History
# Registration date Revision Id
2 2020-04-11, 1399/01/23 129145
1 2020-03-28, 1399/01/09 127106
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  • Protocol summary

    In this simple clinical trial study, 80 patients with inclusion criteria will be selected by the randomized complete block design and divided in two balance group. The two groups will be matched as the same gender, age and background disorders.
    In this simple clinical trial study, 80 patients with inclusion criteria will be selected by the non-randomized selection and divided in two balance group. The two groups will be matched as the same gender, age and background disorders.
    این مطالعه یک کارآزمایی بالینی ساده می باشد که بیماران مراجعه کننده به مجتمع بیمارستانی امام خمینی (ره) با تشخیص COVID-19 را شامل می شود. 80 بیمار انتخاب و به دو گروه 40 نفره تقسیم می شوند. جهت حفظ تعادل (balance) در دو گروه از روش Block randomization استفاده خواهد شد. همچنین دو گروه از نظر جنس، سن و بیماری های زمینه ای با یکدیگر match خواهند شد.
    این مطالعه یک کارآزمایی بالینی ساده می باشد که بیماران مراجعه کننده به مجتمع بیمارستانی امام خمینی (ره) با تشخیص COVID-19 را شامل می شود. 80 بیمار انتخاب و به دو گروه 40 نفره تقسیم می شوند. انتخاب به روش غیرتصادفی انجام می گیرد. همچنین دو گروه از نظر جنس، سن و بیماری های زمینه ای با یکدیگر match خواهند شد.
  • General information

    15
    18
    Randomized
    Not randomized
    Double blinded
    Not blinded
    1
    1
    1
    1
    1
    Used
    Not used
    empty
    because of difficulties in production of placebo, the control group have not taken placebo.
    empty
    به علت مشکلات در تهیه پلاسبو گروه کنترل پلاسبو ندارد
    بررسي تاثیر داروي ضد التهاب و ایمونومدلاتور آلتبرل به عنوان یک Anti TNF-α بر روند بیماری در میتلایان مبتلا به بیماری کووید-19
    بررسي تاثیر داروي ضد التهاب و ایمونومدلاتور آلتبرل به عنوان یک Anti TNF-α بر روند بیماری در میتلایان مبتلا به بیماری کووید-19 (COVID-19)
    Confirmed the COVID-19 disease with one or more of these: fever, dry cough, dyspnea and one or more of below: positive SARS-COV2 PCR • Characteristic changes of SARS-COV2 in chest CT scan such as bilateral ground grass opacity in bases of the lungs ( confirmation with the radiologist)
    Age>15 years old
    Signing inform consent from the patient or patient̓ s accompaniment
    No manifestations of bacterial infection
    No history of rheumatologic disorders
    No history of cancer for the last 1 year.No history of immunodeficiency (primary or acquired)
    No manifestations, history and radiologic parameters according to active or latent TB
    No diabetes or autoimmune hepatitis
    No uveitis
    No history of immunosuppressive treatment in the last 6 months
    No history of growth hormone, Testosterone and any Anabolic steroids in the last one month
    No history of Corticosteroid therapy (>30 mg/m2) for > 5 days in the last one month
    No history of Corticosteroid pulses or IVIG treatments for last one month
    No history of Biologics treatment for the last 6 months
    Confirmed the COVID-19 disease with one or more of these: fever, dry cough, dyspnea and one or more of below: positive SARS-COV2 PCR • Characteristic changes of SARS-COV2 in chest CT scan such as bilateral ground grass opacity in bases of the lungs ( confirmation with the radiologist)
    Age>18 years old
    Signing inform consent from the patient or patient̓ s accompaniment
    No manifestations of bacterial infection
    No history of rheumatologic disorders
    No history of cancer for the last 1 year.No history of immunodeficiency (primary or acquired)
    No manifestations, history and radiologic parameters according to active or latent TB
    No diabetes or autoimmune hepatitis
    No uveitis
    No history of immunosuppressive treatment in the last 6 months
    No history of growth hormone, Testosterone and any Anabolic steroids in the last one month
    No history of Corticosteroid therapy (>30 mg/m2) for > 5 days in the last one month
    No history of Corticosteroid pulses or IVIG treatments for last one month
    No history of Biologics treatment for the last 6 months
    Randomized Complete Block Design. The patients are selected as a randomized block table. So, the randomization in both group and in each phases of the research are equivalent.
    تصادفی سازی ساده بلوکی-بیماران با استفاده از جدول بلوک های تصادفی که نه تنها باعث میشود Randomization در مجموع در دو گروه مساوی باشد بلکه در هر مرحله از انجام مطالعه نیز بیماران بطور مساوی به هر دو گروه تخصیص یابند
    In this simple clinical trial study, 80 patients with inclusion criteria will be selected by the randomized complete block design and divided in two balance group. The two groups will be matched as the same gender, age and background disorders. The antiviral protocols in the treatment of COVID-19 will be the similar in both groups consisted of; tablet hydroxychloroquine 400 mg daily, tablet lupinavir/ritonavir 50/200 two tablets twice a day for 5 days. In the case group, anti-TNFα (Altebrel: The brand name drug) made by Aryogen pharmed company will be added 50 mg in one week in two doses with 2-3 days interval subcutaneously in deltoid region, to the main protocol. In control group, the similar injection will be done by distilled water. The other interventions and treatments will be exactly similar in both groups. Cooperation in this research will be voluntarily in two groups by signing the informed consents. The evaluation of effectiveness, complications and outcomes will be documented in both groups.
    این مطالعه یک کارآزمایی بالینی ساده می باشد که بیماران مراجعه کننده به مجتمع بیمارستانی امام خمینی (ره) با تشخیص COVID-19 را شامل می شود. از بیمارانی که کرایتریای ورود به مطالعه را داشته باشند، 80 بیمار انتخاب و به دو گروه 40 نفره تقسیم می شوند. جهت حفظ تعادل (balance) در دو گروه از روش Block randomization استفاده خواهد شد. همچنین دو گروه از نظر جنس، سن و بیماری های زمینه ای با یکدیگر match خواهند شد. گروه کنترل، درمان پیشنهادی COVID-19 طبق پروتکل کشوری (شامل قرص هیدروکسی کلروکین 400 میلی گرم یک نوبت، کپسول اوسلتامیویر 75 میلی گرم دوبار در روز تا پنج روز، قرص لوپیناویر/ریتوناویر 200/50 هر 12 ساعت دو عدد به مدت 5 روز) را دریافت می کنند. در گروه مداخله، همان پروتکل پیشنهاد شده کشوری به همراه داروی Anti TNF-α با نام تجاری آلتبرل (ساخت شرکت آریوژن) به صورت دو دوز 50 میلیگرمی درطی یک هفته به صورت زیر جلدی دریافت می شود. تمامی مداخلات و درمان های دیگر به صورت استاندارد برای بیماران در هر دو گروه یکسان خواهد بود. پروتکل تزریق داروی آلتبرل به صورت زیرجلدی در یکی از عضلات دلتوئید به فاصله 3 تا 4 روز تزریق خواهد بود. مشارکت در این پروژه به طور داوطلبانه و با رضایت کتبی میباشد، یعنی بیماران میبایست خودشان داوطلب حضور در پروژه باشند. به منظور ارزیابی اثرات درمانی و عوارض جانبی این دارو، بیماران در گروه مداخله و کنترل براساس پروتکل با یکدیگر مقایسه میگردند.
  • Health conditions studied

    #1
    empty
    U07.1
  • Intervention groups

    #1
    Placebo
    Rehabilitation
    Control group: In control group, the similar injection will be done by distilled water.
    Control group: In control group, supportive care and protocol without any injection
    گروه کنترل: تزریق اب مقطر
    گروه کنترل: تزریق پلاسبو نداریم
  • Recruitment centers

    #1
    Name of recruitment center - English: Imam Khomeini Hospital
    Name of recruitment center - Persian: بیمارستان امام خمینی
    Full name of responsible person - English: raheleh assari
    Full name of responsible person - Persian: راحله عصاری
    Street address - English: Bagherkhan street
    Street address - Persian: خیابان باقرخان
    City - English: Tehran
    City - Persian: تهران
    Province: Tehran
    Country: Iran (Islamic Republic of)
    Postal code: 1419733151
    Phone: +98 21 6694 8443
    Fax:
    Email: r1assari@yahoo.com
    Web page address:
    Name of recruitment center - English: Imam Khomeini Hospital
    Name of recruitment center - Persian: بیمارستان امام خمینی
    Full name of responsible person - English: Raheleh Assari
    Full name of responsible person - Persian: راحله عصاری
    Street address - English: Imam Khomeini Hospital, Bagherkhan street
    Street address - Persian: خیابان باقرخان
    City - English: Tehran
    City - Persian: تهران
    Province: Tehran
    Country: Iran (Islamic Republic of)
    Postal code: 1419733151
    Phone: +98 21 6694 8443
    Fax:
    Email: r1assari@yahoo.com
    Web page address:
  • Sponsors / Funding sources

    #1

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: vahid ziaee
    Full name of responsible person - Persian: وحید ضیایی
    Street address - English: No62 Dr Gharib St. Keshavars Blvd, Tehran 14194,Iran
    Street address - Persian: بلوار کشاورز- خیابان دکتر قریب- مرکز طبی کودکان
    City - English: tehran
    City - Persian: تهران
    Province: Tehran
    Country: Iran (Islamic Republic of)
    Postal code: 1419733151
    Phone: +98 21 6694 8443
    Fax:
    Email: ziaee@tums.ac.ir
    Web page address:

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Mohammad Ali Sahraian
    Full name of responsible person - Persian: محمدعلی صحراییان
    Street address - English: No.226,Qods St, Keshavarz Blvd, Tehran,Iran.
    Street address - Persian: بلوار کشاورز نبش خیابان قدس سازمان مرکزی دانشگاه طبقه ششم معاونت تحقیقات و فناوری
    City - English: tehran
    City - Persian: تهران
    Province: Tehran
    Country: Iran (Islamic Republic of)
    Postal code: 1419733151
    Phone: +98 21 8163 3686
    Fax:
    Email: vcr@tums.ac.ir
    Web page address:

Protocol summary

Study aim
Evaluation the efficacy of Anti- TNF on COVID-19
Design
In this simple clinical trial study, 80 patients with inclusion criteria will be selected by the non-randomized selection and divided in two balance group. The two groups will be matched as the same gender, age and background disorders.
Settings and conduct
The blood glucose, CBC, ESR, CRP, LFT will be checked for all patients according to hospital protocols. The LFT and blood glucose will be checked again one week and 10 days after injection of medicine and placebo. The radiologic evaluation with CT scan will be done in all patients according to the hospital protocols. The second CT one week later, will depend on the patient̓ s situation.The data will be documented in the anonymous questionnaire with special codes for each person.
Participants/Inclusion and exclusion criteria
Confirmed the COVID-19 disease with one or more of these: fever, dry cough, dyspnea and one or more of below: positive SARS-COV2 PCR; characteristic changes of SARS-COV2 in chest CT; age>18 years old; signing inform consent; no history of diabet , heart failure, TB and the other chronic disease. Exclusion criteria: administration of corticosteroids pulses and/or IVIG in the disease process or one month after anti-TNF prescription; unwillingness of involved patients.
Intervention groups
Altebrel 50 mg subcutaneously in 2 dose in one week.
Main outcome variables
Improvement of pulmonary manifestations and the duration of it;Improvement the radiologic parameters; necessity to ICU admission; duration the ICU admission; duration the hospitalization; the mortality; the time of mortality; the three months outcomes: complete improvement; improvement with transient complication; improvement with persistent complication; death

General information

Reason for update
because of difficulties in production of placebo, the control group have not taken placebo.
Acronym
IRCT registration information
IRCT registration number: IRCT20200312046749N1
Registration date: 2020-03-28, 1399/01/09
Registration timing: registered_while_recruiting

Last update: 2020-04-12, 1399/01/24
Update count: 1
Registration date
2020-03-28, 1399/01/09
Registrant information
Name
Raheleh Assari
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 21 6694 8443
Email address
r1assari@yahoo.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2020-03-27, 1399/01/08
Expected recruitment end date
2020-09-29, 1399/07/08
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Evaluation the efficacy of Tumor Necrosis Factor alpha inhibitor in COVID-19 outcomes: a prospective clinical trial study.
Public title
Efficacy of Tumor Necrosis Factor alpha inhibitor in COVID-19
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Confirmed the COVID-19 disease with one or more of these: fever, dry cough, dyspnea and one or more of below: positive SARS-COV2 PCR • Characteristic changes of SARS-COV2 in chest CT scan such as bilateral ground grass opacity in bases of the lungs ( confirmation with the radiologist) Age>18 years old Signing inform consent from the patient or patient̓ s accompaniment No manifestations of bacterial infection No history of rheumatologic disorders No history of cancer for the last 1 year.No history of immunodeficiency (primary or acquired) No manifestations, history and radiologic parameters according to active or latent TB No diabetes or autoimmune hepatitis No uveitis No history of immunosuppressive treatment in the last 6 months No history of growth hormone, Testosterone and any Anabolic steroids in the last one month No history of Corticosteroid therapy (>30 mg/m2) for > 5 days in the last one month No history of Corticosteroid pulses or IVIG treatments for last one month No history of Biologics treatment for the last 6 months
Exclusion criteria:
Administration of corticosteroids pulses and/or IVIG in the disease process or one month after anti-TNF prescription. Unwillingness of involved patients to continue this research.
Age
From 18 years old
Gender
Both
Phase
2-3
Groups that have been masked
No information
Sample size
Target sample size: 80
Randomization (investigator's opinion)
Not randomized
Randomization description
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Tehran University of Medical Sciences
Street address
Tehran University of Medical Sciences, Qods St., Keshavarz Blvd., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1417653761
Approval date
2020-03-24, 1399/01/05
Ethics committee reference number
IR.TUMS.VCR.REC.1399.034

Health conditions studied

1

Description of health condition studied
COVID-19
ICD-10 code
U07.1
ICD-10 code description
COVID-19

Primary outcomes

1

Description
Improvement of pulmonary manifestations and the duration.
Timepoint
One week, two weeks and 6 months after
Method of measurement
physical examination, labratory data and CT scan

2

Description
Improvement the radiologic parameters.
Timepoint
after 7-10 days
Method of measurement
computed tomography

3

Description
Necessity and Duration to ICU admission and hospitalization
Timepoint
One to two weeks later
Method of measurement
Questionnaire

4

Description
Mortality
Timepoint
One month later
Method of measurement
Number

5

Description
The three months outcomes: complete improvement; improvement with transient complication; improvement with persistent complication
Timepoint
After three months
Method of measurement
Physical examination and history

Secondary outcomes

empty

Intervention groups

1

Description
Intervention group: altebrel 50mg by aryogen company subcutaneously in two dose with2-3 days duration in one week.
Category
Treatment - Drugs

2

Description
Control group: In control group, supportive care and protocol without any injection
Category
Rehabilitation

Recruitment centers

1

Recruitment center
Name of recruitment center
Imam Khomeini Hospital
Full name of responsible person
Raheleh Assari
Street address
Imam Khomeini Hospital, Bagherkhan street
City
Tehran
Province
Tehran
Postal code
1419733151
Phone
+98 21 6694 8443
Email
r1assari@yahoo.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Mohammad Ali Sahraian
Street address
No.226,Qods St, Keshavarz Blvd, Tehran,Iran.
City
tehran
Province
Tehran
Postal code
1419733151
Phone
+98 21 8163 3686
Email
vcr@tums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
No
Title of funding source
vice chancellor for research
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Industry

Person responsible for general inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Vahid Ziaee
Position
professor
Latest degree
Subspecialist
Other areas of specialty/work
Pediatrics
Street address
Markaz Tebi Atfal hospital, Dr. Gharib street
City
tehran
Province
Tehran
Postal code
1419733151
Phone
+98 21 6692 0981
Email
ziaee@tums.ac.ir

Person responsible for scientific inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Raheleh Assari
Position
assisstand professor
Latest degree
Subspecialist
Other areas of specialty/work
Pediatrics
Street address
Children Medical Center, Dr Gharib St.
City
Tehran
Province
Tehran
Postal code
1971844458
Phone
+98 21 6694 8443
Email
r1assari@yahoo.com

Person responsible for updating data

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Raheleh Assari
Position
assistant proffessor
Latest degree
Subspecialist
Other areas of specialty/work
Pediatrics
Street address
Children Medical centre, Dr Gharib street
City
Tehran
Province
Tehran
Postal code
1419733151
Phone
+98 21 6694 8443
Email
r1assari@yahoo.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Not applicable
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
Study protocol
When the data will become available and for how long
After finished sampling and data analysis
To whom data/document is available
The researchers in university
Under which criteria data/document could be used
Help in managing of patients
From where data/document is obtainable
The principal investigator
What processes are involved for a request to access data/document
Contact with the chief
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