A randomized, double blind, multicenter, placebo-controlled, parallel group, fixed dose, phase II study to evaluate the efficacy and safety of glenzocimab in ARDS.
This randomized, double blind, multicenter, placebo-controlled, parallel group, fixed dose, phase II study evaluates the efficacy and safety of glenzocimab in ARDS. Patients will be screened for eligibility and all tests should have results prior to any randomization, so as to avoid screening failures to a maximum extent. The turn-around time for these tests should be comprised within 24hrs to allow for rapid inclusions if needed. Eligible patients (n=68) will be randomized in a 1:1 ratio to glenzocimab or placebo. Patient inclusions will be fractioned into sequential (3-day apart) cohorts of growing size (2, 4 then 6 patients), each balanced between glenzocimab and placebo in order to check safety in a gradual manner. A Data Safety Monitoring Board (DSMB) will meet after 12 patients will have been accrued, and again after the first 30 patients. Glenzocimab will be administered by IV infusion. The dosing regimen will be 1000mg for 3 days. All patients will receive in parallel the best medical care at the discretion of the investigating center, or per local guidelines. The allocation of each patient in any given center to an active treatment or placebo will strictly follow a central randomization scheme. The study period will be of a maximum of 40 days per patient. Patients will be closely monitored during the first 7 days following randomization with complete evaluations being performed at 24 hrs, 48 hrs, 72 hrs, then on Days 4 (96 hrs), 5 (120 hrs), 7 (+/-1 day), 14 (+/-2 days), 20 (+/-2 days), 40 (+/-3 days). Should a patient being discharged before Day 40, distant consultations by telemedicine may be undertaken if it is not deemed desirable that the patient comes back to the institution.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
60
IV administration as a sterile product
IV administration
Hôpital de Hautepierre
Strasbourg, France
Progression from moderate to severe respiratory distress assessed at Day 4
Progression from moderate to severe assessed at Day 4 is a composite failure endpoint defined as the occurrence of at least one of the following failure events : * Respiratory rate (RR) ≥ 30/min, or * Oxygen Saturation (SpO2) ≤ 93% in resting state, or * Oxygen Pressure/ Inspired fraction (PaO2/FiO2) ≤ 200mmHg * Death occurring prior to or on Day 4
Time frame: Day 4
All cause mortality at day 40
Time frame: Day 40 (maximum)
WHO-COVID-19 Scale
WHO COVID-19 Ordinal Scoring Scale is 9 point ordinal scale
Time frame: Up to Day 40
NEWS-2 Scale
Determines the degree of illness of a patient and prompts critical care intervention (recommended by NHS over original NEWS): total possible score ranges from 0 to 20. The higher the scores the greater the clinical risk.
Time frame: Up to Day 40
Respiratory Rate status (RR)
Respiratory Rate status defined as:: o Normal:\<20/min, * Mild:20/min≤RR\<24/min, * Moderate:24/min≤RR\<30/min, o Severe:≥30/min, * Death.
Time frame: Up to Day 40
Hypoxemia status
Hypoxemia status defined as:: o Normal:\>300mmHg, * Mild: 200 mmHg \< PaO2/FiO2 ≤ 300 mmHg, * Moderate:100mmHg\<PaO2/FIO2≤200mmHg, o Severe:PaO2/FIO2≤100mmHg, * Death.
Time frame: Up to Day 40
SpO2 status
SpO2 status defined as: o Normal:\>95% * Mild:93%\<SpO2≤95%, * Moderate:90%\<SpO2≤93%, o Severe:≤90%, * Death.
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Time frame: Up to Day 40
CHEST CT-Scan (or in exceptional cases, chest radiogram)
Time frame: Day 4
Oxygen-free days
Time frame: Up to Day 40
Admission to the ICU
Time frame: Up to Day 40
ICU-free days
Time frame: Up to Day 40
Hospital-free days
Time frame: Up to Day 40
Clinical recovery and Time to Clinical recovery
Time frame: Up to Day 40
Cure and Time-to-cure
Time frame: Up to Day 40
Incidence, nature and severity of Adverse Events, SAEs, SUSARs and Treatment-Emergent Adverse Events (TEAEs)
Time frame: Up to Day 40
Incidence of bleeding-related events
Time frame: Up to Day 40
Incidence of hypersensitivity reactions
Time frame: Up to Day 40
Changes from baseline on blood pressure
Time frame: Up to Day 40
Changes from baseline on heart rate
Time frame: Up to Day 40
Changes from baseline on NFS
Time frame: Up to Day 40
Changes from baseline on INR/PTT
Time frame: Up to Day 40
Changes from baseline on platelet count
Time frame: Up to Day 40
Changes from baseline on plasma fibrinogen level
Time frame: Up to Day 40
Changes from baseline on plasma D-Dimers level
Time frame: Up to Day 40
Changes from baseline on serum-glucose level
Time frame: Up to Day 40
Changes from baseline on urea level
Time frame: Up to Day 40
Changes from baseline on creatinemia
Time frame: Up to Day 40
Changes from baseline on LFTs (ASAT/ALAT)
Time frame: Up to Day 40
Changes from baseline on CRP level
Time frame: Up to Day 40
Changes from baseline on LDH level
Time frame: Up to Day 40
Changes from baseline on IL6 level
Time frame: Up to Day 40
Changes from baseline on Tnt
Time frame: Up to Day 40
Changes from baseline on NT proBNP
Time frame: Up to Day 40
Changes from baseline on procalcitonin level
Time frame: Up to Day 40
Changes from baseline on ferritin level
Time frame: Up to Day 40
ECG over the course of the study versus screening
Changes in one or several of the usual ECG parameters compared to baseline or screening, i.e. sinusal rhythm, cardiac axis, QRS value, QT/QTc segment, Wave direction, and any abnormality.
Time frame: Up to Day 40