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NCT Number: NCT07743580

A Study of Secutrelvir in Participants With Coronavirus Disease 2019 (COVID-19) Who Are at High Risk for Progression to Severe Disease

The primary purpose of this study is to evaluate the efficacy and safety of secutrelvir in symptomatic nonhospitalized adult and adolescent participants with COVID-19 who are at high risk for progression to severe disease.

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Key information

Age range

12 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Medical Center Unimed EOOD, Sevlievo, Gabrovo, Bulgaria

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria:

  • Must be 12 to <18 years of age (where permitted by local regulations) with a body weight ≥40 kilograms, or ≥18 years of age regardless of body weight, at the time of signing the informed consent form.
  • Presence of risk factors for progression to severe COVID-19 at the time of screening.
  • Must have ≥1 COVID-19 signs/symptoms that are at least mild in severity, and the symptoms must still be present in the 24 hours prior to randomization.
  • Confirmed SARS-CoV-2 infection, as determined by any SARS-CoV-2 test (for example, quantitative reverse transcription polymerase chain reaction, antigen test) approved according to local regulations, of any respiratory tract specimen (for example, oropharyngeal, nasopharyngeal or nasal swab, or saliva), collected ≤72 hours prior to randomization.
  • Must be randomized within 72 hours of symptom onset, defined as the time when the first COVID-19 symptom occurs.
  • Contraceptive use by women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
  • A women of childbearing potential must have a negative urine pregnancy test within 24 hours prior to receiving the investigational intervention.
  • Unable or unwilling to take other locally available COVID-19 antivirals (for example, nirmatrelvir/ritonavir, molnupiravir, remdesivir, ensitrelvir).

Key Exclusion Criteria:

  • Planned >24 hours hospitalization for any medical procedure through Day 28.
  • Documented respiratory infection (for example, influenza, respiratory syncytial virus) other than COVID-19 within the 14 days prior to the screening visit.
  • Known history of cirrhosis or liver decompensation (including ascites, variceal bleeding, or hepatic encephalopathy).
  • Known history of any of the following abnormalities in the following clinical laboratory tests (within 6 months prior to the screening visit):
  • Total bilirubin ≥2*upper limit of normal (ULN) (except for Gilbert's syndrome)
  • Aspartate aminotransferase or alanine aminotransferase ≥3*ULN
  • Suspected or confirmed COVID-19 unrelated to the current episode within 6 months prior to randomization or, for moderately immunocompromised participants, within 3 months prior to randomization.
  • Suspected or confirmed concurrent active systemic infection other than COVID-19 that may interfere with the evaluation of response to the investigational intervention.
  • Ongoing long COVID-19 or post-acute sequelae of COVID-19 diagnosis.
  • Current severely immunocompromised conditions.
  • Received any other COVID-19-specific therapies within the following timeframes:
  • Antiviral agents (for example, remdesivir, nirmatorelvir/ritonavir, molnupiravir, ensitrelvir) within 30 days or 5 half-lives (whichever is longer) prior to randomization
  • Anti-SARS-CoV-2 monoclonal antibodies and COVID-19 convalescent plasma within 6 months prior to randomization

Note: Other protocol-define criteria apply

Treatment and study plan

Secutrelvir

Drug

Secutrelvir will be administered orally as a tablet.

Other names: S-892216

Placebo

Drug

Placebo will be administered orally as a tablet.

Primary outcomes

  1. Proportion of Participants Experiencing Any Component of the Following Composite Endpoint: Targeted Medically Attended Visits (tMAVs) Due to Worsening COVID-19, All-cause Hospitalizations, or All-cause Deaths

    Time frame: Baseline through Day 28

Secondary outcomes

  1. Time to Sustained Resolution of 14 COVID-19 Symptoms

    Time frame: Baseline through Day 28

  2. Proportion of Participants with tMAVs Due to Worsening COVID-19

    Time frame: Baseline through Day 28

  3. Proportion of Participants with All-cause Hospitalization or All-cause Death

    Time frame: Baseline through Day 28

  4. Proportion of Participants with Hospitalization Due to Worsening COVID-19

    Time frame: Baseline through Day 28

  5. Time to First Resolution of 14 COVID-19 Symptoms

    Time frame: Baseline through Day 28

  6. Time to Sustained Alleviation of 14 COVID 19 Symptoms

    Time frame: Baseline through Day 28

  7. Time to Sustained Resolution of Each of the 14 COVID-19 Symptoms

    Time frame: Baseline through Day 28

  8. Time to First Alleviation of 14 COVID-19 Symptoms

    Time frame: Baseline through Day 28

  9. Change from Baseline in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Viral Ribonucleic Acid (RNA) Level

    Time frame: Baseline, Day 28

  10. Number of Participants Returning to Usual Health

    Time frame: Baseline through Day 28

  11. Number of Participants Returning to Usual Activity

    Time frame: Baseline through Day 28

  12. Number of Participants Reporting No Symptoms

    Time frame: Baseline through Day 28

  13. Change from Baseline in EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) Score

    Time frame: Baseline, Day 28

  14. Plasma Concentration of Secutrelvir and Secutrelvir Metabolites

    Time frame: Day 4, Day 8

  15. Number of Participants with Treatment-emergent Adverse Events

    Time frame: Baseline through Week 24

Study contacts

Contact information is provided by the study sponsor or research team.

Shionogi Clinical Trials Administrator Clinical Support Help Line

CONTACT

[email protected]

1-800-849-9707

Sponsors and collaborators

Lead sponsor

Shionogi

Industry

Registry information

Official study title

A Phase 3 Randomized, Double-blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Secutrelvir in Participants With COVID-19 Who Are at High Risk for Progression to Severe Disease

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Aug 4, 2026
Registry last updated
Aug 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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