This phase 2 study is to assess the safety and tolerability of APX-115 active doses compared to placebo following multiple oral dosing in hospitalized patients with confirmed, mild to moderate, symptomatic COVID-19. It is anticipated that approximately 80 patients will be randomized into the study in a 1:1 ratio to 100 mg APX-115 or placebo arm.
APX-115 is a potent small molecule inhibitor of NADPH-oxidase (Nox) isozymes being developed by Aptabio Therapeutics Inc. The Nox enzymes represent a family of 7 membrane enzymes (Nox1, Nox2, Nox3, Nox4, Nox5, Duox1, and Duox2) which catalyze NADPH-dependent generation of superoxide and secondary reactive oxygen species (ROS). ROS are often generated during virus infection, thus promoting apoptosis, lung injury, and inflammation/allergy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
16
Alternative Research Associates, LLC
Hialeah, Florida, United States
Anne Arundel Medical Center
Baltimore, Maryland, United States
Millennium Physicians Group
Houston, Texas, United States
Incidence of Treatment-Emergent Adverse Events
Adverse events will be assessed to evaluate the safety and tolerability of APX-115 in mild-to-moderate COVID-19 patients. Clinical laboratory evaluations, vital signs, and ECG will be used to assess adverse events.
Time frame: over the 60-day period
Time to clinical recovery
Recovery is defined as when WHO Clinical Improvement Ordinal Scale equal to or less than 3
Time frame: Up to 60 Days
Time to discharge
WHO Clinical Improvement Ordinal Scale is equal to or less than 2
Time frame: Up to Day 60
Time to symptomatic recovery
When none of the COVID-19 Symptom Assessment scores are higher than 1
Time frame: Up to Day 60
Time to complete symptomatic recovery
When none of the COVID-19 Symptom Assessment scores are higher than 0
Time frame: Up to Day 60
Change in log10 SARS-CoV-2 viral load
hange from baseline in log10 SARS-CoV-2 viral load as measured by RT-PCR by Days 5 and 14
Time frame: Up to Day 14
Proportion of patients in clinical recovery
Symptom Assessment
Time frame: Up to Day 29
scoring of WHO Clinical Improvement Ordinal Scale
9-point scale on key analysis days for levels ≥3
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Up to Day 29
Changes from baseline in anti-inflammatory markers in blood
Blood will be analyzed for changes from baseline in anti-inflammatory markers, such as C-reactive protein, ferritin, lactate dehydrogenase, D-dimer, troponin, and transforming growth factor-β.
Time frame: Day 1 and Day 14
Changes from baseline in pro-inflammatory cytokines in blood
Blood will be analyzed for changes from baseline in pro-cytokine panel of the blood, such as interleukin (IL)-1β, IL-6, and interferon-γ.
Time frame: Day 1 and 14
Changes from baseline in 8-isoprostane in blood
Blood will be analyzed for changes from baseline in 8-isoprostane.
Time frame: Days 1 and 14
Trough (predose) plasma concentration (Ctrough)
Trough (predose) plasma concentration (Ctrough) will be analyzed from plasma samples for pharmacokinetic assessment of APX-115.
Time frame: Day 1
Maximum observed plasma concentration (Cmax)
Maximum observed plasma concentration (Cmax) will be analyzed from plasma samples for pharmacokinetic assessment of APX-115.
Time frame: Days 1, 5, and 14
Time to Cmax (Tmax)
Time to Cmax (Tmax) will be analyzed from plasma samples for pharmacokinetic assessment of APX-115.
Time frame: Days 1, 5, and 14
Area under the plasma concentration versus time curve (AUC) from time zero to the Time of last quantifiable concentration (AUC0-last)
Area under the plasma concentration versus time curve (AUC) from time zero to the time of last quantifiable concentration (AUC0-last) will be analyzed from plasma samples for pharmacokinetic assessment of APX-115.
Time frame: Days 1, 5, and 14
AUC within a dosing interval (AUCtau, where tau = 12 hours)
AUC within a dosing interval (AUCtau, where tau = 12 hours) will be analyzed from plasma samples for pharmacokinetic assessment of APX-115.
Time frame: Days 1, 5, and 14