the trial and randomized into one of the two groups: group 1 patients will take Anaferon for children following a 5-day regimen; group 2 patients will receive Placebo using the Anaferon for children 5-day regimen. The parent/adopter of patient will receive a diary where they should record the child's axillary temperature data in the morning and evening, and score the severity of symptoms.
The subject will be monitored for 14 days (screening, randomization - 1 day, treatment - 5 days, follow-up - 1 day; late-scheduled phone "visit" - day 14).
At Visits 2-4, the physician will document objective examination data; obtain nasopharyngeal swabs from subjects with positive influenza tests for subsequent RT-PCR to determine the viral load and its reduction in the course of treatment; monitor the prescribed and concomitant therapy, and check the patient's diary data. The phone "visit" will be made to elicit information from the parents regarding the patient's general health, presence/absence of secondary bacterial/viral complications, and use of antibacterial drugs.
Interim statistical analysis is stipulated by the study protocol. Interim analysis will be performed using the data obtained from the examination and treatment of the protocol-defined number of patients who completed the study. Based on the expected effect, the minimum required Particular Per Protocol (pPP) sample size will be 254 patients (127 subjects in each group - Anaferon for children and Placebo).
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This study's enrollment of 569 is above the median of 120 across 4,200 interventional studies indexed under Infections.
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Exclusion Criteria:
On day 1, five tablets are taken in the first 2 hours (one tablet every 30 min), followed by three more tablets regularly spaced during the rest of the day. From day 2 through 5, one tablet is administered three times daily.
Drug: Anaferon for Children
On day 1, five tablets are taken in the first 2 hours (one tablet every 30 min), followed by three more tablets regularly spaced during the rest of the day. From day 2 through 5, one tablet is administered three times daily.
Drug: Anaferon for Children
Anaferon for children: For oral use.
Also known as: Anaferon for Children in tablets
Average Illness Duration
Disease duration is assessed until recovery or significant improvement. Average illness duration is defined as the interval between the start of the trial treatment and the start of the first 24-hour period in which the non-specific symptoms and nasal/ throat/ chest symptoms improve to "absent" or "mild" (Total Symptom Score of severity had decreased to ≤2 points) and body temperature returns to 37.2°C or below. Based on patient diary data.
Time frame: From the time of randomization until the time of recovery/improvement (days 1-14)
Percentage of Patients With Recovery/Improvement in Health
Based on Days 2, 3, 4 and 5 of observation treatment (according to the patient's diary), on days 3 and 5 of therapy (according to physician's objective examination).
Time frame: on days 2, 3, 4 and 5 of the treatment
Changes in Body Temperature
Changes in Body Temperature Based on Patient Diary Data
Time frame: baseline and days 2, 3, 4 and 5 of observation treatment
Percentage of Patients With Normal Body Temperature (≤37.0ºС)
Based on the patient diary data. Axillary temperature (morning and evening) decline to or below 37.0 ºС.
Time frame: on days 2, 3, 4 and 5 of observation treatment
Severity of Clinical Manifestations of Influenza / Acute Respiratory Viral Infection by Total Symptom Score.
Total Symptom Score is based on the severity of each Influenza / Acute Respiratory Viral Infection symptom. Total Symptom Score includes 13 symptoms: body temperature, non-specific symptoms (headache, chills, sweating, weakness, muscle pain, drowsiness), nasal/throat/chest symptoms. The severity of non-specific and nasal/throat/chest symptom is scored on a symptom severity scale (0=no symptoms; 1=mild symptoms; 2=moderate symptoms; 3=severe symptoms). Minimum score=0; maximum score=39. The severity of symptoms is recorded by the doctors on the case record form on days 3, 5 and by parents/adopter on a diary card twice a day on days 2-6.
Time frame: on days 2-6 of observation treatment
Assessment of the Severity of Influenza Virus / Acute Respiratory Viral Infection Using the "Area Under the Curve" for an Overall Symptom Assessment
Total Symptom Score is based on the severity of each disease symptom. The TSS includes 13 symptoms: body temperature/fever, non-specific symptoms (headache, chills, sweating, weakness, muscle pain, drowsiness), nasal/throat/chest symptoms (runny nose, nasal congestion, sneezing, sore throat, hoarseness, cough, chest pain/tightness of the chest). Minimum score=0; maximum score=39. The area under the curve 1 = on days 1, 3, 5 and 7 on the results of doctor's examination The area under the curve 2 = based on days 1-7 on the patient diary data
Time frame: on days 1-7 of observation (based on days 1-7 on the patient diary data; on days 1, 3, 5 and 7 of observation - according to physician's objective examination)
Number of Intakes of Antipyretics
Number of Intakes of Antipyretics based on patient diary data
Time frame: on days 1-5 of therapy
Change in Viral Load During the Treatment and Follow-up Periods
Viral load is evaluated in subjects with positive influenza A and B tests. Virus load \[log10 copies influenza А/В RNA per 1 mL\] in nasal and pharyngeal swabs is determined using real-time PCR on days 1, 3, 5 and 7.
Time frame: on days 1, 3, 5, 7 of observation treatment
Percentage of Patients With Exacerbation of the Disease Course
The development of disease complications requiring antibiotics drugs or hospitalization
Time frame: 14 days of observation treatment
| Milestone | Anaferon for Children | Placebo |
|---|---|---|
| Started | 290 | 279 |
| Completed | 258 | 240 |
| Not completed | 32 | 39 |
| Withdrew: Did not meet in-/exclusion criteria | 14 | 15 |
| Withdrew: Protocol violation | 16 | 23 |
| Withdrew: Physician decision | 0 | 1 |
| Withdrew: Non-compliance with protocol requirement | 2 | 0 |
Disease duration is assessed until recovery or significant improvement. Average illness duration is defined as the interval between the start of the trial treatment and the start of the first 24-hour period in which the non-specific symptoms and nasal/ throat/ chest symptoms improve to "absent" or "mild" (Total Symptom Score of severity had decreased to ≤2 points) and body temperature returns to 37.2°C or below. Based on patient diary data.
| days | Anaferon for Children | Placebo |
|---|---|---|
| Average Illness Duration | 4.6 ± 1.4 | 4.9 ± 1.3 |
Based on Days 2, 3, 4 and 5 of observation treatment (according to the patient's diary), on days 3 and 5 of therapy (according to physician's objective examination).
| Participants | Anaferon for Children | Placebo |
|---|---|---|
| Day 2 (patient diary data) | 1 | 1 |
| Day 3 (patient diary data) | 25 | 11 |
| Day 4 (patient diary data) | 61 | 40 |
| Day 5 (patient diary data) | 107 | 84 |
| Day 3 (physician's examination) | 31 | 16 |
| Day 5 (physician's examination) | 116 | 90 |
Changes in Body Temperature Based on Patient Diary Data
| °C | Anaferon for Children | Placebo |
|---|---|---|
| Day 1 | 38.5 ± 0.4 | 38.5 ± 0.4 |
| Day 2 | 38.0 ± 0.8 | 38.2 ± 0.8 |
| Day 3 | 37.4 ± 0.8 | 37.5 ± 0.8 |
| Day 4 | 37.0 ± 0.6 | 37.1 ± 0.7 |
| Day 5 | 36.8 ± 0.4 | 36.9 ± 0.4 |
Based on the patient diary data. Axillary temperature (morning and evening) decline to or below 37.0 ºС.
| Participants | Anaferon for Children | Placebo |
|---|---|---|
| Day 2 (patient diary data) | 31 | 23 |
| Day 3 (patient diary data) | 104 | 76 |
| Day 4 (patient diary data) | 167 | 139 |
| Day 5 (patient diary data) | 219 | 196 |
Total Symptom Score is based on the severity of each Influenza / Acute Respiratory Viral Infection symptom. Total Symptom Score includes 13 symptoms: body temperature, non-specific symptoms (headache, chills, sweating, weakness, muscle pain, drowsiness), nasal/throat/chest symptoms. The severity of non-specific and nasal/throat/chest symptom is scored on a symptom severity scale (0=no symptoms; 1=mild symptoms; 2=moderate symptoms; 3=severe symptoms). Minimum score=0; maximum score=39. The severity of symptoms is recorded by the doctors on the case record form on days 3, 5 and by parents/adopter on a diary card twice a day on days 2-6.
| score on a scale | Anaferon for Children | Placebo |
|---|---|---|
| Day 2 (patient diary data) | 10.0 ± 5.3 | 11.0 ± 5.1 |
| Day 3 (patient diary data) | 7.0 ± 4.8 | 8.1 ± 4.8 |
| Day 4 (patient diary data) | 5.0 ± 3.8 | 5.5 ± 3.8 |
| Day 5 (patient diary data) | 3.3 ± 2.9 | 3.8 ± 3.1 |
| Day 3 (physician's examination) | 7.0 ± 4.6 | 8.1 ± 4.8 |
| Day 5 (physician's examination) | 3.5 ± 3.0 | 3.9 ± 3.0 |
Total Symptom Score is based on the severity of each disease symptom. The TSS includes 13 symptoms: body temperature/fever, non-specific symptoms (headache, chills, sweating, weakness, muscle pain, drowsiness), nasal/throat/chest symptoms (runny nose, nasal congestion, sneezing, sore throat, hoarseness, cough, chest pain/tightness of the chest). Minimum score=0; maximum score=39. The area under the curve 1 = on days 1, 3, 5 and 7 on the results of doctor's examination The area under the curve 2 = based on days 1-7 on the patient diary data
| score*day | Anaferon for Children | Placebo |
|---|---|---|
| Days 1-7 (patient diary data) | 34.4 ± 18.8 | 38.2 ± 18.5 |
| Days 1, 3, 5 and 7 (physician's examination) | 17.6 ± 8.9 | 19.3 ± 8.9 |
Number of Intakes of Antipyretics based on patient diary data
| Number of intakes | Anaferon for Children | Placebo |
|---|---|---|
| Day 1 | 1.2 ± 0.9 | 1.3 ± 1.0 |
| Day 2 | 0.7 ± 1.0 | 0.9 ± 1.1 |
| Day 3 | 0.3 ± 0.6 | 0.4 ± 0.8 |
| Day 4 | 0.1 ± 0.4 | 0.1 ± 0.5 |
| Day 5 | 0.0 ± 0.2 | 0.1 ± 0.4 |
Viral load is evaluated in subjects with positive influenza A and B tests. Virus load \[log10 copies influenza А/В RNA per 1 mL\] in nasal and pharyngeal swabs is determined using real-time PCR on days 1, 3, 5 and 7.
| log10 copies influenza А/В RNA per 1 mL | Anaferon for Children | Placebo |
|---|---|---|
| Day 1 | 5.7 ± 1.1 | 5.6 ± 1.3 |
| Day 3 | 4.1 ± 2.2 | 4.8 ± 1.3 |
| Day 5 | 3.1 ± 2.3 | 4.4 ± 1.3 |
| Day 7 | 2.1 ± 2.4 | 4.0 ± 1.5 |
The development of disease complications requiring antibiotics drugs or hospitalization
| Participants | Anaferon for Children | Placebo |
|---|---|---|
| Percentage of Patients With Exacerbation of the Disease Course | 7 | 11 |
Collected over Adverse/Serious adverse events were registered during 14 days (during the treatment and follow-up periods ).. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Anaferon for Children | 0/290 (0%) | 1/290 (0.3%) | 26/290 (9%) |
| Placebo | 0/279 (0%) | 1/279 (0.4%) | 30/279 (10.8%) |
| Event | Anaferon for Children | Placebo |
|---|---|---|
| InfluenzaInfections and infestations | 1/290 | 1/279 |
| Event | Anaferon for Children | Placebo |
|---|---|---|
| Otitis media acuteInfections and infestations | 4/290 | 5/279 |
| BronchitisInfections and infestations | 3/290 | 4/279 |
| ConjunctivitisInfections and infestations | 1/290 | 3/279 |
| Abdominal painGastrointestinal disorders | 3/290 | 2/279 |
| EpistaxisRespiratory, thoracic and mediastinal disorders | 3/290 | 0/279 |
| RhinitisInfections and infestations | 3/290 | 1/279 |
| Bacterial infectionInfections and infestations | 0/290 | 2/279 |
| InfectionInfections and infestations | 1/290 | 2/279 |
| NasopharyngitisInfections and infestations | 0/290 | 2/279 |
| NauseaGastrointestinal disorders | 0/290 | 2/279 |
| Age, Continuous(years) | Anaferon for Children | Placebo | Total |
|---|---|---|---|
| Mean | 6.8 ± 2.7 | 6.7 ± 2.7 | 6.7 ± 2.7 |
| Sex: Female, Male(Participants) | Anaferon for Children | Placebo | Total |
|---|---|---|---|
| Female | 118 | 115 | 233 |
| Male | 140 | 125 | 265 |
| Race and Ethnicity Not Collected(Participants) | Anaferon for Children | Placebo | Total |
|---|---|---|---|
| Count of participants | — | — | 0 |
| Count of Participants(Participants) | Anaferon for Children | Placebo | Total |
|---|---|---|---|
| Count of participants | 258 | 240 | 498 |
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