The primary objective of this study is to assess whether the use of lenzilumab in addition to current standard of care can alleviate the immune-mediated cytokine release syndrome (CRS) and improve ventilator-free survival in hospitalized subjects with severe or critical COVID-19 pneumonia.
In COVID-19, high levels of granulocyte macrophage-colony stimulating factor (GM-CSF) and inflammatory myeloid cells correlate with disease severity, cytokine storm, and respiratory failure. The mortality rate for hospitalized COVID-19 patients remains unacceptably high, particularly in patients who progress to invasive mechanical ventilation (IMV). This randomized, double-blind, multicenter, placebo-controlled pivotal phase 3 trial will evaluate the impact of lenzilumab (anti-human GM-CSF monoclonal antibody) on ventilator-free survival in hospitalized, hypoxic patients with COVID-19. The study is also designed to evaluate other key endpoints, including ventilator-free days, duration of ICU stay, incidence of IMV, ECMO and/or death, time to death, all-cause mortality and time to recovery. Approximately 516 patients will be randomized to receive lenzilumab + SOC vs. placebo + SOC in a 1:1 ratio.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
520
Administered as an intravenous (IV) infusion
Standard of care therapy can include remdesivir and/or dexamethasone per institutional treatment guidelines or written policies
Ventilator-free Survival
Time frame: Up to Day 28
Ventilator-free Days
Time frame: Up to Day 28
Duration of Intensive Care Unit (ICU) Stay
Time frame: Up to Day 28
Incidence of Invasive Mechanical Ventilation, ECMO and/or Death
Time frame: Up to Day 28
Time to Death
Time frame: Up to Day 28
All-cause Mortality
Time frame: Day 28
Time to Recovery
Time to recovery is defined as the first day on which a subject satisfies one of the following 3 categories from the 8-point ordinal scale (Hospitalized, not requiring supplemental oxygen-no longer requires ongoing medical care; Not hospitalized, limitation on activities and/or requiring home oxygen; Not hospitalized, no limitations on activities).
Time frame: Up to Day 28
Incidence of severe acute respiratory distress syndrome (ARDS)
Time frame: Up to Day 28
Duration of Hospitalization
Time frame: Up to Day 28
Time to Improvement in 1 or 2 Categories using 8-point Ordinal Scale
Time frame: Up to Day 28
Number of Subjects Alive and Off Oxygen
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Mayo Clinic
Phoenix, Arizona, United States
University of California, Irvine
Irvine, California, United States
University of Southern California (USC) Medical Center
Los Angeles, California, United States
USC - Los Angeles County Medical Center
Los Angeles, California, United States
MedStar Washington Hospital Center
Washington D.C., District of Columbia, United States
Mayo Clinic
Jacksonville, Florida, United States
AdventHealth Orlando
Orlando, Florida, United States
Emory University
Atlanta, Georgia, United States
St. Elizabeth Healthcare
Edgewood, Kentucky, United States
Hennepin County Medical Center
Minneapolis, Minnesota, United States
...and 19 more locations
Time frame: Up to Day 60
Percentage of Participants Experiencing Adverse Events
Using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
Time frame: Up to Day 60
Percentage of Participants Experiencing Serious Adverse Events
Using the NCI CTCAE version 5.0
Time frame: Up to Day 60
Proportion of Subjects Discharged from Hospital
Time frame: Up to Day 60
Time to improvement in oxygenation for > 48 hours
Time frame: Up to Day 28
Incidence of Non-invasive Ventilation (or Use of High-flow Oxygen Device)
Time frame: Up to Day 28
Time to Clinical Improvement, Defined as NEWS2 < 2 Maintained for 24 Hours
NEWS2 consists of: Physiological Parameters: respiration rate (per minute), SpO2 Scale 1 (%), SpO2 Scale 2 (%), use of air or oxygen, systolic blood pressure (mmHg), pulse (per minute), consciousness and temperature (°C)
Time frame: Up to Day 28
Change from Baseline to Day 28 in Clinical status Based on the 8-point Ordinal Scale
Time frame: Up to Day 28
Duration of Time on Low-flow or High-flow Supplemental Oxygen
Time frame: Up to Day 28