Trial Outcomes & Findings for Fostamatinib for Hospitalized Adults With COVID-19 (NCT NCT04579393)

NCT ID: NCT04579393

Last Updated: 2022-03-02

Results Overview

Number of participants with at least 1 serious adverse event by day 29 using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. CTCAE is a list of common adverse event (AE) terms. Each AE term is defined and accompanied by a grading scale (1 to 5) that indicates the severity of the AE. Grading ranges from Grade 1 which is mild to Grade 5 which is death.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

59 participants

Primary outcome timeframe

Day 29

Results posted on

2022-03-02

Participant Flow

Participants were enrolled from October 8, 2020, through March 2, 2021 across 2 centers: Inova Fairfax Hospital (Falls Church, VA) and the National Institutes of Health (NIH) Clinical Center (Bethesda, MD).

Participant milestones

Participant milestones
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Overall Study
STARTED
30
29
Overall Study
COMPLETED
27
24
Overall Study
NOT COMPLETED
3
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Overall Study
Withdrawal by Subject
2
2
Overall Study
Death
1
3

Baseline Characteristics

Fostamatinib for Hospitalized Adults With COVID-19

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Total
n=59 Participants
Total of all reporting groups
Age, Continuous
54.3 years
STANDARD_DEVIATION 13.5 • n=93 Participants
57.0 years
STANDARD_DEVIATION 14.1 • n=4 Participants
55.6 years
STANDARD_DEVIATION 13.7 • n=27 Participants
Sex: Female, Male
Female
8 Participants
n=93 Participants
4 Participants
n=4 Participants
12 Participants
n=27 Participants
Sex: Female, Male
Male
22 Participants
n=93 Participants
25 Participants
n=4 Participants
47 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
18 Participants
n=93 Participants
17 Participants
n=4 Participants
35 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
12 Participants
n=93 Participants
12 Participants
n=4 Participants
24 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
2 Participants
n=93 Participants
4 Participants
n=4 Participants
6 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=93 Participants
3 Participants
n=4 Participants
6 Participants
n=27 Participants
Race (NIH/OMB)
White
12 Participants
n=93 Participants
11 Participants
n=4 Participants
23 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=93 Participants
0 Participants
n=4 Participants
1 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
12 Participants
n=93 Participants
11 Participants
n=4 Participants
23 Participants
n=27 Participants
Region of Enrollment
United States
30 participants
n=93 Participants
29 participants
n=4 Participants
59 participants
n=27 Participants
Score on Ordinal Scale
Requiring supplemental oxygen
11 Participants
n=93 Participants
12 Participants
n=4 Participants
23 Participants
n=27 Participants
Score on Ordinal Scale
Noninvasive ventilation or high-flow oxygen devices
17 Participants
n=93 Participants
15 Participants
n=4 Participants
32 Participants
n=27 Participants
Score on Ordinal Scale
Invasive mechanical ventilation or extracorporeal membrane oxygen
2 Participants
n=93 Participants
2 Participants
n=4 Participants
4 Participants
n=27 Participants
Medication for COVID-19 other than the study drug
Remdesivir
30 participants
n=93 Participants
29 participants
n=4 Participants
59 participants
n=27 Participants
Medication for COVID-19 other than the study drug
Dexamethasone or other steroids (methylprednisolone and prednisone)
30 participants
n=93 Participants
29 participants
n=4 Participants
59 participants
n=27 Participants
Medication for COVID-19 other than the study drug
Convalescent plasma or monoclonal antibodies
12 participants
n=93 Participants
13 participants
n=4 Participants
25 participants
n=27 Participants

PRIMARY outcome

Timeframe: Day 29

Population: Intention-to-treat analysis

Number of participants with at least 1 serious adverse event by day 29 using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. CTCAE is a list of common adverse event (AE) terms. Each AE term is defined and accompanied by a grading scale (1 to 5) that indicates the severity of the AE. Grading ranges from Grade 1 which is mild to Grade 5 which is death.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Number of Participants With at Least 1 Serious Adverse Event
3 Participants
6 Participants

SECONDARY outcome

Timeframe: day 29

Time to sustained recovery determined by ordinal scale score of 3 or less and defined as time to recovery \[either discharge from the hospital or hospitalization for infection control reasons only\], with the recovery status sustained through day 29. The ordinal scale is an assessment of the clinical status. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Number of Participants With Sustained Recoveries Defined by Ordinal Scale Score of 3 or Less
27 Participants
22 Participants

SECONDARY outcome

Timeframe: day 29

Population: Participants who were not receiving mechanical ventilation at baseline

Number of participants who progress to mechanical ventilation by day 29

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=28 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=27 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Number of Participants Who Progress to Mechanical Ventilation
1 Participants
2 Participants

SECONDARY outcome

Timeframe: day 14, day 28, day 60

Population: Intention-to-treat analysis

Number of Participants with Cumulative Clinical Endpoint of Death at Day 14, Day 28 and Day 60

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Number of Participants With Cumulative Clinical Endpoint of Death
day 28
0 Participants
3 Participants
Number of Participants With Cumulative Clinical Endpoint of Death
day 60
1 Participants
3 Participants
Number of Participants With Cumulative Clinical Endpoint of Death
day 14
0 Participants
1 Participants

SECONDARY outcome

Timeframe: Day 60

Population: Intention-to-treat analysis

Number of Grade 3 and 4 AE through day 60 using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. CTCAE is a list of common adverse event (AE) terms. Each AE term is defined and accompanied by a grading scale (1 to 5) that indicates the severity of the AE. Grading ranges from Grade 1 which is mild to Grade 5 which is death.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Number of Grade 3 and 4 Adverse Events Through Day 60
Grade 4
3 Adverse Events
7 Adverse Events
Number of Grade 3 and 4 Adverse Events Through Day 60
Grade 3
17 Adverse Events
23 Adverse Events

SECONDARY outcome

Timeframe: Day 15, Day 29

Population: intent to treat analysis

Participant score on ordinal scale at day 15 and day 29. The ordinal scale is an assessment of the clinical status. The scale is as follows: 8) Death; 7) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 6) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 5) Hospitalized, requiring supplemental oxygen; 4) Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 3) Hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 2) Not hospitalized, limitation on activities and/or requiring home oxygen; 1) Not hospitalized, no limitations on activities.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Participant Score on Ordinal Scale
Day 15
1 score on a scale
Interval 1.0 to 2.0
2 score on a scale
Interval 1.0 to 5.0
Participant Score on Ordinal Scale
Day 29
1 score on a scale
Interval 1.0 to 2.0
1 score on a scale
Interval 1.0 to 2.0

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in C-Reactive Protein (CRP) blood levels from baseline. The upper limit of normal is 5 mg/L (milligrams per liter).

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in C-Reactive Protein Levels From Baseline
Day 3
-37 mg/L (milligrams per liter)
Interval -94.0 to -6.0
-46 mg/L (milligrams per liter)
Interval -105.0 to -1.0
Change in C-Reactive Protein Levels From Baseline
Day 29
-65 mg/L (milligrams per liter)
Interval -117.0 to -33.0
-106 mg/L (milligrams per liter)
Interval -155.0 to -57.0
Change in C-Reactive Protein Levels From Baseline
Day 5
-34 mg/L (milligrams per liter)
Interval -84.0 to 5.0
-51 mg/L (milligrams per liter)
Interval -128.0 to -23.0
Change in C-Reactive Protein Levels From Baseline
Day 8
-56 mg/L (milligrams per liter)
Interval -108.0 to -17.0
-66 mg/L (milligrams per liter)
Interval -118.0 to -39.0
Change in C-Reactive Protein Levels From Baseline
Day 11
-52 mg/L (milligrams per liter)
Interval -114.0 to -29.0
-68 mg/L (milligrams per liter)
Interval -139.0 to -46.0
Change in C-Reactive Protein Levels From Baseline
Day 15
-43 mg/L (milligrams per liter)
Interval -109.0 to -33.0
-71 mg/L (milligrams per liter)
Interval -126.0 to -47.0

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in Fibrinogen blood levels from baseline. The upper limit of normal is Fibrinogen 466 milligrams per decilitre (mg/dL).

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in Fibrinogen Levels From Baseline.
Day 3
-60 mg/dL (milligrams per decilitre)
Interval -177.0 to -11.0
-65 mg/dL (milligrams per decilitre)
Interval -155.0 to 41.0
Change in Fibrinogen Levels From Baseline.
Day 15
-132 mg/dL (milligrams per decilitre)
Interval -182.0 to -24.0
-76 mg/dL (milligrams per decilitre)
Interval -214.0 to 10.0
Change in Fibrinogen Levels From Baseline.
Day 29
-113 mg/dL (milligrams per decilitre)
Interval -235.0 to -63.0
-231 mg/dL (milligrams per decilitre)
Interval -351.0 to -64.0
Change in Fibrinogen Levels From Baseline.
Day 5
-86 mg/dL (milligrams per decilitre)
Interval -187.0 to 2.0
-78 mg/dL (milligrams per decilitre)
Interval -245.0 to 36.0
Change in Fibrinogen Levels From Baseline.
Day 8
-130 mg/dL (milligrams per decilitre)
Interval -260.0 to -34.0
-96 mg/dL (milligrams per decilitre)
Interval -236.0 to -40.0
Change in Fibrinogen Levels From Baseline.
Day 11
-141 mg/dL (milligrams per decilitre)
Interval -277.0 to -77.0
-138 mg/dL (milligrams per decilitre)
Interval -250.0 to -14.0

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in D-Dimer blood levels from baseline. The upper limit of normal is 0.50 mcg/mL (microgram per milliliter).

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in D-Dimer Levels From Baseline
Day 5
-0.06 mcg/mL (microgram per milliliter)
Interval -0.24 to 0.11
-0.1 mcg/mL (microgram per milliliter)
Interval -0.74 to 0.15
Change in D-Dimer Levels From Baseline
Day 8
-0.15 mcg/mL (microgram per milliliter)
Interval -0.74 to 0.07
-0.24 mcg/mL (microgram per milliliter)
Interval -1.25 to 0.1
Change in D-Dimer Levels From Baseline
Day 3
-0.01 mcg/mL (microgram per milliliter)
Interval -0.19 to 0.25
-0.08 mcg/mL (microgram per milliliter)
Interval -0.4 to 0.31
Change in D-Dimer Levels From Baseline
Day 11
-0.11 mcg/mL (microgram per milliliter)
Interval -0.56 to 0.12
-0.43 mcg/mL (microgram per milliliter)
Interval -0.99 to 0.06
Change in D-Dimer Levels From Baseline
Day 15
-0.06 mcg/mL (microgram per milliliter)
Interval -0.2 to 0.12
-0.32 mcg/mL (microgram per milliliter)
Interval -1.02 to 0.0
Change in D-Dimer Levels From Baseline
Day 29
-0.15 mcg/mL (microgram per milliliter)
Interval -0.31 to 0.0
-0.16 mcg/mL (microgram per milliliter)
Interval -0.82 to 0.46

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in Ferritin levels from baseline. The upper limit of normal for Ferritin is 400 mcg/L (micrograms per liter).

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in Ferritin Levels From Baseline
Day 3
-94 mcg/L (micrograms per liter)
Interval -306.0 to 20.0
-190 mcg/L (micrograms per liter)
Interval -622.0 to -102.0
Change in Ferritin Levels From Baseline
Day 5
-213 mcg/L (micrograms per liter)
Interval -532.0 to -25.0
-199 mcg/L (micrograms per liter)
Interval -684.0 to 16.0
Change in Ferritin Levels From Baseline
Day 8
-73 mcg/L (micrograms per liter)
Interval -428.0 to 438.0
-253 mcg/L (micrograms per liter)
Interval -586.0 to -17.0
Change in Ferritin Levels From Baseline
Day 11
-169 mcg/L (micrograms per liter)
Interval -853.0 to 93.0
-491 mcg/L (micrograms per liter)
Interval -756.0 to -239.0
Change in Ferritin Levels From Baseline
Day 15
-346 mcg/L (micrograms per liter)
Interval -904.0 to 4.0
-561 mcg/L (micrograms per liter)
Interval -882.0 to -350.0
Change in Ferritin Levels From Baseline
D29
-578 mcg/L (micrograms per liter)
Interval -1038.0 to -206.0
-738 mcg/L (micrograms per liter)
Interval -1562.0 to -530.0

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in Interleukin 6 (IL6) blood levels from baseline. The upper limit of normal for IL6 is 1.8 picograms per milliliter (pg/mL).

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in Interleukin 6 (IL6) Levels From Baseline
Day 11
-0.1 pg/mL (picograms per milliliter)
Interval -9.9 to 1.4
-0.3 pg/mL (picograms per milliliter)
Interval -8.2 to 0.3
Change in Interleukin 6 (IL6) Levels From Baseline
Day 15
-1.5 pg/mL (picograms per milliliter)
Interval -5.5 to 1.0
-0.7 pg/mL (picograms per milliliter)
Interval -4.3 to 0.5
Change in Interleukin 6 (IL6) Levels From Baseline
Day 3
-0.7 pg/mL (picograms per milliliter)
Interval -11.5 to 1.4
1.4 pg/mL (picograms per milliliter)
Interval -2.6 to 6.9
Change in Interleukin 6 (IL6) Levels From Baseline
Day 5
-1 pg/mL (picograms per milliliter)
Interval -16.1 to 4.4
0.3 pg/mL (picograms per milliliter)
Interval -1.8 to 4.5
Change in Interleukin 6 (IL6) Levels From Baseline
Day 8
0 pg/mL (picograms per milliliter)
Interval -5.5 to 3.8
-2.5 pg/mL (picograms per milliliter)
Interval -6.6 to 0.0
Change in Interleukin 6 (IL6) Levels From Baseline
Day 29
-1.4 pg/mL (picograms per milliliter)
Interval -6.5 to -0.4
-1.4 pg/mL (picograms per milliliter)
Interval -4.0 to -0.8

SECONDARY outcome

Timeframe: Day 29

Population: Participants admitted to Intensive Care Unit

Median days participants were admitted to Intensive Care Unit (ICU) by day 29

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=13 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=12 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Median Days Participants Were Admitted to Intensive Care Unit
3 Days
Interval 2.0 to 5.0
7 Days
Interval 2.0 to 10.0

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Only SpO2/FiO2 ratio is available as PaO2 was not consistently measured. Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Relative change in PaO2/FiO2 or SpO2/FiO2 ratio.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Relative Change in SpO2/FiO2 Ratio
Day 29
0.74 SpO2/FiO2 ratio
Interval 0.74 to 0.74
0.49 SpO2/FiO2 ratio
Interval 0.42 to 0.97
Relative Change in SpO2/FiO2 Ratio
Day 3
0.87 SpO2/FiO2 ratio
Interval 0.7 to 0.97
0.93 SpO2/FiO2 ratio
Interval 0.65 to 1.04
Relative Change in SpO2/FiO2 Ratio
Day 5
1.09 SpO2/FiO2 ratio
Interval 0.75 to 1.33
0.88 SpO2/FiO2 ratio
Interval 0.76 to 1.08
Relative Change in SpO2/FiO2 Ratio
Day 8
0.75 SpO2/FiO2 ratio
Interval 0.59 to 1.83
1.09 SpO2/FiO2 ratio
Interval 0.59 to 1.39
Relative Change in SpO2/FiO2 Ratio
Day 11
1.49 SpO2/FiO2 ratio
Interval 0.81 to 2.14
0.99 SpO2/FiO2 ratio
Interval 0.53 to 1.59
Relative Change in SpO2/FiO2 Ratio
Day 15
1.23 SpO2/FiO2 ratio
Interval 0.87 to 1.5
1.07 SpO2/FiO2 ratio
Interval 0.67 to 1.79

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in SOFA score from baseline (day 1). The Sequential Organ Failure Assessment (SOFA) Score is a mortality prediction score that is based on the degree of dysfunction of six organ systems. The score is calculated on admission and every 24 hours until discharge using the worst parameters measured during the prior 24 hours. Each organ system is assigned a point value from 0 (normal) to 4 (high degree of dysfunction/failure). The "worst" measurement was defined as the measure that correlated to the highest number of points. The SOFA score ranges from 0 to 24.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in SOFA Score From Baseline
Day 11
0 score on a SOFA scale
Interval -1.0 to 0.0
0 score on a SOFA scale
Interval 0.0 to 2.0
Change in SOFA Score From Baseline
Day 3
0 score on a SOFA scale
Interval 0.0 to 0.0
0 score on a SOFA scale
Interval -1.0 to 0.0
Change in SOFA Score From Baseline
Day 5
0 score on a SOFA scale
Interval -1.0 to 0.0
0 score on a SOFA scale
Interval 0.0 to 0.0
Change in SOFA Score From Baseline
Day 8
0 score on a SOFA scale
Interval -1.0 to 1.0
0 score on a SOFA scale
Interval -1.0 to 0.0
Change in SOFA Score From Baseline
Day 15
-1 score on a SOFA scale
Interval -2.0 to 0.0
0 score on a SOFA scale
Interval -1.0 to 2.0
Change in SOFA Score From Baseline
Day 29
0 score on a SOFA scale
Interval 0.0 to 0.0
1 score on a SOFA scale
Interval 0.0 to 2.0

SECONDARY outcome

Timeframe: day 29

Median days on participants received supplemental oxygen through day 29

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Median Days on Participants Received Supplemental Oxygen
8 days
Interval 5.0 to 10.0
20 days
Interval 14.0 to 27.0

SECONDARY outcome

Timeframe: day 29

Population: Intent to treat analysis

The number of participants that experienced acute renal failure by day 29. Acute renal failure defined as increase in serum creatinine by ≥0.3mg/dL within 48 hours or increase in serum creatinine by ≥1.5 times baseline which is known or presumed to have occurred within the prior seven days.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
The Number of Participants That Experienced Acute Renal Failure
3 Participants
5 Participants

SECONDARY outcome

Timeframe: day 29

Population: Intent to Treat Analysis.

Number of participants that experienced a deep vein thrombosis (DVT) or pulmonary embolism (PE) by day 29

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Number of Participants That Experienced a Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE)
2 Participants
0 Participants

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in Absolute lymphocyte count blood levels from baseline.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in Absolute Lymphocyte Count Levels From Baseline
Day 29
0.56 thousand cells per microliter
Interval 0.42 to 0.89
0.81 thousand cells per microliter
Interval 0.42 to 1.38
Change in Absolute Lymphocyte Count Levels From Baseline
Day 3
0.43 thousand cells per microliter
Interval 0.02 to 0.64
0.13 thousand cells per microliter
Interval -0.18 to 0.42
Change in Absolute Lymphocyte Count Levels From Baseline
Day 5
0.48 thousand cells per microliter
Interval 0.08 to 1.03
0.38 thousand cells per microliter
Interval -0.14 to 0.73
Change in Absolute Lymphocyte Count Levels From Baseline
Day 8
0.41 thousand cells per microliter
Interval 0.06 to 1.22
0.34 thousand cells per microliter
Interval -0.02 to 1.09
Change in Absolute Lymphocyte Count Levels From Baseline
Day 11
1.03 thousand cells per microliter
Interval 0.15 to 1.37
1.02 thousand cells per microliter
Interval 0.57 to 1.44
Change in Absolute Lymphocyte Count Levels From Baseline
Day 15
1.03 thousand cells per microliter
Interval 0.52 to 1.18
0.68 thousand cells per microliter
Interval 0.25 to 1.07

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in Absolute neutrophil count blood levels from baseline.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in Absolute Neutrophil Count Levels From Baseline
Day 3
0.04 thousand cells per microliter
Interval -1.22 to 1.06
-0.09 thousand cells per microliter
Interval -2.06 to 1.88
Change in Absolute Neutrophil Count Levels From Baseline
Day 8
0.63 thousand cells per microliter
Interval -3.4 to 3.78
2.74 thousand cells per microliter
Interval -0.4 to 6.26
Change in Absolute Neutrophil Count Levels From Baseline
Day 11
-0.95 thousand cells per microliter
Interval -2.34 to 1.1
0.85 thousand cells per microliter
Interval -1.42 to 2.6
Change in Absolute Neutrophil Count Levels From Baseline
Day 15
-1.77 thousand cells per microliter
Interval -3.41 to -0.6
-1.6 thousand cells per microliter
Interval -5.22 to 1.61
Change in Absolute Neutrophil Count Levels From Baseline
Day 5
1.53 thousand cells per microliter
Interval -2.31 to 2.5
0.94 thousand cells per microliter
Interval -0.97 to 2.1
Change in Absolute Neutrophil Count Levels From Baseline
Day 29
-2.54 thousand cells per microliter
Interval -4.62 to -1.12
-2.89 thousand cells per microliter
Interval -7.9 to -0.22

SECONDARY outcome

Timeframe: Day 3, Day 5, Day 8, Day 11, Day 15, Day 29

Population: Intent to treat analysis. 58 patients (29 in each group) provided research samples for at least one time-point since baseline except for one patient who did not take any study drug and withdrew consent after enrollment.

Change in Platelet count blood levels from baseline.

Outcome measures

Outcome measures
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=29 Participants
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 Participants
Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Change in Platelet Count Levels From Baseline
Day 15
11 thousand cells per microliter
Interval -30.0 to 92.0
-26 thousand cells per microliter
Interval -198.0 to 26.0
Change in Platelet Count Levels From Baseline
Day 29
-29 thousand cells per microliter
Interval -87.0 to 42.0
-7 thousand cells per microliter
Interval -102.0 to 60.0
Change in Platelet Count Levels From Baseline
Day 3
59 thousand cells per microliter
Interval 19.0 to 117.0
58 thousand cells per microliter
Interval 24.0 to 103.0
Change in Platelet Count Levels From Baseline
Day 5
103 thousand cells per microliter
Interval 55.0 to 150.0
63 thousand cells per microliter
Interval 1.0 to 142.0
Change in Platelet Count Levels From Baseline
Day 8
145 thousand cells per microliter
Interval 91.0 to 217.0
62 thousand cells per microliter
Interval -34.0 to 171.0
Change in Platelet Count Levels From Baseline
Day 11
80 thousand cells per microliter
Interval 20.0 to 156.0
25 thousand cells per microliter
Interval -132.0 to 128.0

Adverse Events

Fostamatinib With Standard of Care for Treatment of COVID-19

Serious events: 5 serious events
Other events: 8 other events
Deaths: 1 deaths

Placebo With Standard of Care for Treatment of COVID-19

Serious events: 10 serious events
Other events: 15 other events
Deaths: 3 deaths

Serious adverse events

Serious adverse events
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 participants at risk
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 participants at risk
Placebo: Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Endocrine disorders
Hypoglycemia
3.3%
1/30 • Number of events 1 • 60 days
0.00%
0/29 • 60 days
Gastrointestinal disorders
Bleeding
3.3%
1/30 • Number of events 1 • 60 days
0.00%
0/29 • 60 days
Respiratory, thoracic and mediastinal disorders
Hypoxia
6.7%
2/30 • Number of events 2 • 60 days
10.3%
3/29 • Number of events 3 • 60 days
Respiratory, thoracic and mediastinal disorders
ACUTE RESPIRATORY FAILURE
3.3%
1/30 • Number of events 1 • 60 days
0.00%
0/29 • 60 days
General disorders
Multi-organ failure
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Immune system disorders
Allergic reaction
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Infections and infestations
Lung infection
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Metabolism and nutrition disorders
Acidosis
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Renal and urinary disorders
Acute kidney injury
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Respiratory, thoracic and mediastinal disorders
Self-Extubation
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Respiratory, thoracic and mediastinal disorders
Post COVID Fibrosis
0.00%
0/30 • 60 days
3.4%
1/29 • Number of events 1 • 60 days

Other adverse events

Other adverse events
Measure
Fostamatinib With Standard of Care for Treatment of COVID-19
n=30 participants at risk
Fostamatinib, will be administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Placebo With Standard of Care for Treatment of COVID-19
n=29 participants at risk
Placebo: Placebo tablets to match fostamatinib 150 mg will be provided and administered orally at a dose of 150 mg twice daily for 14 days or 28 doses.
Investigations
Lymphocyte count decreased
13.3%
4/30 • Number of events 4 • 60 days
24.1%
7/29 • Number of events 7 • 60 days
Metabolism and nutrition disorders
Hypoalbuminemia
6.7%
2/30 • Number of events 2 • 60 days
10.3%
3/29 • Number of events 3 • 60 days
Metabolism and nutrition disorders
Hypokalemia
6.7%
2/30 • Number of events 2 • 60 days
3.4%
1/29 • Number of events 1 • 60 days
Blood and lymphatic system disorders
Anemia
0.00%
0/30 • 60 days
10.3%
3/29 • Number of events 3 • 60 days
Metabolism and nutrition disorders
Hypocalcemia
0.00%
0/30 • 60 days
6.9%
2/29 • Number of events 2 • 60 days
Vascular disorders
Thromboembolic event
6.7%
2/30 • Number of events 2 • 60 days
0.00%
0/29 • 60 days

Additional Information

Jeffrey Strich, MD

The National Institutes of Health / The National Heart, Lung, and Blood Institute

Phone: 301.496.9320

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place