Up to 1/3 of all patients infected with COVID-19 can develop complications that require hospitalization. Severe pneumonia associated with acute respiratory distress syndrome (ARDS) is the most threatening and feared complication of COVID-19 infection, with mortality rates close to 50% in some groups. Autopsies between these severe cases reveal severe capillary involvement, with signs of intense inflammatory changes, microvascular thrombosis, endothelial injury and abnormal tissue repair. The available evidence suggests that abnormal activation or imbalance in the counter-regulation of the kallikrein-kinin system may play a central role in a positive feedback cycle, leading to consequent diffuse microangiopathy. Blockade of the kallikrein-kinin system can therefore prevent deterioration of lung function by reducing inflammation, edema and microthrombosis. The objective of this phase IIb study is to assess the preliminary effects on the oxygenation parameters of an antisense oligonucleotide that inhibits pre-kallikrein synthesis in patients with moderate to severe COVID-19.
The objective of this phase IIb study is to assess the preliminary effects on the oxygenation parameters of an antisense oligonucleotide that inhibits pre-kallikrein synthesis in patients with moderate to severe COVID-19. This is a blind randomized pilot clinical study which aims to include 110 patients (55 per arm).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
111
1.2 mL of ISIS 721744 subcutaneous once after randomization
1.2 mL subcutaneous
Hospital Naval Marcílio Dias
Rio de Janeiro, Brazil
BP-A Beneficiência Portuguesa de São Paulo
São Paulo, Brazil
Hospital São Paulo - UNIFESP
São Paulo, Brazil
Days alive without respiratory support (any supplemental oxygen) after 15 days (DAFOR15)
Number of days the patient is alive and not receiving any supplementary respiratory support (oxygen, non-invasive ventilation, high flow nasal catheter or mechanical ventilation) during 15 days
Time frame: 15 days
SOFA - Sequential Organ Failure Assessment Score up to 15 days after randomization
Sequential Organic Failure Assessment \[SOFA\]. This will be a primary secondary outcome. Analysis will check for trends in SOFA up to 15 days in a single model.
Time frame: 15 days
Need for mechanical ventilation
Intubation and initiation of mechanical ventilation for any given reason
Time frame: 30 days (or until hospital discharge)
Duration of mechanical ventilation
Number of days the patient remains in mechanical ventilation
Time frame: 30 days (or until hospital discharge)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.