Inhaled Aviptadil for the Treatment of COVID-19 in Patients at High Risk for ARDS

• Status: Recruiting
• Trial end date: 2022-04-01
• Target enrollment: 0
• Participant gender: All

Summary

The world is currently experiencing a coronavirus (CoV-2) pandemic. A new (SARS)-CoV infection epidemic began in Wuhan, Hubei, China, in late 2019; originally called 2019- nCoV the virus is now known as SARSCoV- 2 and the disease it causes COVID-19. Previous CoV epidemics included severe acute respiratory syndrome (SARS)-CoV, which started in China in 2003 and Middle East respiratory syndrome (MERS)-CoV in the Middle East, which started in 2012. The mortality rates were >10% for SARS and >35% for MERS. The direct cause of death is generally due to ensuing severe atypical pneumonia and ensuing acute respiratory distress syndrome (ARDS). Pneumonia also is generally the cause of death for people who develop influenza, although the mortality rate is lower (1%-3% for the influenza A H5N1 pandemic of 1918-1919 in the United States). Risk factors for a poor outcome of SARS-CoV-2 infection have so far been found to include older age and co-morbidities including chronic cardiovascular and respiratory conditions and current smoking status. In May 2020, the FDA authorized the emergency use of remdesivir for treatment of COVID-19 disease based on topline date of two clinical trials, even though an underpowered clinical trial did not find significant improvement in COVID- 19 patients treated with remdesivir. Nevertheless, remdesivir is the first and so far, only approved treatment for COVID-19. Additionally further trials and clinical observations have not found a significant benefit of other antiviral drugs. Although the results of several studies are still pending, there is still a desperate need for an effective, safe treatment for COVID-19. Aviptadil, which is a synthetic form of Human Vasoactive Intestinal Polypeptide (VIP), might be beneficial in patients at risk of developing ARDS. Nonclinical studies demonstrate that VIP is highly concentrated in the lung, where it reduces inflammation.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Prof. Dr. Jörg Leuppi

Criteria

Inclusion Criteria:

• COVID-19 infection diagnosed

• Risk factors for the development of an ARDS according to an adapted EALI (early acute lung injury score) ≥ 2 Points (with at least one point from the EALI score)

EALI Score:

• 2-6l O2 supplementation to achieve a SaO2>90%: 1 point

• >6l O2 supplementation to achieve a SaO2>90%: 2 points

• Respiratory rate ≥ 30/min: 1 point

• Immunosuppression: 1 Point

Modification (for adapting for risk factors for ARDS in SARS-CoV-2 affected patients

• Arterial hypertension: 1 point

• Diabetes: 1 point

• Fever > 39°C: 1 point

• Age > 18 years

• Ability to adequate compliance with the inhalation manoeuvre

• Ability to sign the informed consent

Exclusion Criteria:

• Known or highly suspected bacterial infection (antibiotic treatment to avoid bacterial superinfection may be allowed)

• PCT ≥ 1μg/l

• Mechanical ventilation

• Inability to conduct inhalation therapy

• Hemodynamic instability with requirement of vasopressor therapy

• Severe comorbidities interfering with the safe participation at the trial according to the treating physician

• Pregnancy

• Systemic immunosuppression