The main purpose of this phase-1b, multicenter, randomized double-blind, placebo-controlled, trial is to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of bempegaldesleukin (BEMPEG; NKTR-214) in combination with standard of care (SOC) in adult patients with mild COVID-19 (coronavirus disease 2019). The trial will also define the recommended phase 2 dose (RP2D) of bempegaldesleukin in patients with mild COVID-19.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
30
Administered as an intravenous infusion
Standard of Care Treatment for COVID-19 Infection
Administered as an intravenous infusion
A G A Clinical Trials - HyperCore - PPDS
Hialeah, Florida, United States
New Generation Medical Research
Hialeah, Florida, United States
Clinical Site Partners - Winter Park - HyperCore -PPDS
Winter Park, Florida, United States
SMS Clinical Research, LLC
Mesquite, Texas, United States
AUC of Bempegaldesleukin [Pharmacokinetic Parameter].
Area under the serum concentration-time curve (AUC) of bempegaldesleukin calculated from time 0 to 168 hours.
Time frame: Day 1: Predose, 0.5, 24, 48, 72, 120, and 168 hours post dose.
Cmax of Bempegaldesleukin [Pharmacokinetic Parameter].
Maximum observed serum concentration (Cmax) of bempegaldesleukin.
Time frame: Day 1: Predose, 0.5, 24, 48, 72, 120, and 168 hours post dose.
Tmax of Bempegaldesleukin [Pharmacokinetic Parameter].
Time to maximum concentration of bempegaldesleukin. Cmax = maximum concentration. Tmax = time to maximum concentration.
Time frame: Day 1: Predose, 0.5, 24, 48, 72, 120, and 168 hours post dose.
Number of Participants With Treatment-Emergent Adverse Events [Safety and Tolerability]
Safety and Tolerability of bempegaldesleukin (starting at dose 0.00075 mg/kg) in combination with SOC was evaluated by incidence of Treatment-Emergent Adverse Events of Any Grade, Grade 3-4, and Grade 5 (Death).
Time frame: Safety and tolerability were evaluated from baseline up to approximately 30 days.
Number of Participants Experiencing Dose-Limiting Toxicities (DLTs)
Dose finding for this study was based on the assessment of DLT of bempegaldesleukin dose levels. Number and percentage of patients with any DLT were summarized by bempegaldesleukin dose level in bempegaldesleukin plus SOC treatment groups \[0.00075 mg/kg, N=5; 0.0015 mg/kg, N=5; and 0.003 mg/kg, N=5\] and placebo plus SOC (N=15). Adverse events related to study drug(s) that were defined as DLTs included the following: * Any Grade ≥ 3 drug-related AE. * Any Grade ≥ 3 drug-related laboratory abnormality that was clinically significant per the Investigator. * Respiratory compromise or other virus-related AE attributed to worsening COVID-19, such as severe hypoxia, cyanosis, or chest pain/pressure. The event was considered a DLT if it was confirmed to be at least possibly related to study drug, met any of the above definitions, and was confirmed to have occurred in a patient treated with bempegaldesleukin.
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Time frame: The DLT evaluation period was up to approximately 7 days following the bempegaldesleukin treatment.
Percent Change From Baseline for Absolute Lymphocyte Count (ALC) by Dose/Arm.
To assess the effect of bempegaldesleukin on the time course and extent of changes in absolute lymphocyte counts (ALC). Data are reported by dose and arm for Day 8 compared to baseline.
Time frame: ALC was evaluated from baseline up to 7 days (Day 8) following the study drug administration.
Percentage of Patients Who Require Supplemental Oxygen.
The percentage of patients requiring supplemental oxygen was evaluated as part of disease measurements to assess efficacy. No patient in the study required supplemental oxygen.
Time frame: From baseline, following the administration of study drug approximately up to 30 days.
Change From Baseline on the Daily Collection World Health Organization (WHO) Clinical Progression Scale, an 11-point Clinical Status Ordinal Scale.
The WHO Clinical Progression Scale scores and descriptors are as follows: 0- Uninfected; no viral RNA detected; 1- Asymptomatic; viral RNA detected; 2- Symptomatic; independent; 3- Symptomatic; assistance needed; 4- Hospitalized, no oxygen therapy(a); 5- Hospitalized; oxygen by mask or nasal prongs ; 6- Hospitalized; oxygen by non-invasive ventilation or high-flow; 7- Intubation and mechanical ventilation, PaO2/FiO2 ≥ 150 or SpO2/FiO2 ≥ 200; 8- Mechanical ventilation, PaO2/FiO2 \< 150 (SpO2/FiO2 \< 200) or vasopressors; 9- Mechanical ventilation, PaO2/FiO2 \< 150 and vasopressors, dialysis, or ECMO; 10- Death. The data are reported for Day 8 by arm. There were no scores rated 3 and higher per this scale at any timepoint. Abbreviations: ECMO = extracorporeal membrane oxygenation; FiO2 = fraction of inspired oxygen; PaO2 = partial pressure of arterial oxygen; SpO2 = oxygen saturation (a) If hospitalized for isolation only, record status as for ambulatory patient. Source: WHO 2020.
Time frame: From baseline up to 7 days (Day 8) following the study drug administration.