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Clinical Trial Details — Status: Withdrawn

Administrative data

NCT number NCT04382625
Other study ID # 18244
Secondary ID
Status Withdrawn
Phase Phase 4
First received
Last updated
Start date October 2020
Est. completion date June 1, 2022

Study information

Verified date May 2020
Source Kootenai Health
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Novel coronavirus SARS(Severe Acute Respiratory Syndrome)-CoV-2 was first identified during the outbreak in Wuhan, China in December 2019 with the now resulting pandemic. Aggressive supportive care is the mainstay of treatment currently and rescue with lung protective mechanical ventilation is essential for survival in patients with severe acute respiratory distress syndrome. Despite supportive care, mortality is significant in hospitalized patients in the U.S., especially among patients > 65 years of age. Pharmacologic treatments to decrease disease severity are urgently needed. Hydroxychloroquine is currently widely used for treatment of autoimmune disease including systemic lupus erythematosus and rheumatoid arthritis, and it has been used to prevent and treat malaria. In vitro and in vivo antiviral activity towards SARS-CoV-2 has been reported. Since hydroxychloroquine has been used for decades its properties as a drug are well known. The investigators propose a pragmatic trial of hydroxychloroquine in moderately ill hospitalized adults with SARS-CoV-2 pneumonia with the hypothesis that hydroxychloroquine reduces severity of acute lung injury caused by SARS-CoV-2 infection.


Description:

Novel coronavirus SARS-CoV-2 was first identified during the outbreak in Wuhan, China in December 2019 with the now resulting pandemic. Aggressive supportive care is the mainstay of treatment currently and rescue with lung protective mechanical ventilation is essential for survival in patients with severe acute respiratory distress syndrome. Despite supportive care, mortality is significant in hospitalized patients in the U.S., especially among patients > 65 years of age. Pharmacologic treatments to decrease disease severity are urgently needed. Candidate treatments with antiviral activity and/or immune-modulating effects include hydroxychloroquine (HCQ), lopinavir/ritonavir, remdesivir, and tocilizumab among others. There is limited high quality clinical data prompting a dilemma of how to use and review potential treatments and ensure patient safety now as the pandemic begins to peak. There are also significant limitations in drug supplies at many institutions. Hydroxychloroquine is currently widely used for treatment of autoimmune disease including systemic lupus erythematosus and rheumatoid arthritis, and it has been used to prevent and treat malaria. In vitro and in vivo antiviral activity towards SARS-CoV-2 has been reported. Since hydroxychloroquine has been used for decades its properties as a drug are well known. Pertinent adverse events to monitor in a hospitalized patient include QTc (corrected QT interval) prolongation, elevation of liver enzymes/acute liver injury, and hypokalemia. Acute lung injury and progressive respiratory failure is the major cause of mortality in SARS-CoV-2 infection. In acute lung injury and respiratory distress syndrome, the severity of hypoxia is categorized by the Pao2/FIO2 (fraction of inspired oxygen) ration as mild (200 mm Hg


Recruitment information / eligibility

Status Withdrawn
Enrollment 0
Est. completion date June 1, 2022
Est. primary completion date January 1, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Age > 18 years of age 2. SARS-CoV-2 positive per FDA approved RT-PCR (reverse transcription-polymerase chain reaction) 3. Acute hypoxia (O2 sat < 90 % or paO2 < 60 on room air), or above baseline chronic O2 requirement 4. Inpatient admission Exclusion Criteria: 1. Requires supplemental O2 >10 litres per minute or mechanical ventilation on admission 2. Pregnancy 3. AST/ALT > 5 times the upper limit normal 4. Baseline prolonged QT 5. Child-Pugh Score B or greater 6. ESRD(end-stage renal disease) requiring dialysis 7. Known allergy to medication component, 8. History of severe G6PD (glucose-6-phosphate dehydrogenase) 9. Myasthenia gravis 10. Porphyria 11. Ongoing treatment for epilepsy 12. Life expectancy < 6 months, 13. Patient lacks capacity to provide consent and does not have a surrogate decision maker. 14. Retinal Disease

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Hydroxychloroquine
Hydroxychloroquine is currently widely used for treatment of autoimmune disease including systemic lupus erythematosus and rheumatoid arthritis, and it has been used to prevent and treat malaria.

Locations

Country Name City State
United States Kootenai Health Coeur d'Alene Idaho

Sponsors (2)

Lead Sponsor Collaborator
Kootenai Health Washington State University

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change from Baseline Oxygenation on Day 1 to Day 5 paO2 Day 1 of treatment to day 5 of treatment
Primary Change from Baseline Oxygenation at Day 5 FIO2 Day 1 of treatment to day 5 of treatment
Secondary Intensive Care length of stay Length in hours Day 0 to Day 28
Secondary Required Mechanical Ventilation Length in hours Day 0 to Day 28
Secondary Required Oxygen supplementation Length in hours Day 0 to Day 28
Secondary Hospitalization length of Stay Length in hours Day 0 to Day 28
Secondary Mortality Date of Death Day 0 to Day 28
Secondary Cardiac Arrhythmia - Polymorphic Ventricular Tachycardia Cardiologist Diagnostic Documentation Day 0 to Day 28
Secondary Cardiac Arrhythmia - Ventricular Tachycardia Cardiologist Diagnostic Documentation Day 0 to Day 28
Secondary Cardiac Arrhythmia - Lengthening QTc Cardiologist Diagnostic Documentation Day 0 to Day 28
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