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NCT04374149

Therapeutic Plasma Exchange Alone or in Combination With Ruxolitinib in COVID-19 Associated CRS

Completed Phase 2 Results posted Last updated 2 December 2021
What this trial tests

Phase 2 trial testing Therapeutic Plasma Exchange in Cytokine Release Syndrome in 20 participants. Completed in 1 December 2020.

Timeline
30 April 2020
Primary endpoint
30 September 2020
1 December 2020

Quick facts

Lead sponsorPrisma Health-Upstate
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment20
Start date30 April 2020
Primary completion30 September 2020
Estimated completion1 December 2020
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Prisma Health-Upstate — full company profile →

Who can join

Adults 12 to 80, any sex, with Cytokine Release Syndrome or COVID19. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

C-reactive Protein (CRP) Levels at Baseline and Day 14 Primary · Baseline and at Day 14

Defined as decreasing the CRP level from baseline to study day 14

CRP Baseline
GroupValue95% CI
1 - TPE Alone75.4541.75 – 147.9
2 - TPE Plus Ruxolitinib59.849.025 – 101.6
CRP Day 14
GroupValue95% CI
1 - TPE Alone41.917.9 – 156.2
2 - TPE Plus Ruxolitinib38.78.6 – 103.8
Cytokine Levels at Baseline and Day 14 Primary · Baseline and at Day 14

Defined as decreasing the interleukin (IL) IL-6 and IL-10 load and the tumor necrosis factor (TNF) load from baseline to study day 14

IL-6 Baseline
GroupValue95% CI
1 - TPE Alone41.329.79 – 67.25
2 - TPE Plus Ruxolitinib14.227.02 – 42.07
IL-6 Day 14
GroupValue95% CI
1 - TPE Alone14.85.8 – 53.88
2 - TPE Plus Ruxolitinib18.727.4 – 31.92
IL-10 Baseline
GroupValue95% CI
1 - TPE Alone8.066.22 – 20.81
2 - TPE Plus Ruxolitinib5.64.67 – 6.84
IL-10 Day 14
GroupValue95% CI
1 - TPE Alone20.56 – 3.16
2 - TPE Plus Ruxolitinib3.162.64 – 3.2
TNF Baseline
GroupValue95% CI
1 - TPE Alone10.667.38 – 11.3
2 - TPE Plus Ruxolitinib7.065.02 – 10.5
TNF Day 14
GroupValue95% CI
1 - TPE Alone9.969.28 – 13.64
2 - TPE Plus Ruxolitinib75.32 – 7.56

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse event data collected from date of consent through study day 28. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

1 - TPE Alone
Serious: 1/10 (10%)
Deaths: 1/10
2 - TPE Plus Ruxolitinib
Serious: 3/10 (30%)
Deaths: 2/10

Serious adverse events (3 terms)

ReactionSystem1 - TPE Alone2 - TPE Plus Ruxolitinib
acute respiratory failureRespiratory, thoracic and mediastinal disorders
myocardial infarctionCardiac disorders
acute respiratory failureRespiratory, thoracic and mediastinal disorders

Most-reported serious reactions: acute respiratory failure, myocardial infarction, acute respiratory failure.

Data from ClinicalTrials.gov NCT04374149 adverse events section.

Sponsor's own description

This protocol will evaluate the efficacy of Therapeutic Plasma Exchange (TPE) alone or in combination with ruxolitinib in COVID positive patients with PENN grade 2, 3, 4 cytokine release syndrome (CRS). It is hypothesized that dual intervention of acute apheretic depletion of cytokines and concomitant suppression of production will produce superior amelioration of the cytokine load and to help to prevent cytokine load rebound. This protocol is envisioned as a pilot study (n=20) for hypothesis generation for future investigation.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Cytokine storm and leukocyte changes in mild versus severe SARS-CoV-2 infection: Review of 3939 COVID-19 patients in China and emerging pathogenesis and therapy concepts.
    Wang J, Jiang M, Chen X, Montaner LJ. · · 2020 · cited 551× · PMID 32534467 · DOI 10.1002/jlb.3covr0520-272r
  2. Targeting JAK-STAT Signaling to Control Cytokine Release Syndrome in COVID-19.
    Luo W, Li YX, Jiang LJ, Chen Q, et al · · 2020 · cited 217× · PMID 32580895 · DOI 10.1016/j.tips.2020.06.007
  3. JAK-STAT Pathway Inhibition and their Implications in COVID-19 Therapy.
    Satarker S, Tom AA, Tom AA, Shaji RA, et al · · 2021 · cited 117× · PMID 33245005 · DOI 10.1080/00325481.2020.1855921
  4. The potential of JAK/STAT pathway inhibition by ruxolitinib in the treatment of COVID-19.
    Goker Bagca B, Biray Avci C. · · 2020 · cited 84× · PMID 32636055 · DOI 10.1016/j.cytogfr.2020.06.013
  5. Potential Therapeutic Options for COVID-19: Current Status, Challenges, and Future Perspectives.
    Sarkar C, Mondal M, Torequl Islam M, Martorell M, et al · · 2020 · cited 64× · PMID 33041814 · DOI 10.3389/fphar.2020.572870
  6. Repurposing anticancer drugs for the management of COVID-19.
    El Bairi K, Trapani D, Petrillo A, Le Page C, et al · · 2020 · cited 59× · PMID 33125946 · DOI 10.1016/j.ejca.2020.09.014
  7. Vasculopathy and Coagulopathy Associated with SARS-CoV-2 Infection.
    Labò N, Ohnuki H, Tosato G. · · 2020 · cited 57× · PMID 32629875 · DOI 10.3390/cells9071583
  8. Tackling the cytokine storm in COVID-19, challenges and hopes.
    Abdin SM, Elgendy SM, Alyammahi SK, Alhamad DW, et al · · 2020 · cited 54× · PMID 32663575 · DOI 10.1016/j.lfs.2020.118054

Verify or expand the search:

Other trials of Therapeutic Plasma Exchange

Trials testing the same drug.

Other recruiting trials for Cytokine Release Syndrome

Currently open trials in the same condition.

Other Prisma Health-Upstate trials

Trials by the same sponsor.

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