The overall objective of this study is to efficiently evaluate the clinical efficacy and safety of different investigational therapeutics among adults who have COVID-19 but are not yet sick enough to require hospitalization. The overall hypothesis is that through an adaptive trial design, potential effective therapies (single and combination) may be identified for this group of patients. COVID-19 Outpatient Pragmatic Platform Study (COPPS) is a pragmatic platform protocol designed to evaluate COVID-19 treatments by assessing their ability to reduce viral shedding (Viral Domain) or improve clinical outcomes (Clinical Domain). To be included into the platform, every investigational product will collect data for both Domain primary endpoints. Individual treatments to be evaluated in the platform will be described in separate sub-protocols.
The platform study allows investigational products with objectives either: evaluating viral
shedding (Virology Domain); and COVID-19 related Clinical Outcomes (Clinical Domain).
The primary objective for investigational products within the Viral Domain is:
A. To evaluate the efficacy of each therapeutic intervention in addition to standard
supportive care (SSC) compared with SSC in reducing viral shedding of SARS-CoV-2 virus in
outpatients with COVID-19 disease.
The primary objective for investigational products within for the Clinical Domain is:
B. To evaluate the efficacy of each therapeutic intervention in addition to SSC as compared
to SSC in improving sustained clinical outcomes in outpatients with COVID-19 disease.
Secondary objectives are:
1. The objective of the non-assigned domain an investigational product is under.
1. If under Clinical Domain, reduction in viral shedding.
2. If under Viral Domain, time to resolution of symptoms.
2. To evaluate the efficacy of each therapeutic intervention in reducing SARS-CoV-2 related
hospitalizations, ED visits, or death in outpatients with COVID-19 disease.
3. To assess the development of antibodies against SARS-CoV-2
4. To evaluate the safety and tolerability of each therapeutic intervention compared with
placebo (supportive care).
Drug: Camostat
200 mg (2 x 100 mg tablet) administered orally four times daily (800 mg total daily dose).
Drug: Placebo
Placebo to match camostat administered orally four times daily
Inclusion Criteria:
1. 1. Outpatient setting
2. Age ≥ 18 years and ≤ 80 years at the time of the assessment
3. Able and willing to understand the study, adhere to all study procedures, and provide
written informed consent
4. Initial diagnosis of COVID-19 disease as defined by an FDA-cleared molecular
diagnostic assay positive for SARS-CoV-2 with no more than 72 hours from the initial
swab used in the diagnosis to the time of commencing informed consent.
5. At baseline, at least two symptoms should have mild or higher severity score, where at
least one of the mild symptoms is not cough, fatigue, or loss of smell/taste OR at
least one symptom has a moderate or higher severity score on the COVID Outpatient
Symptom Scale (COSS).
6. Participant's COVID-19 related symptom onset occurred within 7 days prior to time of
randomization.
7. Other inclusion criteria specific to the investigational product that may, in the eyes
of the investigator, be deemed necessary.
Additional inclusion criteria for camostat protocol:
1. If male, must be sterile, OR agree not to donate semen AND agree to strictly adhere to
contraceptive measures during the study and for seven days following the last dose of
study medication
2. If female, must be unable to bear children, OR ensure that their male partner is
incapable of fathering a child, OR, if of childbearing potential will strictly adhere
to contraceptive measures during the study and for seven days following the last dose
of study medication, and must agree to stop breast-feeding prior to first dose of
study drug and through seven days after completing therapy.
Exclusion Criteria:
1. At screening, the participant needs to be admitted to the hospital or is being
evaluated for potential admission.
2. Previous use of experimental drugs that may be active against COVID-19 in the eyes of
the investigators.
3. Participant yields a positive urine pregnancy test at screening.
4. Participant is using adrenocorticosteroids (except topical or inhaled preparations or
oral preparations equivalent to or less than 10 mg of oral prednisone) or
immunosuppressive or immunomodulatory drugs (e.g., immunosuppressants, anticancer
drugs, interleukins, interleukin antagonists or interleukin receptor blockers).
NOTE: Treatment of study participants following institutional COVID-19 treatment
policies or guidelines, including the use of immunomodulatory medications, is
permitted. This excludes treatment with agents that have the potential for direct
antiviral activity, including convalescent plasma and NO, and co-enrollment into other
clinical studies that evaluate investigational agents for COVID-19.
5. Participant has a serious chronic disease (e.g., uncontrolled human immunodeficiency
virus [HIV], cancer requiring chemotherapy within the preceding 6 months, and/or
moderate or severe hepatic insufficiency).
6. Has renal insufficiency including severe renal impairment and ESRD and/or requiring
hemodialysis or continuous ambulatory peritoneal dialysis (CAPD).
7. Has liver impairment greater than Child Pugh A.
8. Has a history of alcohol or drug abuse in the previous 6 months.
9. Has a psychiatric disease that is not well controlled where controlled is defined as:
stable on a regimen for more than one year.
10. Has taken another investigational drug within the past 30 days.
11. Is deemed by the Investigator to be ineligible for any reason.
Additional exclusion criteria for camostat protocol:
1. Participant has a history of gout and coagulation disorders.
2. Participant has a concomitant bacterial respiratory infection as documented by a
respiratory culture with microbiologic growth. NOTE: Participants on empirical
antibiotic treatment for possible but unproven bacterial pneumonia, but who are
positive for SARS-CoV-2, are allowed in the study.
3. Has previously received camostat mesilate within the past 30 days.
ValleyCare Medical Center
Pleasanton, California, United States
Stanford University
Stanford, California, United States