This is a prospective, phase 2, multicenter, randomized, double blind, placebo controlled, parallel group study to assess the safety and efficacy of CSL312 administered intravenously, in combination with standard of care (SOC) treatment, in patients with Coronavirus disease 2019 (COVID 19)
Biological: Garadacimab, Factor XIIa Antagonist Monoclonal Antibody
Garadacimab, Factor XIIa Antagonist Monoclonal Antibody administered intravenously
Drug: Placebo
CSL312 diluent administered intravenously
Inclusion Criteria:
- Age ≥ 18 years
- Positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection as
determined using a molecular diagnostic test (reverse transcription polymerase chain
reaction [RT-PCR] or equivalent) approved by regulatory authorities (including Food
and Drug Administration or Brazilian Health Regulatory Agency) or allowed under an
emergency use authorization within 14 days before Screening. If a false negative
result is suspected, the SARS-CoV-2 test may be repeated within the Screening Period.
- Chest CT scan or X ray results confirming interstitial pneumonia
- Severe COVID 19 disease as evidenced by ≥ 1 of the following criteria at Screening
including within 24 hours before Screening:
- Respiratory frequency > 30 breaths per minute
- SpO2 ≤ 93% on room air
- Ratio of partial pressure of arterial oxygen to fraction of inspired oxygen
(PaO2/FiO2) < 300
- Ratio of Arterial oxygen saturation to fraction of inspired oxygen (SaO2/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 IP, including expanded access or
compassionate use with the only exception being administration of convalescent plasma.
Administration of IP is permitted only if an emergency use authorization has been
granted (eg, remdesivir). Additionally, off label use of approved drugs (eg, anti IL
6/anti IL 6R) is also permitted.
- Pregnant or breastfeeding (female subjects)
- Intubated and require mechanical ventilation (including ECMO) at the time of
randomization
- In the opinion of the investigator, the subject is expected to be intubated in the
first 24 hours after IMP administration
- Has a Do-Not-Intubate (DNI) or Do-Not-Resuscitate (DNR) order
- In the opinion of the investigator, not expected to survive for > 48 hours after
admission
- Presence of any of the following comorbid conditions prior to randomization and prior
to SARS CoV 2 infection:
- Severe heart failure (New York Heart Association Class IV)
- End stage renal disease (Stage ≥ 4) or need for renal replacement therapy
- Biopsy confirmed cirrhosis, portal hypertension, or hepatic encephalopathy
- Malignancy (Stage IV)
- Chronic lung disease requiring the use of oxygen at home
- Active tuberculosis disease
- Active bleeding or a current clinically significant coagulopathy (eg, international
normalized ratio [INR] > 1.5) or clinically significant risk for bleeding (eg, recent
intracranial hemorrhage or bleeding peptic ulcer within the last 4 weeks)
- History of venous thrombosis, myocardial infarction or cerebrovascular event within 3
months, or a prothrombotic disorder (eg, antithrombin III, protein C or protein S
deficiency)
- Known or suspected Grade 3 or 4 infusion-related reaction or hypersensitivity (per
Common Terminology Criteria for Adverse Events [CTCAE]) to monoclonal antibody
therapy, or hypersensitivity to the IMP or any excipients of the IMP
- Currently receiving a therapy not permitted during the study.
- Female subject of childbearing potential or fertile male subject either not using or
not willing to use an acceptable method of contraception to avoid pregnancy during the
study and for 90 days after receipt of the last dose of IMP
- Any clinical or laboratory abnormality or other underlying conditions (eg,
psychological disorders, substance abuse) that would render the subject unsuitable for
participation in the study, in the opinion of the investigator
Nova Clinical Research, LLC
Bradenton, Florida, United States
Theia Clinical Research, LLC
Saint Petersburg, Florida, United States
MercyOne North Iowa Medical Center
Mason City, Iowa, United States
Northeast Iowa Medical Education Foundation
Waterloo, Iowa, United States
Lahey Hospital and Medical Center
Burlington, Massachusetts, United States
University of Mississippi Medical Center
Jackson, Mississippi, United States
Holy Name Hospital
Teaneck, New Jersey, United States
Inspira Health Center Vineland
Vineland, New Jersey, United States
Sisters of Charity Hospital/ St. Joseph's Campus
Buffalo, New York, United States
Carolina Institute for Clinical Research
Fayetteville, North Carolina, United States
Monument Health Clinical Research
Rapid City, South Dakota, United States
PharmaTex Research
Amarillo, Texas, United States
UT Health Science Center, McGovern Medical School
Houston, Texas, United States
Inova Alexandria Hospital
Alexandria, Virginia, United States
Study Director, Study Director
CSL Behring