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The goal of this clinical trial is to evaluate the efficacy and safety of liquid dosage form of Rengalin in the treatment of cough in acute viral upper respiratory tract infections infections in children in during the epidemic growth of influenza and ARVI. The main questions it aims to answer are:
Investigators will compare the liquid dosage form of Rengalin to a placebo (a look-alike substance that contains no drug) to see if Rengalin in the liquid dosage form works for cough in acute viral upper respiratory tract infections in children.
Participants will:
Take the liquid dosage form of Rengalin or placebo per os 5 ml per administration 3 times a day for 7 days.
The design is a multicenter, double-blind, placebo-controlled, randomized, parallel-group clinical trial evaluating the efficacy and safety of the study therapy.
The trial will enroll children of either gender aged 6 months to 3 years, who consulted a physician for dry/non-productive cough caused by acute viral upper respiratory tract infections during the seasonal growth of influenza and ARVI.
The duration of cough at inclusion in the trial should be at least 24 hours but not more than 72 hours; cough severity - 6 or more points (according to the Cough Severity Score (CSS)).
After one of the parents/adoptive parents signs the patient information leaflet (PIL) and the informed consent form (ICF) (two versions are used - with the consent of the parent/adoptive parent to take blood and urine samples for the purpose of conducting laboratory tests or without consent) for participation in the clinical trial at Visit 1, complaints and anamnesis are collected, vital signs are assessed, a physical examination is performed, concomitant therapy is recorded, and laboratory tests are conducted.
It is planned to conduct a general urine analysis, general and biochemical blood tests in at least 50% of patients.
At Visit 1, the physician together with the parent/adoptive parent fills out the CSS scale.
If inclusion criteria are met and there are no any exclusion criteria at Visit 1 (Day 1), the patient is enrolled in the study and randomized to one of two groups: Group 1 patients will receive Rengalin; Group 2 patients will receive Placebo.
After three days of the study therapy, at Visit 2 (Day 4), the physician evaluates the patient's condition and adjusts the therapy. If there are indications (secretion of viscous sputum), the physician prescribes the mucolytic ambroxol; at the same time, patients of group 1 continue taking Rengalin, and patients of group 2 continue taking Placebo.
The study will use an electronic patient diary (EPD) in which the parent/adoptive parent will record the severity of daytime and nighttime cough as measured by the CSS during the 7 days the patient is in the study. In addition, any possible worsening of the patient's condition (if applicable) will be recorded in the EPD for safety assessment and recording of adverse events.The investigator will instruct parents/adoptive parents will instruct parents/adoptive parents on how to fill out the diary.
The parent/adoptive parent will make the first marks on the cough severity scale in the EDS together with the physician at Visit 1. The EPD will be available for completion throughout the patient's participation in the study. Twice a day, the parent/adoptive parent will receive an SMS reminder: "Please mark the severity of daytime and nighttime cough in the diary. Do not forget to take the medication given to you." The patient treatment continues for 7 days, observation - for 14 days (screening, randomization - 1 day, treatment - 7 days, follow-up - up to 14 days; delayed "phone visit" - 14 days).
On days 4 (Visit 2) and 8 (Visit 3), two visits are planned (at home or at a medical center), during which the physician collects complaints, records medical examination data, identifies possible bacterial complications of acute respiratory infections, monitors prescribed and concomitant therapy, evaluates the safety of the treatment, and checks the filling of the CSS in the EPD.
At Visit 3 (Day 8), samples are collected for laboratory testing. The study drug that the parent/adopter received at Visit 1 must be returned at Visit 3 to assess compliance with the study therapy.
If the patient's condition worsens, the doctor make an unscheduled visit. "Telephone visit" (Visit 4, Day 14±1) is conducted to interview parents/adoptive parents about the patient's condition, presence/absence of cough, bacterial complications of acute respiratory viral infections, and the possible use of antibacterial drugs.
During the study, the use of antiviral drugs, symptomatic agents, and drugs for the treatment of concomitant diseases is permitted, with the exception of drugs listed in the section "Prohibited concomitant therapy".
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rengalin | Experimental | Orally. 5 ml per dose 3 times a day for 7 days. The drug is taken without meals. |
|
| Placebo | Placebo Comparator | Placebo using the dosing regimen Rengalin for 7 days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rengalin | Drug | Solution for oral administration |
| |
| Placebo |
| Measure | Description | Time Frame |
|---|---|---|
| The percentage of patients responded to treatment | The percentage of patients responded to treatment (reduction in the total (day and night) cough severity score to 3 points or less after 3 days of treatment - isolated cough episodes or complete absence of cough during the day) after 3 days. | On baseline and 3 day |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the total CSS | Change in the total Cough Severity Score (daytime and nighttime) after 7 days of treatment compared to baseline. The minimum value - 0 (no cough) and maximum value - 10 (severe cough). | On baseline and 7 day |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients without daytime cough | Percentage of patients with no daytime cough acording to Cough Severity Score (SCC) after 7 days of treatment. The minimum value - 0 (no cough) and maximum value - 5 (severe cough). | On baseline and 7 day |
| Percentage of patients with a decrease in daytime cough |
Inclusion Criteria:
Exclusion Criteria:
Presence of the following diseases at the time of inclusion in the clinical trial:
1.1 Inflammatory processes in the lower respiratory tract. 1.2 Grade III adenoid hypertrophy. 1.3 Chronic adenoiditis. 1.4 Postnasal drip syndrome. 1.5 Gastroesophageal reflux. 1.6 Bronchial asthma. 1.7 Cystic fibrosis. 1.8 Primary ciliary dyskinesia 1.9 Bronchopulmonary dysplasia 1.10 Malformations of the respiratory and ENT organs 1.11 Other chronic lung diseases. 1.12 Primary/secondary immunodeficiency. 1.13 Oncological disease of any localization.
Suspected bacterial infection of any localization, including pneumonia, sinusitis, otitis media.
Allergic rhinitis.
Bronchial obstruction syndrome.
Acute obstructive laryngitis [croup] and epiglottitis.
Congenital heart defects with hypervolemia in pulmonary circulation.
Acute respiratory failure.
Inflammatory, degenerative, demyelinating diseases of the central nervous system, polyneuropathies, epilepsy.
Exacerbation or decompensation of chronic diseases affecting the patient's ability to participate in a clinical trial.
Presence of allergy/hypersensitivity to any components of the medicines used in the treatment.
Taking medications listed in the section "Prohibited Concomitant Therapy" within 4 weeks prior to inclusion in the study.
Patients whose parents/adoptive parents, from the investigator's point of view, will not comply with observation requirements during the study or with the administration of study drugs.
Participation in other clinical trials within 3 months prior to inclusion in this trial.
A patient's parent/adoptive parent is related to on-site research personnel directly involved in the trial, or is the immediate family member of the investigator. 'Immediate family members' mean spouses, parents, children, or siblings, whether related or adopted.
The patient's parent/adoptive parent is employed by OOO "NPF "MATERIA MEDICA HOLDING", i.e., is an employee of the company, a temporary contract employee, or a designated official responsible for conducting the trial or their immediate family member.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mikhail Putilovskiy, MD,PhD | Contact | +74952761571 | 302 | PutilovskiyMA@materiamedica.ru |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gatchina Clinical Interdistrict Hospital | Recruiting | Gatchina | 188300 | Russia |
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Double-blind, placebo-controlled, randomized, parallel-group
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| Drug |
Solution for oral administration |
|
Percentage of patients with a decrease in daytime cough severity ≤ 1 point on the Cough Severity Score (SCC) after 7 days of treatment. The minimum value - 0 (no cough) and maximum value - 5 (severe cough). |
| On baseline and 7 day |
| Percentage of patients without night cough | Percentage of patients with no night cough (0 points according to the Cough Severity Score (SCC)) after 7 days of treatment. The minimum value - 0 (no cough) and maximum value - 5 (severe cough). | On baseline and 7 day |
| Percentage of patients with a reduction in nighttime cough | Percentage of patients with a reduction in nighttime cough severity ≤ 1 point on the Cough Severity Score (SCC) after 7 days of treatment. The minimum value - 0 (no cough) and maximum value - 5 (severe cough). | On baseline and 7 day |
| Cough severity | Cough severity during 7 days of treatment (based on the area under the curve (AUC) of daytime and nighttime cough scores). The area under the curve is determined in conventional units (points multiplied by days). | 7 days |
| Percentage of patients prescribed the ambroxol | Percentage of patients who were additionally prescribed the mucolytic ambroxol on the 4th day of treatment. | On 4 day |
| Proportion of patients required antibacterial drugs or hospitalization | Proportion of patients with worsening ARVI course (bacterial complications of ARVI that required antibacterial drugs or hospitalization) within 14 days of participation in the trial. | 14 days of treatment |
| Number of patients with adverse events (AEs) | The presence of adverse events. Based on medical records. | From day 1 to day 14 |
| Severity of AEs | Number of patients with the intensity (severity) of adverse events. Based on medical records. | From day 1 to day 14 |
| Causal relationship of AEs to the sudy drug | The causal relationship to the study drug of adverse events. Based on medical records. The assessment of causality is made by the investigator based on his/her clinical opinion (certain, probable, doubtful, conditional, unclassifiable, not related). | From day 1 to day 14 |
| Outcome of AEs | The outcome of adverse events. Based on medical records. The outcome of AE is made by investigator (recovery/resolution, incomplete recovery/resolution, no recovery/resolution, recovery/resolution with consequences, death, unknown). | From day 1 to day 14 |
| Percentage of patients with clinically significant abnormal laboratory tests | Percentage of patients with clinically significant abnormal laboratory tests. Measure is based on the Hematology, blood chemistry, and urinalysis parameters, which are beyond the reference values at the end of treatment. | On 1 and 14 days of treatment |
| Changes in Vital Signs (Heart Rate) | Pulse Rate measured in beats per minute. Based on medical records. | On Visit 1 (day 1), Visit 2 (day 4) and Visit 3 (day 8) |
| Changes in Vital Signs (Breathing Rate) | Respiratory Rate measured in breaths per minute. Based on medical records. | On Visit 1 (day 1), Visit 2 (day 4) and Visit 3 (day 8) |
| Changes in Vital Signs (Axillary temperature) | Temperature is measured in the armpit using a classic mercury-free thermometer. Based on medical records. | On Visit 1 (day 1), Visit 2 (day 4) and Visit 3 (day 8) |
| Llc "Medlight" | Recruiting | Kazan' | 420097 | Russia |
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| Specialized Clinical Infectious Diseases Hospital | Recruiting | Krasnodar | 350015 | Russia |
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| Central Research Institute of Epidemiology | Recruiting | Moscow | 111123 | Russia |
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| First Moscow State Medical University named after I.M. Sechenov | Recruiting | Moscow | 119991 | Russia |
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| Llc "Diagnosis and Vaccines" | Withdrawn | Moscow | 129515 | Russia |
| LLC "Health Laboratory" | Not yet recruiting | Mytishchi | 141002 | Russia |
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| Omsk State Medical University/Department of Hospital Pediatrics with a Course of Continuing Professional Education | Not yet recruiting | Omsk | 644099 | Russia |
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| City Children's Clinical Polyclinic # 5 | Recruiting | Perm | 614066 | Russia |
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| LLC "Professor's Clinic" | Recruiting | Perm | 614070 | Russia |
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| Clinical and diagnostic center "Health" in Rostov-on-Don | Recruiting | Rostov-on-Don | 344011 | Russia |
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| LLC "Clinic EuroDon" | Not yet recruiting | Rostov-on-Don | 344022 | Russia |
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| Rostov State Medical University/Department of Childhood Diseases # 3 | Recruiting | Rostov-on-Don | 344022 | Russia |
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| yazan State Medical University named after Academician I.P. Pavlov/Department of Childhood Diseases with a course in hospital pediatrics | Not yet recruiting | Ryazan | 390026 | Russia |
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| Children's City Polyclinic # 44 | Recruiting | Saint Petersburg | 191144 | Russia |
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| Saint Petersburg State Pediatric University/Department of Infectious Diseases of Adults and Epidemiology | Not yet recruiting | Saint Petersburg | 194100 | Russia |
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| LLC "Zvezdnaya Clinic" | Recruiting | Saint Petersburg | 196158 | Russia |
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| Children's City Polyclinic # 35 | Recruiting | Saint Petersburg | 196191 | Russia |
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| Federal Scientific and Clinical Center for Infectious Diseases of the Federal Medical and Biological Agency | Recruiting | Saint Petersburg | 197022 | Russia |
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| City Polyclinic # 3 | Recruiting | Saint Petersburg | 199155 | Russia |
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| City Polyclinic # 4 | Recruiting | Saint Petersburg | 199178 | Russia |
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| Samara Regional Children's Clinical Hospital named after N.N. Ivanova | Recruiting | Samara | 443079 | Russia |
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| Samara State Medical University/Department of Hospital Pediatrics | Withdrawn | Samara | 443099 | Russia |
| National Research Mordovian State University named after N.P. Ogarev/Department of Pediatrics | Recruiting | Saransk | 430005 | Russia |
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| Saratov City Children's Clinical Hospital | Withdrawn | Saratov | 410064 | Russia |
| Bashkir State Medical University/Department of Outpatient and Emergency Pediatrics | Recruiting | Ufa | 450008 | Russia |
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| Yaroslavl State Medical University/Department of Pediatrics, INPO | Recruiting | Yaroslavl | 150000 | Russia |
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| Clinical Hospital # 2 | Recruiting | Yaroslavl | 150030 | Russia |
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| Children's City Clinical Hospital # 11 | Recruiting | Yekaterinburg | 620028 | Russia |
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| Ural State Medical University/Department of Infectious Diseases, Phthisiology and Pulmonology | Recruiting | Yekaterinburg | 620028 | Russia |
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| ID | Term |
|---|---|
| D003371 | Cough |
| D012141 | Respiratory Tract Infections |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007239 | Infections |
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