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This study will evaluate the safety, pharmacokinetics and effectiveness of a single dose of 600 mg IV peramivir in the treatment of elderly subjects with acute uncomplicated influenza infection and in subjects with acute uncomplicated influenza infection at higher risk for influenza complications. All subjects will receive IV peramivir.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peramivir | Experimental | Single dose 600 mg IV injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peramivir | Drug |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability, as Measured by the Number of Adverse Events. | Safety was evaluated through assessment of Adverse Events (AEs). | 14 days |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma Exposure of IV Peramivir as Measured by Drug Concentrations up to 3 Hours Post Infusion | Up to 3 plasma samples will be drawn, where possible: immediately following infusion, 30 mins to 1 hr post-infusion & 1 to 3 hrs post-infusion. Maximum concentration (Cmax), area under the concentration vs. time curve (AUC) from time 0 to 1 hour (AUC0-1), AUC from time 0 to 1.5 hours (AUC0-1.5), and AUC from time 0 to the last measurable time point (AUC0-last) were calculated in Phoenix® WinNonlin® v6.4. No summary statistics were reported due to the variation in the infusion time and sampling times. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Carol Clark, MD | Prof., Dept. of Emergency Medicine, Oakland University, William Beaumont School of Medicine, Royal Oak, MI | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peramivir Investigational Site | Brooksville | Florida | United States | |||
| Peramivir Investigational Site |
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A single dose of IV peramivir was administered to elderly subjects (≥ 65 years old) and at risk subjects with acute uncomplicated influenza. Subjects received a single IV dose of 600 mg peramivir if they had creatinine clearance (CLCR) ≥ 50 mL/min and a reduced dose if they had CLCR < 50 mL/min (200 mg for CLCR 30 to 49 mL/min and 100 mg for CLCR 10 to 29 mL/min).
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| ID | Title | Description |
|---|---|---|
| FG000 | At Risk (<65 Years) | A single IV dose of peramivir was administered to adults considered at risk, including pregnant women, residents of long-term care facilities, American Indians and Alaskan Natives, as well as those with comorbidities (e.g. asthma, heart disease, diabetes) that increased the risk of complications. |
| FG001 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 9, 2017 | Nov 10, 2020 |
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| up to 3 hours post peramivir infusion |
| Time to Resolution of Fever | Time for fever resolution based on subject diary record of temperature recorded twice daily. A subject had resolution of fever if he/she had an oral temperature < 37.4°C/99.4°F oral and no antipyretic medications were taken for at least 12 hours. The time to resolution of fever was estimated for each age group and overall using the Kaplan-Meier method with temperature and symptom relief medication information obtained from the Subject Diary data. Subjects who did not have resolution of fever were censored at the time of their last non-missing post-baseline temperature assessment. | 14 days |
| Time to Resolution of Influenza Symptoms | Subjects were asked to provide an assessment of 7 influenza symptoms (cough, sore throat, nasal congestion, myalgia [aches and pains], headache, feverishness, and fatigue) on a 4-point severity scale (0, absent; 1, mild; 2, moderate; 3, severe) beginning at Screening then twice daily beginning on Day 1 through to Day 13, and prior to the subject's clinic visit on Day 14. Once all symptoms were scored a 0 or 1 for at least 48 hours, recordings were discontinued. The time to alleviation of symptoms, defined as the time from initiation of study drug until the start of the 21.5-hour period (24 hours less 10%), where all symptoms of influenza were recorded as none (0) or mild (1), was estimated overall and for each age group using the Kaplan-Meier method. | 14 days |
| Changes in Influenza Virus Titer in Nasopharyngeal Samples in Response to Treatment. | Change in influenza viral titers was defined as the time-weighted change from Baseline in log_10 tissue culture infective dose_50 (TCID50/mL) and was summarized for each treatment group. | Change from baseline assessed on days 3, 7 and 14. |
| Time to Reduction in Viral Shedding | Assessment of viral shedding in bilateral, mid-nasal swab specimens taken at baseline and then on Day 3, 7 and 14. | 14 days |
| Incidence of Influenza-related Complications | Study personnel evaluated the subject at Screening and Days 3, 7, and 14 for the presence of clinical signs and/or symptoms of the following influenza-related complications: Sinusitis, Otitis media, Bronchitis & Pneumonia. Note that subjects with clinical signs and/or symptoms consistent with bacterial infections, including otitis media, bronchitis, sinusitis, and/or pneumonia at Screening, were not eligible for enrollment in this study. If an influenza-related complication was suspected, then a targeted physical examination was to be conducted to confirm the presence or absence of the influenza-related complication. | 14 days |
| Time to Return to Usual Activities | The ability to perform usual daily activities was assessed on a VAS (Visual Analogue Scale), where 0 indicates "unable to perform usual activities at all" and 10 indicates "able to perform usual activities.". The time to return to usual activities was the number of days from initiation of study drug until the subject recorded a rating of 10 (able to perform all usual activities fully) on the VAS; this was estimated for each age group and overall using the Kaplan-Meier method. | 14 days |
| Lakeland |
| Florida |
| United States |
| Peramivir Investigational Site | Miami | Florida | United States |
| Peramivir Investigational Site | St. Petersburg | Florida | United States |
| Peramivir Investigational Site | Tampa | Florida | United States |
| Peramivir investigative site | Indianapolis | Indiana | United States |
| Peramivir investigative site | Detroit | Michigan | United States |
| Peramivir Investigational Site | Dayton | Ohio | United States |
| Peramivir investigative site | Smithfield | Pennsylvania | United States |
| Peramivir Investigational Site | Houston | Texas | United States |
| Peramivir Investigative Site | San Antonio | Texas | United States |
| Peramivir investigative site | Splendora | Texas | United States |
| Peramivir Investigational Site | Draper | Utah | United States |
| Peramivir Investigational Site | Salt Lake City | Utah | United States |
| Peramivir investigative site | South Jordan | Utah | United States |
| Elderly (65-75 Years) |
A single IV dose of peramivir was administered to adults aged 65 to 75 years |
| FG002 | Very Elderly (>75 Years) | A single IV dose of peramivir was administered to adults aged over 75 years |
| ITT Population | Intent-to-Treat (ITT) population included all enrolled subjects. |
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| Safety Population | The safety population included all enrolled subjects who received any amount of study drug. |
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| ITTI Population | Intent-to-Treat Infected (ITTI) population included all subjects who were enrolled, treated, and had influenza type A or B confirmed by PCR. |
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| E-R Population | Exposure-Response (E-R) population included all subjects in the ITTI population who had a quantifiable peramivir concentration on Day 1 and had at least one post-baseline effectiveness assessment. |
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| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | At Risk (<65 Years) | A single IV dose of peramivir was administered to adults considered at risk |
| BG001 | Elderly (65-75 Years) | A single IV dose of peramivir was administered to adults aged 65 to 75 years |
| BG002 | Very Elderly (>75 Years) | A single IV dose of peramivir was administered to adults aged over 75 years |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Age at screening (years) |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Baseline Influenza Viral Titre | Number | participants |
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| Baseline Temperature Status | Number | participants |
| ||||||||||||||||
| Baseline Composite Influenza Symptom Score | Subjects were asked to provide an assessment of 7 influenza symptoms (cough, sore throat, nasal congestion, myalgia [aches and pains], headache, feverishness, and fatigue) on a 4-point severity scale (0, absent; 1, mild; 2, moderate; 3, severe). Baseline Composite Symptom Score is defined as the sum of the symptoms of influenza recorded by the subject in the diary prior to the initiation of study drug. The maximum possible score is 21. | Mean | Standard Deviation | Composite Influenza Symptom Score |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Safety and Tolerability, as Measured by the Number of Adverse Events. | Safety was evaluated through assessment of Adverse Events (AEs). | Posted | Count of Participants | Participants | 14 days |
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| Secondary | Plasma Exposure of IV Peramivir as Measured by Drug Concentrations up to 3 Hours Post Infusion | Up to 3 plasma samples will be drawn, where possible: immediately following infusion, 30 mins to 1 hr post-infusion & 1 to 3 hrs post-infusion. Maximum concentration (Cmax), area under the concentration vs. time curve (AUC) from time 0 to 1 hour (AUC0-1), AUC from time 0 to 1.5 hours (AUC0-1.5), and AUC from time 0 to the last measurable time point (AUC0-last) were calculated in Phoenix® WinNonlin® v6.4. No summary statistics were reported due to the variation in the infusion time and sampling times. | 73 subjects from the ITT population had sufficient PK samples collected for inclusion in the peramivir PK analysis | Posted | Mean | Standard Deviation | h*ng/mL | up to 3 hours post peramivir infusion |
| ||||||||||||||||||||||||||||||||||
| Secondary | Time to Resolution of Fever | Time for fever resolution based on subject diary record of temperature recorded twice daily. A subject had resolution of fever if he/she had an oral temperature < 37.4°C/99.4°F oral and no antipyretic medications were taken for at least 12 hours. The time to resolution of fever was estimated for each age group and overall using the Kaplan-Meier method with temperature and symptom relief medication information obtained from the Subject Diary data. Subjects who did not have resolution of fever were censored at the time of their last non-missing post-baseline temperature assessment. | Intent to treat infected (ITTI) population. Subjects who did not have resolution of fever were censored at the time of their last non-missing post-baseline temperature assessment; this included 1 subject in the 'At Risk (<65 years)' group. Twelve subjects were excluded from summaries due to missing data or events resolving prior to initiation of study drug. | Posted | Median | 95% Confidence Interval | hours | 14 days |
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| Secondary | Time to Resolution of Influenza Symptoms | Subjects were asked to provide an assessment of 7 influenza symptoms (cough, sore throat, nasal congestion, myalgia [aches and pains], headache, feverishness, and fatigue) on a 4-point severity scale (0, absent; 1, mild; 2, moderate; 3, severe) beginning at Screening then twice daily beginning on Day 1 through to Day 13, and prior to the subject's clinic visit on Day 14. Once all symptoms were scored a 0 or 1 for at least 48 hours, recordings were discontinued. The time to alleviation of symptoms, defined as the time from initiation of study drug until the start of the 21.5-hour period (24 hours less 10%), where all symptoms of influenza were recorded as none (0) or mild (1), was estimated overall and for each age group using the Kaplan-Meier method. | Intent to treat infected (ITTI) population. Subjects who did not experience alleviation of symptoms were censored at the date of their last non-missing post-baseline assessment; this included 5 subjects in the 'At Risk (<65 years)' group, 4 subjects in the 'Elderly (65-75 years)' group and 2 subjects in the 'Very Elderly (>75 years)' group. | Posted | Mean | Standard Deviation | hours | 14 days |
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| Secondary | Changes in Influenza Virus Titer in Nasopharyngeal Samples in Response to Treatment. | Change in influenza viral titers was defined as the time-weighted change from Baseline in log_10 tissue culture infective dose_50 (TCID50/mL) and was summarized for each treatment group. | The Intent To Treat Infected (ITTI) population included all subjects who were enrolled, received study drug, and had confirmed influenza A and/or B by PCR. Eight subjects were excluded due to a negative or missing BL titer. | Posted | Median | Full Range | influenza viral titer - log10 TCID50/mL | Change from baseline assessed on days 3, 7 and 14. |
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| Secondary | Time to Reduction in Viral Shedding | Assessment of viral shedding in bilateral, mid-nasal swab specimens taken at baseline and then on Day 3, 7 and 14. | Intent to treat infected (ITTI) population + ITT population with positive baseline influenza viral titers [> 0.5 log10 TCID50/mL]. Eight subjects were excluded due to a negative or missing Baseline titer. | Posted | Count of Participants | Participants | 14 days |
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| Secondary | Incidence of Influenza-related Complications | Study personnel evaluated the subject at Screening and Days 3, 7, and 14 for the presence of clinical signs and/or symptoms of the following influenza-related complications: Sinusitis, Otitis media, Bronchitis & Pneumonia. Note that subjects with clinical signs and/or symptoms consistent with bacterial infections, including otitis media, bronchitis, sinusitis, and/or pneumonia at Screening, were not eligible for enrollment in this study. If an influenza-related complication was suspected, then a targeted physical examination was to be conducted to confirm the presence or absence of the influenza-related complication. | Intent-to-treat infected (ITTI) population | Posted | Number | participants | 14 days |
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| Secondary | Time to Return to Usual Activities | The ability to perform usual daily activities was assessed on a VAS (Visual Analogue Scale), where 0 indicates "unable to perform usual activities at all" and 10 indicates "able to perform usual activities.". The time to return to usual activities was the number of days from initiation of study drug until the subject recorded a rating of 10 (able to perform all usual activities fully) on the VAS; this was estimated for each age group and overall using the Kaplan-Meier method. | Subjects who did not return to normal activities were censored at the time of their last non-missing post-baseline assessment; this included 9 subjects in the 'At Risk (<65 years)' group, 12 subjects in the 'Elderly (65-75 years)' group and 2 subjects in the 'Very Elderly (>75 years)' group. Two subjects were excluded from summaries due to missing data or events resolving prior to initiation of study treatment. | Posted | Mean | Standard Deviation | days | 14 days |
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Reports of AEs were to be collected from the time the subject signed the informed consent through to the follow-up period ending on Day 14.
Adverse events were graded through use of the Division of Acquired Immune Deficiency Syndrome (DAIDS) Tables for Grading Adult and Pediatric Adverse Experiences. Influenza-related complications were not considered AEs unless they met the criteria for an SAE.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | At Risk (<65 Years) | A single IV dose of peramivir was administered to adults considered at risk | 0 | 41 | 0 | 41 | 17 | 41 |
| EG001 | Elderly (65-75 Years) | A single IV dose of peramivir was administered to adults aged 65 to 75 years | 0 | 25 | 0 | 25 | 9 | 25 |
| EG002 | Very Elderly (>75 Years) | A single IV dose of peramivir was administered to adults aged over 75 years | 0 | 7 | 0 | 7 | 1 | 7 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Breath sounds abnormal | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Wheezing | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Blood pressure increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Cystitis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Urinary tract infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Bronchospasm | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Dermatitis | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Cerumen impaction | Ear and labyrinth disorders | MedDRA (18.0) | Systematic Assessment |
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| Eustachian tube dysfunction | Ear and labyrinth disorders | MedDRA (18.0) | Systematic Assessment |
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| Eye pain | Eye disorders | MedDRA (18.0) | Systematic Assessment |
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| Vision blurred | Eye disorders | MedDRA (18.0) | Systematic Assessment |
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| Blood lactate dehydrogenase increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Blood pressure diastolic increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Blood urine present | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Carbon dioxide decreased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Nitrite urine present | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Red blood cells urine positive | Investigations | MedDRA (18.0) | Systematic Assessment |
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| White blood cells urine positive | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Abdominal pain upper | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Hordeolum | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Pharyngitis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Respiratory tract infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Vulvovaginal mycotic infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Infusion site extravasation | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Insomnia | Psychiatric disorders | MedDRA (18.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | BioCryst Pharmaceuticals Inc | +1 919-859-1302 | clinicaltrials@biocryst.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jun 13, 2018 | Nov 10, 2020 | SAP_001.pdf |
| ID | Term |
|---|---|
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| C414210 | peramivir |
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| Male |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Negative |
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| Missing |
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| Fever |
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| Subjects with at Least 1 Adverse Event Leading to Study Discontinuation |
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| Subjects with at Least 1 Severe or Life-Threatening Adverse Event |
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| Subjects with at Least 1 Severe or Life-Threatening Adverse Event Related to Study Drug |
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A single IV dose of peramivir was administered to adults aged over 75 years |
|
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| OG002 | Very Elderly (>75 Years) | A single IV dose of peramivir was administered to adults aged over 75 years |
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| Units |
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| Counts |
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| Participants |
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| Units | Counts |
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| Participants |
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A single IV dose of peramivir was administered to adults aged over 75 years
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