ClinicalTrials.gg
TerminatedNCT05254990Updated Feb 24, 2026Results posted

Reparixin add-on Therapy to Standard Care to Limit Progression in Pts With COVID19 & Other Community Acquired Pneumonia

A Phase 3 interventional study of Reparixin and Placebo in Infectious Pneumonia and Severe COVID-19, sponsored by Dompé Farmaceutici S.p.A. Terminated at 74 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-02-24.

Sponsored by Dompé Farmaceutici S.p.A · Phase 3, Interventional, and Treatment

Why this study was terminated
The study was stopped due to futility as per protocol
Phase
Phase 3
Study type
Interventional
Enrollment
414
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Primary objective:

- To compare the efficacy of reparixin vs. placebo in the proportion of patients dead or requiring IMV (or ECMO) by Day 28.

Key secondary objectives:

  • To compare the efficacy of reparixin vs placebo in all-cause mortality at day 180.
  • To compare the efficacy of reparixin vs placebo in proportion of patients alive and discharged at day 28
  • To compare the efficacy of reparixin vs placebo in ventilatory-free days at day 28.
  • To compare the efficacy of reparixin vs placebo in proportion of patients with IMV (or ECMO) by day 28.
  • To compare the efficacy of reparixin vs placebo in length of primary hospital stay.

Other efficacy objectives

- To compare the efficacy of reparixin vs placebo on several disease severity/progression measures including recovery, ventilatory free days and mortality.

Safety objectives:

- To evaluate safety and tolerability of oral reparixin versus placebo in the specific clinical setting.

Read the detailed description

Multinational, multicentre, randomized, double-blind, placebo-controlled, parallel-group, phase III trial.

This study was conducted at 101 sites across 7 countries (Argentina, Australia, Austria, Germany, Italy, Turkey, and the United States [US]) that enrolled 414 male and female patients > 18 years of age, hospitalized for CAP (including COVID-19). Please note that of these 101 sites, only 74 had enrolled patients and, hence, have been reported on CT.gov.

The maximum study duration for a participant was 180 days, which included screening (day -1 or 1), treatment (up to day 21), and follow-up period (up to day 180).

Of the 414 patients enrolled, 409 (98.8%) were randomized 1:1 to receive investigational products (oral reparixin [N = 205] or matched placebo [N = 204], three times a day (TID), for up to 21 days. Randomization was stratified according to disease severity and site.

Actually, 394 participants (96.3%)(oral reparixin [N = 201] or matched placebo [N = 193]) received at least 1 dose of the investigational product and hence were included in the FAS population.

All the patients received the Standard of Care (SoC) based on their clinical need, including COVID-19 and CAP medications, as per local standard therapy at the trial site and in line with international guidelines.

Of the randomized population (N = 409), 186 participants (45.5%) completed the study; 223 (54.5%) discontinued the study prematurely.

The primary outcome was evaluated at day 28, while the secondary outcomes were scheduled to be evaluated from day 3 to day 180.

An independent external data monitoring committee (DMC) oversaw the study and evaluated unblinded interim data for efficacy, futility, and safety.

The interim efficacy analysis met the pre-specified criteria for futility and the DMC recommended early termination of the study. Based on the recommendation of the DMC, Dompé decided to terminate the study earlier than planned. The decision was not related to any safety concerns.

Due to the early study termination and not reaching the planned enrollment target, the outcome measure analyses were conducted for descriptive purposes only.

02

Conditions studied

  • Infectious Pneumonia
  • Severe COVID-19

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Keywords

  • COVID-19
  • SARS-CoV-2
  • Infectious pneumonia acquired in the community (CAP)
03

In context

COVID-19

7,990 studies on the registry are indexed under COVID-19; 466 are open to participants now.

This study's enrollment of 414 is above the median of 102 across 4,364 interventional studies indexed under COVID-19.

Browse COVID-19 studies →

Lead sponsor

Dompé Farmaceutici S.p.A is the lead sponsor of 52 studies on the registry; 4 are open to participants now.

Of its 18 completed or terminated interventional studies of FDA-regulated products, 18 (100%) have results posted.

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. signed
  2. Male and female ≥18 years old;
  3. Patients hospitalized for clinically suspected CAP, defined as the occurrence of (within 48h from hospital admission):

    1. at least 1 of the following signs/symptoms: dyspnea, cough, purulent sputum, crackles (rales) and/or rhonchi
    2. body temperature > 38°C or \<36°C (before or during admission) or leucocytosis (> local )
    3. new/increased pulmonary infiltrate(s) by chest imaging
  4. Need for non-invasive supplemental oxygen (NIAID-OS 5-6);
  5. SpO2 \<92% at room air, or PaO2/FiO2 (or SpO2/FiO2) \<300;
  6. Females of and with an active sexual life must not wish to get pregnant within 30 days after the end of the study and must be using at least one of the following reliable methods of :

    1. Hormonal contraception, systemic, implantable, transdermal, or injectable contraceptives for at least 2 months before the screening visit until 30 days after the last IMP dose
    2. A non-hormonal intrauterine device [IUD] or female condom with spermicide or contraceptive sponge with spermicide or diaphragm with spermicide or cervical cap with spermicide for at least 2 months before the screening visit until 30 days after the last IMP dose
    3. A male sexual partner who agrees to use a male condom with spermicide
    4. A sterile sexual partner

Female participants of non-child-bearing potential or in status for at least 1 year will be admitted. For all female subjects, with child-bearing potential, pregnancy test result must be negative before first drug intake.

Exclusion criteria

Exclusion Criteria:

  1. Treatment with IMV or ECMO (NIAID-OS 7);
  2. Hepatic dysfunction: or AST > 5 ; history of chronic hepatic disease (defined with score B or C);
  3. Renal dysfunction: estimated (eGFR, MDRD) \<50 mL/min/1.73 m2, or need for haemodialysis or hemofiltration;
  4. Current use of >2 medications or immunosuppression status (AIDS, aplastic anaemia, asplenia, systemic chemotherapy within the past 3 months, neutropenia (ANC \< local LLN), solid organ or bone marrow transplant recipients)
  5. Treatment with prohibited medication within 5 half-lives, and inability to stop during treatment period;
  6. Anticipated discharge from the hospital or transfer to another hospital within 72 hours of screening
  7. History of:

    1. intolerance or to ibuprofen to more than one medication belonging to the class of sulfonamides, such as sulfamethazine, sulfamethoxazole, sulfasalazine, nimesulide or celecoxib (hypersensitivity to sulphanilamide antibiotics alone, e.g. sulfamethoxazole does not qualify for exclusion)
    2. lactase deficiency, galactosemia or glucose-galactose malabsorption
    3. gastrointestinal bleeding or perforation due to previous NSAIDs therapy or recurrent peptic ulcer/haemorrhage
    4. allergy to reparixin or any component of the IMP formulation
  8. Active bleeding or bleeding diathesis (excluding menses), prior intracranial haemorrhage
  9. Participation in other interventional clinical trials
  10. Clinical condition not compatible with oral administration of the study drug
  11. Pregnancy:

    1. positive or missing pregnancy test before first drug intake or day 1;
    2. pregnant or lactating women;
    3. women of and fertile men who do not agree to use at least one primary form of for the duration of the study
  12. Current hospital stay >72h
  13. Complicated CAP-associated conditions, such as fungal pulmonary infection, tuberculosis infection, abscess, empyema, significant bilateral pleural effusion, massive pulmonary embolism
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
414 participants (actual)

Study arms

  • Experimental
    Reparixin + standard of care (SoC)

    Reparixin was administered orally at the dose of 1200 mg (2 x 600 mg tablets) TID (6 tablets daily) for up to 21 days. The three daily doses were administered maintaining an interval between doses of about 8 hours.

    Drug: Reparixin

  • Placebo comparator
    Placebo + standard of care (SoC)

    Placebo tablets are identical in appearance to the active formulation. Placebo was administered with the same treatment schedule.

    Other: Placebo

Interventions

  • Reparixin 600 mg tablets, administered orally at the dose of 1200 mg TID (2 tablets TID) as add-on therapy to standard of care up to 21 days. IMP was taken with a glass of water (about 250 mL) and a light meal or snack, as it was preferable that reparixin was taken with food. However, If the patient was unwilling or unable to administer oral tablets, investigator could decide a nasogastric tube as an alternative route.

    Also known as: Repertaxin L-lysine salt

  • OtherPlacebo

    Administered orally three times a day (TID) as add-on therapy to standard of care (SoC) up to 21 days. Placebo was taken with a glass of water (about 250 mL) and a light meal or snack, as it was preferable that placebo was taken with food. However, if the patient was unwilling or unable to administer oral tablets, investigator could decide a nasogastric tube as an alternative route.

    Also known as: Matched placebo

06

What researchers measure

Primary outcomes

  1. Proportion of Patients Dead or Requiring Invasive Mechanical Ventilation (IMV) or Extracorporeal Membrane Oxygenation (ECMO) by Day 28 [NIAID-OS 7].

    The primary endpoint was based on NIAID-OS ordinal scale (National Institute of Allergy and Infectious Disease) with score OS 7 which means patients "hospitalized, on invasive mechanical ventilation or ECMO". The scores on this scale of Disease severity range from OS 1 (best outcome) to OS 8 (worst outcome). NIAID-OS (National Institute of Allergy and Infectious Disease Ordinal Scale) SCORE Descriptor: * OS 1 Not hospitalized, no limitations on activities; * OS 2 Not hospitalized, limitation on activities and/or requiring home O2; * OS 3 Hospitalized, no supplemental O2 - no longer requires ongoing medical care; * OS 4 Hospitalized, no supplemental O2 - requiring ongoing medical care; * OS 5 Hospitalized, requiring supplemental O2; * OS 6 Hospitalized, on non-invasive ventilation or high-flow oxygen devices; * OS 7 Hospitalized, on invasive mechanical ventilation or ECMO; * OS 8 Death;

    Time frame: Day 28

Secondary outcomes

  1. All-cause Mortality by Day 180

    Key secondary endpoint. All-cause mortality is a measurement of the total number of deaths from any cause within a specific population over a defined period. It is a broad metric used in medical research and public health to assess overall population health, identify risk factors for premature death, and evaluate the effectiveness of interventions. The number of participants (in the form of unadjusted proportion) who met the endpoint is reported.

    Time frame: Day 180

  2. Proportion of Patients Alive and Discharged From the Hospital by Day 28

    Key secondary endpoint. The number of participants alive or discharged, expressed in the form of unadjusted proportion, who met the endpoint at the final analysis at day 28 is provided.

    Time frame: Day 28

  3. Ventilatory-free Days (VFD) by Day 28

    Key secondary endpoint. Number of days from Day 0 to Day 28 when the patient was alive and free of invasive ventilation is reported. In case of multiple periods of IMV during the first 28 days, the total duration of ventilation considered all periods of ventilation during the index admission. Patients who died within 28 days or who still were on invasive ventilation after 28 days were scored 0 VFDs.

    Time frame: Day 28

  4. Proportion of Patients With IMV (or ECMO) by Day 28

    Key secondary endpoint.The number of participants, expressed in the form of unadjusted proportion, who met the endpoint at the final analysis is reported.

    Time frame: Day 28

  5. Length of Primary Hospital Stay (in Days)

    Key secondary endpoint. The duration of primary hospital stay, expressed in days, are reported. This parameter is included in the set of final evaluation, which comprises: no. of days of hospitalization, etiologic agents (if identified), ICU admission and total days in ICU, occurrence, and duration of IMV and/or ECMO, if any.

    Time frame: Day 180

  6. Clinical Failure by Day 3 and Day 7

    Clinical failure was defined as the occurrence of IMV/ECMO or vasopressor, or death. IMV= invasive mechanical ventilation. ECMO=extracorporeal membrane oxygenation.

    Time frame: Day 3 and Day 7

  7. 28-day ICU-free Days

    ICU-free days = days of hospitalization out of the Intensive Care Unit. Death within Day 28 was handled as an unfavorable event and ICU-free days were set at 0.

    Time frame: Day 28

  8. Days Free of IMV or ECMO (Number of Days With NIAID-OS 1-6) by Day 28

    These parameters are expressed as number of days with NIAID-OS score not equal to 7 or 8, where NIAID-OS is the National Institute of Allergy and Infectious Disease Ordinal Scale; a scale ranging from 1 to 8, where the lower the score, the better the outcome. The IMV/ECMO-free days at Day 28 were analyzed according to MI approach and ANOVA model. Death due to progression of the respiratory disease within Day 28 was handled as an unfavorable event and IMV/ECMO-free days at Day 28 was set at 0.

    Time frame: Day 28

  9. Duration of Antibiotic Therapy (Days) by Day 28

    A descriptive summary of duration of antibiotic therapy (days) at day 28 for the FAS is reported.

    Time frame: Day 28

  10. Hospital Free Days

    Results for hospital-free days at day 28 in the FAS are presented through an unadjusted descriptive summary.

    Time frame: Day 28

  11. Proportion of Patients Recovered

    Results for the proportion of participants recovered at fixed timepoints in the FAS are presented. Recovering was defined as a downward shift from screening of ≤2 points on the NIAID-OS or live discharge from hospital. Unadjusted proportion is reported.

    Time frame: days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)

  12. Proportion of Patients Worsening

    Results for the proportion of participants worsening at fixed timepoints in the FAS are presented. Worsening was expressed as upward shift from screening of at least \>1 point of the NIAID-OS or if patient died before X Visit Day. An unadjusted proportion is reported.

    Time frame: days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)

  13. Change From Baseline in the Arterial Partial Pressure of Oxygen (PaO2)

    Descriptive statistics for the change from baseline in arterial partial pressure of oxygen (PaO2) at fixed timepoints are reported.

    Time frame: days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)

  14. Change From Baseline in Pulse Oximetry (SpO2)

    Descriptive statistics for the change from baseline in pulse oximetry, measured as peripheral arterial oxygen saturation (SpO2), at fixed timepoints are reported.

    Time frame: days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)

  15. Change From Baseline in Inspired Oxygen (FiO2) Levels

    FiO2 is a parameter of lung function representing the fraction of oxygen in the inspired air, ranging from 0.21 (room air) to 1.00 (100% oxygen). The endpoint assesses the change from baseline in FiO2 levels at predefined timepoints during the study.

    Time frame: days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)

  16. Change From Baseline in PaO2/FiO2 Ratio

    The PaO2/FiO2 ratio is a parameter of lung function that reflects the efficiency of oxygen transfer from the lungs to the blood. It is calculated as the ratio between the arterial partial pressure of oxygen (PaO2, measured in mmHg) and the fraction of inspired oxygen (FiO2, expressed as a fraction ranging from 0.21 to 1.00). This endpoint assesses the change from baseline in the PaO2/FiO2 ratio at predefined timepoints during the study.

    Time frame: days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)

  17. Change From Baseline in SpO2/FiO2 Ratio

    The SpO2/FiO2 ratio is a noninvasive indicator of lung function and oxygenation efficiency, calculated as the ratio between peripheral oxygen saturation (SpO2, expressed as a percentage) and the fraction of inspired oxygen (FiO2, expressed as a fraction ranging from 0.21 to 1.00). This endpoint assesses the change from baseline in the SpO2/FiO2 ratio at predefined timepoints during the study.

    Time frame: Days 3, 7, 14, 21, and 28

  18. All-cause Mortality

    Results for all-cause mortality rates in the FAS are reported, at day 28, day 60, and day 90. Analysis was based on logistic regression model with Multiple Imputation using retrieve dropouts with proportion of patients died up to Day 28 as dependent variable, treatment, disease severity at baseline (NIAID-OS \<=5 vs. NIAID-OS 6), age class (\<65, \>= 65 years), sex and presence of concomitant disease at baseline as qualitative independent variables.

    Time frame: Days 28, 60 and 90

  19. Hospital Re-admission by Day 90 and 180

    Hospital Re-admission by Day 90 and 180 in the FAS is presented. The number of participants is expressed as unadjusted proportion.

    Time frame: Days 90 and 180

  20. Time to Discharge or to a NEWS (National Early Warning Score) of ≤ 2 (for 24 Hours), Whichever Occurs First

    The median time to discharge or to a NEWS (National Early Warning Score) of ≤ 2 (for 24 hours), whichever occurs first, was expressed using a "time to event" approach, and measured in days. NIAID-OS, National Early Warning Score (NEWS) was evaluated daily until day 28 (or hospital discharge). In a scored system standardizing the assessment of acute-illness severity in the NHS, NEWS includes Blood Pressure (BP), Heart Rate (HR), Respiratory Rate (RR), body temperature, level of consciousness (A, V, P, U), peripheral arterial oxygen saturation (SpO2) and supplemental oxygen. Time to discharge or to a NEWS of \<= 2 (for 24 hours) = Min(Date of discharge, Date of NEWS of \<= 2 (for 24 hours)) - Day 1 date + 1. Date of NEWS of \<= 2 (for 24 hours): Given two consecutive days with NEWS of \<= 2, the date of the first assessment has been considered.

    Time frame: Day 28

  21. Change in Quality of Life Using EuroQol-5-dimensions-5 Levels (EQ-5D-5L) Questionnaire From Hospital Discharge to Day 90 and Day 180

    The EQ-5D-5L asks patients to indicate whether they have no, slight, moderate, severe, extreme problems on each of 5 dimensions of health: mobility; self-care; usual activities; pain/discomfort; anxiety/depression.The count of patients of each level (1 - no problems, 2 - slight problems, 3 - moderate problems, 4 - severe problems, 5 - extreme problems) for each of the 5 dimensions were reported. The higher the score for each dimension (range 1-5), the worse the outcome.

    Time frame: Days 90±7 and 180±14

  22. Duration of IMV and/or ECMO by Days 90 and 180

    The summary of IMV/ECMO duration by day 90 and day 180 for the FAS is presented. The duration of IMV/ECMO use by day 90 was calculated as the total number of days between day 1 and the last available assessment day (≥ day 83) during which the participant was either receiving IMV/ECMO or had a NIAID-OS score of 7. Participants with less than 83 days of follow-up were considered non-evaluable for this endpoint. Similarly, the duration of IMV/ECMO by day 180 was calculated using the same methodology.

    Time frame: Days 90 and 180

  23. Proportion of Participants Requiring ICU Admission by Days 90 and 180

    Unadjusted proportion of ICU admission is reported as number and percentage of participants requiring ICU admission by day 90 and day 180.

    Time frame: Days 90 and 180

  24. ICU Length of Stay by Days 90 and 180

    Results for the Intensive Care Unit length of stay (days) by day 90 and day 180 in the FAS are reported.

    Time frame: Days 90 and 180

  25. Hospital Length of Stay by Days 90 and 180

    Results for hospital length of stay (days) by day 90 and 180 in the FAS are reported.

    Time frame: Days 90 and 180

  26. Occurrence of Infections by Days 90 and 180

    Occurrence of infections was expressed as the unadjusted proportion of participants with at least one infection by days 90 and 180 in the FAS.

    Time frame: Days 90 and 180

  27. Number of Patients With at Least One Treatment-emergent Adverse Event (TEAE)

    A TEAE is defined as any adverse event reported in the study having a possible, probable, or highly probable relationship to investigational product. A serious AE is defined as any untoward medical occurrence that at any dose: * results in death. * is life-threatening (i.e. the patient was at risk of death at the time of the event. It does not refer to an event which hypothetically might have caused death if it were more severe), * requires inpatient hospitalization or prolongation of existing hospitalization, * results in persistent or significant disability/incapacity, * is a congenital anomaly/birth defect * is a medically significant or important medical condition, i.e. an important medical event that based upon appropriate medical judgment, may jeopardize the patient and may require medical or surgical intervention to prevent one of the outcomes listed above.

    Time frame: Throughout the study till Day 180 (± 14) or end of treatment

07

Results

Posted Feb 24, 2026
Limitations and caveats
An interim analysis conducted on the first 250 participants who had reached day 28 or died or experienced IMV or ECMO by day 28 indicated that the primary efficacy endpoint met the pre-specified criteria for futility. Based on the recommendation of the DMC, Dompé decided to terminate the study early for futility. The decision was not related to any safety concerns.

Participant flow

A total of 444 participants were screened and 414 were enrolled; 409 (98.8%) were randomized 1:1 to receive investigational products (reparixin \[N = 205\] or placebo \[N = 204\]). A total of 186 participants (45.5%) completed the study; 223 (54.5%) discontinued the study prematurely.

Participant flow — Overall Study
MilestoneReparixin + Standard of CarePlacebo + Standard of Care
Started205204
Fas population201193
Saf population201193
Pp population139133
Completed9096
Not completed115108
Withdrew: Sponsor's decision to terminate the study early5343
Withdrew: Death1619
Withdrew: Lost to follow-up2422
Withdrew: Withdrawal by subject1710
Withdrew: Adverse event11
Withdrew: Physician decision24
Withdrew: Other29

Outcome measures

PrimaryProportion of Patients Dead or Requiring Invasive Mechanical Ventilation (IMV) or Extracorporeal Membrane Oxygenation (ECMO) by Day 28 [NIAID-OS 7].

The primary endpoint was based on NIAID-OS ordinal scale (National Institute of Allergy and Infectious Disease) with score OS 7 which means patients "hospitalized, on invasive mechanical ventilation or ECMO". The scores on this scale of Disease severity range from OS 1 (best outcome) to OS 8 (worst outcome). NIAID-OS (National Institute of Allergy and Infectious Disease Ordinal Scale) SCORE Descriptor: * OS 1 Not hospitalized, no limitations on activities; * OS 2 Not hospitalized, limitation on activities and/or requiring home O2; * OS 3 Hospitalized, no supplemental O2 - no longer requires ongoing medical care; * OS 4 Hospitalized, no supplemental O2 - requiring ongoing medical care; * OS 5 Hospitalized, requiring supplemental O2; * OS 6 Hospitalized, on non-invasive ventilation or high-flow oxygen devices; * OS 7 Hospitalized, on invasive mechanical ventilation or ECMO; * OS 8 Death;

Time frame:
Day 28
Reported as:
Count of participants · Participants
Proportion of Patients Dead or Requiring Invasive Mechanical Ventilation (IMV) or Extracorporeal Membrane Oxygenation (ECMO) by Day 28 [NIAID-OS 7].
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Proportion of Patients Dead or Requiring Invasive Mechanical Ventilation (IMV) or Extracorporeal Membrane Oxygenation (ECMO) by Day 28 [NIAID-OS 7].712
SecondaryAll-cause Mortality by Day 180

Key secondary endpoint. All-cause mortality is a measurement of the total number of deaths from any cause within a specific population over a defined period. It is a broad metric used in medical research and public health to assess overall population health, identify risk factors for premature death, and evaluate the effectiveness of interventions. The number of participants (in the form of unadjusted proportion) who met the endpoint is reported.

Time frame:
Day 180
Reported as:
Count of participants · Participants
All-cause Mortality by Day 180
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
All-cause Mortality by Day 1801618
SecondaryProportion of Patients Alive and Discharged From the Hospital by Day 28

Key secondary endpoint. The number of participants alive or discharged, expressed in the form of unadjusted proportion, who met the endpoint at the final analysis at day 28 is provided.

Time frame:
Day 28
Reported as:
Count of participants · Participants
Proportion of Patients Alive and Discharged From the Hospital by Day 28
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Proportion of Patients Alive and Discharged From the Hospital by Day 28170159
SecondaryVentilatory-free Days (VFD) by Day 28

Key secondary endpoint. Number of days from Day 0 to Day 28 when the patient was alive and free of invasive ventilation is reported. In case of multiple periods of IMV during the first 28 days, the total duration of ventilation considered all periods of ventilation during the index admission. Patients who died within 28 days or who still were on invasive ventilation after 28 days were scored 0 VFDs.

Time frame:
Day 28
Reported as:
Mean · number of days
Ventilatory-free Days (VFD) by Day 28
number of daysReparixin + Standard of CarePlacebo + Standard of Care
Ventilatory-free Days (VFD) by Day 2827.4 ± 4.226.5 ± 6.3
SecondaryProportion of Patients With IMV (or ECMO) by Day 28

Key secondary endpoint.The number of participants, expressed in the form of unadjusted proportion, who met the endpoint at the final analysis is reported.

Time frame:
Day 28
Reported as:
Count of participants · Participants
Proportion of Patients With IMV (or ECMO) by Day 28
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Proportion of Patients With IMV (or ECMO) by Day 28610
SecondaryLength of Primary Hospital Stay (in Days)

Key secondary endpoint. The duration of primary hospital stay, expressed in days, are reported. This parameter is included in the set of final evaluation, which comprises: no. of days of hospitalization, etiologic agents (if identified), ICU admission and total days in ICU, occurrence, and duration of IMV and/or ECMO, if any.

Time frame:
Day 180
Reported as:
Mean · days of hospital stay
Length of Primary Hospital Stay (in Days)
days of hospital stayReparixin + Standard of CarePlacebo + Standard of Care
Length of Primary Hospital Stay (in Days)8.7 ± 6.38.7 ± 7.0
SecondaryClinical Failure by Day 3 and Day 7

Clinical failure was defined as the occurrence of IMV/ECMO or vasopressor, or death. IMV= invasive mechanical ventilation. ECMO=extracorporeal membrane oxygenation.

Time frame:
Day 3 and Day 7
Reported as:
Count of participants · Participants
Clinical Failure by Day 3 and Day 7
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Day 327
Day 759
Secondary28-day ICU-free Days

ICU-free days = days of hospitalization out of the Intensive Care Unit. Death within Day 28 was handled as an unfavorable event and ICU-free days were set at 0.

Time frame:
Day 28
Reported as:
Mean · days
28-day ICU-free Days
daysReparixin + Standard of CarePlacebo + Standard of Care
28-day ICU-free Days26.3 ± 5.025.7 ± 6.8
SecondaryDays Free of IMV or ECMO (Number of Days With NIAID-OS 1-6) by Day 28

These parameters are expressed as number of days with NIAID-OS score not equal to 7 or 8, where NIAID-OS is the National Institute of Allergy and Infectious Disease Ordinal Scale; a scale ranging from 1 to 8, where the lower the score, the better the outcome. The IMV/ECMO-free days at Day 28 were analyzed according to MI approach and ANOVA model. Death due to progression of the respiratory disease within Day 28 was handled as an unfavorable event and IMV/ECMO-free days at Day 28 was set at 0.

Time frame:
Day 28
Reported as:
Mean · days
Days Free of IMV or ECMO (Number of Days With NIAID-OS 1-6) by Day 28
daysReparixin + Standard of CarePlacebo + Standard of Care
Days Free of IMV or ECMO (Number of Days With NIAID-OS 1-6) by Day 2827.4 ± 4.226.8 ± 5.6
SecondaryDuration of Antibiotic Therapy (Days) by Day 28

A descriptive summary of duration of antibiotic therapy (days) at day 28 for the FAS is reported.

Time frame:
Day 28
Reported as:
Mean · days
Duration of Antibiotic Therapy (Days) by Day 28
daysReparixin + Standard of CarePlacebo + Standard of Care
Duration of Antibiotic Therapy (Days) by Day 289.6 ± 8.39.2 ± 8.6
SecondaryHospital Free Days

Results for hospital-free days at day 28 in the FAS are presented through an unadjusted descriptive summary.

Time frame:
Day 28
Reported as:
Mean · days
Hospital Free Days
daysReparixin + Standard of CarePlacebo + Standard of Care
Hospital Free Days18.3 ± 6.718.2 ± 7.6
SecondaryProportion of Patients Recovered

Results for the proportion of participants recovered at fixed timepoints in the FAS are presented. Recovering was defined as a downward shift from screening of ≤2 points on the NIAID-OS or live discharge from hospital. Unadjusted proportion is reported.

Time frame:
days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)
Reported as:
Count of participants · Participants
Proportion of Patients Recovered
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Day 31115
Day 74049
Day 14138135
Day 213124
Day 28151139
Hospital discharge (Up to Day 41)146145
SecondaryProportion of Patients Worsening

Results for the proportion of participants worsening at fixed timepoints in the FAS are presented. Worsening was expressed as upward shift from screening of at least \>1 point of the NIAID-OS or if patient died before X Visit Day. An unadjusted proportion is reported.

Time frame:
days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)
Reported as:
Count of participants · Participants
Proportion of Patients Worsening
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Day 3610
Day 746
Day 1426
Day 2137
Day 28510
Hospital discharge (Up to Day 41)54
SecondaryChange From Baseline in the Arterial Partial Pressure of Oxygen (PaO2)

Descriptive statistics for the change from baseline in arterial partial pressure of oxygen (PaO2) at fixed timepoints are reported.

Time frame:
days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)
Reported as:
Mean · mmHg
Change From Baseline in the Arterial Partial Pressure of Oxygen (PaO2)
mmHgReparixin + Standard of CarePlacebo + Standard of Care
To day 315.80 ± 27.969.08 ± 22.18
To day 715.44 ± 29.5011.10 ± 27.94
To day 1420.09 ± 30.4218.28 ± 20.62
To day 218.63 ± 37.0421.88 ± 26.43
To day 2823.65 ± 30.0225.98 ± 21.54
Hospital discharge (Up to Day 41)25.45 ± 17.5724.52 ± 6.20
SecondaryChange From Baseline in Pulse Oximetry (SpO2)

Descriptive statistics for the change from baseline in pulse oximetry, measured as peripheral arterial oxygen saturation (SpO2), at fixed timepoints are reported.

Time frame:
days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)
Reported as:
Mean · percent hemoglobin oxygen saturation
Change From Baseline in Pulse Oximetry (SpO2)
percent hemoglobin oxygen saturationReparixin + Standard of CarePlacebo + Standard of Care
To day 33.86 ± 5.902.79 ± 6.48
To day 74.37 ± 6.532.45 ± 7.79
To day 145.41 ± 5.874.09 ± 7.05
To day 214.32 ± 6.623.12 ± 4.55
To day 285.95 ± 5.425.46 ± 7.19
Hospital discharge (Up to Day 41)4.53 ± 2.209.25 ± 0.35
SecondaryChange From Baseline in Inspired Oxygen (FiO2) Levels

FiO2 is a parameter of lung function representing the fraction of oxygen in the inspired air, ranging from 0.21 (room air) to 1.00 (100% oxygen). The endpoint assesses the change from baseline in FiO2 levels at predefined timepoints during the study.

Time frame:
days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)
Reported as:
Mean · fraction (0.21-1.00)
Change From Baseline in Inspired Oxygen (FiO2) Levels
fraction (0.21-1.00)Reparixin + Standard of CarePlacebo + Standard of Care
Day 3-0.010 ± 0.144-0.038 ± 0.140
Day 7-0.061 ± 0.151-0.072 ± 0.169
Day 14-0.071 ± 0.135-0.071 ± 0.180
Day 21-0.061 ± 0.131-0.082 ± 0.111
Day 28-0.078 ± 0.119-0.086 ± 0.097
Hospital discharge (Up to Day 41)-0.055 ± 0.0780.000
SecondaryChange From Baseline in PaO2/FiO2 Ratio

The PaO2/FiO2 ratio is a parameter of lung function that reflects the efficiency of oxygen transfer from the lungs to the blood. It is calculated as the ratio between the arterial partial pressure of oxygen (PaO2, measured in mmHg) and the fraction of inspired oxygen (FiO2, expressed as a fraction ranging from 0.21 to 1.00). This endpoint assesses the change from baseline in the PaO2/FiO2 ratio at predefined timepoints during the study.

Time frame:
days 3, 7, 14, 21, 28, and hospital discharge (Up to Day 41)
Reported as:
Mean · ratio
Change From Baseline in PaO2/FiO2 Ratio
ratioReparixin + Standard of CarePlacebo + Standard of Care
Day 366.51 ± 115.4954.52 ± 97.65
Day 7105.38 ± 122.94109.57 ± 138.44
Day 14148.84 ± 128.09146.72 ± 129.19
Day 21101.87 ± 134.94180.14 ± 164.18
Day 28177.58 ± 133.95192.55 ± 116.18
Hospital discharge (Up to Day 41)172.34 ± 196.54137.62
SecondaryChange From Baseline in SpO2/FiO2 Ratio

The SpO2/FiO2 ratio is a noninvasive indicator of lung function and oxygenation efficiency, calculated as the ratio between peripheral oxygen saturation (SpO2, expressed as a percentage) and the fraction of inspired oxygen (FiO2, expressed as a fraction ranging from 0.21 to 1.00). This endpoint assesses the change from baseline in the SpO2/FiO2 ratio at predefined timepoints during the study.

Time frame:
Days 3, 7, 14, 21, and 28
Reported as:
Mean · ratio (SpO2 [%] / FiO2 [fraction])
Change From Baseline in SpO2/FiO2 Ratio
ratio (SpO2 [%] / FiO2 [fraction])Reparixin + Standard of CarePlacebo + Standard of Care
Day 319.63 ± 103.3938.01 ± 104.26
Day 767.42 ± 108.7181.50 ± 131.69
Day1498.30 ± 97.9096.20 ± 122.21
Day 2174.69 ± 107.88101.45 ± 94.49
Day 28109.34 ± 93.37118.75 ± 82.93
SecondaryAll-cause Mortality

Results for all-cause mortality rates in the FAS are reported, at day 28, day 60, and day 90. Analysis was based on logistic regression model with Multiple Imputation using retrieve dropouts with proportion of patients died up to Day 28 as dependent variable, treatment, disease severity at baseline (NIAID-OS \<=5 vs. NIAID-OS 6), age class (\<65, \>= 65 years), sex and presence of concomitant disease at baseline as qualitative independent variables.

Time frame:
Days 28, 60 and 90
Reported as:
Number · % participants
All-cause Mortality
% participantsReparixin + Standard of CarePlacebo + Standard of Care
Day 282.608 (NA to 5.219)5.701 (1.612 to 9.790)
Day 606.990 (2.326 to 11.653)11.310 (4.956 to 17.664)
Day 907.898 (2.890 to 12.906)11.910 (5.448 to 18.371)
SecondaryHospital Re-admission by Day 90 and 180

Hospital Re-admission by Day 90 and 180 in the FAS is presented. The number of participants is expressed as unadjusted proportion.

Time frame:
Days 90 and 180
Reported as:
Count of participants · Participants
Hospital Re-admission by Day 90 and 180
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Day 903029
Day 1803437
SecondaryTime to Discharge or to a NEWS (National Early Warning Score) of ≤ 2 (for 24 Hours), Whichever Occurs First

The median time to discharge or to a NEWS (National Early Warning Score) of ≤ 2 (for 24 hours), whichever occurs first, was expressed using a "time to event" approach, and measured in days. NIAID-OS, National Early Warning Score (NEWS) was evaluated daily until day 28 (or hospital discharge). In a scored system standardizing the assessment of acute-illness severity in the NHS, NEWS includes Blood Pressure (BP), Heart Rate (HR), Respiratory Rate (RR), body temperature, level of consciousness (A, V, P, U), peripheral arterial oxygen saturation (SpO2) and supplemental oxygen. Time to discharge or to a NEWS of \<= 2 (for 24 hours) = Min(Date of discharge, Date of NEWS of \<= 2 (for 24 hours)) - Day 1 date + 1. Date of NEWS of \<= 2 (for 24 hours): Given two consecutive days with NEWS of \<= 2, the date of the first assessment has been considered.

Time frame:
Day 28
Reported as:
Median · days
Time to Discharge or to a NEWS (National Early Warning Score) of ≤ 2 (for 24 Hours), Whichever Occurs First
daysReparixin + Standard of CarePlacebo + Standard of Care
Time to Discharge or to a NEWS (National Early Warning Score) of ≤ 2 (for 24 Hours), Whichever Occurs First5 (4.0 to 6.0)5 (5.0 to 6.0)
SecondaryChange in Quality of Life Using EuroQol-5-dimensions-5 Levels (EQ-5D-5L) Questionnaire From Hospital Discharge to Day 90 and Day 180

The EQ-5D-5L asks patients to indicate whether they have no, slight, moderate, severe, extreme problems on each of 5 dimensions of health: mobility; self-care; usual activities; pain/discomfort; anxiety/depression.The count of patients of each level (1 - no problems, 2 - slight problems, 3 - moderate problems, 4 - severe problems, 5 - extreme problems) for each of the 5 dimensions were reported. The higher the score for each dimension (range 1-5), the worse the outcome.

Time frame:
Days 90±7 and 180±14
Reported as:
Count of participants · Participants
Change in Quality of Life Using EuroQol-5-dimensions-5 Levels (EQ-5D-5L) Questionnaire From Hospital Discharge to Day 90 and Day 180
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Mobility - Day 90 — 1 - no problem6154
Mobility - Day 90 — 2 - slight problems4129
Mobility - Day 90 — 3 - moderate problems1016
Mobility - Day 90 — 4 - severe problems55
Mobility - Day 90 — 5 - extreme problems34
Mobility - Day 180 — 1 - no problem3145
Mobility - Day 180 — 2 - slight problems2620
Mobility - Day 180 — 3 - moderate problems910
Mobility - Day 180 — 4 - severe problems23
Mobility - Day 180 — 5 - extreme problems33
Self-care - Day 90 — 1 - no problem8373
Self-care - Day 90 — 2 - slight problems2120
Self-care - Day 90 — 3 - moderate problems96
Self-care - Day 90 — 4 - severe problems45
Self-care - Day 90 — 5 - extreme problems34
Self-care - Day 180 — 1 - no problem4657
Self-care - Day 180 — 2 - slight problems1514
Self-care - Day 180 — 3 - moderate problems74
Self-care - Day 180 — 4 - severe problems24
Self-care - Day 180 — 5 - extreme problems12
Usual activities - Day 90 — 1 - no problem5250
Usual activities - Day 90 — 2 - slight problems3633
Usual activities - Day 90 — 3 - moderate problems2014
Usual activities - Day 90 — 4 - severe problems75
Usual activities - Day 90 — 5 - extreme problems55
Usual activities - Day 180 — 1 - no problem3138
Usual activities - Day 180 — 2 - slight problems1724
Usual activities - Day 180 — 3 - moderate problems1511
Usual activities - Day 180 — 4 - severe problems54
Usual activities - Day 180 — 5 - extreme problems33
Pain/discomfort - Day 90 — 1 - no problem6658
Pain/discomfort - Day 90 — 2 - slight problems3338
Pain/discomfort - Day 90 — 3 - moderate problems1611
Pain/discomfort - Day 90 — 4 - severe problems31
Pain/discomfort - Day 90 — 5 - extreme problems10
Pain/discomfort - Day 180 — 1 - no problem3645
Pain/discomfort - Day 180 — 2 - slight problems2125
Pain/discomfort - Day 180 — 3 - moderate problems911
Pain/discomfort - Day 180 — 4 - severe problems40
Pain/discomfort - Day 180 — 5 - extreme problems00
Anxiety/Depression - Day 90 — 1 - no problem6269
Anxiety/Depression - Day 90 — 2 - slight problems3332
Anxiety/Depression - Day 90 — 3 - moderate problems216
Anxiety/Depression - Day 90 — 4 - severe problems21
Anxiety/Depression - Day 90 — 5 - extreme problems20
Anxiety/Depression - Day 180 — 1 - no problem3851
Anxiety/Depression - Day 180 — 2 - slight problems2024
Anxiety/Depression - Day 180 — 3 - moderate problems114
Anxiety/Depression - Day 180 — 4 - severe problems11
Anxiety/Depression - Day 180 — 5 - extreme problems11
SecondaryDuration of IMV and/or ECMO by Days 90 and 180

The summary of IMV/ECMO duration by day 90 and day 180 for the FAS is presented. The duration of IMV/ECMO use by day 90 was calculated as the total number of days between day 1 and the last available assessment day (≥ day 83) during which the participant was either receiving IMV/ECMO or had a NIAID-OS score of 7. Participants with less than 83 days of follow-up were considered non-evaluable for this endpoint. Similarly, the duration of IMV/ECMO by day 180 was calculated using the same methodology.

Time frame:
Days 90 and 180
Reported as:
Mean · Days
Duration of IMV and/or ECMO by Days 90 and 180
DaysReparixin + Standard of CarePlacebo + Standard of Care
Day 900.0 ± 0.00.3 ± 2.6
Day 1800.0 ± 0.00.1 ± 0.7
SecondaryProportion of Participants Requiring ICU Admission by Days 90 and 180

Unadjusted proportion of ICU admission is reported as number and percentage of participants requiring ICU admission by day 90 and day 180.

Time frame:
Days 90 and 180
Reported as:
Count of participants · Participants
Proportion of Participants Requiring ICU Admission by Days 90 and 180
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Day 902520
Day 1802620
SecondaryICU Length of Stay by Days 90 and 180

Results for the Intensive Care Unit length of stay (days) by day 90 and day 180 in the FAS are reported.

Time frame:
Days 90 and 180
Reported as:
Mean · Days
ICU Length of Stay by Days 90 and 180
DaysReparixin + Standard of CarePlacebo + Standard of Care
Day 900.9 ± 2.51.0 ± 3.9
Day 1800.7 ± 2.40.8 ± 2.2
SecondaryHospital Length of Stay by Days 90 and 180

Results for hospital length of stay (days) by day 90 and 180 in the FAS are reported.

Time frame:
Days 90 and 180
Reported as:
Mean · Days
Hospital Length of Stay by Days 90 and 180
DaysReparixin + Standard of CarePlacebo + Standard of Care
Day 909.8 ± 8.49.9 ± 10
Day 18012.0 ± 12.710.5 ± 8.5
SecondaryOccurrence of Infections by Days 90 and 180

Occurrence of infections was expressed as the unadjusted proportion of participants with at least one infection by days 90 and 180 in the FAS.

Time frame:
Days 90 and 180
Reported as:
Count of participants · Participants
Occurrence of Infections by Days 90 and 180
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Day 902119
Day 1802319
SecondaryNumber of Patients With at Least One Treatment-emergent Adverse Event (TEAE)

A TEAE is defined as any adverse event reported in the study having a possible, probable, or highly probable relationship to investigational product. A serious AE is defined as any untoward medical occurrence that at any dose: * results in death. * is life-threatening (i.e. the patient was at risk of death at the time of the event. It does not refer to an event which hypothetically might have caused death if it were more severe), * requires inpatient hospitalization or prolongation of existing hospitalization, * results in persistent or significant disability/incapacity, * is a congenital anomaly/birth defect * is a medically significant or important medical condition, i.e. an important medical event that based upon appropriate medical judgment, may jeopardize the patient and may require medical or surgical intervention to prevent one of the outcomes listed above.

Time frame:
Throughout the study till Day 180 (± 14) or end of treatment
Reported as:
Count of participants · Participants
Number of Patients With at Least One Treatment-emergent Adverse Event (TEAE)
ParticipantsReparixin + Standard of CarePlacebo + Standard of Care
Number of Subjects with at least one TEAE (n (%))129127
Number of Subjects with at least one serious TEAE (n (%))4656
Number of Subjects with at least one non-Serious TEAE (n (%))115106
Number of Subjects with at least one severe TEAE (n (%))3233
Number of Subjects with at least one TEAE Leading to Discontinuation of IMP (n (%))2324
Number of Subjects with at least one TEAE Leading to Discontinuation of study (n (%))11
Number of Subjects with at least one TEAE Leading to Death (n (%))1618

Adverse events

Collected over Throughout the study, during the treatment period (up to 21 days) and during the follow-up period (till day 180 or EoT) considered together as an "overall period", up to 7 months. Please note: SAF set participants were summarized according to the actual treatment received. Hence n=200 for REP and n=194 for placebo, in serious AE and non-serious AE.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Reparixin + Standard of Care16/205 (7.8%)46/200 (23%)129/200 (64.5%)
Placebo + Standard of Care19/204 (9.3%)56/194 (28.9%)127/194 (65.5%)
Most frequent serious events
Showing 10 of 105
Most frequent serious events
EventReparixin + Standard of CarePlacebo + Standard of Care
PneumoniaRespiratory, thoracic and mediastinal disorders10/20011/194
Respiratory failureRespiratory, thoracic and mediastinal disorders6/2009/194
Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders8/2005/194
Acute respiratory failureRespiratory, thoracic and mediastinal disorders6/2004/194
DyspnoeaRespiratory, thoracic and mediastinal disorders0/2004/194
DiarrhoeaGastrointestinal disorders0/2003/194
DeathGeneral disorders3/2000/194
HypoxiaRespiratory, thoracic and mediastinal disorders1/2002/194
Atrial fibrillationCardiac disorders1/2002/194
MyocarditisCardiac disorders0/2002/194
Most frequent other events
Showing 10 of 360
Most frequent other events
EventReparixin + Standard of CarePlacebo + Standard of Care
DiarrhoeaGastrointestinal disorders15/20011/194
HypokalaemiaMetabolism and nutrition disorders15/20014/194
PneumoniaRespiratory, thoracic and mediastinal disorders11/20014/194
NauseaGastrointestinal disorders11/2008/194
HypotensionVascular disorders11/2004/194
Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders10/2006/194
HypertensionVascular disorders10/2007/194
Respiratory failureRespiratory, thoracic and mediastinal disorders6/2009/194
Acute kidney injuryRenal and urinary disorders9/2001/194
ConstipationGastrointestinal disorders2/2008/194

Baseline characteristics

FAS: All randomized patients who received at least one dose of the investigational product. FAS population was analyzed according to intention-to-treat principle, ie, by treatment allocation regardless of happening of intercurrent events. The FAS population was used to analyze results on efficacy data and demographics.

Age, Categorical
Age, Categorical(Participants)Reparixin + Standard of CarePlacebo + Standard of CareTotal
<=18 years000
Between 18 and 65 years8479163
>=65 years117114231
Age, Continuous
Age, Continuous(years)Reparixin + Standard of CarePlacebo + Standard of CareTotal
Mean64.3 ± 15.765.9 ± 14.965.1 ± 15.3
Sex: Female, Male
Sex: Female, Male(Participants)Reparixin + Standard of CarePlacebo + Standard of CareTotal
Female9776173
Male104117221
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Reparixin + Standard of CarePlacebo + Standard of CareTotal
Hispanic or Latino333972
Not Hispanic or Latino168154322
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Reparixin + Standard of CarePlacebo + Standard of CareTotal
American Indian or Alaska Native112
Asian246
Native Hawaiian or Other Pacific Islander000
Black or African American181432
White176168344
More than one race000
Unknown or Not Reported4610
Region of Enrollment
Region of Enrollment(participants)Reparixin + Standard of CarePlacebo + Standard of CareTotal
Austria191635
Argentina282957
Turkey211940
United States7980159
Italy474390
Australia235
Germany538
08

Study locations

74 sites
  • MD Banner University Medical Center /Arizona University
    Tucson, Arizona 85719, United States
  • UCI Health
    Orange, California 92868, United States
  • Denver Health
    Denver, Colorado 80204, United States
  • MedStar Health Research Institute-Hyatteville, Maryland
    Washington D.C., District of Columbia 20010, United States
  • Research Alliance Inc.
    Clearwater, Florida 33756, United States
  • University of Florida-Jacksonville
    Jacksonville, Florida 32209, United States
  • Emory Johns Creek Hospital
    Atlanta, Georgia 30342, United States
  • Augusta University Health - Augusta University Medical Center
    Augusta, Georgia 30912, United States
  • Northwestern University, Feinberg School of Medicine
    Chicago, Illinois 60611, United States
  • Methodist Hospital
    Gary, Indiana 46404, United States
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
  • Newton-Wellesley Hospital
    Newton, Massachusetts 02462, United States
  • MidMichigan Medical Center - Midland
    Midland, Michigan 48670, United States
  • William Beaumont Hospital
    Royal Oak, Michigan 48073, United States
  • University Hospital - MU Healthcare
    Columbia, Missouri 65212, United States
  • Washington University, School of Medicine
    St Louis, Missouri 63110, United States
  • Mercy Research St Louis
    St Louis, Missouri 63141, United States
  • NYU Langone Hospital-Brooklyn
    Brooklyn, New York 11220, United States
  • New York University Langone Health
    New York, New York 10016, United States
  • Duke University Hospital
    Durham, North Carolina 27708, United States
  • Oregon Health & Science University (OHSU) - Pulmonary Clinic
    Portland, Oregon 97239, United States
  • Jefferson University Hospital
    Philadelphia, Pennsylvania 19107, United States
  • University of Tennessee Medical Center
    Knoxville, Tennessee 37920, United States
  • Baptist Hospitals of Southeast Texas
    Beaumont, Texas 77701, United States
  • Texoma Medical Center
    Denison, Texas 75020, United States
  • University of Utah Hospitals & Clinics
    Salt Lake City, Utah 84108, United States
  • University of Virginia Medical Center
    Charlottesville, Virginia 22903, United States
  • Virginia Commonwealth University Health
    Richmond, Virginia 23298, United States
  • Hospital Interzonal General de Agudos Dr Jose Penna
    Bahía Blanca, Buenos Aires 8001, Argentina
  • Hospital Italiano de Buenos Aires
    Ciudad Autonoma de Buenos Aires, Buenos Aires 1181, Argentina
  • Hospital Italiano de La Plata
    La Plata, Buenos Aires 1900, Argentina
  • Instituto Medico Platense
    La Plata, Buenos Aires 1900, Argentina
  • Clinica Independencia
    Munro, Buenos Aires 1605, Argentina
  • Sanatorio Finochietto
    Ciudad Autonoma de Buenos Aire, Buenos Aires F.D. 1187, Argentina
  • Sanatorio de la Cañada
    Villa María, Córdoba Province 5900, Argentina
  • Sanatorio Britanico S.A.
    Rosario, Santa Fe Province 2000, Argentina
  • Clinica Adventista Belgrano
    Buenos Aires, 1430, Argentina
  • Sanatorio Agote
    Buenos Aires, C1425 EOE, Argentina
  • Hospital Britanico de Buenos Aires
    Ciudad Autonoma Buenos Aires, 1280, Argentina
  • Nuevo Hospital San Roque
    Córdoba, 5000, Argentina
  • Sanatorio Privado de la Cañada - Cordoba
    Córdoba, 5000, Argentina
  • Sanatorio Privado Duarte Quiroz De Clinica Colombo SA
    Córdoba, 5000, Argentina
  • Westmead Hospital
    Sydney, New South Wales 2145, Australia
  • Mater Hospital Brisbane
    South Brisbane, Queensland 4101, Australia
  • Royal Adelaide Hospital
    Adelaide, South Australia 5000, Australia
  • Kepler Universitatsklinikum Med Campus III
    Linz, 4020, Austria
  • KH der Barmherzigen Brüder Linz
    Linz, 4020, Austria
  • Medizinische Universitaet Wien, Medizinische Klinik I, Abteilung für Infektionskrankheiten und Tropenmedizin
    Vienna, 1090, Austria
  • Klinik Favoriten (Sozialmedizinisches Zentrum Sued - Kaiser-Franz-Josef-Spital mit Gottfried von Preyer'schem Kinderspital)
    Vienna, 1100, Austria
  • Helios Hamper-Klinikum Dachau
    Dachau, Bavaria 85221, Germany
  • Universitaetsklinikum Carl Gustav Carus TU Dresden
    Dresden, Saxony 01307, Germany
  • Universitätsmedizin Göttingen
    Göttingen, Südniedersachsen 37075, Germany
  • ASST - Ospedale Papa Giovanni XXIII - UOC Pneumologia
    Bergamo, 24127, Italy
  • Azienda Ospedaliera Universitaria di Bologna - Ospedale Sant'Orsola
    Bologna, 40138, Italy
  • Campus Universitario "Salvatore Venuta", Complesso Clinico, Padiglione B, 8° livello, Pneumologia
    Catanzaro, 88100, Italy
  • University Of Genoa - Ospedale Policlinico IRCCS San Martino di Genova
    Genova, 16132, Italy
  • IRCCS Istituto Clinico Humanitas U.O. Medicina D'Urgenza
    Milan, 20089, Italy
  • IRCCS Ospedale San Raffaele Centro di Ricerca Anestesia e Rianimazione
    Milan, 20132, Italy
  • ASST SANTI PAOLO E CARLO Ospedale San Paolo Struttura Complessa Malattie Infettive
    Milan, 20142, Italy
  • Università degli Studi di Milano-Ospedale "L.Sacco" Polo Universitario - ASST Fatebenefratelli Sacco
    Milan, 20157, Italy
  • ASST Grande Ospedale Metropolitano Niguarda Dipartimento Malattie Infettive
    Milan, 20162, Italy
  • ASST-Monza Ospedale San Gerardo Malattie Infettive
    Monza, 20900, Italy
  • Clinica Pneumologica "L. Vanvitelli" - Osp Monaldi
    Naples, 80131, Italy
  • AOUP "P.Giaccone" - UOC Pneumologia
    Palermo, 90127, Italy
  • Fondazione IRCCS Policlinico San Matteo - UOC Pneumologia, Dipartimento di Scienze Mediche e Malattie Infettive
    Pavia, 27100, Italy
  • Struttura semplice di terapia demi-intensiva respiratoria S.C. di pneumologia AO IRCCS Santa Maria Nuova
    Reggio Emilia, 42123, Italy
  • Ankara City Hospital
    Ankara, 06800, Turkey (Türkiye)
  • Dicle University, Medical Faculty
    Diyarbakır, 21280, Turkey (Türkiye)
  • Gaziantep Universitesi Sahinbey Arastirma Ve Uygulama Hastanesi
    Gaziantep, 27310, Turkey (Türkiye)
  • Acibadem Atakent Hospital
    Istanbul, 34303, Turkey (Türkiye)
  • Dokuz Eylul University Faculty of Medicine
    Izmir, 35340, Turkey (Türkiye)
  • Kayseri State Hospital
    Kayseri, 38039, Turkey (Türkiye)
  • Kocaeli Universitesi Tip Fakultesi
    Kocaeli, 41380, Turkey (Türkiye)
  • Inonu Uni.Med.Faculty
    Malatya, 44100, Turkey (Türkiye)
09

References and documents

Publications

  • Truwit JD, Fleming K, Nanchal RS. Empowering Respiratory Therapists to Restrict Nebulized 3% Saline and N-Acetylcysteine During Mechanical Ventilation. Respir Care. 2025 Aug;70(8):937-945. doi: 10.1089/respcare.12586. Epub 2025 Feb 24. PubMed 40028879 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Apr 2022 to primary completion in Jul 2024, 27 months.

Results were first posted in Feb 2026, 1 year 6 months after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 22, 2022
First posted
Feb 24, 2022
StartActual
Apr 27, 2022
Primary completionActual
Jul 29, 2024
CompletionActual
Sep 27, 2024
Results first posted
Feb 24, 2026
Last update
Feb 24, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT05254990
Responsible party
Sponsor
First posted
Feb 24, 2022
Start date
Apr 27, 2022
Primary completion
Jul 29, 2024
Completion
Sep 27, 2024
Results posted
Feb 24, 2026
Last update
Feb 24, 2026

Study contacts

Giovanni Landoni, MD
principal investigator · IRCCS Ospedale San Raffaele Centro di Ricerca Anestesia e Rianimazione

Oversight

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

Not currently enrolling

This study is terminated, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Reparixin

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