Clinical trial NCT04723394: Phase III Study of AZD7442 for Treatment of COVID-19 in Outpatient Adults
Official title: A Phase III Randomized, Double-blind, Placebo-controlled, Multicenter Study to Determine the Safety and Efficacy of AZD7442 for the Treatment of COVID-19 in Non-hospitalized Adults
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: COVID-19
Keywords: Treatment of COVID-19
Lead sponsor: AstraZeneca
Sponsor class: INDUSTRY
First posted: 2021-01-25
Enrollment: 910
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This Phase III study will assess whether AZD7442 (a combination of 2 mAbs) can safely treat outpatient adults with COVID-19 and prevent either severe COVID-19 or death.

Detailed description: A novel coronavirus, SARS-CoV-2, first emerged in China in November 2019 causing cases of atypical pneumonia. As of 6 October 2020, the virus has spread to all corners of the globe, with over 35 million confirmed cases reported and more than one million associated deaths according to the WHO. The COVID-19 pandemic is causing major disruption to global healthcare systems with significant socioeconomic impacts. Effective interventions to prevent or treat COVID-19 remain few in number and clinical experience is limited.

There is an urgent need to rapidly evaluate treatments in the non-hospitalized setting to prevent progression and reduce serious complications of COVID-19, as well as its transmission.

As a response to the ongoing pandemic, AstraZeneca is developing mAbs to the SARS-CoV-2 spike protein. The SARS-CoV-2 spike protein contains the virus's RBD, which enables the virus to bind to receptors on human cells. By targeting this region of the virus's spike protein, antibodies can block the virus's attachment to human cells, and, therefore, is expected to block infection. Amino acid substitutions have been introduced into the antibodies to both extend their half-lives, which should prolong their potential prophylactic benefit, and decrease Fc effector function in order to decrease the potential risk of antibody-dependent enhancement of disease.

AZD7442, a combination of 2 of these mAbs (AZD8895 and AZD1061), is being evaluated for administration to treat or prevent COVID-19. There are currently one ongoing Phase I study and two ongoing Phase III studies with AZD7442, in addition to this treatment study.

Enrollment of up to approximately 1700 participants is planned.

Eligibility criteria: Inclusion Criteria:

1. Participant has a documented laboratory-confirmed SARS-CoV-2 infection, as determined by a molecular test (antigen or nucleic acid) from any respiratory tract specimen (eg, oropharyngeal, NP, or nasal swab, or saliva) collected ≤ 3 days prior to Day 1.
2. WHO Clinical Progression Scale score \> 1 and \< 4.
3. Participant must be dosed with IMP no more than 7 days from self-reported onset of COVID-19-related symptoms (mild to moderate COVID-19) or measured fever, defined as the self-reported date of first reported sign/symptom.
4. One or more of the following signs/symptoms must be present within 24 hours prior to Day1: Cough, Sore throat, Shortness of breath or difficulty breathing at rest or with activity, Body pain or muscle pain/aches, Fatigue, Headache, Chills, Nasal obstruction or congestion, Nasal discharge, Nausea or vomiting, Diarrhea, New loss of taste or smell.
5. Oxygenation saturation of ≥ 92% obtained at rest by study staff within 24 hours prior to Day 1 (unless participant regularly receives chronic supplementary oxygen for an underlying lung condition).
6. Participant agrees not to participate in another clinical trial for the treatment of COVID-19 or SARS-CoV-2 during the study period until reaching hospitalization or 28 days after entry into the study (whichever is earliest).
7. Participant must be ≥ 18 years of age, provide informed consent and is able to comply with study requirements/procedures.
8. Male participants: Contraception for male participants is not required; however, to avoid the transfer of any fluids, all male participants must use a condom from Day 1 and agree to continue through 90 days following administration of IMP.
9. Women of childbearing potential must use one highly effective form of birth control.

Exclusion Criteria:

1. History or current hospitalization for COVID-19.
2. Current need for hospitalization/immediate medical attention in a clinic/emergency room service
3. Previous hypersensitivity, infusion related reaction, or adverse reaction to any monoclonal antibodies or known allergy to components of the IMP or placebo.
4. Receipt of any investigational or licensed vaccine for prevention of COVID-19 at any time prior to entry into this study or expected administration immediately after enrollment.
5. Current requirement or anticipated impending need for mechanical ventilation.
6. Any significant disease, disorder or finding that may increase risk to the participant that might affect his/her ability to participate in this study.
7. Received convalescent COVID-19 plasma treatment any time prior to entry into this study.
8. Receipt of systemic steroids (e.g., prednisone, dexamethasone) or inhaled steroids within 30 days prior to study entry, unless a stable dose is used for a chronic condition.
9. Receipt of any IMP in the previous 90 days or 5 half lives (whichever is longer), or expected receipt of IMP during the study follow-up period, or concurrent participation in another interventional study.
10. Pregnant or breastfeeding women.

Primary outcomes:
measure: A Composite of Either Severe COVID-19 or Death From Any Cause Through Day 29
timeFrame: Baseline (Day 1) and Day 29
Secondary outcomes:
measure: A Composite of Death From Any Cause or Hospitalization for COVID-19 Complications or Sequelae Through Day 169
timeFrame: Baseline (Day 1) and Day 169
Other outcomes:
Locations:
city: Jasper
country: United States
facility: Research Site
state: Alabama
city: Tucson
country: United States
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state: Arizona
city: Long Beach
country: United States
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state: California
city: Northridge
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state: California
city: Cutler Bay
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state: Florida
city: Miami
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state: Florida
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city: Chicago
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state: Illinois
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state: Louisiana
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state: Missouri
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state: Nebraska
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state: North Carolina
city: Charlotte
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state: Ohio
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city: Humble
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city: Buenos Aires
country: Argentina
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country: Argentina
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city: Munro
country: Argentina
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country: Brazil
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country: Brazil
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city: Ribeirão Preto
country: Brazil
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city: Sorocaba
country: Brazil
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city: São Paulo
country: Brazil
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city: Hradec Kralove
country: Czechia
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city: Kolin
country: Czechia
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city: Svitavy
country: Czechia
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city: Berlin - Friedrichshain
country: Germany
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city: Berlin
country: Germany
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city: Berlin
country: Germany
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city: Frankfurt/Main
country: Germany
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city: Frankfurt
country: Germany
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city: Hamburg
country: Germany
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city: Hannover
country: Germany
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city: Koblenz
country: Germany
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city: Köln
country: Germany
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city: Mainz
country: Germany
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city: München-Pasing
country: Germany
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city: München
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city: Debrecen
country: Hungary
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city: Gyöngyös
country: Hungary
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city: Guastalla
country: Italy
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city: Milano
country: Italy
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city: Piacenza
country: Italy
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city: Pisa
country: Italy
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city: Roma
country: Italy
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city: Chiba-shi
country: Japan
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city: Hachioji-shi
country: Japan
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city: Iruma-Gun
country: Japan
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city: Kyoto-shi
country: Japan
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city: Maebashi-shi
country: Japan
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city: Narita-shi
country: Japan
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city: Sendai-shi
country: Japan
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city: Shinagawa-ku
country: Japan
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city: Shinagawa-ku
country: Japan
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city: Shinjuku-ku
country: Japan
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city: Chihuahua
country: Mexico
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city: Cuauhtemoc
country: Mexico
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city: Cuautitlan Izcalli
country: Mexico
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city: Ecatepec de Morelos
country: Mexico
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city: Guadalajara
country: Mexico
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city: Guadalajara
country: Mexico
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city: Mazatlán
country: Mexico
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country: Mexico
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country: Mexico
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country: Mexico
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city: Lima
country: Peru
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country: Poland
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country: Poland
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city: Moscow
country: Russian Federation
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city: Murmansk
country: Russian Federation
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city: Saint-Petersburg
country: Russian Federation
facility: Research Site
city: Saint-Petersburg
country: Russian Federation
facility: Research Site
city: Saint-Petersburg
country: Russian Federation
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city: Saint-Petersburg
country: Russian Federation
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city: Saint-Petersburg
country: Russian Federation
facility: Research Site
city: Cabra
country: Spain
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city: Centelles (Barcelona)
country: Spain
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city: Girona
country: Spain
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city: Madrid
country: Spain
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city: Málaga
country: Spain
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city: Dnipro
country: Ukraine
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city: Ivano-Frankivsk
country: Ukraine
facility: Research Site
city: Kherson
country: Ukraine
facility: Research Site
city: Blackpool
country: United Kingdom
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city: Bracknell
country: United Kingdom
facility: Research Site
city: Bristol
country: United Kingdom
facility: Research Site
city: Cambridge
country: United Kingdom
facility: Research Site
city: Connor Downs
country: United Kingdom
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city: Highgate
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facility: Research Site
city: Leicester
country: United Kingdom
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city: Preston
country: United Kingdom
facility: Research Site
city: Rochdale
country: United Kingdom
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Study officials:
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