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Protection of endothelial dysfunction by intravenous infusion of Defibrotide (Defitelio), expected to decrease inflammation and expression of adhesion molecules in the endothelium, leukocyte tissue infiltration and epithelial destruction, and to promote immune tolerance through a change in the Cytokine balance, which is decisive in preventing multiorgan failure and death in patients with SARS-CoV-2 infection with clinical status grade 4 or 5 according to the WHO classification
Protection of endothelial dysfunction by intravenous infusion of Defibrotide (Defitelio), expected to decrease inflammation and expression of adhesion molecules in the endothelium, leukocyte tissue infiltration and epithelial destruction, and to promote immune tolerance through a change in the Cytokine balance, which is decisive in preventing multiorgan failure and death in patients with SARS-CoV-2 infection with clinical status grade 4 or 5 according to the WHO classification
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Defibrotide + standard therapy | Experimental | Defibrotide + standard therapy |
|
| Placebo | Placebo Comparator | Placebo + standard therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Defibrotide | Drug | 6.25 mg/kg every 6 hours in 2 hours infusion for 7 or 15 days |
|
| Measure | Description | Time Frame |
|---|---|---|
| Clinical improvement. | Number of days that the patient maintains the clinical improvement. The patient achieves a change of al least 1 category on WHO scale. | 7,15, 30 day |
| Measure | Description | Time Frame |
|---|---|---|
| 1. Mortality rate | All cause mortality | : up to 30 days |
| Rate os serious adverse events . | Number of adverse events with possible, probable or definite relationship with the study. |
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Inclusion Criteria:
Acceptance of participation in the study by the patient or legal representative.
Patients of any gender, 18 years or older.
Confirmed diagnosis by PCR+ of SARS-CoV-2 infection.
COVID-19 positive patients WHO grades 4, 5 or 6.
Levels of IL-6 ≥ 3 times the upper limit of normality
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital General Universitario Santa LucĂa | Cartagena | Murcia | Spain | |||
| Hospital Clinico y Provincial de Barcelona |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42117493 | Derived | Jara Rubio R, Martinez-Mellado AJ, Kiwitt-Cardenas J, Clavel JG, Garcia-Perez B, Castro P, Diaz-Ricart M, Carrillo-Alcaraz A, Lopez-Bernus A, Bernal Morell E, Roura A, Marin S, Ruiz-Lopez FJ, Solana-Martinez E, Martinez-Bano D, Albacete Moreno CL, Andreu Soler E, Tellez Santoyo A, Fernandez Mendez S, Noguera Velasco JA, Cebreiros Lopez I, Parrilla A, Espuny-Miro A, Garcia-Bernal D, Blanquer M, Sanchez-Salinas A, Iniesta F, Hernandez Garcia C, Muro M, Minguela Puras A, Moreno-Docon A, Torres-Cantero AM, Munoz Garcia M, Serrano M, Iacobelli M, Carlo-Stella C, Wei LJ, Richardson PG, Moraleda JM. Phase IIB, Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Intravenous Defibrotide for the Prevention and Treatment of Respiratory Distress and Cytokine Release Syndrome in COVID-19. Eur J Haematol. 2026 May 12. doi: 10.1111/ejh.70214. Online ahead of print. |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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| ID | Term |
|---|---|
| C036901 | defibrotide |
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Phase IIb prospective, multi-center, randomized, parallel, double blind, placebo controlled
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double blind
| Placebo | Drug | Placebo 250 cc every 6 hours for 7 or15 days |
|
| 7, 15, 30 and 60 Day |
| Clinical improvement by WHO | Decrease ventilation days in grade 6 patients | 7, 15, 30 and 60 Day |
| Clinical improvement by NEWS2 scales | Decrease the rate of grades 4-5 patients requiring mechanical ventilation. | 7, 15, 30 and 60 Day |
| Clinical improvement by NEWS2 scales | Decrease ventilation days in grade 6 patients | 7, 15, 30 and 60 Day |
| Biologic response | Decrease of IL-6 levels with respect to the basal ones > 50%. | 7, 15, 30 and 60 Day |
| Biologic response | Absolute lymphocytes count: 50% increase with respect to the baseline | 7, 15, 30 and 60 Day |
| Biologic response | Normal D-dimer (DD) or decrease of 50% with respect to the baseline | 7, 15, 30 and 60 Day |
| Biologic response | Normal CRP or decrease of 50% with respect to the baseline | 7, 15, 30 and 60 Day |
| Biologic response | Normal LDH or decrease of 50% with respect to the baseline | 7, 15, 30 and 60 Day |
| Biologic response | Normal CPK or decrease of 50% with respect to the baseline | 7, 15, 30 and 60 Day |
| Biologic response | Normal Ferritin or decrease of 50% with respect to the baseline | 7, 15, 30 and 60 Day |
| Radiological response | Improvement of radiological images by conventional radiology | 7, 15, 30 and 60 Day |
| Collection and storage of biological samples | improve the knowledge of the disease at the inclusion of the patients | 15,30 days |
| Clinical improvement by WHO | Decrease the rate of grades 4-5 patients requiring mechanical ventilation. | 7, 15, 30 and 60 Day |
| Barcelona |
| Spain |
| Virgen de la Arrixaca University Clinical Hospital | Murcia | 30120 | Spain |
| Hospital General Universitario Morales Meseguer | Murcia | Spain |
| Hospital General Universitario Reina SofĂa | Murcia | Spain |
| Hospital Universitario Salamanca | Salamanca | Spain |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |