This randomized, double-blind, placebo-controlled, Phase 1b study evaluates the safety and tolerability, and effects on cytokine and acute phase reactants of SP16, an anti-inflammatory drug, in patients with pneumonia due to SARS-CoV-2 infection. The study will enroll up to 20 patients and each eligible patient will be randomized to receive either one of two doses of SP16 (6 mg or 12 mg) or placebo by subcutaneous injection.
SARS-CoV-2 infection is associated with excessive inflammation and cytokine storm that can result in lung damage and potentially severe disease. SP16 is an anti-inflammatory and homeostatic drug that rebalances innate immune responses potentially resulting in mitigation of inflammation and lung damage without immunosuppressive effects. SP16's mechanism of action is through targeting LRP1, a receptor that regulates a variety of physiological processes that contribute to inflammation and tissue injury, particularly in the lung. The main objective of this study is to determine the safety and tolerability, and effects on inflammation of SP16 administered subcutaneously at a dose of 6 mg (0.1 mg/kg) or 12 mg (0.2 mg/kg). SP16 has previously been well tolerated in both healthy individuals and heart attack patients at a dose of 0.2 mg/kg. The study will also evaluate improvements in clinical parameters such as patients requiring ventilation, improvement in blood oxygen levels (as defined by both SpO2 \> 95% and respiratory rate ≤ 20/minute) and duration of hospitalization or time spent in the Intensive Care Unit (ICU).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
2
SP16 will be administered as 2 concurrent, separate 2 mL s.c injections of 3mg/mL SP16
Placebo will be administered as 2 concurrent, separate 2 mL s.c. injections of sterile water
SP16 will be administered as a single 2 mL s.c. injection of 3 mg/mL SP16 and 1 concurrent separate 2 mL s.c. injection of sterile water
UVA Health Center
Charlottesville, Virginia, United States
Safety and tolerability of SP16 in subjects with pneumonia due to SARS-CoV-2
Safety and tolerability of SP16 in subjects with pneumonia due to SARS-CoV-2 based on number of adverse events (AEs)
Time frame: Day 1 to 14
Change in inflammatory cytokines
Subjects' change from baseline in plasma concentrations of inflammatory cytokines (IL-1β, TNF-α, IL-6, and IL-8)
Time frame: Day 3, Day 6, and Day 14
Change in acute phase reactants
Subjects' change from baseline of acute phase reactants (CRP, α-2 macroglobulin, fibrinogen, and D-dimer)
Time frame: Day 3, Day 6, and Day 14
Proportion of subjects requiring ventilation
The proportion of subjects in each dose group who required intubation and noninvasive ventilation by Day 14
Time frame: Day 14
Improvement from baseline in SpO2
The proportion of subjects in each dose group who exhibited improvement from baseline in SpO2 levels, as defined by both SpO2 \> 95% and respiratory rate ≤ 20/minute, at Days 3 and 14
Time frame: Days 3 and 14
Cumulative days on ventilator
Cumulative days on ventilator for each subject who required mechanical ventilation at any time during Day 1 to Day 14 period
Time frame: Day 1 to 14
Duration of hospitalization
Subjects' duration of hospitalization over the Day1 to Day 14 period
Time frame: Day 1 to 14
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Time to clinical improvement
Subjects' time to clinical improvement (TTCI), which is defined as a National Early Warning Score 1 (NEWS2) of \< 2 to be maintained for 24 h (during Days 1 to 14)
Time frame: Day 1 to 14
Proportion of subjects experiencing TTCI
The proportions of subjects in each cohort who experienced TTCI, which is defined as NEWS2 of \< 2 to be maintained for 24 h
Time frame: Day 1 to 14
Subjects time to death
Subjects time to death or censoring over the period from Day 1 to Day 14 (subjects who withdraw prior to Day 14 will be censored on the day of withdrawal; subjects alive on Day 14 will be censored on Day 14)
Time frame: Day 1 to 14
Change from baseline in Horowitz index
Subjects' change from baseline on Days 6 and 14 in Horowitz index or in SpO2/FiO2
Time frame: Days 6 and 14
Subject's cumulative days in ICU
Subjects' cumulative number of days spent in the Intensive Care Unit (ICU) over Days 1 to 14
Time frame: Day 1 to 14