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CompletedNCT05164120Updated Sep 19, 2024Results posted

Safety, Tolerability, and Treatment Effect of Belnacasan in Patients With COVID-19

A Phase 2 interventional study of Belnacasan and Placebo in COVID-19, sponsored by MedStar Health. Completed at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by MedStar Health · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this trial is to assess the safety, tolerability and treatment effect of the orally administered Caspase-1 inhibitor, belnacasan, for the treatment of patients with mild to moderate COVID-19 and to generate proof of concept for future trials.

Read the detailed description

COVID-19 is an acute respiratory disease caused by the SARS-CoV-2 virus which has impacted the lives of millions of patients. Though vaccines and preventive treatments such as monoclonal antibodies, steroids, and anti-virals have been established, they do not specifically target the resulting inflammatory response and complications the virus causes.

This study aims to evaluate how safe and effective a particular oral medication, Belnacasan, is in diminishing your body's inflammatory response, which may go into overdrive when infected with the virus. This overly activated immune response can become uncontrolled resulting in cell death and the release of damaging proteins which can cause major harm to all organs throughout the body.

Belnacasan prevents the activation of a particular enzyme, Caspase-1, which plays a major role in activating this damaging immune response brought on by COVID-19. The goal of this medication being a more targeted treatment that aims to prevent the devastating immune response.

02

Conditions studied

  • COVID-19

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03

In context

COVID-19

7,640 studies on the registry are indexed under COVID-19; 488 are open to participants now.

This study's enrollment of 40 is below the median of 100 across 4,099 interventional studies indexed under COVID-19.

Browse COVID-19 studies →

Lead sponsor

This is the only study on the registry with MedStar Health as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

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

Inclusion criteria

  1. Subject (or legally authorized representative) provides written informed consent prior to the initiation of any study procedures
  2. Subject understands and agrees to comply with planned study procedures, including using the diary
  3. Subject agrees to the collection of nasopharyngeal swabs and venous blood per protocol
  4. Subject is male or non-pregnant female adult ≥18 years of age at time of consent

    a. Women with a history of menstruation must agree to use two methods of contraception, at least one of which is highly effective, for the duration of the study as well as to undergo additional pregnancy testing during the study

  5. Subject has a laboratory confirmed SARS-CoV-2 infection as determined by RT-PCR assay prior to enrollment
  6. Subject has evidence of either mild or moderate COVID-19 illness of less than 7 days from first onset, with minimal baseline symptom severity based on patient-reported FDA scoring system defined as follows:

    1. Subject presents with at least two common symptoms of COVID-19 from the following list: Stuffy or runny nose, sore throat, cough, low energy or tiredness, muscle or body ache, headache, chills or shivering, feeling hot or feverish, nausea, vomiting, diarrhea, shortness of breath with exertion (without supplemental oxygen requirement) with a score of 2 or higher, impairment in sense of smell or taste with a score of 1 or higher OR
    2. Subject presents with any (i.e., at least one) symptom of COVID-19 as defined above AND clinical evidence of moderate COVID-19 as defined by FDA guidance for industry (such as respiratory rate >20 breaths per minute, heart rate >90 beats per minute, with oxygen saturation >93% on room air at sea level)
  7. Subject presents with high-risk for COVID-19-related inflammation determined by at least one comorbidity, including obesity, diabetes, hypertension, stable heart disease, respiratory disease, and/or non-severe fatty liver disease
  8. Subject's overall health condition is deemed as suitable to fully and safely participate in this trial as determined by the investigator

Exclusion criteria

Exclusion Criteria:

  1. Any clinical signs indicative of severe or critical COVID-19 as defined by FDA guidance for Industry at the time, including SpO2 \<93% and/or oxygen requirement
  2. Hospitalization for COVID-19, or consideration thereof
  3. ICU level of care and/or non-mechanical/mechanical ventilation and/or oxygen supplementation at time of enrollment
  4. Pregnant or breast-feeding subjects
  5. Subjects who cannot swallow tablets
  6. History of any pre-existing organ impairment, such as:

    1. Severe kidney disease (known or estimated GFR \<30 mL/minute) or on dialysis
    2. Uncontrolled, clinically significant heart diseases such as arrhythmias, angina or heart failure as defined by AHA/ACC Grade C and D
    3. Chronic respiratory disease requiring supplemental oxygen
    4. Moderate and severe hepatic impairment as defined by Child-Pugh scoring Class B and Class C
  7. Elevated liver function test (determined by ALT, AST, GGT, or ALP >2x upper limit of normal, and/or total Bilirubin > upper limit of normal)
  8. History of malignancy or immunodeficiency within the prior 5 years
  9. Acute respiratory illness other than COVID-19
  10. Acute bacterial, viral or fungal infection (including HIV, hepatitis B, hepatitis C)
  11. While dosed with IP, the taking of prohibited concomitant medication or the ingestion of food that interferes with the IP, including:

    1. Non-COVID19-related anti-viral medication such as lopinavir, ritonavir, ribavirin, or interferon-1β
    2. Systemically administered immunosuppressive and anti-inflammatory agents, other than background standard of care for COVID-19 at the time
    3. Drugs and foods that are potent inhibitors or inducers of CYP3A4 and/or P-gp, as listed in FDA "Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers", including herbal medications such as St. John's Wort within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug
  12. Any other diseases or medical conditions or concomitant medications that are deemed as not compatible or appropriate for the subject's ability to fully and safely participate in this trial as determined by the investigator
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Interventional

    900mg dose TID Administration Total: 2700mg

    Drug: Belnacasan

  • Placebo comparator
    Placebo

    0 mg dose TID Administration Total: 0 mg

    Drug: Placebo

Interventions

  • DrugBelnacasan

    Oral administration

  • DrugPlacebo

    Tablet containing 0mg of API

06

What researchers measure

Primary outcomes

  1. Safety and Tolerability of Belnacasan

    Number of adverse events and serious adverse events

    Time frame: Through 60 days post enrollment

Secondary outcomes

  1. Sustained Recovery and Resolution Rates of Common COVID-19 Symptoms

    Proportion of subjects in treatment group versus placebo group, respectively, who, per symptom questionnaire, rate stuffy or runny nose, sore throat, cough, low energy or tiredness, muscle or body ache, headache, chills or shivering, feeling hot or feverish, nausea, vomiting, diarrhea, shortness of breath at rest, shortness of breath with exertion, or impairment in sense of smell or taste as mild, moderate or severe.

    Time frame: Baseline and Days 4, 7, 10, 14, 21, 28, 42, and 60 post randomization

  2. Sustained Improvement of Global Impression Rates

    Proportion of subjects in treatment group versus placebo group, respectively, who per symptom questionnaire have answered for two consecutive days: "YES" to "In the past 24 hours, have you returned to your usual health (before your COVID-19 illness)?"; "YES" to "In the past 24 hours, have you returned to your usual activities (before your COVID-19 illness)?"

    Time frame: Days 4, 7, 10, 14, 21, 28, 42, and 60 post randomization

  3. Time to Sustained Recovery or Resolution of Common COVID-19 Symptoms

    Comparison in treatment group versus placebo group, respectively, of the number of days from randomization to the first day of achieving sustained recovery and resolution rates of common COVID-19 symptoms.

    Time frame: Over 60 days post randomization

  4. Time to Sustained Improvement of Global Impression

    Comparison in treatment group versus placebo group, respectively, of the mean number of days from randomization to the first day of achieving sustained improvement of global impression rates.

    Time frame: Over 60 days post randomization

  5. Rates of Fever

    Proportion of subjects in treatment group versus placebo group, respectively, who, per thermometer, experienced fever at any point between enrollment and day 2 post randomization.

    Time frame: Days between enrollment and day 2 post randomization

  6. Oxygenation Levels

    Average change from baseline over 60 days in percentage of blood saturation

    Time frame: Over 60 days post randomization

  7. Time in Days to Normalization of Fever and Oxygenation Levels.

    Comparison in treatment group versus placebo group, respectively, of the number of days from randomization to the first day of achieving sustained (i.e., at least 2 days) resolution of fever for subjects who presented with fever at any point between enrollment and day 2 post randomization; with temperature \<38C or \>=38C experienced in total during the first 28 days post randomization; from randomization to the first day post randomization of achieving oxygenation of SpO2\>=96% in room air when resting for subjects who presented with SpO2\>93% and \<96% in room air, when resting, at enrollment; with oxygenation of SpO2\>= 96% or SpO2\>93% in room air, when resting, in total during the first 28 days post randomization.

    Time frame: 28 Days

  8. Experiences of COVID-19 Related Deterioration and Mortality

    Proportion of treatment group, versus placebo group, respectively, who per subject reporting or medical records had experienced an emergency department visit, other than at study enrollment or study visits; hospitalization for COVID-19; hospitalization for COVID-19 requiring oxygen; hospitalization for COVID-19 requiring ICU; hospitalization for COVID-19 requiring ventilation; COVID-19 related death; death; hospitalization or death on Days 14, 28, and 60.

    Time frame: Days 14, 28 and 60 post randomization

  9. The Number of Subjects With COVID-19 Related Deterioration and Mortality Experiences

    Comparison of treatment group versus placebo group, respectively, in the number of subjects who following randomization experienced hospitalization for COVID-19 related deterioration: requiring oxygen, requiring ICU admission, requiring ventilation.

    Time frame: Over 28 days

  10. Changes on the WHO 9-Point Ordinal Scale

    The counts of participants in the treatment group versus placebo group, respectively, who per questionnaire on WHO 9-point ordinal scale \[0: Uninfected or "no clinical or virological evidence of infection"; 1: Not hospitalized, no limitations on activities; 2: Not hospitalized, limitation on activities; 3: Hospitalized, not requiring supplemental oxygen; 4: Hospitalized, requiring supplemental oxygen; 5: Hospitalized, on non-invasive ventilation or high flow oxygen devices; 6: Hospitalized, intubated; 7: Hospitalized, advanced life support including invasive mechanical ventilation or ECMO; 8: Death\] had experienced an improvement from scale 2 to scale 1 or 0; an improvement from scale 1 to scale 0 ; a sustainment from scale 1 to scale 1; any improvement of the scale; any worsening of the scale; scale 4 or higher; scale 6 or higher.

    Time frame: Days 4, 7, 10, 14, 21, 28, 42, and 60 post randomization

  11. Values on the WHO 9-Point Ordinal Scale

    Comparison of treatment group versus placebo group, respectively, in the average of daily scale value (0-8) on Days 14, 28, and 60 with respect to the number of subjects who reported as uninfected (scale value of 0), had no limitations (scale value of 1), or were experiencing limitations (scale value of 2). All patients had a score ranging between 0-2. A description of the WHO 9-Point Ordinal Scale follows: 0. Uninfected or "no clinical or virological evidence of infection" * defined as subject answering "Yes" to "In the past 24 hours, have you returned to your usual health (before your COVID-19 illness)?" 1. Not hospitalized, no limitations on activities * defined as subject answering "Yes" to "In the past 24 hours, have you returned to your usual activities (before your COVID-19 illness)?" 2. Not hospitalized, limitation on activities * defined as subject answering "No" to "In the past 24 hours, have you returned to your usual act

    Time frame: Days 14, 28, and 60 post randomization

  12. Time to Improvement on the WHO 9-Point Ordinal Scale

    Comparison of treatment group versus placebo group, respectively, in the mean number of days from enrollment to reporting "no limitations" or "uninfected". The discrepancy in patient numbers (enrolled versus analyzed) is due to patients who either dropped out or have missing data.

    Time frame: Post treatment to Day 60

  13. Mean Number of Days of Experiencing WHO 9-Point Ordinal Scale Values

    Comparison of treatment group versus placebo group, respectively, in the mean number of days on which subjects experienced "limitations", "no limitations", and "uninfected" post treatment (60 Days).

    Time frame: Post treatment through Day 60

  14. IL-6

    Plasma levels of IL-6

    Time frame: Baseline and Days 7, 14, 21, 28

  15. IL-1ra

    Measurement of plasma IL-1ra levels

    Time frame: Baseline and Days 7, 14, 21, 28

  16. IL-18

    Measurement of plasma levels of IL-18

    Time frame: Baseline and Days 7, 14, 21, and 28

  17. TNF-alpha

    Plasma levels of TNF-alpha

    Time frame: Baseline and Days 7, 14, 21, and 28

  18. Caspase-1

    Plasma levels of caspase-1

    Time frame: Baseline and Days 7, 14, 21, and 28

  19. Gasdermin D

    Plasma levels of gasdermin D

    Time frame: Baseline and Days 7, 14, 21, and 28

  20. G-CSF

    Plasma levels of G-CSF

    Time frame: Baseline and Days 7, 14, 21, and 28

07

Results

Posted Sep 19, 2024

Participant flow

Participant flow — Overall Study
MilestoneInterventionalPlacebo
Started2020
Completed1818
Not completed22

Outcome measures

PrimarySafety and Tolerability of Belnacasan

Number of adverse events and serious adverse events

Time frame:
Through 60 days post enrollment
Reported as:
Number · Number of AEs and SAEs
Safety and Tolerability of Belnacasan
Number of AEs and SAEsInterventionalPlacebo
Number of adverse events1110
Number of serious adverse events00
SecondarySustained Recovery and Resolution Rates of Common COVID-19 Symptoms

Proportion of subjects in treatment group versus placebo group, respectively, who, per symptom questionnaire, rate stuffy or runny nose, sore throat, cough, low energy or tiredness, muscle or body ache, headache, chills or shivering, feeling hot or feverish, nausea, vomiting, diarrhea, shortness of breath at rest, shortness of breath with exertion, or impairment in sense of smell or taste as mild, moderate or severe.

Time frame:
Baseline and Days 4, 7, 10, 14, 21, 28, 42, and 60 post randomization
Reported as:
Count of participants · Participants
Sustained Recovery and Resolution Rates of Common COVID-19 Symptoms
ParticipantsInterventionalPlacebo
Runny/stuffy nose at Baseline1419
Runny/stuffy nose at Day 41313
Runny/stuffy nose at Day 71717
Runny/stuffy nose at Day 1064
Runny/stuffy nose at Day 141210
Runny/stuffy nose at Day 2153
Runny/stuffy nose at Day 2851
Runny/stuffy nose at Day 4210
Runny/stuffy nose at Day 6010
Sore throat at Baseline1314
Sore throat at Day 443
Sore throat at Day 7149
Sore throat at Day 1010
Sore throat at Day 1442
Sore throat at Day 2100
Sore throat at Day 2810
Sore throat at Day 4200
Sore throat at Day 6000
Cough at Baseline1718
Cough at Day 41312
Cough at Day 71618
Cough at Day 1079
Cough at Day 141115
Cough at Day 2176
Cough at Day 2863
Cough at Day 4210
Cough at Day 6010
Low energy or tiredness at Baseline1714
Low energy or tiredness at Day 4107
Low energy or tiredness at Day 71817
Low energy or tiredness at Day 1061
Low energy or tiredness at Day 14114
Low energy or tiredness at Day 2163
Low energy or tiredness at Day 2871
Low energy or tiredness at Day 4210
Low energy or tiredness at Day 6000
Muscle or body aches at Baseline1311
Muscle or body aches at Day 471
Muscle or body aches at Day 71313
Muscle or body aches at Day 1020
Muscle or body aches at Day 1461
Muscle or body aches at Day 2132
Muscle or body aches at Day 2830
Muscle or body aches at Day 4210
Muscle or body aches at Day 6000
Headache at Baseline1012
Headache at Day 452
Headache at Day 71511
Headache at Day 1041
Headache at Day 1455
Headache at Day 2131
Headache at Day 2852
Headache at Day 4220
Headache at Day 6000
Chills or shivering at Baseline74
Chills or shivering at Day 411
Chills or shivering at Day 767
Chills or shivering at Day 1000
Chills or shivering at Day11
Chills or shivering at Day 2110
Chills or shivering at Day 2820
Chills or shivering at Day 4200
Chills or shivering at Day 6000
Feeling hot or feverish at Baseline88
Feeling hot or feverish at Day 430
Feeling hot or feverish at Day 71010
Feeling hot or feverish at Day 1000
Feeling hot or feverish at Day 1411
Feeling hot or feverish at Day 2100
Feeling hot or feverish at Day 2810
Feeling hot or feverish at Day 4200
Feeling hot or feverish at Day 6000
Nausea at Baseline61
Nausea at Day 421
Nausea at Day 773
Nausea at Day 1020
Nausea at Day 1431
Nausea at Day 2102
Nausea at Day 2820
Nausea at Day 4200
Nausea at Day 6000
Vomiting at Baseline00
Vomiting at Day 400
Vomiting at Day 700
Vomiting at Day 1000
Vomiting at Day 1400
Vomiting at Day 2100
Vomiting at Day 2800
Vomiting at Day 4200
Vomiting at Day 6000
Diarrhea at Baseline31
Diarrhea at Day 464
Diarrhea at Day 7106
Diarrhea at Day 1030
Diarrhea at Day 1473
Diarrhea at Day 2143
Diarrhea at Day 2852
Diarrhea at Day 4200
Diarrhea at Day 6000
Shortness of breath at rest at Baseline61
Shortness of breath at rest at Day 442
Shortness of breath at rest at Day 700
Shortness of breath at rest at Day 1020
Shortness of breath at rest at Day 1441
Shortness of breath at rest at Day 2120
Shortness of breath at rest at Day 2820
Shortness of breath at rest at Day 4200
Shortness of breath at rest at Day 6000
Shortness of breath with exertion at Baseline75
Shortness of breath with exertion at Day 454
Shortness of breath with exertion at Day 71410
Shortness of breath with exertion at Day 1053
Shortness of breath with exertion at Day 1482
Shortness of breath with exertion at Day 2142
Shortness of breath with exertion at Day 2821
1Shortness of breath with exertion at Day 4211
Shortness of breath with exertion at Day 6001
Impairment of sense of smell at Baseline43
Impairment of sense of smell at Day 443
Impairment of sense of smell at Day 755
Impairment of sense of smell at Day 1011
Impairment of sense of smell at Day 1412
Impairment of sense of smell at Day 2111
Impairment of sense of smell at Day 2800
Impairment of sense of smell at Day 4200
Impairment of sense of smell at Day 6000
Impairment of sense of taste at Baseline66
Impairment of sense of taste at Day 455
Impairment of sense of taste at Day 766
Impairment of sense of taste at Day 1021
Impairment of sense of taste at Day 1412
Impairment of sense of taste at Day 2100
Impairment of sense of taste at Day 2800
Impairment of sense of taste at Day 4200
Impairment of sense of taste at Day 6000
SecondarySustained Improvement of Global Impression Rates

Proportion of subjects in treatment group versus placebo group, respectively, who per symptom questionnaire have answered for two consecutive days: "YES" to "In the past 24 hours, have you returned to your usual health (before your COVID-19 illness)?"; "YES" to "In the past 24 hours, have you returned to your usual activities (before your COVID-19 illness)?"

Time frame:
Days 4, 7, 10, 14, 21, 28, 42, and 60 post randomization
Reported as:
Count of participants · Participants
Sustained Improvement of Global Impression Rates
ParticipantsInterventionalPlacebo
Day 4 "Returned to usual health"00
Day 7 "Returned to usual health"55
Day 10 "Returned to usual health"56
Day 14 "Returned to usual health"1112
Day 21 "Returned to usual health"1116
Day 28 "Returned to usual health"1212
Day 42 "Returned to usual health"1616
Day 60 "Returned to usual health"1615
Day 4 "Returned to usual activity"04
Day 7 "Returned to usual activity"99
Day 10 "Returned to usual activity"1115
Day 14 "Returned to usual activity"1517
Day 21 "Returned to usual activity"1517
Day 28 "Returned to usual activity"1413
Day 42 "Returned to usual activity"1617
Day 60 "Returned to usual activity"1715
SecondaryTime to Sustained Recovery or Resolution of Common COVID-19 Symptoms

Comparison in treatment group versus placebo group, respectively, of the number of days from randomization to the first day of achieving sustained recovery and resolution rates of common COVID-19 symptoms.

Time frame:
Over 60 days post randomization
Reported as:
Mean · Days
Time to Sustained Recovery or Resolution of Common COVID-19 Symptoms
DaysInterventionalPlacebo
Time to Sustained Recovery or Resolution of Common COVID-19 Symptoms20.6 ± 18.115.4 ± 7.8
SecondaryTime to Sustained Improvement of Global Impression

Comparison in treatment group versus placebo group, respectively, of the mean number of days from randomization to the first day of achieving sustained improvement of global impression rates.

Time frame:
Over 60 days post randomization
Reported as:
Mean · Days
Time to Sustained Improvement of Global Impression
DaysInterventionalPlacebo
Time to Sustained Improvement of Global Impression10.5 ± 1.513.5 ± 2.9
SecondaryRates of Fever

Proportion of subjects in treatment group versus placebo group, respectively, who, per thermometer, experienced fever at any point between enrollment and day 2 post randomization.

Time frame:
Days between enrollment and day 2 post randomization
Reported as:
Count of participants · Participants
Rates of Fever
ParticipantsInterventionalPlacebo
Rates of Fever10
SecondaryOxygenation Levels

Average change from baseline over 60 days in percentage of blood saturation

Time frame:
Over 60 days post randomization
Reported as:
Mean · percentage of blood saturation
Oxygenation Levels
percentage of blood saturationInterventionalPlacebo
Oxygenation Levels-0.01 (-0.01 to 0.00)-0.01 (-0.02 to 0.01)
SecondaryTime in Days to Normalization of Fever and Oxygenation Levels.

Comparison in treatment group versus placebo group, respectively, of the number of days from randomization to the first day of achieving sustained (i.e., at least 2 days) resolution of fever for subjects who presented with fever at any point between enrollment and day 2 post randomization; with temperature \<38C or \>=38C experienced in total during the first 28 days post randomization; from randomization to the first day post randomization of achieving oxygenation of SpO2\>=96% in room air when resting for subjects who presented with SpO2\>93% and \<96% in room air, when resting, at enrollment; with oxygenation of SpO2\>= 96% or SpO2\>93% in room air, when resting, in total during the first 28 days post randomization.

Time frame:
28 Days
Reported as:
Mean · Days
Time in Days to Normalization of Fever and Oxygenation Levels.
DaysInterventionalPlacebo
Time in days to normalization of fever4 ± 0.00—
Time in days to normalization of oxygenation level—7 ± 0.00
SecondaryExperiences of COVID-19 Related Deterioration and Mortality

Proportion of treatment group, versus placebo group, respectively, who per subject reporting or medical records had experienced an emergency department visit, other than at study enrollment or study visits; hospitalization for COVID-19; hospitalization for COVID-19 requiring oxygen; hospitalization for COVID-19 requiring ICU; hospitalization for COVID-19 requiring ventilation; COVID-19 related death; death; hospitalization or death on Days 14, 28, and 60.

Time frame:
Days 14, 28 and 60 post randomization
Reported as:
Number · Number of subjects
Experiences of COVID-19 Related Deterioration and Mortality
Number of subjectsInterventionalPlacebo
Subjects who had COVID-related: ER visit, hospitalization, ICU visit, or died by Day 14.00
Subjects who had COVID-related: ER visit, hospitalization, ICU visit, or died by Day 2800
Subjects who had COVID-related: ER visit, hospitalization, ICU visit, or died by Day 6000
Subjects who required oxygen or ventilation by Day 1400
Subjects who required oxygen or ventilation by Day 2800
Subjects who required oxygen or ventilation by Day 6000
SecondaryThe Number of Subjects With COVID-19 Related Deterioration and Mortality Experiences

Comparison of treatment group versus placebo group, respectively, in the number of subjects who following randomization experienced hospitalization for COVID-19 related deterioration: requiring oxygen, requiring ICU admission, requiring ventilation.

Time frame:
Over 28 days
Reported as:
Number · participants
The Number of Subjects With COVID-19 Related Deterioration and Mortality Experiences
participantsInterventionalPlacebo
The Number of Subjects With COVID-19 Related Deterioration and Mortality Experiences00
SecondaryChanges on the WHO 9-Point Ordinal Scale

The counts of participants in the treatment group versus placebo group, respectively, who per questionnaire on WHO 9-point ordinal scale \[0: Uninfected or "no clinical or virological evidence of infection"; 1: Not hospitalized, no limitations on activities; 2: Not hospitalized, limitation on activities; 3: Hospitalized, not requiring supplemental oxygen; 4: Hospitalized, requiring supplemental oxygen; 5: Hospitalized, on non-invasive ventilation or high flow oxygen devices; 6: Hospitalized, intubated; 7: Hospitalized, advanced life support including invasive mechanical ventilation or ECMO; 8: Death\] had experienced an improvement from scale 2 to scale 1 or 0; an improvement from scale 1 to scale 0 ; a sustainment from scale 1 to scale 1; any improvement of the scale; any worsening of the scale; scale 4 or higher; scale 6 or higher.

Time frame:
Days 4, 7, 10, 14, 21, 28, 42, and 60 post randomization
Reported as:
Count of participants · Participants
Changes on the WHO 9-Point Ordinal Scale
ParticipantsInterventionalPlacebo
Day 436
Day 788
Day 101413
Day 141411
Day 211515
Day 281616
Day 421616
Day 601715
SecondaryValues on the WHO 9-Point Ordinal Scale

Comparison of treatment group versus placebo group, respectively, in the average of daily scale value (0-8) on Days 14, 28, and 60 with respect to the number of subjects who reported as uninfected (scale value of 0), had no limitations (scale value of 1), or were experiencing limitations (scale value of 2). All patients had a score ranging between 0-2. A description of the WHO 9-Point Ordinal Scale follows: 0. Uninfected or "no clinical or virological evidence of infection" * defined as subject answering "Yes" to "In the past 24 hours, have you returned to your usual health (before your COVID-19 illness)?" 1. Not hospitalized, no limitations on activities * defined as subject answering "Yes" to "In the past 24 hours, have you returned to your usual activities (before your COVID-19 illness)?" 2. Not hospitalized, limitation on activities * defined as subject answering "No" to "In the past 24 hours, have you returned to your usual act

Time frame:
Days 14, 28, and 60 post randomization
Reported as:
Mean · units on a scale
Values on the WHO 9-Point Ordinal Scale
units on a scaleInterventionalPlacebo
Average WHO-9 point scale value at Day 141.00 ± 0.690.94 ± 0.87
Average WHO-9 point scale value at Day 280.33 ± 0.690.17 ± 0.51
Average WHO-9 point scale value at Day 600.00 ± 0.000.12 ± 0.48
SecondaryTime to Improvement on the WHO 9-Point Ordinal Scale

Comparison of treatment group versus placebo group, respectively, in the mean number of days from enrollment to reporting "no limitations" or "uninfected". The discrepancy in patient numbers (enrolled versus analyzed) is due to patients who either dropped out or have missing data.

Time frame:
Post treatment to Day 60
Reported as:
Mean · Days
Time to Improvement on the WHO 9-Point Ordinal Scale
DaysInterventionalPlacebo
Days to "no limitations"9.3 ± 6.17.1 ± 5.0
Days to "uninfected"27.2 ± 14.319.0 ± 8.9
SecondaryMean Number of Days of Experiencing WHO 9-Point Ordinal Scale Values

Comparison of treatment group versus placebo group, respectively, in the mean number of days on which subjects experienced "limitations", "no limitations", and "uninfected" post treatment (60 Days).

Time frame:
Post treatment through Day 60
Reported as:
Mean · Days
Mean Number of Days of Experiencing WHO 9-Point Ordinal Scale Values
DaysInterventionalPlacebo
Limitations2.9 ± 1.82.8 ± 1.7
No limitations2.2 ± 1.91.7 ± 1.4
Uninfected3.0 ± 1.73.8 ± 2.1
SecondaryIL-6

Plasma levels of IL-6

Time frame:
Baseline and Days 7, 14, 21, 28
Reported as:
Mean · pg/mL
IL-6
pg/mLInterventionalPlacebo
Baseline17.4 ± 13.614.6 ± 10.0
Day 715.1 ± 12.111.1 ± 8.4
Day 1416.9 ± 13.49.7 ± 2.7
Day 2116.0 ± 15.110.2 ± 2.1
Day 2813.9 ± 10.89.7 ± 3.7
SecondaryIL-1ra

Measurement of plasma IL-1ra levels

Time frame:
Baseline and Days 7, 14, 21, 28
Reported as:
Mean · pg/mL
IL-1ra
pg/mLInterventionalPlacebo
Baseline37.2 ± 19.032.5 ± 14.4
Day 731.2 ± 18.126.6 ± 11.4
Day 1434.0 ± 13.623.2 ± 7.7
Day 2140.2 ± 14.523.7 ± 11.2
Day 2837.1 ± 15.825.4 ± 7.6
SecondaryIL-18

Measurement of plasma levels of IL-18

Time frame:
Baseline and Days 7, 14, 21, and 28
Reported as:
Mean · pg/mL
IL-18
pg/mLInterventionalPlacebo
Baseline120.1 ± 69.6116.0 ± 65.9
Day 782.0 ± 60.488.6 ± 47.6
Day 1477.0 ± 58.881.7 ± 38.6
Day 2175.1 ± 58.980.7 ± 43.6
Day 2873.7 ± 56.074.4 ± 36.6
SecondaryTNF-alpha

Plasma levels of TNF-alpha

Time frame:
Baseline and Days 7, 14, 21, and 28
Reported as:
Mean · pg/mL
TNF-alpha
pg/mLInterventionalPlacebo
Baseline131.1 ± 99.997.0 ± 46.8
Day 7124.5 ± 104.297.8 ± 38.9
Day 14137.1 ± 123.797.8 ± 51.4
Day 21121.4 ± 112.684.0 ± 46.5
Day 28128.4 ± 140.889.9 ± 42.3
SecondaryCaspase-1

Plasma levels of caspase-1

Time frame:
Baseline and Days 7, 14, 21, and 28
Reported as:
Mean · pg/mL
Caspase-1
pg/mLInterventionalPlacebo
Baseline97.2 ± 77.6115.5 ± 110
Day 784.7 ± 95.2104.4 ± 92.0
Day 1469.5 ± 74.896.4 ± 105.8
Day 2198.7 ± 120.096.4 ± 105.8
Day 28101.6 ± 150.983.4 ± 66.4
SecondaryGasdermin D

Plasma levels of gasdermin D

Time frame:
Baseline and Days 7, 14, 21, and 28
Reported as:
Mean · pg/mL
Gasdermin D
pg/mLInterventionalPlacebo
Baseline2.5 ± 1.93.5 ± 2.9
Day 74.0 ± 2.54.9 ± 4.0
Day 145.0 ± 3.15.2 ± 3.6
Day 216.2 ± 3.17.2 ± 4.0
Day 285.4 ± 3.35.4 ± 2.7
SecondaryG-CSF

Plasma levels of G-CSF

Time frame:
Baseline and Days 7, 14, 21, and 28
Reported as:
Mean · pg/mL
G-CSF
pg/mLInterventionalPlacebo
Baseline137.2 ± 34.2147.0 ± 56.9
Day 7125.0 ± 29.1106.6 ± 36.4
Day 14121.4 ± 41.2100.2 ± 20.8
Day 21114.5 ± 34.9103.8 ± 21.3
Day 28122.5 ± 45.3102.9 ± 24.1

Adverse events

Collected over From the time of enrollment through Day 60. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Interventional0/20 (0%)0/20 (0%)2/20 (10%)
Placebo0/20 (0%)0/20 (0%)0/20 (0%)
Most frequent other events
Most frequent other events
EventInterventionalPlacebo
Chest painCardiac disorders2/20—

Baseline characteristics

Age, Continuous
Age, Continuous(years)InterventionalPlaceboTotal
Mean45.1 ± 11.941.6 ± 12.143.4 ± 12.0
Sex: Female, Male
Sex: Female, Male(Participants)InterventionalPlaceboTotal
Female111122
Male9918
Race (NIH/OMB)
Race (NIH/OMB)(Participants)InterventionalPlaceboTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American437
White131124
More than one race000
Unknown or Not Reported369
Region of Enrollment
Region of Enrollment(participants)InterventionalPlaceboTotal
United States202040
08

Study locations

2 sites
  • MedStar Washington Hospital Center
    Washington, District of Columbia 20010, United States
  • MedStar Franklin Square
    Baltimore, Maryland 21237, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Dec 23, 2021

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT05164120
Lead sponsor
MedStar Health
Responsible party
Sponsor
First posted
Dec 20, 2021
Start date
Dec 14, 2021
Primary completion
Jul 18, 2022
Completion
Oct 11, 2022
Results posted
Sep 19, 2024
Last update
Sep 19, 2024

Study contacts

Glenn Wortmann, MD
principal investigator · MedStar Health

Oversight

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

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