Study of Immune Modulatory Drugs and Other Treatments in COVID-19 Patients: Sarilumab, Azithromycin, Hydroxychloroquine Trial - CORIMUNO-19 - VIRO (CORIMUNO-VIRO)

Assistance Publique - Hôpitaux de Paris

Status and phase: Suspended; Phase 3; Phase 2

Conditions: SARS-CoV-2 Infection; COVID19

Treatments: Drug: Sarilumab; Drug: Azithromycin; Drug: Hydroxychloroquine

Study type: Interventional

Funder types: Other

Identifiers

NCT04341870

APHP200375-3

Details and patient eligibility

About

The overall objective of the study is to determine the therapeutic effect and tolerance of Sarilumab in combination with Azithromycin and Hydroxychloroquine, compared to Sarilumab only, patients with moderate, severe pneumonia associated with Coronavirus disease 2019 (COVID-19). Sarilumab is a human IgG1 monoclonal antibody that binds specifically to both soluble and membrane-bound IL-6Rs (sIL-6Rα and mIL-6Rα) and has been shown to inhibit IL-6-mediated signaling through these receptors. The study has a cohort multiple Randomized Controlled Trials (cmRCT) design. Randomization will occur prior to offering investigational treatments administration to patients enrolled in the CORIMUNO-19 cohort (NCT04324047). Sarilumab+Azithromycin+Hydroxychloroquine, or Sarilumab only will be administered to consenting adult patients hospitalized with COVID-19 either diagnosed with moderate or severe pneumonia requiring no mechanical ventilation. All patients will receive standard of care along with randomized investigational treatments. Outcomes of included patients will be compared between groups as well as with outcomes of patients in the CORIMUNO-19 cohort treated with other immune modulators or standard of care.

Enrollment: 27 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients included in the CORIMUNO-19 cohort (NCT04324047)

• COVID-19 cases not requiring ICU at admission with moderate or severe pneumopathy according to the WHO Criteria of severity of COVID pneumopathy:

  • Moderate cases: Cases meeting all of the following criteria: [Showing fever and respiratory symptoms with radiological findings of pneumonia] AND [Requiring between 3L/min and 5L/min of oxygen to maintain SpO2>97%] OR
  • Severe cases: Cases meeting any of the following criteria: [Respiratory distress ( ≥ 30 breaths/ min)] OR [Oxygen saturation≤93% at rest in ambient air; or Oxygen saturation ≤97 % with O2 > 5L/min] OR [PaO2/FiO2 ≤ 300mmHg]

Exclusion criteria

1. Patients with exclusion criteria to the CORIMUNO-19 cohort.

2. Respiratory failure requiring non invasive or mechanical ventilation

3. Patients requiring intensive care

4. Do-not-resuscitate order (DNR order)

5. Known hypersensitivity to sarilumab or to any of their excipients.

6. Known contra-indication to hydroxychloroquine or chloroquine: including hypersensitivity/allergy, retinopathy, G6PD deficiency and QT prolongation

7. Known contra-indication to azithromycin: including hypersensitivity/allergy and QT prolongation

8. Pregnancy or breastfeeding

9. Current documented bacterial infection.

10. Patient with any of following laboratory results out of the ranges detailed below at screening should be discussed depending of the medication:

    • Absolute neutrophil count (ANC) ≤ 1.0 x 109/L
    • Haemoglobin level: no limitation
    • Platelets (PLT) < 50 G /L
    • SGOT or SGPT > 5N

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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27 participants in 2 patient groups

Sarilumab + Azithromycin + Hydroxychloroquine

Experimental group

Description:

Sarilumab combined with Azithromycin and Hydroxychloroquine

Treatment:

Drug: Azithromycin

Drug: Hydroxychloroquine

Drug: Sarilumab

Sarilumab

Active Comparator group

Description:

Sarilumab only

Treatment:

Drug: Sarilumab