Official Title
A Randomized, Double-blind, Placebo-controlled Phase 2 (2a and 2b) Study to Evaluate the Safety and Efficacy of XAV-19 in Patients With COVID-19 Induced Moderate Pneumonia
Brief Summary

Early inhibition of entry and replication of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a very promising therapeutic approach. Polyclonal neutralizing antibodies offers many advantages such as providing immediate immunity, consequently blunt an early pro-inflammatory pathogenic endogenous antibody response and lack of drug-drug interactions1-3. Because a suboptimal endogenous early antibody response with regard to SARS-CoV-2 replication in severe cases is observed, neutralising antibody treatment can be very interesting for patient with COVID-19 induced moderate pneumonia4,5. Convalescent plasma to treat infected patients is therefore an interesting therapeutic option currently under evaluation. However, the difficulties of collecting plasma and its safety aspects are not adapted to many patients. A new polyclonal humanized anti-SARS-CoV2 antibodies (XAV-19) is being developed by Xenothera, which can be administered as intravenous treatment. XAV-19 is a heterologous swine glyco-humanized polyclonal antibody (GH-pAb) raised against the spike protein of SARS-CoV-2, inhibiting infection of ACE-2 positive human cells with SARS-CoV-2. Pharmacokinetic and pharmacodynamic studies have been performed in preclinical models including primates and a First In Human study with another fully representative GH-pAb from Xenothera is ongoing in volunteer patients recipients of a kidney graft. These studies indicated that 5 consecutive administrations of GH-pAbs can be safely performed in humans. The objective of this 2-steps phase 2 randomized double-blind, placebo-controlled study is 1) to define the optimal and safety XAV-19 dose to administrate in patients with COVID-19 induced moderate pneumonia ; 2) to show the clinical benefit of selected dose of XAV-19 when administered to patients with COVID-19 induced moderate pneumonia.

Detailed Description

For the first set of statistical analyses, to allow early reporting of primary and secondary
endpoints at D15, the blind will be partially broken once all patients have completed Day 29.
Except for statisticians, only the principal investigator and the scientific coordinator will
have access to the full data set for the analysis of the primary and secondary endpoints up
to day 29. The database will be partially locked (with all data up to day 29) as neither
monitors nor investigators will be informed of the unblinding until the final data for day 60
is completed and the final database is locked.

Completed
SARS Virus

Drug: XAV-19

Phase 2a: Administration on Day 1 and day 5 for Group1 and 2, Administration on Day 1 for Group 3 Phase 2b: Administration on Day 1

Drug: Placebo

Phase 2a: Administration on Day 1 and day 5 for Group1 and 2, Administration on Day 1 for Group 3 Phase 2b: Administration on Day 1

Eligibility Criteria

Phase 2a:

Inclusion Criteria:

1. Willing and able to provide written informed consent prior to performing study
procedures

2. Male or female ≥ 18 years and ≤ 85 years

3. Hospitalized for COVID-19

4. Positive SARS-CoV-2 RT-PCR in any body specimen (nasopharynx, saliva, sputum) ≤ 10
days before enrolment

5. Evidence of pulmonary involvement (on lung examination [rales/crackles] and/or
chest-imaging [Chest X-ray or computed tomography])

6. Requiring O2 supplement ≤ 6L/min at screening

7. Requiring O2 supplementation with SpO2 ≥ 94% on O2 therapy at screening

8. First onset of COVID-19 symptoms ≤ 10 days, among fever and/or chills, headache,
myalgias, cough, shortness of breath, whichever as occurred fist

9. WOCBP must have a negative urinary pregnancy test the day of inclusion

10. All sexually active male subjects must agree to use an adequate method of
contraception throughout the study period and for 90 days after the last dose of study
drug and agree to no sperm donation until the end of the study, or for 90 days after
the last dose of XAV-19, whichever is longer

11. Patients with French social security

Exclusion Criteria:

1. Evidence of multiorgan failure (severe COVID-19)

2. Mechanically ventilated (including ECMO)

3. Receipt of immunoglobulins or any blood products in the past 30 days

4. Psychiatric or cognitive illness or recreational drug/alcohol use that in the opinion
of the investigator, would affect subject safety and/or compliance

5. End-stage renal disease (eGFR < 15 ml/min/1,73 m2)

6. Child-Pugh C stage liver cirrhosis

7. Decompensated cardiac insufficiency

8. History of active drug abuse

9. Known allergy, hypersensitivity, or intolerance to the study drug, or to any of its
components

10. Females of childbearing potential without contraceptive method, or with positive
pregnancy test, breastfeeding, or planning to become pregnant during the study period

11. Current documented and uncontrolled bacterial infection.

12. Prior severe (grade 3) allergic reactions to plasma transfusion

13. Patient participating in another interventional clinical trial

14. Life expectancy estimated to be less than 6 months

15. Patient under guardianship or trusteeship

Phase 2b:

Inclusion criteria:

1. Willing and able to provide written informed consent prior to performing study
procedures

2. Male or female ≥ 18 years

3. Hospitalized for COVID-19

4. Documentation of SARS-Cov-2 infection before enrolment, by positive SARS-CoV-2 RT-PCR
or antigen in any body specimen (nasopharynx, oropharynx, saliva, sputum,
bronchoalveolar lavage …) before enrolment

5. Evidence of pulmonary involvement (on lung examination [rales/crackles] and/or
chestimaging [Chest X-ray or computed tomography])

6. Requiring O2 supplement ≤ 6L/min at screening

7. Requiring O2 supplementation with SpO2 ≥ 92% on O2 therapy at screening (or ≥ 90

% if chronic obstructive pulmonary disease)

8. First onset of COVID-19 symptoms ≤ 14 days, among fever and/or chills, headache,
myalgias, cough, shortness of breath, whichever as occurred fist (other symptoms such
as asthenia not to be considered in this list)

9. WOCBP must have a negative urinary pregnancy test the day of inclusion

10. All sexually active male subjects must agree to use an adequate method of
contraception throughout the study period and for 90 days after the last dose of study
drug and agree to no sperm donation until the end of the study, or for 90 days after
the last dose of XAV-19, whichever is longer

11. Patients with French social security

Exclusion criteria:

1. Evidence of multiorgan failure (severe COVID-19)

2. Mechanically ventilated (including ECMO)

3. Receipt of immunoglobulins or any blood products in the past 30 days

4. Psychiatric or cognitive illness or recreational drug/alcohol use that in the opinion
of the investigator, would affect subject safety and/or compliance

5. End-stage renal disease (eGFR < 15 ml/min/1,73 m2)

6. Child-Pugh C stage liver cirrhosis

7. Decompensated cardiac insufficiency

8. Known allergy, hypersensitivity, or intolerance to the study drug, or to any of its
components

9. Females of childbearing potential without contraceptive method, or with positive
pregnancy test, breastfeeding, or planning to become pregnant during the study period

10. Current documented and uncontrolled bacterial infection.

11. Prior severe (grade 3) allergic reactions to plasma transfusion

12. Patient participating in another interventional clinical trial

13. Life expectancy estimated to be less than 6 months

14. Patient under guardianship or trusteeship

15. Patient already included

16. Prior hospitalisation in intensive care unit for the current covid-19 episode

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
France
Martinique
Réunion
Locations

CHU Amiens Picardie
Amiens, France

CHU Angers
Angers, France

Hôpital Privé d'Antony
Antony, France

CH Avignon
Avignon, France

CH de la Côte Basque
Bayonne, France

APHP - Hôpital Avicennes
Bobigny, France

CHU Caen
Caen, France

CH Métropole Savoie
Chambéry, France

CH Colmar
Colmar, France

CH Sud Francilien
Corbeil-Essonnes, France

CHD Vendée
La Roche-sur-Yon, France

CH de La Rochelle
La Rochelle, France

CH Le Mans
Le Mans, France

CHRU Lille
Lille, France

CHU Limoges
Limoges, France

Hospices Civils Lyon
Lyon, France

CH de Mont de Marzan
Mont-de-Marsan, France

GHR Mulhouse Sud-Alsace
Mulhouse, France

CHU Nantes
Nantes, France

CHU Nice
Nice, France

CHU Nîmes
Nîmes, France

CHR Orléans La Source
Orléans, France

APHP - Hôpital Tenon
Paris, France

Hôpital Saint Antoine
Paris, France

CH René Dubos
Pontoise, France

CH Cornouaille
Quimper, France

CHU Reims
Reims, France

CHU Saint Etienne
Saint-Priest-en-Jarez, France

CHU Strasbourg
Strasbourg, France

Hôpital FOCH
Suresnes, France

CHRU Nancy
Vandœuvre-lès-Nancy, France

CH Bretagne Atlantique
Vannes, France

CHU Martinique
Fort de France, Martinique

CHU La Réunion
Saint-Pierre, Réunion

Benjamin Gaborit, Principal Investigator
CHU Nantes

Nantes University Hospital
NCT Number
Keywords
SARS-CoV-2
Covid-19
Moderate
Pneumonia
antibody
MeSH Terms
COVID-19
Pneumonia