This is a phase 2, prospective, multicenter, randomized, double blind, placebo controlled, parallel group study to evaluate the safety and efficacy of intravenous (IV) administration of CSL324, administered in combination with SOC treatment, in subjects with COVID 19. For the purposes of this study, standard of care (SOC) may include any written or established treatment protocol followed at the study site for the treatment of severe COVID-19 or its complications, including off-label use of marketed pharmaceutical products and / or products with emergency use authorization granted for the treatment of COVID-19 (ie, not yet marketed) (eg, remdesivir).
Biological: CSL324
Recombinant anti-granulocyte colony-stimulating factor (G-CSF) receptor monoclonal antibody
Drug: Placebo
Normal saline (0.9% sodium chloride)
Inclusion Criteria:
- Age ≥ 18 years at the time informed consent is obtained
- Positive for SARS-CoV-2 infection determined by a diagnostic test approved by the Food
and Drug Administration (FDA) or allowed under an emergency use authorization
- Chest computed tomography (CT) scan or X ray results confirming interstitial pneumonia
- Meets ≥ 1 of the following criteria (subjects improving while on respiratory support
still qualify):
- Respiratory rate > 30 breaths per minute
- Peripheral (capillary) oxygen saturation (SpO2) ≤ 93% on room air
- Partial pressure of oxygen in arterial blood (PaO2) to fraction of inspired
oxygen (FiO2) ratio (PaO2 / FiO2) < 300
- SpO2 / FiO2 ratio < 218 (if PaO2 / FiO2 ratio is not available)
- Radiographic lung infiltrates > 50%
Exclusion Criteria:
- Currently enrolled, planning to enroll, or participated, within the last 30 days, in a
clinical study requiring administration of an investigational product (ie, not yet
marketed), including expanded access or compassionate use
- Exceptions:
- Administration of investigational product with emergency use authorization
granted for treatment of COVID 19 (eg, remdesivir) is permitted
- Convalescent plasma as part of approved special access programs such as
expanded access, emergency IND, or compassionate use is permitted
- Pregnant or breastfeeding (female subjects)
- Intubated and requires mechanical ventilation (including ECMO) at time of
randomization
- Exception: use of HFNC oxygen and noninvasive ventilation are permitted
- Endotracheal intubation is imminent, in the opinion of the investigator
- Not expected to survive for more than 48 hours after hospital admission, in the
opinion of the investigator
- Presence of any of the following comorbid conditions before randomization and prior to
SARS-CoV-2 infection:
- New York Heart Association class IV heart failure
- Stage 4 or 5 chronic kidney disease or requires renal replacement therapy
- Biopsy proven cirrhosis, portal hypertension or hepatic encephalopathy
- Stage IV malignancy
- Chronic lung disease requiring home oxygen
- Active tuberculosis
- History or evidence of pulmonary alveolar proteinosis
- Confirmed diagnosis or clinical suspicion of bacterial pneumonia or active
uncontrolled bacterial, fungal, or non SARS-CoV-2 viral infection at Screening
- Absolute neutrophil count (ANC) value < 5 × 109 cells/L at Screening (can be lowered
up to < 1.5 × 109 cells/L after Independent Data Monitoring Committee review of safety
data, if CSL324 induced neutropenia is not assessed as a safety concern)
- Currently receiving a prohibited therapy including G-CSF, granulocyte-macrophage
colony-stimulating factor (GM-CSF), or antibody against interleukin 6 (IL-6) / IL 6
receptor (anti IL-6 / 6R)
Memorial Health University Medical Center
Savannah, Georgia, 31404