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The purpose of this study is to obtain additional data on efficacy and safety of Ergoferon in the treatment of viral intestinal infections in inpatient children.
Design: a multicenter, double-blind, placebo-controlled, randomized clinical trial in parallel groups.
This study will enroll subjects of both sexes aged from 6 months to 6 years who are admitted to hospital within 48 h of the onset of acute intestinal infection (AII), presumably of viral aetiology. Patients to be enrolled in the screening will be children with typical viral gastroenteritis/enteritis symptoms. The key symptom is decreased in the consistency of stools (loose or liquid) and increased in the frequency of its evacuations (at list 3 time daily). Virus detection in stool samples will be performed by polymerase chain reaction (PCR).
After the parent/adopter signs a parents/adopters information sheet (Informed Consent form) for the child's participation in the clinical trial, the recording of medical history data, a medical examination including the evaluation of symptoms on the Clinical Dehydration Scale (CDS) by pediatrician, and laboratory tests will be performed during Visit 1 (Day 1). If inclusion criteria are met and non-inclusion criteria are absent (day 1), the patient will be included in the trial and randomized to administer either Ergoferon or Placebo.
In addition to the standard/pathogenetic therapies, group 1 patients will take Ergoferon following a 5-day regimen, whereas group 2 patients will receive Placebo. The parents/adopters of the patient will be provided with a patient diary and instructed how to complete the diary.
Before treatment stool specimens will be collected from the patients for detection and differentiation of Rotavirus A, Norovirus 2 genotype, Astrovirus, Adenovirus F, Shigella spp., enteroinvasive E.coli (EIEC), Salmonella spp., and thermophilic Campylobacter spp. using a PCR assay to diagnose the etiology of intestinal infection. In total, the patients will be monitored for 10 days (screening, randomization, treatment initiation - Day 1; the treatment on Days 1-5; observation in hospital - Day 6, and follow-up period - Day 7-10). During the treatment and inpatient observation periods (Days 1-6, Visits 1-6), the patients will be examined daily by a pediatrician, and the examination results, including the CDS scores, will be recorded in source documents. The patient's parent/adopter will complete the patient diary every day, recording the presence/absence of diarrhea signs, vomiting, and body temperature. The pediatrician will check them each time for the correctness of completion. On day 10 (after hospital discharge), Visit 7 will be done (as an in-person visit (a hospital or calling a doctor) or a distance, 'phone' visit) to interview the parents/adopters about the patient's health, presence of any complications, and use of medications (the pediatrician will use this information to complete a questionnaire). Collection of stool specimens and repeat PCR for Rotaviruses/Noroviruses/Astroviruses/Adenoviruses, Shigella spp., EIEC, Salmonella spp., and Campylobacter spp. will be performed on Days 3, 4, and 6 of inpatient observation and after discharge from the hospital (Day 10); collection of blood and urine specimens for safety tests will be carried out at baseline and before hospital discharge (day 6). The recording of the intake of study therapies and of concomitant medications as well as the assessment of compliance with and safety of the study therapies will be performed on Days 2-6 and 10.
Patients who recovered while in hospital and are discharged from the unit earlier than at 5 days will undergo the procedures of Visit 6, including the collection of biological specimens for PCR (efficacy evaluation) and biochemistry, blood test and urinalysis (safety assessment). The parents/adopters will be given the blister pack with the remaining study drug so that the patient can continue the treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ergoferon | Experimental | Tablet for oral use. Dose per administration - 1 tablet per intake (outside a meal/feeding). Within the first 2 hours - 1 tablet every 30 minutes, followed by 3 more tablets at time intervals equally separated throughout the rest of the day; from day 2 to day 5 - 1 tablet 3 times daily. |
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| Placebo | Placebo Comparator | Tablet for oral use. Dose per administration - 1 tablet per intake (outside a meal/feeding). Within the first 2 hours - 1 tablet every 30 minutes, followed by 3 more tablets at time intervals equally separated throughout the rest of the day; from day 2 to day 5 - 1 tablet 3 times daily. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ergoferon | Drug |
| ||
| Placebo |
| Measure | Description | Time Frame |
|---|---|---|
| Average Diarrhea Duration. | Diarrhea duration is considered as the time between receiving the first dose of investigational medicine /placebo and the normal consistency of stool pattern (to the previous stool consistency before diarrhea), i.e.
| On days 1-10 of observation period. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Patients Without Diarrhea. | Based on medical records. | 48, 72 and 96 hours of the treatment. |
| Percentage of Patients With Recovery. | Based on medical records. Recovery criteria: absence of diarrhea, vomiting, symptoms of dehydration, and increased body temperature (based on daily examinations by pediatrician). |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| State budgetary Health Care institution of the Arkhangelsk region "Arkhangelsk Regional Pediatric Clinical Hospital named after PG Vyzhletsova" | Arkhangelsk | 163002 | Russia |
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| ID | Title | Description |
|---|---|---|
| FG000 | Ergoferon | Within the first 2 hours - 1 tablet every 30 minutes, followed by 3 more tablets at time intervals equally separated throughout the rest of the day; from day 2 to day 5 - 1 tablet 3 times daily. Ergoferon |
| FG001 | Placebo |
| 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_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Nov 2, 2015 |
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|
| 48, 72 and 96 hours of the treatment. |
| Average Illness Duration. | From the enrollment to the recovery. Recovery criteria: absence of diarrhea, vomiting, symptoms of dehydration, and increased body temperature (based on daily examinations by pediatrician). | On days 1-10 of observation period. |
| Total Clinical Dehydration Scale Score. | Based on medical records. Clinical Dehydration Scale score is more or equal 1. Note: minimum values - 0 points, maximum values - 8 points. Interpretation: 0 points - no dehydration, from 1 to 4 points - light dehydration, 5-8 points - average/severe dehydration. | 24, 48, and 72 hours of the treatment. |
| Average Vomiting Duration (if Any). | Based on medical records. | On days 1-10 of observation period. |
| Percentage of Patients With Negative PCR Tests. | Based on medical records. | On days 3, 4, 6 and 10 of observation period. |
| Percentage of Patients With Worsening of Illness and/or Hospital-acquired Infection. | Based on medical records. Worsening of illness: an increase in dehydration scores and worsening of non-specific symptoms, as evidenced by a decline in general appearance, increasing fatigue and drowsiness, refusal to eat and drink, severe tachycardia/bradycardia, unstable hemodynamics, tachypnea, hypo- or hyperventilation, circulation disorders, peripheral cyanosis, sunken eyes, severe dryness of skin and mucous/tongue, poor tissue turgor, absent tears, persistent vomiting, anuria/acute kidney injury, seizure/convulsions, and meningismus. Hospital-acquired infection: a viral or bacterial infection (intestinal, respiratory or urinary tract infection, etc.) occurring after at least 48 h of hospital stay and confirmed by laboratory tests. | On days 1-10 of observation period. |
| Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University" of the Ministry of Healthcare of the Russian Federation | Kazan' | 420012 | Russia |
| Federal Budget Institution of Science "Central Research Institute of Epidemiology" of The Federal Service on Customers' Rights Protection and Human Well-being Surveillance | Moscow | 111123 | Russia |
| Pirogov Russian National Research Medical University | Moscow | 117997 | Russia |
| Federal State Budgetary Educational Institution of Higher Education "Orenburg State Medical University" of the Ministry of Healthcare of the Russian Federation | Orenburg | 460000 | Russia |
| Municipal Budgetary Health Care Institution "Semashko City Hospital â„–1 Rostov-on-Don " | Rostov-on-Don | 344000 | Russia |
| Federal State Budgetary Educational Institution of Higher Education "Saint Petersburg State Pediatric Medical University" of the Ministry of Healthcare of the Russian Federation | Saint Petersburg | 194100 | Russia |
| Sailnt Petersburg State Budgetary Health Care Institution "City Child Hospital â„–22" | Saint Petersburg | 196657 | Russia |
| Federal State Institution "Scientific Research Institute of Children's Infections Federal Biomedical Agency" | Saint Petersburg | 197022 | Russia |
| The State Budget Educational institution of High Professional Training Smolensk State Medical University of Ministry of Health Care of the Russian Federation | Smolensk | 214018 | Russia |
| Federal State Budgetary Educational Institution of Higher Education "Yaroslavl State Medical University" of the Ministry of Healthcare of the Russian Federation | Yaroslavl | 150000 | Russia |
| Federal State Budgetary Institution of Higher Professional Education "Urals State Medical University" of the Ministry of Healthcare of the Russian Federation | Yekaterinburg | 620028 | Russia |
| Scientific Research Institute of Virology of Ministry of Health of Republic Uzbekistan | Tashkent | 100194 | Uzbekistan |
Within the first 2 hours - 1 tablet every 30 minutes, followed by 3 more tablets at time intervals equally separated throughout the rest of the day; from day 2 to day 5 - 1 tablet 3 times daily.
Placebo
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| ID | Title | Description |
|---|---|---|
| BG000 | Ergoferon | 1 tablet 3 times a day Ergoferon |
| BG001 | Placebo | 1 tablet 3 times a day Placebo |
| BG002 | 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, Categorical | Count of Participants | Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Average Diarrhea Duration. | Diarrhea duration is considered as the time between receiving the first dose of investigational medicine /placebo and the normal consistency of stool pattern (to the previous stool consistency before diarrhea), i.e.
| 2 patients in Ergoferon group and 2 patients in Placebo group had no primary outcome data | Posted | Mean | 95% Confidence Interval | hours | On days 1-10 of observation period. |
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| Secondary | Percentage of Patients Without Diarrhea. | Based on medical records. | 2 patients in Ergoferon group and 2 patients in Placebo group had no primary outcome data | Posted | Count of Participants | Participants | 48, 72 and 96 hours of the treatment. |
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| Secondary | Percentage of Patients With Recovery. | Based on medical records. Recovery criteria: absence of diarrhea, vomiting, symptoms of dehydration, and increased body temperature (based on daily examinations by pediatrician). | 2 patients in Ergoferon group and 2 patients in Placebo group had no primary outcome data | Posted | Count of Participants | Participants | 48, 72 and 96 hours of the treatment. |
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| Secondary | Average Illness Duration. | From the enrollment to the recovery. Recovery criteria: absence of diarrhea, vomiting, symptoms of dehydration, and increased body temperature (based on daily examinations by pediatrician). | 2 patients in Ergoferon group and 2 patients in Placebo group had no primary outcome data | Posted | Mean | 95% Confidence Interval | hours | On days 1-10 of observation period. |
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| Secondary | Total Clinical Dehydration Scale Score. | Based on medical records. Clinical Dehydration Scale score is more or equal 1. Note: minimum values - 0 points, maximum values - 8 points. Interpretation: 0 points - no dehydration, from 1 to 4 points - light dehydration, 5-8 points - average/severe dehydration. | Posted | Mean | 95% Confidence Interval | score on a scale | 24, 48, and 72 hours of the treatment. |
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| Secondary | Average Vomiting Duration (if Any). | Based on medical records. | Vomiting occured in 64.8% patients of Ergoferon group and 71.1% patients of placebo group. | Posted | Mean | 95% Confidence Interval | hours | On days 1-10 of observation period. |
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| Secondary | Percentage of Patients With Negative PCR Tests. | Based on medical records. | PCR tests on days 4, 6 and 10 were run on less patients due to technical issues in laboratory | Posted | Count of Participants | Participants | On days 3, 4, 6 and 10 of observation period. |
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| Secondary | Percentage of Patients With Worsening of Illness and/or Hospital-acquired Infection. | Based on medical records. Worsening of illness: an increase in dehydration scores and worsening of non-specific symptoms, as evidenced by a decline in general appearance, increasing fatigue and drowsiness, refusal to eat and drink, severe tachycardia/bradycardia, unstable hemodynamics, tachypnea, hypo- or hyperventilation, circulation disorders, peripheral cyanosis, sunken eyes, severe dryness of skin and mucous/tongue, poor tissue turgor, absent tears, persistent vomiting, anuria/acute kidney injury, seizure/convulsions, and meningismus. Hospital-acquired infection: a viral or bacterial infection (intestinal, respiratory or urinary tract infection, etc.) occurring after at least 48 h of hospital stay and confirmed by laboratory tests. | Posted | Count of Participants | Participants | On days 1-10 of observation period. |
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Adverse/Serious adverse events were collected for 10 days of the therapy and follow-up periods.
Adverse/Serious adverse events were collected in patients of the Safety population (n=259).
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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 | Ergoferon | 1 tablet 3 times a day Ergoferon | 0 | 127 | 2 | 127 | 10 | 127 |
| EG001 | Placebo | 1 tablet 3 times a day Placebo | 0 | 132 | 0 | 132 | 5 | 132 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute respiratory infection | Infections and infestations | MedDRA | Systematic Assessment |
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| Purine metabolism disorder | Metabolism and nutrition disorders | MedDRA | Systematic Assessment | Functional stomach upset. Disoder of purine metabolism (acetone vomiting). |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute nasopharyngitis | Infections and infestations | MedDRA | Systematic Assessment |
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| Acute otitis media | Infections and infestations | MedDRA | Systematic Assessment | Left-sided otitis media (acute, non-suppurative) |
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| Rotavirus infection | Infections and infestations | MedDRA | Systematic Assessment |
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| Pharyngitis | Infections and infestations | MedDRA | Systematic Assessment |
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| Leukocytes in urine | Renal and urinary disorders | MedDRA | Systematic Assessment | An increase in the number of leukocytes in the urine. |
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| Candida Infection | Infections and infestations | MedDRA | Systematic Assessment |
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| Increased levels of ALT | Blood and lymphatic system disorders | MedDRA | Systematic Assessment |
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| Increased levels of AST | Blood and lymphatic system disorders | MedDRA | Systematic Assessment |
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| Increase in the percentage of lymphocytes | Blood and lymphatic system disorders | MedDRA | Systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | MedDRA | Systematic Assessment | Decrease in the percentage of neutrophils |
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| Positive test result for staphylococcus | Infections and infestations | MedDRA | Systematic Assessment | Positive result of isolation and identification of staphylococcus. Discharge of staphylococcus from the nasopharynx. |
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| Hematochezia | Gastrointestinal disorders | MedDRA | Systematic Assessment | The presence of blood in the stool. |
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| Sleep disorder | Psychiatric disorders | MedDRA | Systematic Assessment |
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| Herpangina caused by Coxsackie virus | Infections and infestations | MedDRA | Systematic Assessment | Vesicular pharyngitis |
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| Urinary tract infection | Infections and infestations | MedDRA | Systematic Assessment |
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| Hyperphosphaturia | Renal and urinary disorders | MedDRA | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Mikhail Putilovskiy, MD, PhD, Clinical and Medical Department Director | Materia Medica Holding | +74952761571 | 302 | PutilovskiyMA@materiamedica.ru |
| Jul 7, 2020 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| C000621422 | ergoferon |
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| Between 18 and 65 years |
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| >=65 years |
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