VERU-111 in the Treatment of SARS-Cov-2 Infection by Assessing Its Effect on the Proportion of Patients Who Die on Study
Condition: SARS-CoV Infection
MeSH terms: Infections; Severe Acute Respiratory Syndrome
Intervention: VERU-111
Intervention description: Subjects in the VERU-111 treatment groups will receive standard of care, plus oral daily VERU-111 9mg for 21 days or until released from hospital.
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Subjects in the VERU-111 treatment groups will receive standard of care, plus oral daily VERU-111 9mg for 21 days or until released from hospital. Subjects in the Placebo treatment group will receive standard of care, plus a placebo capsule for 21 days or until released from hospital.
Masking: Triple (Participant, Care Provider, Investigator)
Masking description: The study will be a randomized, double-blind, placebo-controlled study. Randomization will be stratified by baseline WHO Ordinal Scale score of 4,5 and 6 such that subjects with a WHO Ordinal Scale of 4, 5 and 6 at screening are approximately equally distributed between the treatment groups. An emergency code break will be available to the investigator / pharmacist / investigational drug storage manager. This code break option in IWRS may only be disclosed in emergency situations when the identity of the trial drug must be known to the investigator in order to provide appropriate medical treatment or if required to assure safety of trial participants. If the code break for a patient is opened, the sponsor and CRO will be informed immediately via IWRS notification. The reason for the IWRS unblinding of the subject must be documented on the appropriate eCRF page along with the date and the initials of the person who broke the code.
Enrollment: 204.0
Sex: All
Minimum age: 18 Years
Maximum age: 100 Years
Healthy volunteers: No

Summary:

      To demonstrate the efficacy of VERU-111 in the treatment of SARS-Cov-2 Infection by assessing
      its effect on the proportion of patients who die on study (prior to Day 60).
    

Eligibility criteria:

        Inclusion Criteria:

          -  Provide informed consent from the subject or the subject's Legally Authorized
             Representative (LAR)

          -  Aged ≥18 years

          -  Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection confirmed by
             polymerase chain reaction (PCR) test

          -  Patients with a WHO Ordinal Scale for Clinical Improvement score of 4 at high risk for
             ARDS, must have at least one of the known comorbidities for being at high risk, such
             as, Asthma (moderate to severe), Chronic Lung Disease, Diabetes, Hypertension, Severe
             Obesity (BMI ≥40), 65 years of age or older, primarily reside in a nursing home or
             long-term care facility, or immunocompromised and patients with a WHO Ordinal Scale
             for Clinical Improvement score of 5 or 6 regardless of presence of comorbidities.

          -  WHO Ordinal Scale for Clinical Improvement score of 4 (Oxygen by mask or nasal
             prongs), 5 (Non-invasive ventilation or high-flow oxygen) or 6 (Intubation and
             mechanical ventilation)

          -  Peripheral capillary oxygen saturation (SpO2) ≤ 94% on room air at screening. If
             patient is on oxygen therapy at the time of presentation for screening and the SpO2
             levels were ≤94% prior to introduction to oxygen therapy with proper documentation
             example EMT notes or ER/ED notes, then the patient is considered to have met this
             inclusion criterion. If patient is on oxygen therapy at the time of presentation for
             screening and the SpO2 levels prior to introduction to oxygen therapy are unknown, the
             patient may be considered to have met this inclusion criterion if oxygen therapy is
             removed and the SpO2 levels fall to ≤94%, then the patient is considered to have met
             this inclusion criterion. However, removal of the oxygen therapy should only be done
             if it is considered medically reasonable

          -  Subjects must agree to follow doctor's recommendation for oxygen supplementation

          -  Subjects must agree to use acceptable methods of contraception:

               -  If female of childbearing potential or a male subject's partner could become
                  pregnant, use acceptable methods of contraception from the time of the first
                  administration of study medication until 6months following administration of the
                  last dose of study medication. Acceptable methods of contraception are as
                  follows: Condom with spermicidal foam/gel/film/cream/suppository [i.e., barrier
                  method of contraception], surgical sterilization (vasectomy with documentation of
                  azospermia) and a barrier method {condom used with spermicidal
                  foam/gel/film/cream/suppository}, the female partner uses oral contraceptives
                  (combination estrogen/progesterone pills), injectable progesterone or subdermal
                  implants and a barrier method (condom used with spermicidal
                  foam/gel/film/cream/suppository)

               -  If the female partner of a male subject has undergone documented tuballigation
                  (female sterilization), a barrier method (condom used with spermicidal
                  foam/gel/film/cream/suppository)should also be used

               -  If female partner of a male subject has undergone documented placement of an
                  intrauterine device (IUD) or intrauterine system (IUS),a barrier method (condom
                  with spermicidal foam/gel/film/cream/suppository)should also be used

          -  Subject is willing to comply with the requirements of the protocol through the end of
             the study

        Exclusion Criteria:

          -  Known hypersensitivity or allergy to colchicine

          -  Pregnant or currently breast feeding

          -  Participation in any other clinical trial of an experimental treatment for COVID- 19.
             Convalescent plasma, dexamethasone and remdesivir are allowed in this study.

          -  Concurrent treatment with other experimental agents with actual or possible direct
             acting antiviral activity against COVID-19is prohibited <24 hours prior to study drug
             dosing(except standard of care). Remdesivir, dexamethasone and convalescent plasma are
             allowed in the study.

          -  Requiring ventilation + additional organ support - pressors, RRT, ECMO(WHO Ordinal
             Scale for Clinical Improvement - Score of 7). NOTE: short term (PRN) use of pressors
             is allowed

          -  Alanine Aminotransferase (ALT) or aspartate aminotransferase(AST) >3X upper limit of
             normal (ULN)

          -  Total bilirubin > ULN

          -  Creatinine clearance < 60 mL/min

          -  Documented medical history of liver disease, including but not limited to, prior
             diagnosis of hepatitis of any etiology, cirrhosis, portal hypertension, or confirmed
             or suspected esophageal varices

          -  Moderate to severe renal impairment

          -  Hepatic impairment

          -  History of hepatitis - (Hepatitis B and C) NOTE: treated and controlled hepatitis C is
             allowed

          -  Any comorbid disease or condition (medical or surgical) which might compromise the
             hematologic, cardiovascular, endocrine, pulmonary, renal, gastrointestinal, hepatic,
             or central nervous system; or other conditions that may interfere with the absorption,
             distribution, metabolism or excretion of study drug, or would place the subject at
             increased risk

          -  Participants must agree to refrain from prolonged exposure to the sun or agree to use
             at least SPF 50 on all exposed skin and protective clothing during prolonged sun
             exposure throughout participation in this study and/or treatment with VERU-111