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An Open-label, prospective, randomized, comparative, multiple doses applied in addition to the standard of care treatment of patients with moderate to severe COVID-19 infection
The justification for the use of immunomodulatory therapy is based on the evidence that drugs that are inhibitors of interleukin IL6 may prevent the more severe lung tissue damage caused by cytokine release in patients with more severe COVID19. Several studies have suggested a "cytokine storm" caused by the release of IL-6, IL-1, IL-12 and IL-18 with tumor necrosis factor TNF alpha and other inflammatory mediators. Increased inflammatory response of lung tissue may result in increased gas exchange at the alveolar-capillary level making oxygenation difficult in patients with more severe forms of the disease and the need for mechanical ventilation. In this regard, it is hypothesized that the use of immunomodulatory therapy should have an effect in reducing the lethal outcome, the need for oxygen therapy, and mechanical ventilation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ENKORTEN | Experimental |
| |
| The standard of care treatment | Other | The usual therapeutically established protocol for the treatment of patients with moderate to severe COVID-19 infection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| metenkefalin + tridecactide | Drug | ENKORTEN® 5 mg + 1 mg Lyophilisate for Solution for Injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to onset of change in the patient's clinical condition | The time of onset of improvement in the patient's clinical condition will be measured following the clinical objective and subjective signs and radiological indicators. | 21 day |
| Safety and tolerability evaluation - treatment-related adverse events will be assessed by CTCAE | At every examination/evaluation, all AEs, whether noticed by investigators and their associates in the trial, or spontaneously reported by the subjects, or given as answer to direct question, must be evaluated by the investigator and reported on case report forms for AE. AE will be recorded in the e-CRF. Three-degree scale will be used for assessment of AE's severity: mild, moderate, severe. | 21 day |
| Measure | Description | Time Frame |
|---|---|---|
| Length of in-hospital stay | To monitor the period of patient's hospitalization | 21 day |
| Survival rate | To monitor the survival rate during the hospitalization |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rusmir Baljić, PhD | Clinical Center University of Sarajevo | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical Center University of Sarajevo | Sarajevo | Sarajevo Canton | 71000 | Bosnia and Herzegovina | ||
| University Clinical Centre of the Republic of Srpska |
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Open-label, prospective, randomized, comparative, multiple doses applied in addition to the standard of care treatment
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| The standard of care | Drug | The usual therapeutically established protocol, for the treatment of patients with moderate to severe COVID-19 infection prescribed by The Agency for medicinal products and medical devices of Bosnia and Herzegovina |
|
| 21 day |
| Intubation rate | To monitor the intubation frequency during the hospitalization | 21 day |
| Proinflammatory markers levels | To monitor the levels of proinflammatory markers during the hospitalization (IL-6) | 21 day |
| Banja Luka |
| 78000 |
| Bosnia and Herzegovina |
| University Clinical Hospital Mostar | Mostar | 88000 | Bosnia and Herzegovina |
| Hospital Travnik | Travnik | 72270 | Bosnia and Herzegovina |
| Cantonal Hospital Zenica | Zenica | 72000 | Bosnia and Herzegovina |
| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D004744 | Enkephalin, Methionine |
| ID | Term |
|---|---|
| D004745 | Enkephalins |
| D018847 | Opioid Peptides |
| D009479 | Neuropeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D009419 | Nerve Tissue Proteins |
| D011506 | Proteins |
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