Ruxolitinib to Combat COVID-19

COVID-19 Clinical Trial

Official title:

A Pilot Study of Ruxolitinib to Combat COVID-19

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT04354714
• Other study ID #: 04-13-20-DiPersio
• Status: Withdrawn
• Phase: Phase 2
• Start date: June 30, 2020
• Est. completion date: December 31, 2021

Study information

• Verified date: May 2020
• Source: Washington University School of Medicine
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators hypothesize that JAK 1/2 inhibition with ruxolitinib, an FDA approved treatment for intermediate or high-risk myelofibrosis, could have a similar effect in patients with severe COVID-19, quelling the immune-hyperactivation, allowing for clearance of the virus and reversal of the disease manifestations.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: December 31, 2021
• Est. primary completion date: July 31, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• A diagnosis of advanced COVID-19 as defined by both of the following:

• A positive test for SARS-CoV-2 RNA detected by RT-PCR collected from the upper respiratory tract (nasopharyngeal and oropharyngeal swab) and, if possible, the lower respiratory tract (sputum, tracheal aspirate, or bronchoalveolar lavage), analyzed by a CLIA certified lab

• Critical disease manifested by any of the following:

• Chest imaging (CT or chest X-ray permitted) with = 50% lung involvement

• Respiratory failure requiring invasive mechanical ventilation or supplementary oxygen with FiO2 = 50%

• Shock (defined as mean arterial pressure = 65 mmHg unresponsive to 25ml/kg isotonic intravenous fluid resuscitation and/or requiring vasopressor support

• Cardiac dysfunction defined by:

• New global systolic dysfunction with ejection fraction = 40%

• Takotsubo cardiomyopathy

• New onset supraventricular or ventricular arrhythmias

• Plasma troponin I = 0.10 ng/mL in someone without previously documented troponin elevation beyond that level

• Elevated plasma NT-proBNP in someone without documented prior elevation

• If Age < 50, NT-proBNP > 450 pg/ml

• If Age 50-74, NT-proBNP > 900 pg/ml

• If Age = 74, NT-proBNP > 1800 pg/ml

• Receipt of investigational or off-label agents for COVID-19 (prior or ongoing) does not exclude eligibility.

• Patients who have received autologous or allogeneic stem cell transplant are eligible at the discretion of the investigators.

• 18 years of age or older at the time of study registration

• Adequate hematologic function defined as:

• absolute neutrophil count = 1000/mm3

• platelet count = 50,000/mm3 without growth factor or transfusion support for 7 days prior to screening

• Creatinine clearance = 15 mL/minute or receiving renal replacement therapy

• Women of childbearing potential (defined as women with regular menses, women with amenorrhea, women with irregular cycles, women using a contraceptive method that precludes withdrawal bleeding, or women who have had a tubal ligation) are required to have a negative pregnancy test and use two forms of acceptable contraception, including one barrier method, during participation in the study treatment period.

• Male patients (if engaging in reproductive sex with a women of childbearing potential) are required to use two forms of acceptable contraception, including one barrier method, during participation in the study and throughout the evaluation period.

• Able to understand and willing to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable)

Exclusion Criteria:

• Known allergy or intolerance to ruxolitinib or another JAK inhibitor.

• Known or suspected active viral (including HIV, hepatitis B, and hepatitis C), bacterial, mycobacterial, or fungal infection other than COVID-19. Virologic testing not required unless infection is suspected.

• Pregnant and/or breastfeeding.

• Any uncontrolled intercurrent illness that would put the patient at greater risk or limit compliance with study requirements in the opinion of the investigator.

Related Conditions & MeSH terms

• COVID-19

Intervention

Drug:
• Ruxolitinib
For patients unable to swallow pills, a ruxolitinib suspension will be administered through a nasogastric/orogastric tube

Procedure:
• Peripheral blood draw
-Screening, Day 2, Day 4, Day 8, Day 15, and Day 29

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
Washington University School of Medicine	Incyte Corporation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall survival		Through 28 days
Secondary	Length of hospital stay		Through completion of follow-up (estimated to be 7 months)
Secondary	Length of ICU stay		Through completion of follow-up (estimated to be 7 months)
Secondary	Duration of ventilator use		Through completion of follow-up (estimated to be 7 months)
Secondary	Duration of vasopressors use		Through completion of follow-up (estimated to be 7 months)
Secondary	Duration on renal replacement therapy		Through completion of follow-up (estimated to be 7 months)
Secondary	Viral kinetics as measured by virologic failure	-Defined as increase in viral load of >0.5 log on two consecutive days, or >1 log increase in one day, not in keeping with any baseline trend of rising viral loads during the pre-treatment viral testing	Through completion of follow-up (estimated to be 7 months)
Secondary	Number of adverse events as measured by CTCAE v. 5.0		Through completion of follow-up (estimated to be 7 months)
Secondary	Proportion of participants with detectable virus		Day 5
Secondary	Proportion of participants with detectable virus		Day 10
Secondary	Proportion of participants with detectable virus		Day 15
Secondary	Proportion of participants with detectable virus		Day 29

External Links

•   Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine