A Multicenter Phase 2 Randomized Controlled Study on the Efficacy and Safety of Reparixin in the Treatment of Hospitalized Patients with COVID-19 Pneumonia.

Autor: Landoni G; IRCCS San Raffaele Scientific Institute, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy., Piemonti L; IRCCS San Raffaele Scientific Institute, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy., Monforte AD; Ospedale San Paolo, Milan, Italy., Grossi P; Ospedale di Varese, Varese, Italy., Zangrillo A; IRCCS San Raffaele Scientific Institute, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy., Bucci E; Sbarro Health Research Organization, Temple University, Philadelphia, PA, USA.; Resis Srl, Samone, Italy., Allegretti M; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy., Goisis G; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy., Gavioli EM; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy., Patel N; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy., De Pizzol M; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy., Pasedis G; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy., Mantelli F; Dompé Farmaceutici SpA, Via Santa Lucia 6, 20122, Milan, Italy. Flavio.Mantelli@dompe.com.
Jazyk: angličtina
Zdroj: Infectious diseases and therapy [Infect Dis Ther] 2022 Aug; Vol. 11 (4), pp. 1559-1574. Date of Electronic Publication: 2022 May 26.
DOI: 10.1007/s40121-022-00644-6
Abstrakt: Introduction: Acute lung injury and acute respiratory distress syndrome are common complications in patients with coronavirus disease 2019 (COVID-19). Poor outcomes in patients with COVID-19 are associated with cytokine release syndrome. Binding of interleukin-8 (CXCL8/IL-8) to its chemokine receptors, CXCR1/2, may mediate this inflammatory process. The aim of this clinical trial was to determine if CXCR1/2 blockade with reparixin can improve clinical outcomes in hospitalized patients with severe COVID-19 pneumonia. The dose and safety of reparixin have been investigated in clinical trials of patients with metastatic breast cancer.
Methods: This was a phase 2, open-label, multicenter, randomized study in hospitalized adult patients with severe COVID-19 pneumonia from May 5, 2020 until November 27, 2020. Patients were randomized 2:1 to receive 1200 mg reparixin orally three times daily or standard of care (SOC) for up to 21 days. The primary endpoint was defined as a composite of clinical events: use of supplemental oxygen, need for mechanical ventilation, intensive care unit admission, and/or use of rescue medication.
Results: Fifty-five patients were enrolled between reparixin (n = 36) and SOC (n = 19). The rate of clinical events was statistically significantly lower in the reparixin group compared with the SOC group (16.7% [95% CI 6.4-32.8%] vs. 42.1% [95% CI 20.3-66.5%], P = 0.02). The sensitivity analysis based on the Cox regression model provided an adjusted hazard ratio of 0.33 with statistical significance lower than 0.05 (95% CI 0.11-0.99; P = 0.047). Reparixin treatment appeared to be well tolerated.
Conclusion: In patients with severe COVID-19, reparixin led to an improvement in clinical outcomes when compared with the SOC. A larger phase 3 clinical study is needed to confirm these results.
Trial Registration: EudraCT identifier, 2020-001645-40; registered May 6, 2020 (retrospectively registered), and clinicaltrials.gov (NCT04794803) on March 8, 2021.
(© 2022. The Author(s).)
Databáze: MEDLINE
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