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Two recent studies have suggested that in patients with Covid19, treatment with hydroxychloroquine may shorten the duration of symptoms and improve viral clearance, an effect that appears most pronounced when combined with azithromycin. Hydroxychloroquine treatment may inhibit viral nucleic acid-mediated activation of various innate immune pathways, as well as blockade of lysosomal functions in cell types relevant for viral entry and antigen presentation.
The purpose of the study was to determine if oral hydroxychloroquine monotherapy, or in combination with azithromycin results in clinical benefit in patients hospitalized with COVID19 pneumonia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1: hydroxychloroquine + aithromycin placebo | Experimental | Hydroxychloroquine 600mg o.d. as loading dose (Day 1) +followed by 200mg t.i.d was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin (AZT) placebo o.d. |
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| Arm 2: hydroxychloroquine + azithromycin | Experimental | Hydroxychloroquine 600 mg o.d. as a loading dose (Day 1) followed by 200 mg t.i.d. was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin: 500 mg as a loading dose (Day 1) followed by 250 mg o.d. Day 2 - Day 5 |
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| Arm 3: hydroxychloroquine placebo + azithromycin placebo | Placebo Comparator | Hydroxychloroquine placebo o.d. (day 1) followed by hydroxychloroquine placebo t.i.d Azythromycin placebo o.d. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HCQ | Drug | Hydroxychloroquine Monotherapy |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Who Achieved Clinical Response by Day 15 | Clinical response was defined as a) discharged alive; or b) No need for mechanical ventilation in any participants and no need for supplemental oxygen requirement (SpO2) in participants without pre-morbid O2 requirement. | 15 days |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Who Achieved Viral Clearance | Number and percentage of participants with negative or below LLOQ SARS-COV-2 based on polymerase chain reaction (PCR) test | 6 days and 10 Days |
| Number of Participants Discharged or Ready for Discharge |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Novartis Investigative Site | Fullerton | California | 92835 | United States | ||
| Novartis Investigative Site |
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| Label | URL |
|---|---|
| A Plain Language Trial Summary is available on novartisclinicaltrials.com | View source |
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Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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One patient was mis-randomized and never received any treatment. This patient has creatine clearance level <45 mL/min or required acute renal replacement therapy and therefore was not eligible for inclusion in the study.
Study was conducted in 9 centers in the United States. A total of 20 participants were randomized, of whom 19 were treated.
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| ID | Title | Description |
|---|---|---|
| FG000 | Arm 1: Hydroxychloroquine + Aithromycin Placebo | Hydroxychloroquine 600mg o.d. as loading dose (Day 1) +followed by 200mg t.i.d was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin placebo o.d. |
| FG001 | Arm 2: Hydroxychloroquine + Azithromycin |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Treatment Phase of 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 | Apr 8, 2020 | Mar 8, 2021 |
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| HCQ+AZT | Drug | Hydroxychloroquine with azithromycin |
|
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| Placebo | Drug | Placebo |
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Number of participants who received hydrochloroquine plus azithromycin relative to placebo who were discharged from hospital |
| 15 days |
| Time to Return to Pre-morbid Supplemental Oxygen Requirement in Participants Receiving Hydrochloroquine or Hydrochloroquine Plus Azithromycin Relative to Placebo | Number of participants requiring supplemental oxygen at the time of randomization who returned to pre-morbid supplemental oxygen | 15 days |
| Los Angeles |
| California |
| 90095-1793 |
| United States |
| Novartis Investigative Site | Chicago | Illinois | 60612 | United States |
| Novartis Investigative Site | Baton Rouge | Louisiana | 70809 | United States |
| Novartis Investigative Site | Baltimore | Maryland | 21287 | United States |
| Novartis Investigative Site | Chapel Hill | North Carolina | 27599 | United States |
| Novartis Investigative Site | Seattle | Washington | 98104 | United States |
Hydroxychloroquine 600 mg o.d. as a loading dose (Day 1) followed by 200 mg t.i.d. was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin: 500 mg as a loading dose (Day 1) followed by 250 mg o.d. Day 2 - Day 5 |
| FG002 | Arm 3: Hydroxychloroquine Placebo + Azithromycin Placebo | Hydroxychloroquine placebo o.d. (day 1) followed by hydroxychloroquine placebo t.i.d Azythromycin placebo o.d. |
| COMPLETED |
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| NOT COMPLETED |
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| Study Completion Phase |
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Full Analysis Set (FAS) was comprised of all participants to whom study treatment had been assigned by randomization excluding one mis-randomized participant.
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm 1: Hydroxychloroquine + Aithromycin Placebo | Hydroxychloroquine 600mg o.d. as loading dose (Day 1) +followed by 200mg t.i.d was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin placebo o.d. |
| BG001 | Arm 2: Hydroxychloroquine + Azithromycin | Hydroxychloroquine 600 mg o.d. as a loading dose (Day 1) followed by 200 mg t.i.d. was initiated within 8-12 hours of the loading dose (not to exceed 12 hours) Azithromycin: 500 mg as a loading dose (Day 1) followed by 250 mg o.d. Day 2 - Day 5 |
| BG002 | Arm 3: Hydroxychloroquine Placebo + Azithromycin Placebo | Hydroxychloroquine placebo o.d. (day 1) followed by hydroxychloroquine placebo t.i.d Azythromycin placebo o.d. |
| 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, 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/Ethnicity, Customized | FAS | 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 | ||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants Who Achieved Clinical Response by Day 15 | Clinical response was defined as a) discharged alive; or b) No need for mechanical ventilation in any participants and no need for supplemental oxygen requirement (SpO2) in participants without pre-morbid O2 requirement. | Full Analysis Set (FAS) was comprised of all participants to whom study treatment had been assigned by randomization excluding one mis-randomized participant. | Posted | Count of Participants | Participants | 15 days |
|
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| ||||||||||||||||||||||||||||||||
| Secondary | Number of Participants Who Achieved Viral Clearance | Number and percentage of participants with negative or below LLOQ SARS-COV-2 based on polymerase chain reaction (PCR) test | FAS | Posted | Count of Participants | Participants | 6 days and 10 Days |
| ||||||||||||||||||||||||||||||||||
| Secondary | Number of Participants Discharged or Ready for Discharge | Number of participants who received hydrochloroquine plus azithromycin relative to placebo who were discharged from hospital | FAS | Posted | Number | participants | 15 days |
| ||||||||||||||||||||||||||||||||||
| Secondary | Time to Return to Pre-morbid Supplemental Oxygen Requirement in Participants Receiving Hydrochloroquine or Hydrochloroquine Plus Azithromycin Relative to Placebo | Number of participants requiring supplemental oxygen at the time of randomization who returned to pre-morbid supplemental oxygen | FAS | Posted | Number | participants | 15 days |
|
at day 15
Adverse Events (AEs) are any untoward sign or symptom that occured during the study treatment period of 15 days
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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 | Hydroxychloroquine + Aithromycin Placebo | HCQ | 0 | 7 | 1 | 7 | 4 | 7 |
| EG001 | Hydroxychloroquine + Azithromycin | HCQ + AZI | 0 | 7 | 0 | 7 | 5 | 7 |
| EG002 | Hydroxychloroquine Placebo + Azithromycin Placebo | HCG + AZI + Placebo | 1 | 5 | 2 | 5 | 2 | 5 |
| EG003 | Total | Total | 1 | 19 | 3 | 19 | 11 | 19 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cardiac arrest | Cardiac disorders | MedDRA (23.0) | Systematic Assessment |
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| Acute kidney injury | Renal and urinary disorders | MedDRA (23.0) | Systematic Assessment |
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| Hypoxia | Respiratory, thoracic and mediastinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Tachypnoea | Respiratory, thoracic and mediastinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Intracardiac mass | Cardiac disorders | MedDRA (23.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Gastrooesophageal reflux disease | Gastrointestinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Chest discomfort | General disorders | MedDRA (23.0) | Systematic Assessment |
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| Chest pain | General disorders | MedDRA (23.0) | Systematic Assessment |
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| Chills | General disorders | MedDRA (23.0) | Systematic Assessment |
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| Fatigue | General disorders | MedDRA (23.0) | Systematic Assessment |
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| Pain | General disorders | MedDRA (23.0) | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA (23.0) | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Aspartate aminotransferase increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Blood bilirubin increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Blood lactate dehydrogenase increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Blood triglycerides increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Electrocardiogram QT prolonged | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Hepatic enzyme increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Neutrophil percentage increased | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Urine analysis abnormal | Investigations | MedDRA (23.0) | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | MedDRA (23.0) | Systematic Assessment |
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| Hypercholesterolaemia | Metabolism and nutrition disorders | MedDRA (23.0) | Systematic Assessment |
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| Hyperkalaemia | Metabolism and nutrition disorders | MedDRA (23.0) | Systematic Assessment |
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| Vitamin B12 deficiency | Metabolism and nutrition disorders | MedDRA (23.0) | Systematic Assessment |
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| Muscular weakness | Musculoskeletal and connective tissue disorders | MedDRA (23.0) | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (23.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (23.0) | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | MedDRA (23.0) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (23.0) | Systematic Assessment |
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| Feeling of despair | Psychiatric disorders | MedDRA (23.0) | Systematic Assessment |
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| Insomnia | Psychiatric disorders | MedDRA (23.0) | Systematic Assessment |
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| Acute kidney injury | Renal and urinary disorders | MedDRA (23.0) | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Hypoxia | Respiratory, thoracic and mediastinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Pleuritic pain | Respiratory, thoracic and mediastinal disorders | MedDRA (23.0) | Systematic Assessment |
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| Night sweats | Skin and subcutaneous tissue disorders | MedDRA (23.0) | Systematic Assessment |
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| Hypotension | Vascular disorders | MedDRA (23.0) | Systematic Assessment |
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Only 20 participants of the initially planned 444 were randomized; and one of those was mis-randomized (so total of 19 participants). Due to this limited number of participants, study objectives could not be evaluated as planned. Results for select efficacy and for safety were summarized based in the information collected up to the eCRF database lock on 13-Aug-2020.
The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (i.e., data from all sites) in the clinical trial or disclosure of trial results in their entirety.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Novartis Pharmaceuticals | +1 (862) 778-8300 | novartis.email@novartis.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Aug 13, 2020 | Mar 8, 2021 | SAP_001.pdf |
| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D018352 | Coronavirus Infections |
| D045169 | Severe Acute Respiratory Syndrome |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| Between 18 and 65 years |
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| >=65 years |
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| Male |
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| Black or African American |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Unknown |
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