Adaptive COVID-19 Treatment Trial 3 (ACTT-3)


Trial ID: NCT04492475


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
Nidhi Rohatgi, MD MS

Clinical Professor, Medicine Clinical Professor (By courtesy), Neurosurgery

Evelyn Bin Ling
Evelyn Bin Ling

Clinical Assistant Professor, Medicine


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

   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

   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

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

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

      - 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.


drug: Interferon beta-1a

other: Placebo

drug: Remdesivir


Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305