Chloroquine Diphosphate for the Treatment of Severe Acute Respiratory Syndrome Secondary to SARS-CoV2

NCT ID: NCT04323527

Last Updated: 2021-08-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

278 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-23

Study Completion Date

2020-06-07

Brief Summary

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In December 2019, the Municipal Health Committee of Wuhan, China, identified an outbreak of viral pneumonia of unknown cause. This new coronavirus was called SARS-CoV-2 and the disease caused by that virus, COVID-19. Recent numbers show that 222,643 infections have been diagnosed with 9115 deaths, worldwide. Currently, there are no approved therapeutic agents available for coronaviruses. In this scenario, the situation of a global public health emergency and evidence about the potential positive effect of chloroquine (CQ) in most coronaviruses, including SARS-CoV-1, and recent data on small trials on SARS-CoV-2, the investigators intend to investigate the efficacy and the safety of CQ diphosphate in the treatment of hospitalized patients with severe acute respiratory syndrome in the scenario of SARS-CoV2. Preliminary in vitro studies and uncontrolled trials with low number of patients of CQ repositioning in the treatment of COVID-19 have been encouraging. The main hypothesis is that CQ diphosphate will reduce mortality in 50% in those with severe acute respiratory syndrome infected by the SARS-COV2. Therefore, the main objective is to assess whether the use of chloroquine diphosphate reduces mortality by 50% in the study population. The primary outcome is mortality in day 28 of follow-up. According to local contingency plan, developed by local government for COVID-19 in the State of Amazonas, the Hospital Pronto-Socorro Delphina Aziz, located in Manaus, is the reference unit for the admission of serious cases of the new virus. The unit currently has 50 ICU beds, with the possibility of expanding to 335 beds, if needed. The hospital also has trained multiprofessional human resources and adequate infrastructure. In total, 440 participants (220 per arm) will receive either high dose chloroquine 600 mg bid regime (4x150 mg tablets, every 12 hours, D1-D10) or low dose chloroquine 450mg bid regime (3x150mg tablets + 1 placebo tablet every 12 hours on D1, 3x150mg tablets + 1 placebo followed by 4 placebo tablets 12h later from D2 to D5, and 4 placebo tablets every 12 hours, D6-D10). Placebo tablets were used to standardize treatment duration and blind research team and patients. All drugs administered orally (or via nasogastric tube in case of orotracheal intubation). Both intervention and placebo drugs will be produced by Farmanguinhos. Clinical and laboratory data during hospitalization will be used to assess efficacy and safety outcomes.

Detailed Description

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Conditions

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SARS-CoV Infection Severe Acute Respiratory Syndrome (SARS) Pneumonia

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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Low Dose Chloroquine Diphosphate (5 days) (Study stage 1) - Clorocovid 1

Low dose chloroquine group consists of 450 mg bid (3 tablets of 150 mg + 1 placebo tablet, every 12 hours) on D1, 3x150mg tablets + 1 placebo followed by 4 placebo tablets 12h later from D2 to D5, and 4 placebo tablets every 12 hours, D6-D10 . Oral administration or via nasogastric tube in case of orotracheal intubation. (this was the first stage of the original study and was approved by the Brazilian IRB on 23/March/2020).

Group Type ACTIVE_COMPARATOR

Chloroquine diphosphate

Intervention Type DRUG

150mg chloroquine diphosphate tablets. Note: Tablets used in the study were Chloroquine Diphosphate (produced by Farmanguinhos/Fiocruz), and the dosing stated in the clinicaltrials.gov refers to chloroquine base (in mg).

High Dose Chloroquine Diphosphate (10 days) (Study stage 1) - Clorocovid 1

High dose chloroquine group consists of 600 mg bid (4 tablets of 150 mg, every 12 hours) for 10 days. Oral administration or via nasogastric tube in case of orotracheal intubation. (this was the first stage of the original study and was approved by the Brazilian IRB on 23/March/2020).

Group Type ACTIVE_COMPARATOR

Chloroquine diphosphate

Intervention Type DRUG

150mg chloroquine diphosphate tablets. Note: Tablets used in the study were Chloroquine Diphosphate (produced by Farmanguinhos/Fiocruz), and the dosing stated in the clinicaltrials.gov refers to chloroquine base (in mg).

Placebo (5 days) (Study stage 2) - Clorocovid 3

Placebo group consists of 3 placebo tablets bid (day 1), and 3 placebo tablets once daily from D2 to D5. Oral administration or via a nasogastric tube in case of orotracheal intubation. (this was a second stage of the original study and was approved by the Brazilian IRB on 03/May/2020).

Group Type PLACEBO_COMPARATOR

Chloroquine diphosphate

Intervention Type DRUG

150mg chloroquine diphosphate tablets. Note: Tablets used in the study were Chloroquine Diphosphate (produced by Farmanguinhos/Fiocruz), and the dosing stated in the clinicaltrials.gov refers to chloroquine base (in mg).

Low Dose Chloroquine Diphosphate (5 days) (Study stage 2) - Clorocovid 3

Low dose chloroquine group consisted of 450 mg bid (3 tablets of 150 mg) on D1, and 3x150mg tablet once daily from D2 to D5. Oral administration or via a nasogastric tube in case of orotracheal intubation. (this was a second stage of the original study and was approved by the Brazilian IRB on 03/May/2020).

Group Type ACTIVE_COMPARATOR

Chloroquine diphosphate

Intervention Type DRUG

150mg chloroquine diphosphate tablets. Note: Tablets used in the study were Chloroquine Diphosphate (produced by Farmanguinhos/Fiocruz), and the dosing stated in the clinicaltrials.gov refers to chloroquine base (in mg).

Interventions

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Chloroquine diphosphate

150mg chloroquine diphosphate tablets. Note: Tablets used in the study were Chloroquine Diphosphate (produced by Farmanguinhos/Fiocruz), and the dosing stated in the clinicaltrials.gov refers to chloroquine base (in mg).

Intervention Type DRUG

Other Intervention Names

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chloroquine

Eligibility Criteria

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Inclusion Criteria

1. Male and female participants aged over 18 years old
2. Hospitalized
3. presenting:

* respiratory rate higher than 24 breathing incursions per minute AND/OR
* heart rate higher than 125 beats per minute (in the absence of fever) AND/OR
* peripheral oxygen saturation lower than 90% in ambient air AND/OR
* shock (defined as mean arterial pressure less than 65 mmHg, requiring vasopressor or oliguria or lowering level of consciousness)

Exclusion Criteria

• None.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Marcus Vinícius Guimarães de Lacerda

UNKNOWN

Sponsor Role collaborator

Mayla Gabriela Silva Borba

UNKNOWN

Sponsor Role collaborator

Wuelton Marcelo Monteiro

UNKNOWN

Sponsor Role collaborator

Gisely Cardoso de Melo

UNKNOWN

Sponsor Role collaborator

Fernando Fonseca de Almeida e Val

UNKNOWN

Sponsor Role collaborator

Felipe Gomes Naveca

UNKNOWN

Sponsor Role collaborator

Maria Paula Gomes Mourão

UNKNOWN

Sponsor Role collaborator

Ludmila Abrahão Hajjar

UNKNOWN

Sponsor Role collaborator

Jorge Souza Mendonça

UNKNOWN

Sponsor Role collaborator

Fundação de Medicina Tropical Dr. Heitor Vieira Dourado

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hospital e Pronto Socorro Delphina Rinaldi Abdel Aziz

Manaus, Amazonas, Brazil

Site Status

Countries

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Brazil

References

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Erratum: Correlation between clinical and pathological findings of liver injury in 27 patients with lethal COVID-19 infections in Brazil. Hepatol Commun. 2024 Jun 27;8(7):e0492. doi: 10.1097/HC9.0000000000000492. eCollection 2024 Jul 1. No abstract available.

Reference Type DERIVED
PMID: 38934714 (View on PubMed)

Borba MGS, Val FFA, Sampaio VS, Alexandre MAA, Melo GC, Brito M, Mourao MPG, Brito-Sousa JD, Baia-da-Silva D, Guerra MVF, Hajjar LA, Pinto RC, Balieiro AAS, Pacheco AGF, Santos JDO Jr, Naveca FG, Xavier MS, Siqueira AM, Schwarzbold A, Croda J, Nogueira ML, Romero GAS, Bassat Q, Fontes CJ, Albuquerque BC, Daniel-Ribeiro CT, Monteiro WM, Lacerda MVG; CloroCovid-19 Team. Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial. JAMA Netw Open. 2020 Apr 24;3(4):e208857. doi: 10.1001/jamanetworkopen.2020.8857.

Reference Type DERIVED
PMID: 32330277 (View on PubMed)

Other Identifiers

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CAAE: 30152620.1.0000.0005

Identifier Type: -

Identifier Source: org_study_id

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