Official Title
Adaptive Design Phase 2 to 3, Randomized, Double-blind, to Evaluate Safety, Efficacy, Pharmacokinetics and Pharmacodynamics of BIO101 in the Prevention of the Respiratory Deterioration in Hospitalized COVID-19 Patients
Brief Summary

The COVA clinical study is a global multicentric, double-blind, placebo-controlled, group sequential and adaptive 2 parts phase 2-3 study targeting in patients with SARS-CoV-2 pneumonia. Part 1 is a Phase 2 exploratory Proof of Concept (PoC) study to provide preliminary data on the activity, safety and tolerability of BIO101 in the target population. Part 2 is a phase 3 pivotal randomized study to provide further evidence of safety and efficacy of BIO101 after 28 days of double-blind dosing. BIO101 is the investigational new drug that activates the Mas receptor (MasR) through the protective arm of the Renin Angiotensin System (RAS).

Detailed Description

Biophytis is developing BIO101, an investigational new drug, an oral preparation of
immediate-release 20-hydroxyecdysone (20E) at ≥ 97% purity. BIO101 activates MasR on the
protective arm of the Renin Angiotensin System (RAS). The engagement of MasR by BIO101 is
responsible for a number of preclinical beneficial activities in normal and pathological
contexts.

The COVA clinical study is a global, multicentric, double-blind, placebo-controlled, group
sequential and adaptive 2 parts phase 2-3 study in participants with SARS-CoV-2 pneumonia.
Part 1 is a Phase 2 exploratory Proof of Concept (PoC) study to provide preliminary data on
the activity, safety and tolerability of BIO101 in the target population. Part 2 is a phase 3
pivotal randomized study to provide further evidence of safety and efficacy of BIO101 after
28 days of dosing.

The trial will use an adaptive design based on pre-specified criteria, using an independent
external Data Monitoring Committee (DMC) to monitor safety, efficacy, and review data at
appropriate intervals to allow the initiation of the confirmatory part of the study.

The general objectives of the study are:

- The purpose of Part 1 is to obtain preliminary indication of activity of BIO101, in
preventing respiratory deterioration in the target population (50 patients, age ≥ 55
years) and provide preliminary data on the safety and tolerability of BIO101 in the
target population

- The purpose of Part 2 is to re-assess the sample size that is needed for the
confirmatory part of the study and to provide confirmation on the benefit of BIO101 and
safety in the larger target population (up to 310 patients)

Terminated
COVID-19
SARS-COV2

Drug: BIO101

BIO101 capsules
Other Name: Sarconeos (BIO101)

Drug: Placebo

placebo capsules
Other Name: Sarconeos (placebo)

Eligibility Criteria

Inclusion Criteria:

1. Age: 45 and older (in France: 55 and older)

2. A confirmed diagnosis of COVID-19 infection, within the last 28 days, prior to
randomization, as determined by PCR or other approved commercial or public health
assay, in a specimen as specified by the test used.

3. Hospitalized, in observation or planned to be hospitalized due to COVID-19 infection
symptoms with anticipated hospitalization duration >=3 days

a. Patients can be included even if treated with: oxygen supplementation, High-flow
oxygen (HFO2), BiPAP and CPAP

4. With evidence of pneumonia based on all of the following:

1. Clinical findings on a physical examination

2. Respiratory symptoms developed within the past 14 days

5. With evidence of respiratory decompensation that started not more than 7 days before
start of study medication and present at screening, meeting one of the following
criteria, as assessed by healthcare staff:

1. Tachypnea: ≥25 breaths per minute

2. Arterial oxygen saturation ≤92%

3. A special note should be made if there is suspicion of COVID-19- related
myocarditis or pericarditis, as the presence of these is a stratification
criterion

6. Without a significant deterioration in liver function tests:

1. ALT and AST ≤ 5x upper limit of normal (ULN)

2. Gamma-glutamyl transferase (GGT) ≤ 5x ULN

3. Total bilirubin ≤ 5×ULN

7. Willing to participate and able to sign an informed consent form (ICF)

8. Female subjects should be:

at least 5 years post-menopausal (i.e., persistent amenorrhea 5 years in the absence
of an alternative medical cause) or surgically sterile; OR

1. Have a negative urine pregnancy test at screening

2. Be willing to use a contraceptive method as outlined in inclusion criterion 9
from screening to 30 days after last dose.

9. Male subjects who are sexually active with a female partner must agree to the use of
an effective method of birth control throughout the study and until 3 months after the
last administration of investigational product; Note: medically acceptable methods of
contraception that may be used by the subject and/or partner include combined oral
contraceptive, contraceptive vaginal ring, contraceptive injection, intrauterine
device, etonogestrel implant, each supplemented with a condom, as well as
sterilization and vasectomy.

10. Male subjects must agree not to donate sperm for the purpose of reproduction
throughout the study and until 3 months after the last administration of
investigational product;

11. For France only: Being affiliated with a European Social Security.

Exclusion Criteria:

1. Not needing or not willing to remain in a healthcare facility during the entire study
medication (i.e. while receiving study medication)

2. Moribund condition (death likely in days) or not expected to survive for >7 days - due
to other and non-COVID-19 related conditions

3. Patient on invasive mechanical ventilation via an endotracheal tube, or extracorporeal
membrane oxygenation (ECMO)

4. Patient within 7 days of participating in other therapeutic clinical trial with
angiotensin-converting-enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB)
or recombinant ACE-2

5. Patient not able to take medications by mouth (as capsules or as a powder, mixed in
water).

6. Disallowed concomitant medication:

a. Consumption of any herbal products containing 20-hydroxyecdysone and derived from
Leuzea carthamoides; Cyanotis vaga or Cyanotis arachnoidea is not allowed (e.g.
performance enhancing agents)

7. Any known hypersensitivity to any of the ingredients, or excipients of the study
medication, BIO101

8. In France:

- Non-affiliation to compulsory French social security scheme (beneficiary or
right-holder)

- Being under tutelage or legal guardianship

Eligibility Gender
All
Eligibility Age
Minimum: 45 Years ~ Maximum: N/A
Countries
Belgium
Brazil
France
Puerto Rico
United States
Locations

Abrazo Health
Phoenix, Arizona, United States

University of California, Irvine
Irvine, California, United States

Barnum Medical Research, Inc. 1029 Keyser Ave Suite H
Natchitoches, Louisiana, United States

Beaumont Health
Royal Oak, Michigan, United States

United Health Services Hospitals
Johnson City, New York, United States

WellSpan Health
York, Pennsylvania, United States

CHU Saint-Pierre
Brussels, Belgium

CHU Saint-Pierre
Brussel, Belgium

AZ-Sint Maarten
Mechelen, Belgium

CHU CLU Namur (Saint-Elisabeth) Place Louise Godin
Namur, Belgium

Hospital Vera Cruz
Belo Horizonte, Minas Gerais, Brazil

Santa Casa de Porto Alegre
Porto Alegre, Rio Grande Do Sul, Brazil

Hospital Municipal de Barueri Dr. Francisco Moran
Barueri, São Paulo, Brazil

Hospital e Maternidade Celso Pierro - PUCCAMP
Campinas, São Paulo, Brazil

Hospital de Base Da Faculdade de Medicina de São José Do Rio Preto
São José Do Rio Preto, São Paulo, Brazil

Avenida Dr. Enéas de Carvalho Aguiar, 44 - Centro de Pesquisa Clínica Prof. Dr. Fúlvio Pileggi - Bloco 1 - 1º Andar
São Paulo, Brazil

Unité ambulatoire Service de Pneumologie, Médecine Intensive et Réanimation (SPMIR) 47-83 Boulevard de l'Hôpital
Paris, Paris Cedex 13, France

Centre Hospitalier Argenteuil
Argenteuil, France

Centre Hospitalier Universitaire Bordeaux
Bordeaux, France

Centre Hospitalier Rene Dubos
Cergy-Pontoise, France

Centre Hospitalier Départemental de Vendée
La Roche-sur-Yon, France

Hôpital Pitié-Salpêtrière, 47 bd de l'Hôpital, 75013 Paris
Paris, France

FDI Clinical Research - San Juan City Hospital
San Juan, Puerto Rico

Capucine Morelot-Panzini, MD, Principal Investigator
Département R3S GHU APHP-Sorbonne Université, Pitié Salpetrière

NCT Number
MeSH Terms
COVID-19