A Phase 2/3 interventional study of Fostamatinib and Placebo in COVID-19, SARS-CoV2 Infection and Coronavirus Infection, sponsored by NEAT ID Foundation. Terminated at 21 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-05-02.
Sponsored by NEAT ID Foundation · Phase 2/3, Interventional, and Treatment
The overarching goal of the Master Protocol is to find effective strategies for inpatient management of patients with COVID-19. Therapeutic goals for patients hospitalized for COVID-19 include hastening recovery and preventing progression to critical illness, multiorgan failure, or death. Our objective is to determine whether modulating the host tissue response improves clinical outcomes among patients with COVID-19.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. The clinical spectrum of COVID-19 infection is broad, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia with respiratory failure and death. Between 13 and 40% of patients become hospitalized, up to 30% of those hospitalized require admission for intensive care, and there is a 13% inpatient mortality rate. The reasons for hospitalization include respiratory support, as well as support for failure of other organs, including the heart and kidneys. The risk of thrombotic complications is increased, even when compared to other viral respiratory illnesses, such as influenza. While 82% of hospitalized patients with COVID-19 are ultimately discharged alive, median length of stay is 10-13 days.
Early work in treating COVID-19 has focused on preventing worsening of the initial clinical presentation to prevent hospitalization and disease progression to organ failure and death. Studies conducted under this Master Host Tissue Protocol are expected to extend our knowledge of how to manage patients who are hospitalized for COVID-19 illness. Our objective is to determine whether modulating the host tissue response improves clinical outcomes among patients with COVID-19. This Master Protocol is a randomized, placebo-controlled trial of agents targeting the host response in COVID-19 in hospitalized patients with hypoxemia. The Master Host Tissue Protocol is designed to be flexible in the number of study arms, the use of a single placebo group, and the stopping and adding of new therapies. Our primary outcome is oxygen free days through day 28. This is defined as days alive and without supplemental oxygen use during the first 28 days following randomization. Patients who die on or before day 28 are assigned -1 oxygen free days.
6,687 studies on the registry are indexed under Infections; 807 are open to participants now.
This study's enrollment of 28 is below the median of 120 across 4,200 interventional studies indexed under Infections.
Browse Infections studies →NEAT ID Foundation is the lead sponsor of 7 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
SARS-CoV-2 infection, documented by:
Symptoms or signs of acute COVID-19, defined as one or more of the following:
Exclusion Criteria:
Fostamatinib Arm-Specific Exclusion Criteria:
The following exclusion criteria differ from the master protocol criteria:
Study arm exclusion criteria measured within 24 hours prior to randomization:
An investigational oral spleen tyrosine kinase inhibitor.
Drug: Fostamatinib
Orange film-coated, plain, bioconvex tablets for fostamatinib. For the purposes of interim and final analyses, the route and frequency of placebo will be ignored, and all placebo participants will be pooled together as a single group. In comparing an active drug versus placebo, only those placebo participants that were eligible for the active drug will be included.
Drug: Placebo
Fostamatinib100-150mg orally twice daily for 14 days or 28 doses. Study medication will be continued as an outpatient if the patient is discharged prior to completing 28 doses.
Orange film-coated, plain bioconvex tablets orally twice daily for 14 days or 28 doses for fostamatinib. Study medication will be continued as an outpatient if the patient is discharged prior to completing 28 doses.
Oxygen Free Days Through Day 28
This is defined as days alive and without supplemental oxygen use during the first 28 days following randomization. Patients who die on or before day 28 are assigned -1 oxygen free days. Patients will be considered to be receiving supplemental oxygen therapy when they are receiving any of the following: supplemental oxygen by nasal cannula, supplemental oxygen by face mask, high flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive mechanical ventilation (IMV), or extracorporeal membrane oxygenation (ECMO).
Time frame: Day 1 to Day 28
In-hospital Mortality
Number of patients who die during hospitalization
Time frame: Day 1 to hospital discharge or Day 90 whichever comes first
Alive and Oxygen Free at Day 14
Number of patients oxygen free at day 14. Patients will be considered to be receiving supplemental oxygen therapy when they are receiving any of the following: supplemental oxygen by nasal cannula, supplemental oxygen by face mask, high flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive mechanical ventilation (IMV), or extracorporeal membrane oxygenation (ECMO).
Time frame: Day 1 to Day 14
Alive and Oxygen Free at Day 28
Number of patients oxygen free at day 28. Patients will be considered to be receiving supplemental oxygen therapy when they are receiving any of the following: supplemental oxygen by nasal cannula, supplemental oxygen by face mask, high flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive mechanical ventilation (IMV), or extracorporeal membrane oxygenation (ECMO)
Time frame: Day 1 to Day 28
Alive and Free of New Invasive Mechanical Ventilation at Day 28
Number of patients alive free of new invasive mechanical ventilation at day 28
Time frame: Day 1 to Day 28
28-day Mortality
Number of patients who have died at Day 28
Time frame: Day 28
60-day Mortality
Number of patients who have died at Day 60
Time frame: Day 60
90-day Mortality
Number of participants mortality at Day 90
Time frame: Day 90
Clinical Status Assessed Using World Health Organization (WHO) 8-point Ordinal Scale at Day 14
Number of participants who fell within the ordinal scale per the below criteria. A higher score indicates a worse outcome. 1. Ambulatory - Not hospitalized and no limitation of activities 2. Ambulatory - Not hospitalized with limitation of activities or home oxygen use 3. Hospitalized Mild Disease - Hospitalized, no oxygen therapy 4. Hospitalized Mild Disease - Hospitalized, oxygen by mask or nasal prongs 5. Hospitalized Severe Disease - Non-invasive ventilation or high-flow nasal cannula 6. Hospitalized Severe Disease -Invasive mechanical ventilation 7. Hospitalized Severe Disease - Invasive mechanical ventilation plus additional organ support with- vasopressors, RRT, or ECMO 8. Dead
Time frame: Day 14
Clinical Status Assessed Using WHO 8-point Ordinal Scale at Day 28
The number of participants who fell within the ordinal scale per the below criteria. A higher score means a worse outcome 1. Ambulatory - Not hospitalized and no limitation of activities 2. Ambulatory - Not hospitalized with limitation of activities or home oxygen use 3. Hospitalized Mild Disease - Hospitalized, no oxygen therapy 4. Hospitalized Mild Disease - Hospitalized, oxygen by mask or nasal prongs 5. Hospitalized Severe Disease - Non-invasive ventilation or high-flow nasal cannula 6. Hospitalized Severe Disease -Invasive mechanical ventilation 7. Hospitalized Severe Disease - Invasive mechanical ventilation plus additional organ support with- vasopressors, RRT, or ECMO 8. Dead
Time frame: Day 28
Clinical Status Assessed Using WHO 8-point Ordinal Scale at Day 60
Number of participants who fell within the ordinal scale per the below criteria. A higher score means a worse outcome 1. Ambulatory - Not hospitalized and no limitation of activities 2. Ambulatory - Not hospitalized with limitation of activities or home oxygen use 3. Hospitalized Mild Disease - Hospitalized, no oxygen therapy 4. Hospitalized Mild Disease - Hospitalized, oxygen by mask or nasal prongs 5. Hospitalized Severe Disease - Non-invasive ventilation or high-flow nasal cannula 6. Hospitalized Severe Disease -Invasive mechanical ventilation 7. Hospitalized Severe Disease - Invasive mechanical ventilation plus additional organ support with- vasopressors, RRT, or ECMO 8. Dead
Time frame: Day 60
Hospital-free Days Through Day 28
Days alive and not hospitalized during the first 28 days following randomization. Patients who die on or before day 28 are assigned a value -1.
Time frame: Day 1 to Day 28
Ventilator-free Days Through Day 28
Days alive and not receiving mechanical ventilation during the first 28 days following randomization. Patients who die on or before day 28 are assigned a value -1.
Time frame: Day 1 to Day 28
Respiratory Failure-free Days Through Day 28
Days alive and not in respiratory failure during the first 28 days following randomization. A respiratory failure-free day is defined as a day alive without the use of HFNC, NIV, IMV, or (ECMO). Patients who die on or before day 28 are assigned a value -1.
Time frame: Day 1 to Day 28
| Milestone | Fostamatinib | Placebo |
|---|---|---|
| Started | 14 | 14 |
| Completed | 12 | 9 |
| Not completed | 2 | 5 |
This is defined as days alive and without supplemental oxygen use during the first 28 days following randomization. Patients who die on or before day 28 are assigned -1 oxygen free days. Patients will be considered to be receiving supplemental oxygen therapy when they are receiving any of the following: supplemental oxygen by nasal cannula, supplemental oxygen by face mask, high flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive mechanical ventilation (IMV), or extracorporeal membrane oxygenation (ECMO).
| days | Fostamatinib | Placebo |
|---|---|---|
| Oxygen Free Days Through Day 28 | 13.4 ± 12.4 | 14.2 ± 12.1 |
Number of patients who die during hospitalization
| Participants | Fostamatinib | Placebo |
|---|---|---|
| In-hospital Mortality | 1 | 1 |
Number of patients oxygen free at day 14. Patients will be considered to be receiving supplemental oxygen therapy when they are receiving any of the following: supplemental oxygen by nasal cannula, supplemental oxygen by face mask, high flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive mechanical ventilation (IMV), or extracorporeal membrane oxygenation (ECMO).
| Participants | Fostamatinib | Placebo |
|---|---|---|
| Alive and Oxygen Free at Day 14 | 10 | 8 |
Number of patients oxygen free at day 28. Patients will be considered to be receiving supplemental oxygen therapy when they are receiving any of the following: supplemental oxygen by nasal cannula, supplemental oxygen by face mask, high flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive mechanical ventilation (IMV), or extracorporeal membrane oxygenation (ECMO)
| Participants | Fostamatinib | Placebo |
|---|---|---|
| Alive and Oxygen Free at Day 28 | 11 | 9 |
Number of patients alive free of new invasive mechanical ventilation at day 28
| Participants | Fostamatinib | Placebo |
|---|---|---|
| Alive and Free of New Invasive Mechanical Ventilation at Day 28 | 12 | 11 |
Number of patients who have died at Day 28
| Participants | Fostamatinib | Placebo |
|---|---|---|
| 28-day Mortality | 1 | 1 |
Number of patients who have died at Day 60
| Participants | Fostamatinib | Placebo |
|---|---|---|
| 60-day Mortality | 1 | 2 |
Number of participants mortality at Day 90
| Participants | Fostamatinib | Placebo |
|---|---|---|
| 90-day Mortality | 1 | 3 |
Number of participants who fell within the ordinal scale per the below criteria. A higher score indicates a worse outcome. 1. Ambulatory - Not hospitalized and no limitation of activities 2. Ambulatory - Not hospitalized with limitation of activities or home oxygen use 3. Hospitalized Mild Disease - Hospitalized, no oxygen therapy 4. Hospitalized Mild Disease - Hospitalized, oxygen by mask or nasal prongs 5. Hospitalized Severe Disease - Non-invasive ventilation or high-flow nasal cannula 6. Hospitalized Severe Disease -Invasive mechanical ventilation 7. Hospitalized Severe Disease - Invasive mechanical ventilation plus additional organ support with- vasopressors, RRT, or ECMO 8. Dead
| Participants | Fostamatinib | Placebo |
|---|---|---|
| Score 1 | 8 | 6 |
| Score 2 | 3 | 1 |
| Score 3 | 0 | 1 |
| Score 4 | 1 | 3 |
| Score 5 | 0 | 0 |
| Score 6 | 0 | 0 |
| Score 7 | 0 | 0 |
| Score 8 | 1 | 1 |
The number of participants who fell within the ordinal scale per the below criteria. A higher score means a worse outcome 1. Ambulatory - Not hospitalized and no limitation of activities 2. Ambulatory - Not hospitalized with limitation of activities or home oxygen use 3. Hospitalized Mild Disease - Hospitalized, no oxygen therapy 4. Hospitalized Mild Disease - Hospitalized, oxygen by mask or nasal prongs 5. Hospitalized Severe Disease - Non-invasive ventilation or high-flow nasal cannula 6. Hospitalized Severe Disease -Invasive mechanical ventilation 7. Hospitalized Severe Disease - Invasive mechanical ventilation plus additional organ support with- vasopressors, RRT, or ECMO 8. Dead
| Participants | Fostamatinib | Placebo |
|---|---|---|
| Score 1 | 9 | 7 |
| Score 2 | 1 | 3 |
| Score 3 | 1 | 1 |
| Score 4 | 1 | 0 |
| Score 5 | 0 | 0 |
| Score 6 | 0 | 0 |
| Score 7 | 0 | 0 |
| Score 8 | 1 | 1 |
Number of participants who fell within the ordinal scale per the below criteria. A higher score means a worse outcome 1. Ambulatory - Not hospitalized and no limitation of activities 2. Ambulatory - Not hospitalized with limitation of activities or home oxygen use 3. Hospitalized Mild Disease - Hospitalized, no oxygen therapy 4. Hospitalized Mild Disease - Hospitalized, oxygen by mask or nasal prongs 5. Hospitalized Severe Disease - Non-invasive ventilation or high-flow nasal cannula 6. Hospitalized Severe Disease -Invasive mechanical ventilation 7. Hospitalized Severe Disease - Invasive mechanical ventilation plus additional organ support with- vasopressors, RRT, or ECMO 8. Dead
| Participants | Fostamatinib | Placebo |
|---|---|---|
| Score 1 | 7 | 7 |
| Score 2 | 2 | 1 |
| Score 3 | 0 | 1 |
| Score 4 | 1 | 1 |
| Score 5 | 0 | 0 |
| Score 6 | 0 | 0 |
| Score 7 | 0 | 0 |
| Score 8 | 1 | 2 |
Days alive and not hospitalized during the first 28 days following randomization. Patients who die on or before day 28 are assigned a value -1.
| days | Fostamatinib | Placebo |
|---|---|---|
| Spain | 21.3 ± 8.2 | 19.5 ± 12.5 |
| Brazil | -1 ± NA | — |
| Germany | — | 0 ± NA |
| Italy | 14 ± NA | — |
| South Africa | 25.5 ± 3.5 | 26.5 ± 0.7 |
Days alive and not receiving mechanical ventilation during the first 28 days following randomization. Patients who die on or before day 28 are assigned a value -1.
| days | Fostamatinib | Placebo |
|---|---|---|
| Spain | 21.3 ± 8.2 | 19.5 ± 12.5 |
| Brazil | -1 ± NA | — |
| Germany | — | 0 ± NA |
| Italy | 14 ± NA | — |
| South Africa | 25.3 ± 3.5 | 26.5 ± 0.7 |
Days alive and not in respiratory failure during the first 28 days following randomization. A respiratory failure-free day is defined as a day alive without the use of HFNC, NIV, IMV, or (ECMO). Patients who die on or before day 28 are assigned a value -1.
| days | Fostamatinib | Placebo |
|---|---|---|
| Spain | 21.3 ± 8.2 | 19.5 ± 12.5 |
| Brazil | -1 ± NA | — |
| Germany | — | 0 ± NA |
| Italy | 14 ± NA | — |
| South Africa | 25.3 ± 3.5 | 26.5 ± 0.7 |
Collected over Adverse events will be collected from day 0-60, Mortality will be collected from day 0-90. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Fostamatinib | 1/14 (7.1%) | 8/14 (57.1%) | 8/14 (57.1%) |
| Placebo | 3/14 (21.4%) | 5/14 (35.7%) | 4/14 (28.6%) |
| Event | Fostamatinib | Placebo |
|---|---|---|
| Cardiac failure congestiveCardiac disorders | 1/14 | 0/14 |
| DiarrhoeaGastrointestinal disorders | 1/14 | 0/14 |
| Gastrointestinal haemorrhageGastrointestinal disorders | 1/14 | 0/14 |
| Retroperitoneal haemorrhageGastrointestinal disorders | 0/14 | 1/14 |
| HypertransaminasaemiaHepatobiliary disorders | 0/14 | 1/14 |
| PneumoniaInfections and infestations | 0/14 | 1/14 |
| Pneumonia bacterialInfections and infestations | 0/14 | 1/14 |
| Respiratory tract infectionInfections and infestations | 1/14 | 0/14 |
| Acute kidney injuryRenal and urinary disorders | 1/14 | 0/14 |
| HypoxiaRespiratory, thoracic and mediastinal disorders | 1/14 | 1/14 |
| Event | Fostamatinib | Placebo |
|---|---|---|
| ConstipationGastrointestinal disorders | 0/14 | 1/14 |
| Abdominal pain upperGastrointestinal disorders | 1/14 | 0/14 |
| DiarrhoeaGastrointestinal disorders | 0/14 | 1/14 |
| VomitingGastrointestinal disorders | 1/14 | 0/14 |
| DiscomfortGeneral disorders | 0/14 | 1/14 |
| Injection site phlebitisGeneral disorders | 1/14 | 0/14 |
| SepsisInfections and infestations | 1/14 | 0/14 |
| HyperkalaemiaMetabolism and nutrition disorders | 1/14 | 0/14 |
| InsomniaPsychiatric disorders | 0/14 | 1/14 |
| HaematuriaRenal and urinary disorders | 1/14 | 0/14 |
Participants were over 18 years old hospitalised with documented SARS-COV-2 infection confirmed by nucleic acid test. Participants were assigned to one either the Fostamatinib the active drug or matching placebo.
| Age, Categorical(Participants) | Fostamatinib | Placebo | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 4 | 3 | 7 |
| >=65 years | 10 | 11 | 21 |
| Sex: Female, Male(Participants) | Fostamatinib | Placebo | Total |
|---|---|---|---|
| Female | 6 | 6 | 12 |
| Male | 8 | 8 | 16 |
| Race (NIH/OMB)(Participants) | Fostamatinib | Placebo | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 2 | 2 | 4 |
| White | 10 | 12 | 22 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 2 | 0 | 2 |
| Region of Enrollment(participants) | Fostamatinib | Placebo | Total |
|---|---|---|---|
| Brazil | 1 | 0 | 1 |
| South Africa | 2 | 3 | 5 |
| Italy | 1 | 1 | 2 |
| Germany | 0 | 1 | 1 |
| Spain | 10 | 9 | 19 |
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