Fenofibrate for Patients With COVID-19 Requiring Hospitalization

NCT ID: NCT04661930

Last Updated: 2022-04-19

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

55 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2022-07-01

Brief Summary

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This is an open-label run-in followed by a randomized, double-blind drug treatment study of COVID-19 infected patients requiring inpatient hospital admission.

Detailed Description

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This is an open-label run-in followed by a randomized, double-blind drug treatment study of COVID-19 infected patients requiring inpatient hospital admission. Open-label patients will be matched at least 1:10 with observational retrospective Propensity score-matched (PSM) patients' medical files. The double-blinded step will be randomized 2:1 to daily Fenofibrate or placebo for 10 days or hospital discharge.

Conditions

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Corona Virus Disease (COVID-19) Respiratory Distress Syndrome SARS-CoV-2 Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

An interventional single-arm non-randomized pilot study in 15 patients, followed by an Interventional double-blinded randomized quadruple masked study in 40 patients.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Fenofibrate + Usual Care

Participants in this arm will receive the study drug, Fenofibrate, in combination with usual care.

Group Type EXPERIMENTAL

TriCor® 145mg tablets

Intervention Type DRUG

Fenofibrate; 145 mg daily (1/day); oral administration; 10 days

Usual care

Intervention Type OTHER

All participants will otherwise receive usual medical care

Placebo + Usual Care

Participants in this arm will receive placebo treatment, in combination with usual care.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo (microcrystalline methylcellulose, gelatin capsule); oral administration

Usual care

Intervention Type OTHER

All participants will otherwise receive usual medical care

Usual Care (Observetional)

Participants in this arm will receive the usual care and be compared by their medical records and laboratory results

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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TriCor® 145mg tablets

Fenofibrate; 145 mg daily (1/day); oral administration; 10 days

Intervention Type DRUG

Placebo

Placebo (microcrystalline methylcellulose, gelatin capsule); oral administration

Intervention Type OTHER

Usual care

All participants will otherwise receive usual medical care

Intervention Type OTHER

Other Intervention Names

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Lipanthyl NT 145mg tablets

Eligibility Criteria

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Inclusion Criteria

* Presumptive positive laboratory test for SARS-CoV-2 based on local laboratory standard
* Age greater than or equal to 18 years of age
* Severe COVID-19, defined by:

* A disease severity score of 3 (Hospitalized, on non-invasive ventilation or high flow oxygen devices) to 4 (Hospitalized, requiring supplemental oxygen).

AND o A respiratory SOFA \>=1 and increased oxygen requirement compared to baseline among those on home O2, a blood oxygen saturation of 93% or less on room air, a ratio of the partial pressure of oxygen to the fraction of inspired oxygen (PaO2/FiO2) of less than 300 mm Hg, respiratory rate \>30 breaths/min, or lung infiltrates \>50% on chest CT

• Enrollment within 72 hours of presentation of hospital admission or within 72 hours of a positive test result, whichever is later

Exclusion Criteria

* Enrollment \> 72 hours of admission order or positive test result, whichever is later
* Admission to the hospital with a respiratory SOFA \>=5 , Critical COVID-19, or Disease Severity Score \>5 (requiring extracorporeal membrane oxygenation (ECMO), invasive mechanical ventilation, or all)
* Known hypersensitivity to fenofibrate
* For female subjects:

1. Pregenant, determined by a human chorionic gonadotropin (HCG) rapid detection kit or a blood test
2. Breastfeeding
3. Undergoing fertility treatments
* Patient-reported history or electronic medical record history of kidney disease, defined as:

1. Any history of dialysis
2. History of chronic kidney disease stage IV
3. Estimated Glomerular Filtration Rate (eGFR) of \< 30ml/min/1.73 m2 at the time of enrollment
* Acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician
* Most recent mean arterial blood pressure prior to enrollment \<65 mmHg
* Patient-reported history or electronic medical record history of severe liver disease, defined as:

1. Cirrhosis
2. History of hepatitis B or C
3. Documented AST or ALT \> 10 times the upper limit of normal measured within 24 hours prior to enrollment
* Patient-reported history or electronic medical record history of gallbladder disease
* Potassium \>5.0 within 24 hours prior to enrollment unless a repeat value was \<=5.0
* Treatment with coumarin anticoagulants (e.g., Warfarin), immunosuppressants (e.g. cisplatin), bile acid resins, or sulfonylurea.
* Inability to obtain informed consent from participant or legally authorized representative
* Enrollment in another blinded randomized clinical trial for COVID
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Barzilai Medical Center

OTHER

Sponsor Role collaborator

Rambam Health Care Campus

OTHER

Sponsor Role collaborator

Nazareth Hospital

OTHER

Sponsor Role collaborator

Yaakov Nahmias

OTHER

Sponsor Role lead

Responsible Party

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Yaakov Nahmias

Director of the Grass Center for Bioengineering

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Shlomo Mayaan, MD

Role: PRINCIPAL_INVESTIGATOR

Barzilai Medical Center

Mahram Nassar, MD

Role: STUDY_DIRECTOR

Barzilai Medical Center

Yaakov Nahmias, PhD

Role: PRINCIPAL_INVESTIGATOR

Hebrew University of Jerusalem

Locations

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Barzilai Medical Center

Ashkelon, , Israel

Site Status RECRUITING

Rambam Health Care Campus

Haifa, , Israel

Site Status RECRUITING

Nazareth Hospital EMMS

Nazareth, , Israel

Site Status RECRUITING

Countries

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Israel

Central Contacts

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Yaakov Nahmias, PhD

Role: CONTACT

+972-2-5494640

Avner Ehrlich

Role: CONTACT

+972-54-3181422

Facility Contacts

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Shlomo Maayan, MD

Role: primary

Shadi Hamoud, Prof. MD.

Role: primary

04-7773097

Amir Alimi, MD

Role: primary

References

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Bornstein SR, Dalan R, Hopkins D, Mingrone G, Boehm BO. Endocrine and metabolic link to coronavirus infection. Nat Rev Endocrinol. 2020 Jun;16(6):297-298. doi: 10.1038/s41574-020-0353-9.

Reference Type BACKGROUND
PMID: 32242089 (View on PubMed)

Ehrlich, A., Uhl, S., Ioannidis, K., Hofree, M., tenOever, B., and Nahmias, Y. (2020). The SARS-CoV-2 Transcriptional Metabolic Signature in Lung Epithelium. SSRN Electronic Journal.

Reference Type BACKGROUND

McBride CE, Machamer CE. Palmitoylation of SARS-CoV S protein is necessary for partitioning into detergent-resistant membranes and cell-cell fusion but not interaction with M protein. Virology. 2010 Sep 15;405(1):139-48. doi: 10.1016/j.virol.2010.05.031. Epub 2010 Jul 1.

Reference Type BACKGROUND
PMID: 20580052 (View on PubMed)

Wu Q, Zhou L, Sun X, Yan Z, Hu C, Wu J, Xu L, Li X, Liu H, Yin P, Li K, Zhao J, Li Y, Wang X, Li Y, Zhang Q, Xu G, Chen H. Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection. Sci Rep. 2017 Aug 22;7(1):9110. doi: 10.1038/s41598-017-09536-z.

Reference Type BACKGROUND
PMID: 28831119 (View on PubMed)

Yan B, Chu H, Yang D, Sze KH, Lai PM, Yuan S, Shuai H, Wang Y, Kao RY, Chan JF, Yuen KY. Characterization of the Lipidomic Profile of Human Coronavirus-Infected Cells: Implications for Lipid Metabolism Remodeling upon Coronavirus Replication. Viruses. 2019 Jan 16;11(1):73. doi: 10.3390/v11010073.

Reference Type BACKGROUND
PMID: 30654597 (View on PubMed)

Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010 Sep;47(3):193-9. doi: 10.1007/s00592-009-0109-4. Epub 2009 Mar 31.

Reference Type BACKGROUND
PMID: 19333547 (View on PubMed)

Yuan S, Chu H, Chan JF, Ye ZW, Wen L, Yan B, Lai PM, Tee KM, Huang J, Chen D, Li C, Zhao X, Yang D, Chiu MC, Yip C, Poon VK, Chan CC, Sze KH, Zhou J, Chan IH, Kok KH, To KK, Kao RY, Lau JY, Jin DY, Perlman S, Yuen KY. SREBP-dependent lipidomic reprogramming as a broad-spectrum antiviral target. Nat Commun. 2019 Jan 10;10(1):120. doi: 10.1038/s41467-018-08015-x.

Reference Type BACKGROUND
PMID: 30631056 (View on PubMed)

Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, Lei F, Wang H, Xie J, Wang W, Li H, Zhang P, Song X, Chen X, Xiang M, Zhang C, Bai L, Xiang D, Chen MM, Liu Y, Yan Y, Liu M, Mao W, Zou J, Liu L, Chen G, Luo P, Xiao B, Zhang C, Zhang Z, Lu Z, Wang J, Lu H, Xia X, Wang D, Liao X, Peng G, Ye P, Yang J, Yuan Y, Huang X, Guo J, Zhang BH, Li H. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metab. 2020 Jun 2;31(6):1068-1077.e3. doi: 10.1016/j.cmet.2020.04.021. Epub 2020 May 1.

Reference Type BACKGROUND
PMID: 32369736 (View on PubMed)

Ehrlich A, Ioannidis K, Nasar M, Abu Alkian I, Daskal Y, Atari N, Kliker L, Rainy N, Hofree M, Shafran Tikva S, Houri I, Cicero A, Pavanello C, Sirtori CR, Cohen JB, Chirinos JA, Deutsch L, Cohen M, Gottlieb A, Bar-Chaim A, Shibolet O, Mandelboim M, Maayan SL, Nahmias Y. Efficacy and safety of metabolic interventions for the treatment of severe COVID-19: in vitro, observational, and non-randomized open-label interventional study. Elife. 2023 Jan 27;12:e79946. doi: 10.7554/eLife.79946.

Reference Type DERIVED
PMID: 36705566 (View on PubMed)

Other Identifiers

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0105-20-BRZ; FENOC-005

Identifier Type: -

Identifier Source: org_study_id

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