NCT04498273

Brief Summary

A multi-center adaptive randomized placebo-controlled platform trial evaluating the efficacy and safety of anti-thrombotic strategies in COVID-19 adults not requiring hospitalization at time of diagnosis

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
657

participants targeted

Target at P50-P75 for phase_3 covid19

Timeline
Completed

Started Sep 2020

Geographic Reach
1 country

71 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 3, 2020

Completed
1 day until next milestone

First Posted

Study publicly available on registry

August 4, 2020

Completed
1 month until next milestone

Study Start

First participant enrolled

September 7, 2020

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 5, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 5, 2021

Completed
7 months until next milestone

Results Posted

Study results publicly available

February 17, 2022

Completed
Last Updated

February 17, 2022

Status Verified

February 1, 2022

Enrollment Period

11 months

First QC Date

August 3, 2020

Results QC Date

January 14, 2022

Last Update Submit

February 15, 2022

Conditions

Outcome Measures

Primary Outcomes (1)

  • Hospitalization for Cardiovascular/Pulmonary Events

    The primary outcome will be a composite endpoint of need for hospitalization for cardiovascular/pulmonary events, symptomatic deep venous thrombosis, pulmonary embolism, arterial thromboembolism, myocardial infarction, ischemic stroke, and all-cause mortality for up to 45 days after initiation of assigned treatment.

    45 days

Study Arms (4)

Apixaban 2.5mg

ACTIVE COMPARATOR

Anticoagulation: prophylactic dose Apixaban 2.5mg po bid

Drug: Apixaban 2.5 MG

Apixaban 5mg

ACTIVE COMPARATOR

Anticoagulation: therapeutic dose Apixaban 5.0mg po bid

Drug: Apixaban 5MG

Aspirin

ACTIVE COMPARATOR

Antiplatelet agent: low dose aspirin 81mg po qd

Drug: Aspirin

Placebo

PLACEBO COMPARATOR

Placebo

Drug: Placebo

Interventions

Subjects will be contacted either electronically or by telephone within 24 hours of randomization to confirm receipt of the study treatment. Study drug will be shipped to subjects home. Subjects will take Apixaban 2.5 MG twice a day; once in the morning and once in the evening for 45 days. Subjects will be contacted (electronic or telephone) minimally weekly after initial start of study medication and contact will continue up to day 75 after starting study treatment. Follow up electronic contact will be dependent on initial patient response, compliance with response, and medication adherence, for the trial duration using electronic contacts and through telephone contacts. Participants will be queried for any clinically relevant endpoints, especially major bleeding, or need to seek healthcare attention for any reason. Follow-up will occur from the time of study drug receipt and through the 30 day safety period.

Apixaban 2.5mg

Subjects will be contacted either electronically or by telephone within 24 hours of randomization to confirm receipt of the study treatment. Study drug will be shipped to subjects home. Subjects will take Apixaban 5 MG twice a day; once in the morning and once in the evening for 45 days. Subjects will be contacted (electronic or telephone) minimally weekly after initial start of study medication and contact will continue up to day 75 after starting study treatment. Follow up electronic contact will be dependent on initial patient response, compliance with response, and medication adherence, for the trial duration using electronic contacts and through telephone contacts. Participants will be queried for any clinically relevant endpoints, especially major bleeding, or need to seek healthcare attention for any reason. Follow-up will occur from the time of study drug receipt and through the 30 day safety period.

Apixaban 5mg

Subjects will be contacted either electronically or by telephone within 24 hours of randomization to confirm receipt of the study treatment. Study drug will be shipped to subjects home. Subjects will take Aspirin twice a day; once in the morning and once in the evening for 45 days. Subjects will be contacted (electronic or telephone) minimally weekly after initial start of study medication and contact will continue up to day 75 after starting study treatment. Follow up electronic contact will be dependent on initial patient response, compliance with response, and medication adherence, for the trial duration using electronic contacts and through telephone contacts. Participants will be queried for any clinically relevant endpoints, especially major bleeding, or need to seek healthcare attention for any reason. Follow-up will occur from the time of study drug receipt and through the 30 day safety period.

Aspirin

Subjects will be contacted either electronically or by telephone within 24 hours of randomization to confirm receipt of the study treatment. Study placebo will be shipped to subjects home. Subjects will take placebo twice a day; once in the morning and once in the evening for 45 days. Subjects will be contacted (electronic or telephone) minimally weekly after initial start of study medication and contact will continue up to day 75 after starting study treatment. Follow up electronic contact will be dependent on initial patient response, compliance with response, and medication adherence, for the trial duration using electronic contacts and through telephone contacts. Participants will be queried for any clinically relevant endpoints, especially major bleeding, or need to seek healthcare attention for any reason. Follow-up will occur from the time of study drug receipt and through the 30 day safety period.

Placebo

Eligibility Criteria

Age40 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • COVID-19+ in past 14 days
  • Platelets \> 100,000
  • eGFR \> 30ml/min

You may not qualify if:

  • Hospitalized
  • Contradiction/ other indication for anti-coagulation
  • Pregnancy
  • Active cancer

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (71)

University of Southern California

Los Angeles, California, 90033, United States

Location

Stanford University School of Medicine

Palo Alto, California, 94304, United States

Location

Zuckerberg San Francisco General

San Francisco, California, 94143, United States

Location

Olive View-UCLA Medical Center

Sylmar, California, 91342, United States

Location

Pine Ridge Family Medicine

Colorado Springs, Colorado, 80924, United States

Location

Life Tree Health, Inc.

Washington D.C., District of Columbia, 20020, United States

Location

Midland Florida Clinical Research Center, LLC

DeLand, Florida, 23720, United States

Location

University of Florida at Gainesville

Gainesville, Florida, 32611, United States

Location

Vital Pharma Research

Hialeah, Florida, 33016, United States

Location

Advanced Research for Health Improvement, LLC

Immokalee, Florida, 34142, United States

Location

University of Floridia at Jacksonville

Jacksonville, Florida, 32209, United States

Location

Lakeland Regional

Lakeland, Florida, 33805, United States

Location

Total Research Group LLC

Miami, Florida, 33126, United States

Location

Jackson Memorial

Miami, Florida, 33136, United States

Location

Well Pharma Medical Research

Miami, Florida, 33173, United States

Location

Innovation Clinical Trials

Palmetto Bay, Florida, 33157, United States

Location

Bond Community Health Center

Tallahassee, Florida, 32301, United States

Location

Tallahassee Memorial

Tallahassee, Florida, 32308, United States

Location

USF Tampa General Hospital

Tampa, Florida, 33606, United States

Location

Alliance Clinical Research

Tampa, Florida, 33615, United States

Location

Hawaii Pacific Health

Honolulu, Hawaii, 96813, United States

Location

Fox Valley Clinical Research Center, LLC

Aurora, Illinois, 60506, United States

Location

UIC - Mile Square

Chicago, Illinois, 60608, United States

Location

Jesse Brown VA

Chicago, Illinois, 60612, United States

Location

University of Illinois at Chicago

Chicago, Illinois, 60612, United States

Location

Olivo Wellness Medical Center

Chicago, Illinois, 60618, United States

Location

University of Chicago

Chicago, Illinois, 60637, United States

Location

OSF Saint Francis Medical Center

Peoria, Illinois, 61637, United States

Location

Ascension Via Christi

Wichita, Kansas, 67214, United States

Location

University Medical Center New Orleans

New Orleans, Louisiana, 70112, United States

Location

Jadestone Clinical Research, LLC

Gaithersburg, Maryland, 20877, United States

Location

Brigham & Women's Hospital

Boston, Massachusetts, 02115, United States

Location

GFC of Southeastern Michigan

Detroit, Michigan, 48202, United States

Location

SRI International

Plymouth, Michigan, 48170, United States

Location

Metro Health-University of Michigan Health

Wyoming, Michigan, 49519, United States

Location

Raritan Bay Primary Care and Cardiology Associates

Matawan, New Jersey, 07747, United States

Location

G&S Medical Associates, LLC

Paterson, New Jersey, 07514, United States

Location

University of New Mexico

Albuquerque, New Mexico, 87131, United States

Location

Strong Memorial

Rochester, New York, 14642, United States

Location

Montefiore Medical Center

The Bronx, New York, 10467, United States

Location

Spinal Pain and Rehab Medicine

Yonkers, New York, 10701, United States

Location

Duke

Durham, North Carolina, 27701, United States

Location

Peters Medical Research

High Point, North Carolina, 27262, United States

Location

The Heart and Medical Center

Durant, Oklahoma, 74701, United States

Location

Ascension St. John Clinical Research Institute

Tulsa, Oklahoma, 74104, United States

Location

UPMC Passavant Cranberry

Cranberry, Pennsylvania, 16066, United States

Location

UPMC McKeesport

McKeesport, Pennsylvania, 15132, United States

Location

UPMC East

Monroeville, Pennsylvania, 15146, United States

Location

UPMC Magee

Pittsburgh, Pennsylvania, 15213, United States

Location

UPMC Presby

Pittsburgh, Pennsylvania, 15213, United States

Location

UPMC Mercy

Pittsburgh, Pennsylvania, 15219, United States

Location

Preferred Primary Care Physicians

Pittsburgh, Pennsylvania, 15220, United States

Location

UPMC Shadyside

Pittsburgh, Pennsylvania, 15232, United States

Location

UPMC Passavant McCandless

Pittsburgh, Pennsylvania, 15237, United States

Location

Preferred Primary Care Physicians, Inc

Pittsburgh, Pennsylvania, 15243, United States

Location

Preferred Primary Care Physicians

Pittsburgh, Pennsylvania, 15243, United States

Location

Preferred Primary Care Physicians

Uniontown, Pennsylvania, 15401, United States

Location

Pharma Tex Research

Amarillo, Texas, 79109, United States

Location

Ascension Seton Medical Center

Austin, Texas, 78752, United States

Location

Baptist Beaumont

Beaumont, Texas, 77030, United States

Location

McGoven Medical School - UT- Houston

Houston, Texas, 77030, United States

Location

Diversifield Medical Practices

Houston, Texas, 77057, United States

Location

Next Level Urgent Care

Houston, Texas, 77057, United States

Location

Mesquite Regional Internal Medicine

Mesquite, Texas, 75149, United States

Location

University of Texas at Tyler

Tyler, Texas, 75708, United States

Location

University of Texas at Rio Grande Valley

Weslaco, Texas, 78596, United States

Location

Intermountain Healthcare

Murray, Utah, 84107, United States

Location

Community Care of Clay

Clay, West Virginia, 25043, United States

Location

University Healthcare Physicians

Harpers Ferry, West Virginia, 25425, United States

Location

Community Care of Weston

Weston, West Virginia, 26452, United States

Location

Gundersen Health System

La Crosse, Wisconsin, 54601, United States

Location

Related Publications (5)

  • Santos BC, Flumignan RL, Civile VT, Atallah AN, Nakano LC. Prophylactic anticoagulants for non-hospitalised people with COVID-19. Cochrane Database Syst Rev. 2023 Aug 16;8(8):CD015102. doi: 10.1002/14651858.CD015102.pub2.

  • Fischer AL, Messer S, Riera R, Martimbianco ALC, Stegemann M, Estcourt LJ, Weibel S, Monsef I, Andreas M, Pacheco RL, Skoetz N. Antiplatelet agents for the treatment of adults with COVID-19. Cochrane Database Syst Rev. 2023 Jul 25;7(7):CD015078. doi: 10.1002/14651858.CD015078.

  • Bledsoe J, Woller SC, Brooks M, Sciurba FC, Krishnan JA, Martin D, Hou P, Lin JY, Kindzelski A, Handberg E, Kirwan BA, Zaharris E, Castro L, Shapiro NL, Pepine CJ, Majercik S, Fu Z, Zhong Y, Venugopal V, Lai YH, Ridker PM, Connors JM. Clinically stable covid-19 patients presenting to acute unscheduled episodic care venues have increased risk of hospitalization: secondary analysis of a randomized control trial. BMC Infect Dis. 2023 May 15;23(1):325. doi: 10.1186/s12879-023-08295-9.

  • Connors JM, Brooks MM, Sciurba FC, Krishnan JA, Bledsoe JR, Kindzelski A, Baucom AL, Kirwan BA, Eng H, Martin D, Zaharris E, Everett B, Castro L, Shapiro NL, Lin JY, Hou PC, Pepine CJ, Handberg E, Haight DO, Wilson JW, Majercik S, Fu Z, Zhong Y, Venugopal V, Beach S, Wisniewski S, Ridker PM; ACTIV-4B Investigators. Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial. JAMA. 2021 Nov 2;326(17):1703-1712. doi: 10.1001/jama.2021.17272.

  • Kreuzberger N, Hirsch C, Chai KL, Tomlinson E, Khosravi Z, Popp M, Neidhardt M, Piechotta V, Salomon S, Valk SJ, Monsef I, Schmaderer C, Wood EM, So-Osman C, Roberts DJ, McQuilten Z, Estcourt LJ, Skoetz N. SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19. Cochrane Database Syst Rev. 2021 Sep 2;9(9):CD013825. doi: 10.1002/14651858.CD013825.pub2.

MeSH Terms

Conditions

COVID-19

Interventions

apixabanAspirin

Condition Hierarchy (Ancestors)

Pneumonia, ViralPneumoniaRespiratory Tract InfectionsInfectionsVirus DiseasesCoronavirus InfectionsCoronaviridae InfectionsNidovirales InfectionsRNA Virus InfectionsLung DiseasesRespiratory Tract Diseases

Intervention Hierarchy (Ancestors)

SalicylatesHydroxybenzoatesPhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic Chemicals

Limitations and Caveats

Early termination leads to a small number of subjects being analyzed.

Results Point of Contact

Title
Dr. Frank Sciurba
Organization
University of Pittsburgh

Study Officials

  • Frank Sciurba

    University of Pittsburgh

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Double-blind
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

August 3, 2020

First Posted

August 4, 2020

Study Start

September 7, 2020

Primary Completion

August 5, 2021

Study Completion

August 5, 2021

Last Updated

February 17, 2022

Results First Posted

February 17, 2022

Record last verified: 2022-02

Data Sharing

IPD Sharing
Will not share

Locations