Low Dose Anti-inflammatory Radiotherapy for the Treatment of Pneumonia by COVID-19

NCT ID: NCT04380818

Last Updated: 2021-07-30

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

106 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-05

Study Completion Date

2021-11-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Low radiation doses produce anti-inflammatory effects, which may be useful in the treatment of respiratory complications of COVID-19. This type of treatment is non-invasive and therefore, a priori, it can be used in all types of patients.

Main objective: To evaluate the efficacy of low-dose lung irradiation as an adjunctive treatment in interstitial pneumonia in patients with COVID-19 by improving the PAFI O2 by 20% measured 48h after treatment with respect to the pre baseline measurement. -irradiation.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Study design: This is a prospective multicenter study in 2 phases:

1. Exploratory phase. It will include 10 patients, to assess the feasibility and efficacy of low-dose lung irradiation. If a minimum efficiency of 30% is not achieved, the study will not be continued.
2. Comparative phase in two groups, a control group, which will only receive pharmacological treatment, and an experimental one. It will include 96 patients, the allocation will be 1: 2, that is, 32 in the control arm and 64 in the experimental arm, which will receive low-dose lung irradiation.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pneumonia, Viral

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control group

a control group only receive pharmacological treatment

Group Type ACTIVE_COMPARATOR

Hydroxychloroquine Sulfate

Intervention Type DRUG

200 mg/12h for 5 days

Ritonavir/lopinavir

Intervention Type DRUG

400/100 mg/12h for 7-10 days

Tocilizumab Injection [Actemra]

Intervention Type DRUG

600 mg/day for 1-2 doses

Azithromycin

Intervention Type DRUG

500 mg/24h for 3 days

Corticosteroid

Intervention Type DRUG

Corticosteroids (methylprednisolone/dexamethasone/prednisone)

Low molecular weight heparin

Intervention Type DRUG

low molecular weight heparin (LMWH) in prophylaxis of venous thromboembolism

Oxygen supply

Intervention Type DEVICE

Oxygen

Experimental group

an experimental group will receive low-dose lung irradiation

Group Type EXPERIMENTAL

Low-dose radiotherapy

Intervention Type RADIATION

Bilateral low-dose lung irradiation: 0.5 Gy in a single fraction. Optionally, additional 0.5 Gy fraction 48h later

Hydroxychloroquine Sulfate

Intervention Type DRUG

200 mg/12h for 5 days

Ritonavir/lopinavir

Intervention Type DRUG

400/100 mg/12h for 7-10 days

Tocilizumab Injection [Actemra]

Intervention Type DRUG

600 mg/day for 1-2 doses

Azithromycin

Intervention Type DRUG

500 mg/24h for 3 days

Corticosteroid

Intervention Type DRUG

Corticosteroids (methylprednisolone/dexamethasone/prednisone)

Low molecular weight heparin

Intervention Type DRUG

low molecular weight heparin (LMWH) in prophylaxis of venous thromboembolism

Oxygen supply

Intervention Type DEVICE

Oxygen

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Low-dose radiotherapy

Bilateral low-dose lung irradiation: 0.5 Gy in a single fraction. Optionally, additional 0.5 Gy fraction 48h later

Intervention Type RADIATION

Hydroxychloroquine Sulfate

200 mg/12h for 5 days

Intervention Type DRUG

Ritonavir/lopinavir

400/100 mg/12h for 7-10 days

Intervention Type DRUG

Tocilizumab Injection [Actemra]

600 mg/day for 1-2 doses

Intervention Type DRUG

Azithromycin

500 mg/24h for 3 days

Intervention Type DRUG

Corticosteroid

Corticosteroids (methylprednisolone/dexamethasone/prednisone)

Intervention Type DRUG

Low molecular weight heparin

low molecular weight heparin (LMWH) in prophylaxis of venous thromboembolism

Intervention Type DRUG

Oxygen supply

Oxygen

Intervention Type DEVICE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Dolquine Kaletra Actemra

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age \>=18 years old
* Moderate to severe COVID-19 pneumonia with fewer than 8 days of symptom onset and currently receiving standard medication for COVID-19 at appropriate doses
* PAFIO2 of less than 300 mmHg or SaFI02 \<315 mmHg
* Patients who are not candidates for admission to the Intensive Care Unit due to age, concomitant diseases or general condition.
* One of the following conditions:

* or IL6 greater than 40
* or PCR\> 100mg / l

* D-dimer greater than 1500ng / ml
* Suspected cytokine release syndrome
* Have read the information sheet and signed the informed consent

* Leukopenia \<1000
* Pregnancy
* Not understanding or refusing the purpose of the study

Exclusion Criteria

* Age \<18 years
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hospital Universitario Madrid Sanchinarro

OTHER

Sponsor Role collaborator

Hospital del Mar

OTHER

Sponsor Role collaborator

Hospital Universitari Sant Joan de Reus

OTHER

Sponsor Role collaborator

Grupo de Investigación Clínica en Oncología Radioterapia

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Angel Montero, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitario Madrid Sanchinarro

Manel Algara, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital del Mar

Merirxell Arenas, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitario Sant Joan de Reus

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Hospital Sant Joan de Reus

Reus, Tarragona, Spain

Site Status NOT_YET_RECRUITING

Hospital Del Mar

Barcelona, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitario Madrid Sanchinarro

Madrid, , Spain

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Spain

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

ANGEL MONTERO, Md, PhD

Role: CONTACT

+34667767601

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

MERITXELL ARENAS, MD, PhD

Role: primary

MANEL ALGARA, MD, PhD

Role: primary

Angel Montero, MD, PhD

Role: primary

+34915629949

References

Explore related publications, articles, or registry entries linked to this study.

Conti P, Ronconi G, Caraffa A, Gallenga CE, Ross R, Frydas I, Kritas SK. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies. J Biol Regul Homeost Agents. 2020 March-April,;34(2):327-331. doi: 10.23812/CONTI-E.

Reference Type BACKGROUND
PMID: 32171193 (View on PubMed)

Rodel F, Frey B, Manda K, Hildebrandt G, Hehlgans S, Keilholz L, Seegenschmiedt MH, Gaipl US, Rodel C. Immunomodulatory properties and molecular effects in inflammatory diseases of low-dose x-irradiation. Front Oncol. 2012 Sep 25;2:120. doi: 10.3389/fonc.2012.00120. eCollection 2012.

Reference Type BACKGROUND
PMID: 23057008 (View on PubMed)

Arenas M, Sabater S, Hernandez V, Rovirosa A, Lara PC, Biete A, Panes J. Anti-inflammatory effects of low-dose radiotherapy. Indications, dose, and radiobiological mechanisms involved. Strahlenther Onkol. 2012 Nov;188(11):975-81. doi: 10.1007/s00066-012-0170-8. Epub 2012 Aug 22.

Reference Type BACKGROUND
PMID: 22907572 (View on PubMed)

Arenas M, Gil F, Gironella M, Hernandez V, Biete A, Pique JM, Panes J. Time course of anti-inflammatory effect of low-dose radiotherapy: correlation with TGF-beta(1) expression. Radiother Oncol. 2008 Mar;86(3):399-406. doi: 10.1016/j.radonc.2007.10.032. Epub 2007 Nov 26.

Reference Type BACKGROUND
PMID: 18031855 (View on PubMed)

Lodermann B, Wunderlich R, Frey S, Schorn C, Stangl S, Rodel F, Keilholz L, Fietkau R, Gaipl US, Frey B. Low dose ionising radiation leads to a NF-kappaB dependent decreased secretion of active IL-1beta by activated macrophages with a discontinuous dose-dependency. Int J Radiat Biol. 2012 Oct;88(10):727-34. doi: 10.3109/09553002.2012.689464. Epub 2012 May 22.

Reference Type BACKGROUND
PMID: 22545750 (View on PubMed)

Calabrese EJ, Dhawan G. How radiotherapy was historically used to treat pneumonia: could it be useful today? Yale J Biol Med. 2013 Dec 13;86(4):555-70.

Reference Type BACKGROUND
PMID: 24348219 (View on PubMed)

Calabrese EJ, Dhawan G, Kapoor R, Kozumbo WJ. Radiotherapy treatment of human inflammatory diseases and conditions: Optimal dose. Hum Exp Toxicol. 2019 Aug;38(8):888-898. doi: 10.1177/0960327119846925. Epub 2019 May 6.

Reference Type BACKGROUND
PMID: 31060383 (View on PubMed)

Kirkby C, Mackenzie M. Is low dose radiation therapy a potential treatment for COVID-19 pneumonia? Radiother Oncol. 2020 Jun;147:221. doi: 10.1016/j.radonc.2020.04.004. Epub 2020 Apr 6. No abstract available.

Reference Type BACKGROUND
PMID: 32342871 (View on PubMed)

Jean-Marc Cosset, Éric Deutsch, Louis Bazire, Jean-Jacques Mazeron, Cyrus Chargari, Irradiation pulmonaire à faible dose pour l'orage de cytokines du covid-19: pourquoi pas?, Cancer/Radiothérapie, 2020, , ISSN 1278-3218, https://doi.org/10.1016/j.canrad.2020.04.003.

Reference Type BACKGROUND

Dhawan G, Kapoor R, Dhawan R, Singh R, Monga B, Giordano J, Calabrese EJ. Low dose radiation therapy as a potential life saving treatment for COVID-19-induced acute respiratory distress syndrome (ARDS). Radiother Oncol. 2020 Jun;147:212-216. doi: 10.1016/j.radonc.2020.05.002. Epub 2020 May 8.

Reference Type BACKGROUND
PMID: 32437820 (View on PubMed)

Algara M, Arenas M, Marin J, Vallverdu I, Fernandez-Leton P, Villar J, Fabrer G, Rubio C, Montero A. Low dose anti-inflammatory radiotherapy for the treatment of pneumonia by covid-19: A proposal for a multi-centric prospective trial. Clin Transl Radiat Oncol. 2020 Jun 15;24:29-33. doi: 10.1016/j.ctro.2020.06.005. eCollection 2020 Sep.

Reference Type DERIVED
PMID: 32613089 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

IPACOVID

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Low Dose Radiotherapy in COVID-19 Pneumonia
NCT04390412 UNKNOWN PHASE1/PHASE2