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Putative Investigational Therapeutics in the Treatment of Patients With Known Ebola Infection

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ClinicalTrials.gov Identifier: NCT02363322
Recruitment Status : Suspended
First Posted : February 16, 2015
Last Update Posted : June 27, 2018
Sponsor:
Collaborators:
The Ministry of Health and Social Welfare of the Republic of Liberia
The Ministry of Health and Sanitation of the Republic of Sierra Leone
Institut National de la Santé Et de la Recherche Médicale, France
The Ministry of Health and Public Hygiene of the Republic of Guinea
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Institute of Allergy and Infectious Diseases (NIAID) )

Brief Summary:

Background:

- Ebola is a viral infection that can spread quickly and causes life-threatening disease. Right now there is an Ebola outbreak in many countries in West Africa. There are no approved treatments for Ebola. But possible treatments are being developed. Researchers need to study these treatments to see if they help people get better.

Objective:

- To identify possible Ebola treatments. Also, to learn if adding 1 or more experimental drugs to advanced Ebola care can reduce the risk of death.

Eligibility:

- People who have recently been diagnosed with Ebola, usually by a test called the Polymerase Chain Reaction (PCR), and have been hospitalized in an isolation unit for treatment.

Design:

  • Participants will be randomly assigned to Group A or B. Both groups will get advanced level care. One group will also get an experimental drug.
  • Participants may have blood tests. They may have another PCR test.
  • Researchers will try to learn how the participant got Ebola.
  • Participants put in the experimental drug group may start taking medicine within 24 hours of enrollment. It may be given by mouth or intravenously. Additional doses may be needed.
  • Participants may have a series of timed blood tests over the first 24 to 48 hours after they take the medicine.
  • Blood will be drawn frequently. Other body fluids (urine, stool, vaginal fluid, etc.) may also be collected.
  • Participants will be followed for up to 60 days. They may be evaluated for any long-term effects of the experimental treatment(s). They may be asked to return for 1 or more outpatient visits.
  • For consenting participants, follow-up will be extended for up to one full year past Day 58 with contact/visits every 1-3 months to assess for a history of signs or symptoms potentially consistent with late onset of virologic relapse syndrome.

Condition or disease Intervention/treatment Phase
Ebola Virus Infection Drug: ZMApp Other: Treatment A Phase 1 Phase 2

Detailed Description:

Ebolaviruses (EBOV) are members of the Filoviridae and are known primarily as the underlying cause of severe viral hemorrhagic fevers with disturbingly high case fatality rates. Between 1994 and the present, there have been many EBOV outbreaks affecting mostly central Africa, with 2 large outbreaks in 1995 in Kikwit, Democratic Republic of Congo (DRC), and in Gulu, Uganda in 2000-2001. However, the 2014 West African outbreak significantly exceeds all previous outbreaks in geographic range, number of patients affected, and in disruption of typical activities of civil society.

There is strong consensus that the most important element necessary to improve survival from Ebola infection is the provision of full hemodynamic support in the form of aggressive fluid replacement, ability to diagnose and correct severe metabolic derangements, and other standards of modern medical care available in resource-rich environments. However, against this background, a small series of investigational agents or interventions have also been proposed as putative antiviral strategies of potential utility in treating this infection. Unfortunately, phase 1/2 data supporting the safety and efficacy of these agents is generally lacking, and thus there should be equipoise as to which, if any, of these interventions should be utilized in the treatment of severe infection.

In this multicenter randomized trial, we propose a flexible trial design with frequent interim monitoring to facilitate early elimination of poorly performing treatments as well as the introduction of new candidate therapies. The trial allows for a series of pairwise comparisons of novel interventions against a background of optimized medical care, with the goal of determining whether one or more of these interventions can improve the mortality over that achievable through optimized standard-of- care (oSOC) alone. The primary endpoint of this trial will be comparative mortality at Day 28, with a number of secondary endpoints that hopefully will generate generalizable knowledge about the relative safety and antiviral activity of these adjunctive interventions.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 72 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter Randomized Safety and Efficacy Study of Putative Investigational Therapeutics in the Treatment of Patients With Known Ebola Infection
Study Start Date : February 13, 2015
Actual Primary Completion Date : December 31, 2017
Estimated Study Completion Date : January 1, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Ebola
Drug Information available for: Coal Tar

Arm Intervention/treatment
Active Comparator: A
Optimized standard of care to include aggressive fluid resuscitation, hemodynamic support, and other interventions available in an optimized care setting
Other: Treatment A
Optimized standard of care for Ebola virus infection

Experimental: B
ZMapp (Trademark) + Optimized standard of care to include aggressive fluid resuscitation, hemodynamic support, and other interventions available in an optimized care setting.
Drug: ZMApp
Triple monoclonal cocktail of antibodies against Zaire species of Ebola virus

Other: Treatment A
Optimized standard of care for Ebola virus infection




Primary Outcome Measures :
  1. Mortality [ Time Frame: 28 days ]

Secondary Outcome Measures :
  1. Clinical and virology effects of experimental treatment [ Time Frame: 28 days ]
  2. Adverse Events [ Time Frame: Throughout ]
  3. Plasma Viral Load [ Time Frame: Throughout ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria
  • INCLUSION CRITERIA:
  • Males or females with documented positive PCR for Ebola virus infection within 10 days of enrollment
  • Willingness of study participant to accept randomization to any assigned treatment arm
  • Access to oSOC
  • All males and females of childbearing potential, must be willing to use highly effective methods of contraception [e.g. absolute abstinence from potentially reproductive sexual activity, hormonal, surgical or multiple barrier/combined], from time of enrollment for the duration of study participation.
  • Must agree not to enroll in another study of an investigational agent prior to completion of last required protocol visit (Day 58)
  • Ability to provide informed consent personally, or by a legally-authorized [per applicable local laws and regulations] representative [LAR] if the patient is unable to do so.

EXCLUSION CRITERIA:

  • Any medical condition that, in the opinion of the site investigator, would place the patient at an unreasonably increased risk through participation in this study, including any past or concurrent conditions that would preclude randomization to one or more of the assigned treatment arms.
  • Prior treatment with any investigational antiviral drug therapy against Ebola infection other than experimental vaccines, within 5 half-lives or 30 days, whichever is longer, prior to enrollment

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02363322


Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States, 20892
Guinea
CTE Forecariah
Forecariah, Guinea
Liberia
Monrovia Medical Unit
Monrovia, Liberia
ELWA III Hospital
Paynesville, Liberia
Sierra Leone
Police Training School 1 (PTS1), Western Rural District
Freetown, Sierra Leone
Emergency Ebola Treatment Unit
Goderich, Sierra Leone
Police Training School 2
Hastings, Sierra Leone
Chinese Friendship Hospital
Jui, Sierra Leone
International Medical Corps (IMC) Kambia
Kambia District, Sierra Leone
International Medical Corps (IMC) Lunsar
Port Loko District, Sierra Leone
Adventist Development and Relief Ebola Treatment Unit
Waterloo, Sierra Leone
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
The Ministry of Health and Social Welfare of the Republic of Liberia
The Ministry of Health and Sanitation of the Republic of Sierra Leone
Institut National de la Santé Et de la Recherche Médicale, France
The Ministry of Health and Public Hygiene of the Republic of Guinea
Investigators
Principal Investigator: Richard T Davey, M.D. National Institute of Allergy and Infectious Diseases (NIAID)

Additional Information:
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT02363322     History of Changes
Other Study ID Numbers: 150083
15-I-0083
First Posted: February 16, 2015    Key Record Dates
Last Update Posted: June 27, 2018
Last Verified: June 11, 2018

Keywords provided by National Institutes of Health Clinical Center (CC) ( National Institute of Allergy and Infectious Diseases (NIAID) ):
Medical Countermeasures
VHF
EVD

Additional relevant MeSH terms:
Infection
Communicable Diseases
Virus Diseases
Hemorrhagic Fever, Ebola
Hemorrhagic Fevers, Viral
RNA Virus Infections
Filoviridae Infections
Mononegavirales Infections
Coal Tar
Keratolytic Agents
Dermatologic Agents