Status:

COMPLETED

Tenecteplase in Patients With COVID-19

Lead Sponsor:

Hooman Poor

Collaborating Sponsors:

Genentech, Inc.

Conditions:

COVID-19

Respiratory Failure

Eligibility:

All Genders

18-75 years

Phase:

PHASE2

Brief Summary

This is a placebo-controlled, double blind, randomized, Phase II dose escalation study intended to evaluate the potential safety and efficacy of tenecteplase for the treatment of COVID-19 associated r...

Detailed Description

Patients with COVID-19 who suffer from acute hypoxemic respiratory failure have a poor prognosis. COVID-19 has been associated with a hyperinflammatory and hypercoagulable state, leading to a range of...

Eligibility Criteria

Inclusion

  • Inclusion Criteria
  • Patient/legally authorized representative has completed the Informed Consent Form
  • Age ≥18 years
  • Ability to comply with the study protocol, in the investigator's judgment
  • Respiratory failure secondary to COVID-19 requiring mechanical ventilation for no greater than 24 hours, or high-flow nasal cannula (HFNC),non-rebreather (NRB) mask or non-invasive positive pressure ventilation (NIPPV) for no greater than 48 hours
  • Confirmed infection with SARS-CoV-2 virus (PCR positive within 14 days)
  • Elevated D-dimer (\>6 times upper limit of normal within past 72 hours)
  • For patient who are intubated \>12 hours prior to randomization or with any evidence of neurologic deficit a head CT within 12 hours demonstrating no evidence of acute or subacute infarct or hemorrhage
  • Exclusion Criteria
  • Current participation in another investigational drug study within the prior 7 days
  • Known hypersensitivity or allergy to any ingredients of tenecteplase
  • Active internal bleeding
  • Known bleeding diathesis
  • Use of one of the new oral anticoagulants within the last 48 hours (dabigatran, rivaroxaban, apixaban, edoxaban)
  • Treatment with a thrombolytic within the last 3 months prior to randomization (exception for the use of Cathflo alteplase for occlusions of central venous catheters)
  • Baseline platelet count \<80,000/L (results must be available prior to treatment)
  • Baseline blood glucose \>400 mg/dL (22.20 mmol/L)
  • Baseline blood glucose \<50 mg/dL needs to be normalized prior to randomization
  • Intracranial or intraspinal surgery or trauma within 2 months
  • Other, non-COVID-19 related, serious, advanced, or terminal illness (investigator judgment) or life expectancy is less than 6 months
  • History of acute ischemic stroke in the last 90 days
  • History of intracranial bleeding, including hemorrhagic stroke
  • Presumed septic embolus; suspicion of bacterial endocarditis
  • Mechanical ventilation \> 24 hours, HFNC, NRB, NIPPV, or any combination, for greater than 48 hours
  • Mechanical ventilation, HFNC, NRB, or NIPVV (for reasons other than obstructive sleep apnea) within the prior 30 days (excluding 48 hours prior to randomization)
  • Moribund status suggesting imminent vascular collapse and inability to survive \> 72 hours (investigator determination)
  • Uncontrolled hypertension defined as systolic BP \> 180 mm Hg and/or diastolic BP \> 110 mm Hgb
  • Age \> 75 years
  • History of traumatic brain injury within 2 months
  • Recent head trauma with fracture or brain injury
  • History of Heparin Induced Thrombocytopenia (HIT) and/or other hereditary or acquired hemorrhagic diathesis or coagulation factor deficiency
  • INR \> 2 or recent oral anticoagulant therapy with INR \>1.7
  • Pregnancy or lactation within the prior 30 days; women of childbearing age (\<55 years old) should have documentation of a negative pregnancy test
  • Chronic liver disease defined as \> Childs-Pugh Class B
  • Atrial fibrillation, mitral stenosis, or known left heart thrombosis
  • Any other condition that, in the opinion of the investigator, precludes administration of tenecteplase or poses a significant hazard to the patient receives tenecteplase

Exclusion

    Key Trial Info

    Start Date :

    September 25 2020

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    March 10 2022

    Estimated Enrollment :

    13 Patients enrolled

    Trial Details

    Trial ID

    NCT04505592

    Start Date

    September 25 2020

    End Date

    March 10 2022

    Last Update

    April 6 2023

    Active Locations (1)

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    Page 1 of 1 (1 locations)

    1

    Mount Sinai Hospital

    New York, New York, United States, 10029