Anti-SARS-CoV-2 Monoclonal Antibodies for Long COVID (COVID-19)

Study Overview
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Brief Summary
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Persistent viral infection with viral reservoirs and detection of circulating spike protein after the initial acute illness is one potential pathogenic mechanism for Long COVID. This mechanism may be able to be targeted by SARS-CoV-2 monoclonal antibodies (mAbs). This trial will study the safety and efficacy of AER002 to treat individuals with Long COVID in an adult population.

Detailed Description
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The study will enroll approximately 30 participants who meet the World Health Organization (WHO) Long COVID criteria, with Long COVID attributed to a SARS-CoV-2 variant susceptible to AER002. Participants will be enrolled at a single center and randomized 2:1 to receive a SARS-CoV-2 monoclonal antibody (AER002) 1200mg or placebo. Evaluations will take place at baseline and at timepoints up to 1-year post-infusion.

Official Title
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An Exploratory, Randomized, Double-Blind Placebo-Controlled Study to Assess the Safety of an Anti-SARS-CoV-2 Monoclonal Antibody and Response to Treatment in Individuals With Long COVID (outSMART-LC)

Conditions
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Long COVID, Post-Acute Sequela of COVID-19, Post-Acute COVID-19

Intervention / Treatment
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* Drug: AER002
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Key Inclusion Criteria (note, additional eligibility criteria not listed here will be assessed at Screening): Male, female, or transgender ≥18 years of age at Screening. History of confirmed acute SARS-CoV-2 infection. Long COVID attributed to a SARS-CoV-2 infection with a variant against which AER002 is known to have neutralizing activity (prior to August 15, 2022). Note: While individuals re-infected with SARS-CoV-2 after August 15, 2022 will not be excluded, the SARS-CoV-2 infection after which Long COVID symptoms began must pre-date August 15, 2022. At least two symptoms that are new or worsened since the time of SARS-CoV-2 infection, not known to be attributable to another cause upon assessment by the PI. Symptoms must have been present for at least 60 days prior to screening and must be reported to be at least somewhat bothersome. Body mass index (BMI) 18 to 50 kilograms/meter squared (kg/m2), inclusive, at the time of screening. Participants who are of childbearing potential (CBP) and male participants with sexual partner(s) who are females of CBP must agree to use adequate contraception from study consent through 360 days after dosing. Key Exclusion Criteria (note, additional eligibility criteria not listed here will be assessed at Screening): Long COVID attributed to a SARS-CoV-2 infection after August 15, 2022. Previously received treatment or prophylaxis with a SARS-CoV-2-specific mAb, or plan to receive such treatment before exiting the study. Previously received COVID-19 convalescent plasma treatment within 60 days prior to Day 0 or plan to receive such treatment before exiting the study. Plans to receive any investigational or approved vaccine or booster for SARS-CoV-2 within 60 days prior to Day 0 or before Day 30 following Day 0. Active cardiovascular disease or recent (within 3 months) stroke. Recent (within 6 months) or planned major surgery. Currently hospitalized or recent (within 1 month) unplanned hospitalization. Active Hepatitis Bor C infection . Untreated or unstable HIV infection (two or more consecutive plasma HIV RNA values >48 copies/mL in the 6 months prior to screen). Severe coagulopathy (international normalized ratio ((INR) >2.0, history of hemophilia). Severe anemia (hemoglobin <9 grams/deciliter (g/dL)). Moderate or severe immunocompromise, according to the current NIH COVID-19 Treatment Guidelines as of March 6, 2023. History of anaphylaxis or hypersensitivity upon receiving IV antibody infusions, any componenets of the intervention, prescription or non-prescription drugs, or food products in the past. Pregnant, breastfeeding, or unwilling to practice birth control abide by the contraception requirements outlined in the inclusion criteria. Participation in a clinical trial with receipt of an investigational product within 28 days or 5 half-lives (whichever is longer) prior to Day 0. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AER002<br>AER002 1200mg administered once by IV | Drug: AER002<br>* Intravenous infusion of AER002<br>|
| Placebo Comparator: Placebo<br>Placebo administered once by IV | Other: Placebo<br>* Placebo infusion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Patient-Reported Outcomes Measurement Information System (PROMIS)-29 Score from Baseline. | This measure will evaluate whether there is a difference between treatment with AER002 versus placebo on the PROMIS-29 scale between baseline and 3 months post-infusion. PROMIS-29 is a validated scale assessing physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social activities, and pain. Each domain is scored on a 5-point scale (without any difficulty, with a little difficulty, with some difficulty, with much difficulty, unable to do). | Baseline and 3 months post-infusion. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COVID-19, Long COVID, Post-acute Sequelae of SARS-CoV-2 infection