Randomized, Controlled Study of IFX-1 in Patients With Severe COVID-19 Pneumonia

NCT ID: NCT04333420

Last Updated: 2023-06-05

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

399 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-31

Study Completion Date

2021-12-01

Brief Summary

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Phase II \& Phase III:

This is a pragmatic, adaptive, randomized, multicenter phase II/III study evaluating IFX-1 for the treatment of COVID-19 related severe pneumonia. The study consists of two parts: Phase II, an open-label, randomized, 2-arm phase evaluating best supportive care (BSC) + IFX-1 (Arm A) and BSC alone (Arm B); and Phase III, a double-blind, placebo-controlled, randomized phase comparing standard of care (SOC) + IFX-1 (Arm A) versus SOC + placebo-to-match (Arm B)

Detailed Description

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The phase II and Phase III portions enrolled patients subsequently.

1st patient was enrolled in the phase III portion on 1st October 2020.

Conditions

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Severe COVID-19 Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two phases with 2 parallel arms each
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Phase II: Open label study (30 patients), Phase III: Double- blind (360 patients)

Study Groups

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Phase II: IFX-1 + BSC

Phase II study part: IFX-1: 800mg intravenously administered, BSC: Best supportive care

Group Type EXPERIMENTAL

IFX-1 + BSC

Intervention Type DRUG

Phase II study part: IFX-1 + BSC

Phase II: BSC

Phase II study part: BSC: Best supportive care

Group Type OTHER

BSC

Intervention Type DRUG

Phase II study part: BSC

Phase III: IFX-1 + SOC

Phase III study part: IFX-1: 800mg intravenously administered, SOC: Standard of care

Group Type EXPERIMENTAL

IFX-1 + SOC

Intervention Type DRUG

Phase III study part: IFX-1 + SOC

Phase III: Placebo + SOC

Phase III study part: Placebo: placebo infusion intravenously administered, SOC: Standard of care

Group Type PLACEBO_COMPARATOR

Placebo + SOC

Intervention Type DRUG

Phase III study part: Placebo + SOC

Interventions

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IFX-1 + BSC

Phase II study part: IFX-1 + BSC

Intervention Type DRUG

BSC

Phase II study part: BSC

Intervention Type DRUG

IFX-1 + SOC

Phase III study part: IFX-1 + SOC

Intervention Type DRUG

Placebo + SOC

Phase III study part: Placebo + SOC

Intervention Type DRUG

Other Intervention Names

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Vilobelimab + Best Supportive Care Best Supportive Care Vilobelimab + Standard of Care Placebo + Standard of Care

Eligibility Criteria

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Inclusion Criteria

* At least 18 years of age or older
* Clinically evident or otherwise confirmed severe pneumonia
* SARS-CoV-2 infection confirmation (tested positive in last 14 days before randomization with locally available test system)


* At least 18 years of age or older
* Patient on invasive mechanical ventilation (but not more than 48h post intubation at time point of first IMP administration)
* Patients with a PaO2 / FiO2 ratio of \< 200 and \> 60 at randomization (one representative measurement within 6h before randomization)
* SARS-CoV-2 infection confirmation (tested positive in last 14 days before randomization with locally available test system)

Exclusion Criteria

* Known history of progressed COPD as evidenced by use of daily maintenance treatment with long-acting bronchodilators or inhaled/oral corticosteroids for \> 2 months
* Patient moribund or expected to die in next 24h according to the judgment of the investigator
* Known severe congestive heart failure (New York Heart Association \[NYHA\] Class III- IV)
* Received organ or bone marrow transplantation in past 3 months
* Known cardio-pulmonary mechanical resuscitation in past 14 days

Phase III:


* Intubated \> 48 h at time point of first IMP administration
* Expected stop of invasive ventilation or expected extubation in the next 24h without additional intervention according to judgment of the investigator
* Known history of chronic dialysis OR received renal replacement therapy in past 14 days OR anticipated to receive renal replacement therapy within 24h after randomization
* Known history of progressed COPD as evidenced by use of daily maintenance treatment with long-acting bronchodilators or inhaled/oral corticosteroids for \> 2 months
* Treatment of COVID-19 with investigational antibody treatment(s) which are not approved or not included in locally adopted treatment guidelines (e.g., WHO guidance, National Institutes of Health \[NIH\] COVID-19 treatment guidelines) for this indication in the past 7 days (Note: Antibody treatment\[s\] given within past 7 days for pre-existing diseases, other than COVID-19, are allowed.)
* At time point of randomization, treatment of COVID-19 with investigational treatments which are not approved or not included in locally adopted treatment guidelines for this indication (e.g., WHO guidance, NIH COVID-19 treatment guidelines), including SARS-CoV-2 multiplication inhibitor(s) or immunomodulator(s). (Note: If a locally adopted treatment guideline recommends drugs such as remdesivir, dexamethasone, or anticoagulation, this would be allowed. Adopted guidelines and updates must be documented at study initiation and throughout the conduct of the study.)
* Received cytokine adsorption therapy in past 3 days
* Known severe congestive heart failure (corresponding to e.g. NYHA Class III-IV, left ventricular ejection fraction \<40%)
* Known history of chronic liver disease (Child-Pugh B or C)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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InflaRx GmbH

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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A Vlaar, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Amsterdam

Locations

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InflaRx Site #1107

Aalst, , Belgium

Site Status

InflaRx Site #1102

Brussels, , Belgium

Site Status

InflaRx Site #1104

Leuven, , Belgium

Site Status

InflaRx Site #1106

Lodelinsart, , Belgium

Site Status

InflaRx Site #1101

Yvoir, , Belgium

Site Status

InflaRx Site #0301

Belo Horizonte, , Brazil

Site Status

InflaRx Site #0302

Campinas, , Brazil

Site Status

InflaRx Site #0305

Criciúma, , Brazil

Site Status

InflaRx Site #0308

Curitiba, , Brazil

Site Status

InflaRx Site #0304

Porto Alegre, , Brazil

Site Status

InflaRx Site #0303

São José, , Brazil

Site Status

InflaRx Site #0306

São Paulo, , Brazil

Site Status

InflaRx Site #1011

Grenoble, , France

Site Status

InflaRx Site #1005

Nantes, , France

Site Status

InflaRx Site #1009

Nantes, , France

Site Status

InflaRx Site #1003

Nice, , France

Site Status

InflaRx Site #1001

Paris, , France

Site Status

InflaRx Site #1004

Paris, , France

Site Status

InflaRx Site #1006

Paris, , France

Site Status

InflaRx Site #1008

Paris, , France

Site Status

InflaRx Site #1012

Saint-Etienne, , France

Site Status

InflaRx Site #1002

Suresnes, , France

Site Status

InflaRx Site #0201

Aachen, , Germany

Site Status

InflaRx Site #0207

Augsburg, , Germany

Site Status

InflaRx Site #0202

Berlin, , Germany

Site Status

InflaRx Site #0208

Dresden, , Germany

Site Status

InflaRx Site #0204

Essen, , Germany

Site Status

InflaRx Site #0203

Greifswald, , Germany

Site Status

InflaRx Site #0205

Hanover, , Germany

Site Status

InflaRx Site #0206

Jena, , Germany

Site Status

InflaRx Site #0502

Chihuahua City, , Mexico

Site Status

InflaRx Site #0503

Culiacán, , Mexico

Site Status

InflaRx Site #0506

Mérida, , Mexico

Site Status

InflaRx Site #0504

Monterrey, , Mexico

Site Status

InflaRx Site #0501

Nuevo León, , Mexico

Site Status

InflaRx Site #0505

Veracruz, , Mexico

Site Status

InflaRx Site #0101

Amsterdam, , Netherlands

Site Status

InflaRx Site #0103

Amsterdam, , Netherlands

Site Status

InflaRx Site #0106

Eindhoven, , Netherlands

Site Status

InflaRx Site #0104

Enschede, , Netherlands

Site Status

InflaRx Site #0102

Maastricht, , Netherlands

Site Status

InflaRx Site #0601

Callao, , Peru

Site Status

InflaRx Site #0603

Lima, , Peru

Site Status

InflaRx Site #0604

Lima, , Peru

Site Status

InflaRx Site #0701

Barnaul, , Russia

Site Status

InflaRx Site #0704

Moscow, , Russia

Site Status

InflaRx Site #0702

Ryazan, , Russia

Site Status

InflaRx Site # 0804

Somerset West, , South Africa

Site Status

Countries

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Belgium Brazil France Germany Mexico Netherlands Peru Russia South Africa

References

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van Amstel RBE, Slim MA, Lim EHT, Ruckinger S, Seymour CW, Burnett BP, Bos LDJ, van Vught LA, Riedemann NC, van de Beek D, Vlaar APJ; PANAMO Study Group. Heterogeneity of treatment effect of vilobelimab in COVID-19: a secondary analysis of a randomised controlled trial. Crit Care. 2024 Jun 28;28(1):210. doi: 10.1186/s13054-024-05004-z.

Reference Type DERIVED
PMID: 38943192 (View on PubMed)

Lim EHT, Vlaar APJ, de Bruin S, Ruckinger S, Thielert C, Habel M, Guo R, Burnett BP, Dickinson J, Brouwer MC, Riedemann NC, van de Beek D; PANAMO study group. Pharmacokinetic analysis of vilobelimab, anaphylatoxin C5a and antidrug antibodies in PANAMO: a phase 3 study in critically ill, invasively mechanically ventilated COVID-19 patients. Intensive Care Med Exp. 2023 Jun 19;11(1):37. doi: 10.1186/s40635-023-00520-8.

Reference Type DERIVED
PMID: 37332066 (View on PubMed)

Vlaar APJ, Witzenrath M, van Paassen P, Heunks LMA, Mourvillier B, de Bruin S, Lim EHT, Brouwer MC, Tuinman PR, Saraiva JFK, Marx G, Lobo SM, Boldo R, Simon-Campos JA, Cornet AD, Grebenyuk A, Engelbrecht JM, Mukansi M, Jorens PG, Zerbib R, Ruckinger S, Pilz K, Guo R, van de Beek D, Riedemann NC; PANAMO study group. Anti-C5a antibody (vilobelimab) therapy for critically ill, invasively mechanically ventilated patients with COVID-19 (PANAMO): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Respir Med. 2022 Dec;10(12):1137-1146. doi: 10.1016/S2213-2600(22)00297-1. Epub 2022 Sep 7.

Reference Type DERIVED
PMID: 36087611 (View on PubMed)

Vlaar APJ, Lim EHT, de Bruin S, Ruckinger S, Pilz K, Brouwer MC, Guo RF, Heunks LMA, Busch MH, van Paassen P, Riedemann NC, van de Beek D. The anti-C5a antibody vilobelimab efficiently inhibits C5a in patients with severe COVID-19. Clin Transl Sci. 2022 Apr;15(4):854-858. doi: 10.1111/cts.13213. Epub 2022 Jan 14.

Reference Type DERIVED
PMID: 35029045 (View on PubMed)

Kreuzberger N, Hirsch C, Chai KL, Tomlinson E, Khosravi Z, Popp M, Neidhardt M, Piechotta V, Salomon S, Valk SJ, Monsef I, Schmaderer C, Wood EM, So-Osman C, Roberts DJ, McQuilten Z, Estcourt LJ, Skoetz N. SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19. Cochrane Database Syst Rev. 2021 Sep 2;9(9):CD013825. doi: 10.1002/14651858.CD013825.pub2.

Reference Type DERIVED
PMID: 34473343 (View on PubMed)

Vlaar APJ, de Bruin S, Busch M, Timmermans SAMEG, van Zeggeren IE, Koning R, Ter Horst L, Bulle EB, van Baarle FEHP, van de Poll MCG, Kemper EM, van der Horst ICC, Schultz MJ, Horn J, Paulus F, Bos LD, Wiersinga WJ, Witzenrath M, Rueckinger S, Pilz K, Brouwer MC, Guo RF, Heunks L, van Paassen P, Riedemann NC, van de Beek D. Anti-C5a antibody IFX-1 (vilobelimab) treatment versus best supportive care for patients with severe COVID-19 (PANAMO): an exploratory, open-label, phase 2 randomised controlled trial. Lancet Rheumatol. 2020 Dec;2(12):e764-e773. doi: 10.1016/S2665-9913(20)30341-6. Epub 2020 Sep 28.

Reference Type DERIVED
PMID: 33015643 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2020-001335-28

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

IFX-1-P2.9

Identifier Type: -

Identifier Source: org_study_id

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