Infliximab in the Treatment of Patients With Severe COVID-19 Disease

• Status: Recruiting
• Trial end date: 2023-07-01
• Target enrollment: 0
• Participant gender: All

Summary

In this trial, patients that are severely affected by the disease COVID-19 will either receive infliximab, an anti-inflammatory drug, or standard therapy. Infliximab is a drug that inhibits inflammation by blocking a molecule called TNFα. The patients receive the drug via an infusion into a vein. The primary goal of this trial is to see whether the drug infliximab affects how many people died from COVID-19 after 28 days by comparing patients receiving the drug in addition to standard therapy with patients only receiving standard therapy.

Furthermore, this trial will look at whether the drug is safe to use in these patients, whether it has an effect on the inflammation and whether it can affect how ill patients are after surviving the disease.

The trial is conducted in more than one hospital. As COVID-19 is responsible for a global pandemic, positive results of this trial could affect patients, healthcare and economic systems worldwide.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Jena University Hospital
• Collaborators: Celltrion; German Federal Ministry of Education and Research
• Treatments: Infliximab

Criteria

Inclusion Criteria:

• Age ≥ 18 years

• Infection with SARS-CoV-2 (virus detection by means of a PCR test not older than 72 hours)

• Bipulmonary infiltrates (detection by means of X-rays or computed tomography)

• COVID inflammation score ≥ 10

• Ferritin concentration (serum or plasma) ≥ 500 ng / ml

• Arterial oxygen saturation ≤ 93% when breathing room air

• written informed consent from the patient

• Potentially childbearing women: negative pregnancy test

Exclusion Criteria (in medical history):

Contraindications study medication:

• Hypersensitivity to the active substance infliximab (or any of the other ingredients of the medicine) or to other murine proteins

• active or latent tuberculosis

• acute or chronic hepatitis B

• severe infections such as invasive fungal infections, bacterial sepsis, or abscesses

• opportunistic infections (e.g. pneumocystosis, listeriosis)

• moderate or severe heart failure (NYHA class III / IV)

• Immunosuppression (e.g. organ transplantation, AIDS, leukopenia)

• Malignancies or lymphoproliferative diseases or chemotherapy within the last 4 weeks

• Multiple sclerosis or peripheral demyelinating diseases, including the Guillain-Barré syndrome

• Treatment with other biologics for therapy for approved indications of infliximab (e.g. for rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis, psoriasis)

Further exclusion criteria:

• Autoimmune disease with biologics therapy

• Current treatment with TNF antibodies, convalescent plasma, bamlanivimab, or other experimental treatments for COVID-19

• High-flow oxygen therapy, non-invasive / invasive ventilation (WHO-COVID-19 PROGRESSION Scale > 5)

• pre-existing long-term ventilation or home oxygen therapy

• Child-Pugh C liver cirrhosis

• Pregnancy or breastfeeding

• Patients with a life expectancy < 90 days due to other medical conditions

• Limitation or discontinuation of therapy (e.g. refusal of artificial ventilation)

• Participation in another interventional study

• Previous participation in this study

• Interdependence between the patient and the coordinating investigator or other members of the study team