VA Remote and Equitable Access to COVID-19 Healthcare Delivery (VA-REACH TRIAL)

COVID-19 Clinical Trial

— VA-REACH  

Official title:

VA Remote and Equitable Access to COVID-19 Healthcare Delivery (VA-REACH TRIAL)

Clinical Trial Details — Status: Suspended

Administrative data

• NCT number: NCT04363203
• Other study ID #: 20-30517
• Status: Suspended
• Phase: Phase 3
• Start date: April 30, 2020
• Est. completion date: August 2021

Study information

• Verified date: June 2020
• Source: San Francisco VA Health Care System
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

We propose a 3-arm RCT to determine the efficacy of hydroxychloroquine or azithromycin in treating mild to moderate COVID-19 among Veterans in the outpatient setting.

Description:

SARS-CoV-2 is a novel coronavirus disease (COVID-19) that presents with fever, cough, and shortness of breath, and has a mortality rate of 2-4%. Outcomes are worse among the elderly and those with cardiovascular, respiratory, cancer and other co-morbidities. Several treatments are also emerging as promising therapeutic candidates, hydroxychloroquine and azithromycin - both available as generic pills and widely used for other indications - are potential options for treatment. A small randomized controlled trial (RCT) of hospitalized patients suggests chloroquine may be superior to placebo in promoting viral elimination and shortening disease course. Hydroxychloroquine is preferred to chloroquine in the U.S. A small non-randomized trial found azithromycin had a clinical benefit. When azithromycin and hydroxychloroquine are given together, they can cause cardiac side-effects that limit use in the outpatient setting. These drugs, however, have independent potential benefits against COVID-19 that require more rigorous study before either is considered standard of care. We propose a 3-arm RCT to determine the efficacy of hydroxychloroquine or azithromycin in treating mild to moderate COVID-19 among Veterans in the outpatient setting.

Recruitment information / eligibility

• Status: Suspended
• Enrollment: 300
• Est. completion date: August 2021
• Est. primary completion date: March 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 216 Months and older

Eligibility

Inclusion Criteria:

• willingness to take the study drug and ability to take oral medications

• able to be contacted by phone

• willing and able to give informed consent for participation in the study and agrees with its conduct and willing to email the study team a picture of their consent form

Exclusion Criteria:

Exclusion Criteria Based on National VA Data:

We will exclude individuals based on the following national VA data and chart review criteria:

• eGFR <30mL/min or dialysis

• aspartate transaminase (AST) or alanine transaminase (ALT) >5 times the upper limit of normal or cirrhosis in past 2 years

• hypersensitivity to chloroquine, hydroxychloroquine or other 4-aminoquinolines (e.g., amodiaquine), azithromycin or macrolides

• already taking hydroxychloroquine or azithromycin

• congestive heart failure with an ejection fraction (EF) <35% in past 2 years or hospitalization within past 6 months

• concomitant treatment with any QT prolonging drug

• history of cardiac arrest, ventricular fibrillation or ventricular tachycardia in past 5 years

• QT prolongation on any ECG in past 5 years

• potassium <3.5 meq/l in labs in past 2 years

• magnesium< 1/5 meq/l in any lab in past 2 years

• any patient who has not had follow-up with their primary care doctors in past 2 years

• any Veteran who cannot follow-up such as those with dementia, home based primary care or those with active psychosis documented in past 2 years

• G6PD deficiency

Exclusions Based on Baseline Interview:

• any female who is breastfeeding or pregnant or planning to become pregnant.

• any Veteran who receives most of their care in non-VA settings

• Veteran enrolled in another COVID Trial

• Veteran received a prescription for azithromycin and hydroxychloroquine

• Veteran allergic to azithromycin and or hydroxychloroquine

• Veteran receiving QT prolonging drugs from non-VA pharmacy

Related Conditions & MeSH terms

• COVID-19
• SARS-CoV-2

Intervention

Drug:
• Hydroxychloroquine
Hydroxychloroquine: 2x200mg mg .PO in the AM and 2x200mg PO in the PM on Day 1, followed by 200mg PO in the AM and 200 mg PO in the PM on Days 2-5.
• Azithromycin
Azithromycin: 2x250mg by mouth (PO) in the AM on Day 1, followed by 250mg PO every day on Days 2-5.
• Placebo oral tablet
Placebo in pill packs identical to study drugs

Locations

Country	Name	City	State
United States	San Francisco VA	San Francisco	California

Sponsors (2)

Lead Sponsor	Collaborator
Salomeh Keyhani MD	San Francisco VA Health Care System

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Days to resolution of cough, fever and shortness of breath		30-days
Secondary	Days to resolution of all COVID-19 symptoms		30-days
Secondary	All cause hospitalization		30-days
Secondary	All cause mortality		30-days
Secondary	COVID-19 specific mortality		30-days
Secondary	COVID-19 specific hospitalization		30-days