Protocol summary

Study aim
Determination of efficacy and safety of inhaled tocilizumab versus intravenous tocilizumab
Design
A controlled, parallel group, randomised, phase 3 clinical trial on 100 patients. Permuted block randomisation will be used by using Sealedenvelope site. At first, both groups receive 400 mg tocilizumab by intravenous infusion during one hour. After 12 hours, in the case group, 400 mg tocilizumab will be administered by nebulization method (5 cc every 6 hours) and in the control group 400 mg tocilizumab will be administered by intravenous infusion during one hour.
Settings and conduct
Dr. Masih Daneshvari Hospital
Participants/Inclusion and exclusion criteria
Inclusion criteria: Hospitalized patients with confirmed COVID-19 diagnosis (RT-PCR positive) and severe lung involvement (oxygen saturation < 90% or lung involvement >50% or respiratory rate >30) Exclusion criteria: sensitivity to tocilizumab or one of the components of drug formulation, ANC<500 cells/mm3, Pelatelet<50,000 cells/mm3, hepatic transaminase > 5 times normal range or mild increase in liver transaminases along with signs and symptoms of liver disorder, history of malignancy, diverticulitis, positive procalcitonin and active infection , concurrent use of other rheumatoid therapy medications
Intervention groups
At first, both groups will be received 400 mg tocilizumab by intravenous infusion during one hour. After 12 hours, in the case group, 400 mg tocilizumab will be administered by nebulization method (5 cc every 6 hours) and in the control group 400 mg tocilizumab will be administered by intravenous infusion during one hour. Both groups will receive standard diet including ramdesivir, dexamethasone, enoxaparin and supportive therapies.
Main outcome variables
Mortality rate, length of hospital stay, need for ICU hospitalization, need for mechanical ventilation, oxygenation

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20151227025726N27
Registration date: 2021-09-25, 1400/07/03
Registration timing: registered_while_recruiting

Last update: 2021-09-25, 1400/07/03
Update count: 0
Registration date
2021-09-25, 1400/07/03
Registrant information
Name
Farzaneh Dastan
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 912 270 5933
Email address
f_dastan@sbmu.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2021-09-23, 1400/07/01
Expected recruitment end date
2022-02-20, 1400/12/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Evaluation of Efficacy and Safety of Inhaled Tocilizumab in Comparison with Intravenous Tocilizumab in Hospitalized Patients with COVID-19
Public title
Comparison of Inhaled Tocilizumab with Intravenous Tocilizumab in hospitalized patients with COVID-19
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Patients between 18 and 100 years old. Laboratory confirmed COVID-19 (Corona Virus Disease-19) with RT-PCR (Real-Time Polymerase Chain Reaction) or CT scan. Have signed the consent form. O2 saturation < 90% (at room air) or lung involvement >50% or respiratory rate >30 CRP > 75 mg/l IL-6 > 15 pg/ml
Exclusion criteria:
Allergy to Tocilizumab or one of the components of drug formulations. ANC < 500 cells/mm Pelatelet < 50000 cells/mm Hepatic transaminases > 5 times normal range or mild increase in liver transaminases associated with signs and symptoms of liver disorder History of malignancy Diverticulitis Positive procalcitonin and active infection (including latent or active tuberculosis infection) Taking other rheumatoid drugs at the same time
Age
From 18 years old to 100 years old
Gender
Both
Phase
3
Groups that have been masked
No information
Sample size
Target sample size: 100
Randomization (investigator's opinion)
Randomized
Randomization description
Block randomization method was used in this study. Twenty five blocks including 4 patients generated with online website (www.sealedenvelope.com/simple-randomiser/v1/lists). In each block, 2 patients will be assigned to inhaled tocilizumab group and 2 patients will be assigned to intravenous tocilizumab group.
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
Ethics Committe of Shahid Beheshti University of Medical Sciences
Street address
3 rd floor, School of Medicine, Evin St, Shahid Chamran Highway
City
Tehran
Province
Tehran
Postal code
1983963113
Approval date
2021-06-10, 1400/03/20
Ethics committee reference number
IR.SBMU.NRITLD.REC.1400.016

Health conditions studied

1

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

Primary outcomes

1

Description
28 days mortality
Timepoint
From the first day of admission until 28 days
Method of measurement
Medical record

2

Description
Need for mechanical ventilation
Timepoint
Daily until discharge
Method of measurement
Medical record

3

Description
Oxyganation rate
Timepoint
Daily until discharge
Method of measurement
Medical record

Secondary outcomes

1

Description
Number of days admitted to critical care unit
Timepoint
Daily until discharge
Method of measurement
Medical record

2

Description
Length of hospital stay
Timepoint
Daily until discharge
Method of measurement
Medical record

3

Description
Lung radiological changes
Timepoint
First day of the study then at discharge
Method of measurement
Computed tomography

4

Description
Inflammation biomarkers (CRP، IL-6، LDH، Ferritin)
Timepoint
Before first dose and 72 hours after second dose
Method of measurement
Medical record

Intervention groups

1

Description
Case group: At first receive 400 mg tocilizumab by intravenous infusion during one hour. After 12 hours, 400 mg tocilizumab (Temziva, Cinnagen) will be administered by nebulization method (5 cc every 6 hours) .
Category
Treatment - Drugs

2

Description
Control group: At first receive 400 mg tocilizumab by intravenous infusion during one hour. After 12 hours, 400 mg tocilizumab (Temziva, Cinnagen) will be administered by intravenous infusion during one hour.
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Masih Daneshvari Hospital
Full name of responsible person
Farzaneh Dastan
Street address
Masih Daneshvari Hospital, Shahid Bahonar Street (Niyavaran), Darabad.
City
Tehran
Province
Tehran
Postal code
1956944413
Phone
+98 21 2712 3000
Email
f_dastan@sbmu.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Afshin Zarghi
Street address
3rd floor, School of Medicine, Evin St, Shahid Chamran Highway
City
Tehran
Province
Tehran
Postal code
1983963113
Phone
+98 21 23871
Email
mpd@sbmu.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Shahid Beheshti University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Hamidreza Jamaati
Position
Professor
Latest degree
Subspecialist
Other areas of specialty/work
Internal Medicine
Street address
Masih Daneshvari Hospital, Shahid Bahonar Street (Niyavaran), Darabad.
City
Tehran
Province
Tehran
Postal code
1956944413
Phone
+98 21 2712 2020
Email
hamidjamaati@hotmail.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Farzaneh Dastan
Position
Assisstant Professor
Latest degree
Ph.D.
Other areas of specialty/work
Medical Pharmacy
Street address
Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Intersection of Niyayesh Highway, Valieasr St.
City
Tehran
Province
Tehran
Postal code
1991953381
Phone
+98 21 2712 2227
Email
f_dastan@sbmu.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Sahar Yousefian
Position
Hospital pharmacist
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
Dr. Masih Daneshvari Hospital, Daar-Abad, Niavaran
City
Tehran
Province
Tehran
Postal code
19569-44413
Phone
+98 21 2712 2227
Email
saahar26@yahoo.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document
All potential data can be shared after blinding
When the data will become available and for how long
Six months after publishing the results
To whom data/document is available
Researchers working in academic institutions
Under which criteria data/document could be used
For research purposes and meta-analysis studies
From where data/document is obtainable
Dr. farzaneh Dastan, Dr. Masih Daneshvari Hospital, Daar-Abad, Niavaran
What processes are involved for a request to access data/document
Official letter to the researchers through Email (fzh.dastan@gmail.com).
Comments
Loading...