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Adaptive COVID-19 Treatment Trial 3 (ACTT-3)
Recruiting
Trial ID: NCT04492475
Purpose
ACTT-3 will evaluate the combination of interferon beta-1a and remdesivir compared to
remdesivir alone. Subjects will be assessed daily while hospitalized. If the subjects are
discharged from the hospital, they will have a study visit at Days 15, 22, and 29. For
discharged subjects, it is preferred that the Day 15 and 29 visits are in person to obtain
safety laboratory tests and oropharyngeal (OP) swab and blood (serum only) samples for
secondary research as well as clinical outcome data. However, infection control or other
restrictions may limit the ability of the subject to return to the clinic. In this case,
these visits may be conducted by phone, and only clinical data will be obtained. The Day 22
visit does not have laboratory tests or collection of samples and is conducted by phone. The
primary outcome is time to recovery by Day 29.
Official Title
A Multicenter, Adaptive, Randomized Blinded Controlled Trial of the Safety and Efficacy of Investigational Therapeutics for the Treatment of COVID-19 in Hospitalized Adults (ACTT-3)
Stanford Investigator(s)
Nidhi Rohatgi, MD MS
Clinical Professor, Medicine Clinical Professor (By courtesy), Neurosurgery
Evelyn Bin Ling
Clinical Assistant Professor, Medicine
Eligibility
Inclusion Criteria:
1. Admitted to a hospital with symptoms suggestive of COVID-19.
2. Subject (or legally authorized representative) provides informed consent prior to
initiation of any study procedures.
3. Subject (or legally authorized representative) understands and agrees to comply with
planned study procedures.
4. Male or non-pregnant female adult > / = 18 years of age at time of enrollment.
5. Has laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain
reaction (PCR) or other commercial or public health assay in any respiratory specimen
or saliva, as documented by either of the following:
- PCR or other assay positive in sample collected < 72 hours prior to
randomization; OR
- PCR or other assay positive in sample collected >/= 72 hours but < 7 days prior
to randomization AND progressive disease suggestive of ongoing SARS-CoV-2
infection.
Note: if written documentation of the positive test result is not available at
enrollment (e.g., report from other institution), the subject may be enrolled but the
PCR should be repeated at the time of enrollment.
6. Illness of any duration, and at least one of the following:
- Radiographic infiltrates by imaging (chest x-ray, CT scan, etc.), OR
- SpO2 < / = 94% on room air, OR
- Requiring supplemental oxygen.
7. Women of childbearing potential must agree to either abstinence or use at least one
primary form of contraception not including hormonal contraception from the time of
screening through Day 29.
8. Agrees to not participate in another clinical trial (both pharmacologic and other
types of interventions) for the treatment of COVID-19 through Day 29.
Exclusion Criteria:
1. Anticipated discharge from the hospital or transfer to another hospital which is not a
study site within 72 hours.
2. Subject meets criteria for ordinal scale category 6 or 7 at the time of screening.
3. Subject has a positive test for influenza virus during this current hospital
admission.
4. Subjects with an estimated glomerular filtration rate (eGFR) < 30 mL/min are excluded
unless in the opinion of the PI, the potential benefit of receiving remdesivir
outweighs the potential risk of study participation.
5. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 5 times the upper
limits of normal.
6. Total white cell blood cell count (WBC) <1500 cells/microliter.
7. Platelet count <50,000/microliter.
8. History of chronic liver disease (e.g., jaundice, ascites, hepatic encephalopathy,
history of bleeding esophageal or gastric varices). No laboratory testing is needed.
9. Pregnancy or breast feeding (lactating women who agree to discard breast milk from Day
1 until three weeks after the last study product is given are not excluded).
10. Allergy to any study medication including history of hypersensitivity to natural or
recombinant interferon beta or human albumin.
11. Patient has a chronic or acute medical condition or is taking a medication that cannot
be discontinued at enrollment, that in the judgement of the PI, places them at
unacceptable risk for a poor clinical outcome if they were to participate in the
study.
12. Received three or more doses of remdesivir, including the loading dose, outside of the
study for COVID-19.
13. Received convalescent plasma or intravenous immunoglobulin [IVIg] for the treatment of
COVID-19.
14. Received any interferon product within two weeks of screening, either for the
treatment of COVID-19 or for a chronic medical condition (e.g., multiple sclerosis,
HCV infection).
15. Received any of the following in the two weeks prior to screening as treatment of
COVID-19:
- Small molecule tyrosine kinase inhibitors (e.g. baricitinib, imatinib, gefitinib,
acalabrutinib, etc.);
- Monoclonal antibodies targeting cytokines (e.g., TNF inhibitors,
anti-interleukin-1 [IL-1], anti-IL-6 [tocilizumab or sarilumab], etc.);
- Monoclonal antibodies targeting T-cells or B-cells as treatment for COVID-19.
16. Prior enrollment in ACTT-3.
Intervention(s):
drug: Interferon beta-1a
other: Placebo
drug: Remdesivir
Recruiting
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305