The proposed phase 2a trial will determine whether MIB-626 treatment in adults with COVID-19 infection and stage 1 acute kidney injury is more efficacious than placebo in preventing worsening of kidney function, as assessed by longitudinal changes in serum creatinine concentration, and in attenuating the inflammatory response to the infection.
This is a two-center, randomized, double-blind, placebo-controlled, parallel-group, phase 2a study that will determine the efficacy and safety of MIB-626 treatment relative to placebo in adult patients with COVID-19 infection and stage 1 acute kidney injury. Hospitalized adult patients with a confirmed or suspected diagnosis of COVID-19 infection will be screened for conformity to inclusion and exclusion criteria and those meeting eligibility criteria on screening will be offered participation in the study. Fifty participants, who meet all the eligibility criteria, and are able and willing to provide informed consent, will be randomized, stratified by sex, remdesivir use, and trial site, in a 3:2 ratio to receive either MIB-626 1.0 g orally or matching placebo twice daily for 14 days. The participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
42
Fifty participants will be randomized, stratified by sex, remdesivir use, and trial site, in a 3:2 ratio to receive either MIB-626 1.0 g orally or matching placebo twice daily for 14 days.
Subjects will be randomized to receive either the placebo or 1000-mg MIB-626 twice daily orally.
Participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.
The Brigham and Women's Hospital
Boston, Massachusetts, United States
Change from baseline in serum cystatin C levels
Change from baseline in serum cystatin C levels
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)
Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)
Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury
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The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization
Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change from baseline in oxygen saturation
Change from baseline in oxygen saturation
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)
Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants
Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first
Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period
Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period
Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first