Status:

UNKNOWN

A Trial Using ANAKINRA, TOCILIZUMAB Alone or in Association With RUXOLITINIB in Severe Stage 2b and 3 of COVID19-associated Disease

Lead Sponsor:

Assistance Publique Hopitaux De Marseille

Conditions:

Covid19

Eligibility:

All Genders

18-75 years

Phase:

PHASE3

Brief Summary

COVID19-associated disease may have different clinical aspects classified in 3 stages. Some patients initially presenting with a non-hypoxemic viral pneumonia (stage 2a) may evolve toward a more sever...

Eligibility Criteria

Inclusion

  • Patients older than 18 year up to 75 year-old maximum
  • Eligible for resuscitation care in UCI
  • with proven infection with COVID-19, using at least one positive pharyngeal polymerase chain reaction (PCR) test
  • COVID19 infection pneumonia at
  • Stage 2b: Hypoxemic pneumonia (respiratory rate \>30/min, Sat O2\<90 mm Hg in ambient air) associated with a marked biological inflammatory syndrome (CRP\>150mg/l) - or Stage 3: ARDS defined by a mechanically ventilated patient with a PaO2/FiO2 ratio \< 300 for more than 24 hours.
  • or Advanced Stage 3: moderate to severe ARDS (PaO2/FiO2 \< 200 to PEEP of at least 8 cmH2O) on invasive mechanical ventilation associated with another organ failure or syndrome among : 1) Shock with norepinephrine dosage \> 3 mg/hour, 2) Acute renal oligo-anuric failure or requiring extra-renal lavage, 3) Hepatocellular failure or coagulopathy with factor V \< 50%, 4) Myocarditis causing acute heart failure and/or shock. , 5) Hemophagocytic syndrome, 6) Hyperferritinemia \> 5000 ng/mL

Exclusion

  • Patients younger than 18 or older than 75 year-old,
  • Pregnant or breastfeeding woman
  • Patient for whom measures of therapeutic limitations have been issued (non-admission to intensive care unit)
  • Patients treated with immunosuppressant/immunomodulators (Not only the concomitant administration of the following drugs prohibited in the protocol: other JAK inhibitors, corticosteroids, IL6 inhibitors).
  • Patient already included in another interventional therapeutic trial
  • Use of chronic oral corticosteroids \> 10 mg prednisone equivalent per day for non-COVID-19 related disease
  • Uncontrolled autoimmune disease
  • Patients with active, suspected or known active systemic bacterial, viral (excluding COVID-19) or fungal infections that are not controlled (not only HIV, HBV or HCV infection and untreated bacterial or mycotic infection)
  • Patients with severe pre-existing uncontrolled organ dysfunction (heart, liver or kidney failure) not related to COVID-19

Key Trial Info

Start Date :

September 1 2020

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

November 1 2022

Estimated Enrollment :

216 Patients enrolled

Trial Details

Trial ID

NCT04424056

Start Date

September 1 2020

End Date

November 1 2022

Last Update

June 23 2020

Active Locations (1)

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1

Assistance Publique Hôpitaux de Marseille

Marseille, France, 13005