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TerminatedNCT04390594SEN-CoV-FadjUpdated Jun 21, 2024

Efficacy and Safety Evaluation of Treatment Regimens in Adult COVID-19 Patients in Senegal

A Phase 3 interventional study of Nafamostat Mesilate in COVID-19, sponsored by Institut Pasteur de Dakar. Terminated at 3 sites in Senegal. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-06-21.

Sponsored by Institut Pasteur de Dakar · Phase 3, Interventional, and Treatment

Why this study was terminated
In conclusion, the results of the SEN-CoV Fadj trial to date do not meet the objectives of the clinical trial and the sample size required to meet them is clearly too large to be achieved within a reasonable time.
Phase
Phase 3
Study type
Interventional
Enrollment
59
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

COVID-19 is an emerging pandemic disease affecting most countries including Senegal, caused by the new coronavirus (SARS-CoV-2) which was first detected in the city of Wuhan in China in December 2019. A rapid spread of the disease has occurred at a global scale, associated with a mortality rate of 3.4%. The first case in Africa was declared on February 15, 2020 in Egypt and the first case in Senegal was declared on March 2nd, 2020.

In this context, the SEN-CoV-Fadj clinical trial aims to evaluate efficacy and safety, among adults, of different therapeutic regimens considered optimal according to current knowledge, as well as available and adapted to Sub-Saharan Africa. This trial is nested into a cohort of confirmed cases of COVID-19 in Senegal aiming to understand the main clinical, biological, virologic and immunological characteristics of the infection. The protocol of the cohort is based and adapted from the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) / World Health Organization (WHO) Clinical Characterisation Protocol (CCP).

The Nafamostat mesilate, whose antiviral, anticoagulant an anti-inflammatory activities have been shown, has been eligible for SEN-CoV-Fadj for the treatment of moderate to severe COVID-19 cases.

Read the detailed description

COVID-19 is an emerging pandemic disease affecting most countries including Senegal, caused by the new coronavirus (SARS-CoV-2) which was first detected in the city of Wuhan in China in December 2019. A rapid spread of the disease has occurred at a global scale, associated with a mortality rate of 3.4%. The first case in Africa was declared on February 15, 2020 in Egypt and the first case in Senegal was declared on March 2nd, 2020.

In this context, the SEN-CoV-Fadj clinical trial aims to evaluate efficacy and tolerance, among adults, of different therapeutic options considered optimal according to current knowledge, as well as available and adapted to Sub-Saharan Africa. This trial is nested into a cohort of confirmed cases of COVID-19 in Senegal aiming to understand the main clinical, biological, virologic and immunological characteristics of the infection. The protocol of the cohort is based and adapted from the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) / World Health Organization (WHO) Clinical Characterisation Protocol (CCP).

The Nafamostat mesilate, whose antiviral, anticoagulant an anti-inflammatory activities have been shown, has been eligible for SEN-CoV-Fadj for the treatment of moderate to severe COVID-19 cases. Its efficacy and safety will be evaluated against the standard of care used in Senegal.

The primary objective is to :

Evaluate and compare viral clearance between the different therapeutic interventions.

The secondary objectives are to:

  • Evaluate and compare efficacy of the different therapeutic regimens
  • Evaluate and compare the tolerance of the different therapeutic regimens
  • Evaluate and compare the impact of the different therapeutic interventions on the length of hospitalization and other clinical measurements
02

Conditions studied

  • COVID-19

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Keywords

  • COVID-19
  • SARS-CoV-2
  • Efficacy
  • Safety
  • Senegal
  • Nafamostat mesilate
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • Confirmed cases of SARS-CoV-2 infection hospitalized in reference services identified by the Ministry of Health and Social Action of Senegal
  • Adults (≥18 years)
  • Full understanding and consent to participate to the trial
  • No contraindications to taking the tested treatments
  • Clinical status from 3 to 5 on the seven-category ordinal scale
  • Pneumonia highlighted by infiltration of the lungs by chest CT scan or chest radiography
  • Absence of contraindications to radiographic examinations (X-ray and/or CT scan) for diagnosis and/or follow-up
  • Inclusion in the 72 hours following the radiological pneumonia confirmation

Non-inclusion Criteria:

  • Pregnant or breastfeeding woman
  • Patient at high risk of death within 3 days of inclusion, in the clinician's opinion
  • Corrected QT interval (QTc) >500ms
  • Heart electrical dysfunction: atrioventricular block Mobitz type II second-degree, high-grade or complete without a functioning pacemaker
  • Uncontrolled and clinically significant heart diseases, such as arrhythmia, angina or decompensated congestive heart failure
  • Kidney failure (Cl \< 30 mL/min)
  • Patients with liver cirrhosis whose Child-Puch score is B or C
  • Patients who have liver disease abnormalities with ALT or AST > 5 times ULN
  • Patients who have a known HIV status
  • Patients who have other clinically-important diseases in decompensation which may interfere with the evaluation or completion of the tested treatment's procedure, in the clinician's opinion
  • Patients with a clinical or psychological condition which, in the clinician's opinion, does not allow adequate evaluation of the tested treatment
  • Known allergy to the studied treatment regimen
  • Other contraindications with the studied treatment regimen
  • Known drug-drug interaction with a treatment usually taken by the participant contraindicating one of the studied treatment regimen
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
59 participants (actual)

Study arms

  • No intervention
    Standard of Care

    The Standard of Care is the treatment which is the most adapted to the patient in the clinician's opinion. It could include the combination of Hydroxychloroquine and Azithromycin in the absence of contraindication.

  • Experimental
    Standard of Care + Nafamostat mesilate

    * The Standard of Care is the treatment which is the most adapted to the patient in the clinician's opinion. It could include the combination of Hydroxychloroquine and Azithromycin in the absence of contraindication. * Nafamostat mesilate

    Drug: Nafamostat Mesilate

Interventions

  • DrugNafamostat Mesilate

    Nafamostat mesilate continuous intravenous injection. Daily dose ranging between 0.1 mg/kg/h and 0.2 mg/kg/h, based on the severity and underlying disease of the clinical trial participant. Administration for 10-14 days based on the severity and underlying disease of the clinical trial participant

05

What researchers measure

Primary outcomes

  1. SARS-CoV-2 viral load level

    Real time-PCR (RT-PCR) result of the naso- and oro-pharyngeal sample

    Time frame: Day 7

Secondary outcomes

  1. Vital status

    Time frame: Day 15

  2. Proportion of patients with serious adverse events reported during the clinical trial.

    Time frame: through study completion, an average of 7 months

  3. Length of hospitalization

    Time frame: through hospitalization, an average of 2 weeks

  4. Length of hospitalization in a resuscitation unit

    Time frame: through hospitalization, an average of 2 weeks

  5. Duration of oxygen therapy

    Time frame: through hospitalization, an average of 2 weeks

  6. Maximum quick SOFA (qSOFA) score during hospitalisation

    Time frame: through hospitalization, an average of 2 weeks

  7. Clinical status on the seven-category ordinal scale

    1. not hospitalized with resumption of normal activities; 2. not hospitalized, but unable to resume normal activities; 3. hospitalization, not requiring supplemental oxygen; 4. hospitalization, requiring supplemental oxygen; 5. hospitalization, requiring nasal high-flow oxygen therapy and/or noninvasive mechanical ventilation; 6. hospitalization, requiring extracorporeal membrane oxygenation and/or invasive mechanical ventilation; 7. death.

    Time frame: through hospitalization, an average of 2 weeks

06

Study locations

3 sites
  • Infectious and Tropical Diseases Department, Fann Hospital
    Dakar, Senegal
  • Diamniadio Children Hospital
    Diamniadio, Senegal
  • Dalal Jamm Hospital
    Guédiawaye, Senegal
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04390594
Lead sponsor
Institut Pasteur de Dakar
Collaborators
Fann Hospital, Senegal, Ministry of Health, Senegal, Diamniadio Children Hospital, Senegal, Dalal Jamm Hospital, Senegal, Institut Pasteur Korea
Responsible party
Sponsor
First posted
May 15, 2020
Start date
Aug 13, 2020
Primary completion
Feb 8, 2023
Completion
Feb 8, 2023
Last update
Jun 21, 2024

Study contacts

Moussa Seydi, MD
principal investigator · Fann Hospital, Senegal
Amadou A. Sall, PhD
study director · Institut Pasteur de Dakar, Senegal
Fabien Taieb, MD, PhD
principal investigator · Institut Pasteur de Dakar, Senegal

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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