Influenza (the flu) is a common illness that usually occurs in autumn and winter. The flu is usually mild, but can cause serious illness or death. The purpose of this study is to test the safety and effectiveness of an antibody against the flu (called intravenous hyperimmune immunoglobulin or IVIG) in people who are hospitalized for severe flu.
Influenza is responsible for thousands of hospitalizations and deaths each year in the United States and worldwide. One possible new treatment for the flu involves the use of IVIG, a blood product containing antibodies from people who have recovered from the flu or who have had a flu shot. The purpose of this study is to evaluate whether IVIG can reduce the severity and duration of flu in people who are hospitalized with the flu. The study will enroll participants 18 years and older who are hospitalized with the flu. The study will enroll participants over one or more flu seasons. Regardless of the date of enrollment, each participant will be in the study for about 28 days. At study entry (Day 0), participants will be randomly assigned to one of two groups (Arms A and B). Participants in both groups will receive standard of care (SOC) treatment for the flu, but those in Arm A will also receive one dose of IVIG and those in Arm B will receive a placebo for IVIG. Both IVIG and placebo will be given intravenously over at least 2 hours. On Day 0, before receiving IVIG or placebo, participants will undergo a symptoms assessment, blood collection, and a nasopharyngeal (NP) swab to collect a sample of secretions from the nose and throat. Additional study visits will occur on Days 1, 2, 3, 7, 14, and 28. Depending on the visit, participants may take part in the same study procedures that took place on Day 0. On Days 2, 14, and 28, visits for participants who are no longer hospitalized may be conducted over the phone.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
Administered intravenously (IV) at a dose of 0.25 g/kg (up to a maximum of 24.75 g, corresponding to approximately 100 kg actual body weight)
Administered IV as 500 mL of normal saline
UCSD Antiviral Research Center (A VRC)
San Diego, California, United States
Denver Public Health
Number of Patients in Each of 6 Clinical Status Categories on Day 7
This is the primary outcome, a 6-category ordinal outcome ranging from death (worst) to discharged from hospital with resumption of normal activities (best).
Time frame: Assessed on Day 7
Number of Patients in Each of 5 Clinical Status Categories on Day 3
5-category ordinal outcome assessed on day 3; clinical status ranges from death (worst) to discharged from the hospital (best).
Time frame: Assessed on Day 3
Number of Patients in Each of 6 Clinical Status Categories on Day 3
6-category ordinal outcome evaluated on Day 3; clinical status ranges from death (worst) to discharged from hospital with resumption of normal activities (best).
Time frame: Measured on Day 3
Number of Patients With a Favorable Outcome on Day 7
Sliding dichotomy defined as non-ICU hospitalization or discharge if enrolled from ICU, and discharge if enrolled from the general ward.
Time frame: Assessed on Day 7
Hospital Discharge
Number of participants alive and discharged from the hospital
Time frame: Measured through Day 7
Mortality
Number of participants dying through day 28.
Time frame: Measured through day 28
Number of Patients Alive and Out of Hospital
Number and percent alive and out of hospital on day 28
Time frame: Measured through Day 28
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329
Denver, Colorado, United States
University of Illinois
Chicago, Illinois, United States
National Institutes of Health Clinical Center
Bethesda, Maryland, United States
Henry Ford Hospital
Detroit, Michigan, United States
Minneapolis VA Medical Center
Minneapolis, Minnesota, United States
Mayo Clinic
Rochester, Minnesota, United States
Cooper University Hospital
Camden, New Jersey, United States
Cornell CRS
New York, New York, United States
Montefiore Medical Center
The Bronx, New York, United States
...and 11 more locations
Change in Viral Load
Change in nasopharyngeal viral load from baseline to day 3
Time frame: Day 3
Death or Re-hospitalization
Number and percent of participants who died or were re-hospitalized after initial discharge
Time frame: Day 28
Percent of Participants Developing Complications
Number and percent of participants developing respiratory distress syndrome, acute renal failure, sepsis, pneumonia, enteritis, or bronchitis
Time frame: Measured through Day 28
Number of Patients in Each of 6 Clinical Status Categories on Day 14
6-category ordinal outcome measured on day 14
Time frame: Measured on day 14
Number of Patients Alive and Out of Hospital on Day 14
Number and percentage of participants alive and out of the hospital on Day 14
Time frame: day 14
Resumption of Normal Activities by Day 14
Participants reporting resumption of normal daily activities by Day 14
Time frame: day 14
Number of Patients in Each of 6 Clinical Status Categories on Day 28
6-category ordinal outcome corresponding to clinical status on day 28
Time frame: day 28
Number of Influenza A-Infected Patients in Each of 6 Clinical Status Categories on Day 7
Primary 6-category ordinal outcome for participants infected with Influenza A
Time frame: Day 7
Number of Influenza B-Infected Patients in Each of 6 Clinical Status Categories on Day 7
Primary 6-category ordinal outcome for subgroup of participants infected with influenza B
Time frame: Day 7
pH1N1 Titers at Day 7
pH1N1 hemagglutination inhibition assay (HAI) titers among participants infected with pH1N1 using A/Cal/2009 as reference virus
Time frame: Day 7
H3N2 Titers at Day 7
H3N2 HAI titers among participants infected with H3N2 using A/HongKong/2014 as reference virus
Time frame: Day 7
Influenza B Titers at Day 7
Flu B HAI titers among participants infected with influenza B using B/Phuket/2013 as reference virus
Time frame: Day 7