AZD1656 in Diabetic Patients Hospitalised With Suspected or Confirmed COVID-19
NCT ID: NCT04516759
Last Updated: 2022-04-25
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE2
170 participants
INTERVENTIONAL
2020-08-12
2021-05-12
Brief Summary
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Detailed Description
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AZD1656 is a glucokinase (GK; hexokinase 4) activator which has been shown to reduce blood glucose for up to 4 months in humans. Diabetic patients admitted to hospital with COVID-19 often present with hyperglycaemia and are particularly vulnerable to progression to severe COVID-19. Treatment with AZD1656 (in addition to their usual care) may provide additional glucose control which could help improve clinical outcomes in both Type 1 and Type 2 diabetic populations.
In addition to its glucose lowering effect, AZD1656 may have additional benefits to COVID-19 patients via its effects on immune function. In many patients with severe COVID-19, an overreaction of the body's own immune system can cause severe problems including damage to the lungs and heart, which can lead to breathing problems necessitating intubation and ventilation. AZD1656 has been shown to activate the migration of T regulatory cells to sites of inflammation in preclinical experiments. This migration of Treg cells to inflamed tissue is crucial for their immune-modulatory function (Kishore et al (2017)). AZD1656 could enhance Treg migratory capacity and may prevent the development of cardiorespiratory complications observed in hospitalised patients with COVID-19, leading to lower requirements for oxygen therapy and assisted ventilation, and reduced incidences of pneumonia and acute respiratory distress syndrome (ARDS).
Diabetic patients hospitalised with COVID-19 will be randomised to receive either AZD1656 tablets or placebo tablets on a 1:1 basis until they are discharged from hospital or until they require intubation/mechanical ventilation. The aim of the study is to determine whether AZD1656 improves clinical outcomes in diabetic patients hospitalised with COVID-19. The World Health Organization (WHO) 8-point Ordinal Scale for Clinical Improvement will be used as the standard methodology for measuring patient outcomes.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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AZD1656 (plus Usual Hospital Care)
50mg film-coated tablets at a dose of 100mg BID
AZD1656
50mg film-coated tablets (at daily dose of 100mg BID)
Matched Placebo (plus Usual Hospital Care)
Matched placebo tablets
Placebo
Matched placebo tablets
Interventions
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AZD1656
50mg film-coated tablets (at daily dose of 100mg BID)
Placebo
Matched placebo tablets
Eligibility Criteria
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Inclusion Criteria
2. Aged 18 and older.
3. Have either Type I or Type II Diabetes Mellitus.
4. Hospitalised with suspected or confirmed novel coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)) infection at time of enrolment, categorised as stage 3, 4 or 5 on the WHO Ordinal Scale for Clinical Improvement.
5. Blood glucose level at or above 4 mmol/L.
6. Able to take oral (tablet) formulation of medication.
7. Patient is able to provide written informed consent prior to initiation of any study procedures.
Exclusion Criteria
2. Patients admitted with primary suspected or proven Mycoplasma pneumoniae, Chlamydia pneumoniae and bacterial pneumonia, who acquired COVID-19 while hospitalized.
3. Treatment with immunomodulators or anti-rejection drugs within the last 3 months.
4. Pregnant or breast feeding.
5. Men, and women of child-bearing potential, unwilling to use highly effective contraception during their participation in the trial and for 2 weeks after study completion.
6. Anticipated transfer to another hospital which is not a study site within 72 hours.
7. Known sensitivity to any of the study medication/placebo excipients.
8. Prior dosing with AZD1656 on a previous clinical trial.
9. Patients admitted as a result of and receiving immediate treatment for an acute asthmatic attack, acute myocardial infarction, acute cerebrovascular event.
10. Any known non-COVID-19, non-diabetes related, serious condition which, in the opinion of the clinical team, makes the patient unsuitable for the trial.
11. Known history of drug or alcohol abuse within previous 12 months of screening.
12. Known history of HIV, hepatitis C or unresolved hepatitis B or severe liver disease.
13. Current or planned use of gemfibrozil or any other strong inhibitors of CYP2C8.
14. Current or previous participation in another clinical trial where the patient has received a dose of an Investigational Medicinal Product (IMP) containing small molecule treatment(s) within 30 days or 5 half-lives (whichever is longer) prior to enrolment into this study, or containing biological treatment(s) within 3 months prior to entry into this study.
18 Years
ALL
No
Sponsors
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St George Street Capital
OTHER
Responsible Party
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Principal Investigators
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Kieran McCafferty, MD
Role: PRINCIPAL_INVESTIGATOR
Barts & The London NHS Trust
Locations
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Masarykova Univerzita - Fakultni Nemocnice U SV Anny V Brne (308)
Brno, , Czechia
Nemocnice Hořovice (309)
Hořovice, , Czechia
Oblastni Nemocnice Kolín (306)
Kolín, , Czechia
Klaudianova Nemonice (302)
Mladá Boleslav, , Czechia
Fakultni Nemocnice V Motole (303)
Prague, , Czechia
Thomayerova Nemonice (310)
Prague, , Czechia
Nemocnice Třebíč (305)
Třebíč, , Czechia
Colentina Clinical Hospital (204)
Bucharest, , Romania
Spitalul Clinic de Boli Infectioase Cluj-Napoca (203)
Cluj-Napoca, , Romania
Spitalul Clinic de Pneumoftiziologie "Leon Daniello" Cluj-Napoca (202)
Cluj-Napoca, , Romania
Spitalul Clinic de Boli Infectioase Constanţa (207)
Constanța, , Romania
Spitalul Clinic de Boli Infectioase si Pneumoftiziologie Dr Victor Babes Craiova (206)
Craiova, , Romania
Spitalul Judetean de Urgenta Deva (208)
Deva, , Romania
Spitalul Clinic de Boli Infectioase "Sfanta Parascheva" Iaşi (205)
Iași, , Romania
Spitalul Clinic de Boli Infectioase si Pneumoftiziologie Dr Victor Babes Timişoara (201)
Timișoara, , Romania
Barnsley Hospital NHS Foundation Trust (105)
Barnsley, , United Kingdom
Bolton NHS Foundation Trust (122)
Bolton, , United Kingdom
Bradford Teaching Hospitals NHS Foundation Trust (103)
Bradford, , United Kingdom
North Bristol NHS Trust (116)
Bristol, , United Kingdom
County Durham and Darlington NHS Foundation Trust (121)
Darlington, , United Kingdom
The Dudley Group NHS Foundation Trust (107)
Dudley, , United Kingdom
Medway NHS Foundation Trust (108)
Gillingham, , United Kingdom
Hull & East Yorkshire NHS Trust (102)
Hull, , United Kingdom
Barts Health NHS Trust (101 and 111)
London, , United Kingdom
Royal Free London NHS Foundation Trust (119)
London, , United Kingdom
St George's University Hospitals NHS Foundation Trust (114)
London, , United Kingdom
Penine Acute Hospitals NHS Trust (106)
Salford, , United Kingdom
Sheffield Hospitals NHS Foundation Trust (104)
Sheffield, , United Kingdom
Somerset NHS Foundation Trust (109)
Taunton, , United Kingdom
Walsall Healthcare NHS Trust (113)
Walsall, , United Kingdom
Countries
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References
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Chorlton J, Hollowood Z, Dyer C, Lockhart D, Boekman P, McCafferty K, Coffey P, Marelli-Berg F, Martin J. A randomised, double-blind, placebo-controlled, multicentre clinical trial of AZD1656 in diabetic patients hospitalised with COVID-19: The ARCADIA Trial - implications for therapeutic immune modulation. EClinicalMedicine. 2022 Sep;51:101604. doi: 10.1016/j.eclinm.2022.101604. Epub 2022 Aug 18.
McCafferty K, Hollowood Z, Allen M, Lockhart D, Chorlton J, Martin J. ARCADIA study protocol: a phase II, randomised, double-blind, placebo-controlled clinical trial to assess the safety and efficacy of AZD1656 in patients with diabetes hospitalised with suspected or confirmed COVID-19. BMJ Open. 2021 Dec 1;11(12):e049650. doi: 10.1136/bmjopen-2021-049650.
Provided Documents
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Document Type: Study Protocol
Document Type: Statistical Analysis Plan
Other Identifiers
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2020-002211-21
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
SGS.1656.201
Identifier Type: -
Identifier Source: org_study_id
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