Losartan for Patients With COVID-19 Requiring Hospitalization

NCT ID: NCT04312009

Last Updated: 2022-06-29

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

205 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-04-13

Study Completion Date

2021-02-01

Brief Summary

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This is a multi-center, double-blinded study of COVID-19 infected patients requiring inpatient hospital admission randomized 1:1 to daily Losartan or placebo for 7 days or hospital discharge.

Detailed Description

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Conditions

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Corona Virus Infection Acute Respiratory Distress Syndrome SARS-CoV Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Losartan

Participants in this arm will receive the study drug, Losartan.

Group Type EXPERIMENTAL

Losartan

Intervention Type DRUG

Losartan; 50 mg daily; oral administration

Placebo

Participants in this arm will receive a placebo treatment.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo (microcrystalline methylcellulose, gelatin capsule); oral administration

Interventions

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Losartan

Losartan; 50 mg daily; oral administration

Intervention Type DRUG

Placebo

Placebo (microcrystalline methylcellulose, gelatin capsule); oral administration

Intervention Type OTHER

Other Intervention Names

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Cozaar

Eligibility Criteria

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Inclusion Criteria

* Presumptive positive laboratory test for Covid-19 based on local laboratory standard
* Age greater than or equal to 18 years of age
* Admission to the hospital with a respiratory SOFA \>=1 and increased oxygen requirement compared to baseline among those on home O2
* Randomization within 48 hours of presentation of hospital admission or within 48 hours of a positive test result, whichever is later

Exclusion Criteria

* Randomization \> 48 hours of admission order or positive test result, whichever is later
* Currently taking an angiotensin converting enzyme inhibitor (ACEi) or Angiotensin receptor blocker (ARB)
* Prior reaction or intolerance to an ARB or ACE inhibitor, including but not limited to angioedema
* Pregnant or breastfeeding
* Lack of negative urine or serum pregnancy test
* Not currently taking a protocol allowed version of contraception: intrauterine device, Depo-formulation of hormonal contraception (e.g. medroxyprogesterone acetate / Depo-Provera), subcutaneous contraceptive (e.g. Nexplanon), daily oral contraceptives with verbalized commitment to taking daily throughout the study period; use of condoms or agree to abstain from sexual intercourse during the study. All women of child bearing age enrolled in this fashion will be informed of the teratogenic risks. If enrolled under LAR, they will be informed of the risks after regaining capacity.
* Patient reported history or electronic medical record history of kidney disease, defined as:

1. Any history of dialysis
2. History of chronic kidney disease stage IV
3. Estimated Glomerular Filtration Rate (eGFR) of \< 30ml/min/1.73 m2 at the time of randomization
* Severe dehydration at the time of enrollment in the opinion of the investigator or bedside clinician
* Most recent mean arterial blood pressure prior to enrollment \<65 mmHg
* Patient reported history or electronic medical record history of severe liver disease, defined as:

1. Cirrhosis
2. History of hepatitis B or C
3. Documented AST or ALT \> 3 times the upper limit of normal measured within 24 hours prior to randomization
* Potassium \>5.0 within 24 hours prior to randomization unless a repeat value was \<=5.0
* Treatment with aliskiren
* Inability to obtain informed consent from participant or legally authorized representative
* Enrollment in another blinded randomized clinical trial for COVID
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bill and Melinda Gates Foundation

OTHER

Sponsor Role collaborator

University of Minnesota

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christopher Tignanelli, MD

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota

Michael Puskarich, MD, MS

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota

Locations

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University of Florida Health Gainesville

Gainesville, Florida, United States

Site Status

University of Florida Health Jacksonville

Jacksonville, Florida, United States

Site Status

Grady Memorial Hospital

Atlanta, Georgia, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

M Health Fairview Ridges Hospital

Burnsville, Minnesota, United States

Site Status

M Health Fairview Southdale Hospital

Edina, Minnesota, United States

Site Status

Hennepin County Medical Center

Minneapolis, Minnesota, United States

Site Status

M Health Fairview University of Minnesota Medical Center

Minneapolis, Minnesota, United States

Site Status

University of Minnesota

Minneapolis, Minnesota, United States

Site Status

North Memorial Health Hospital

Robbinsdale, Minnesota, United States

Site Status

University of Mississippi Medical Center

Jackson, Mississippi, United States

Site Status

Cooper University Hospital

Camden, New Jersey, United States

Site Status

University of Cincinnati Medical Center

Cincinnati, Ohio, United States

Site Status

Countries

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United States

References

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Puskarich MA, Ingraham NE, Merck LH, Driver BE, Wacker DA, Black LP, Jones AE, Fletcher CV, South AM, Murray TA, Lewandowski C, Farhat J, Benoit JL, Biros MH, Cherabuddi K, Chipman JG, Schacker TW, Guirgis FW, Voelker HT, Koopmeiners JS, Tignanelli CJ; Angiotensin Receptor Blocker Based Lung Protective Strategies for Inpatients With COVID-19 (ALPS-IP) Investigators. Efficacy of Losartan in Hospitalized Patients With COVID-19-Induced Lung Injury: A Randomized Clinical Trial. JAMA Netw Open. 2022 Mar 1;5(3):e222735. doi: 10.1001/jamanetworkopen.2022.2735.

Reference Type DERIVED
PMID: 35294537 (View on PubMed)

Smolander J, Bruchfeld A. [COVID-19 and kidney disease]. Lakartidningen. 2020 Jul 13;117:20110. Swedish.

Reference Type DERIVED
PMID: 32658300 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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INV-017069

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

SURG-2020-28675

Identifier Type: -

Identifier Source: org_study_id

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