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OpenTrials
Completed

NCT Number: NCT04348383

Defibrotide as Prevention and Treatment of Respiratory Distress and Cytokine Release Syndrome of Covid 19.

Protection of endothelial dysfunction by intravenous infusion of Defibrotide (Defitelio), expected to decrease inflammation and expression of adhesion molecules in the endothelium, leukocyte tissue infiltration and epithelial destruction, and to promote immune tolerance through a change in the Cytokine balance, which is decisive in preventing multiorgan failure and death in patients with SARS-CoV-2 infection with clinical status grade 4 or 5 according to the WHO classification

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain

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About this study

Protection of endothelial dysfunction by intravenous infusion of Defibrotide (Defitelio), expected to decrease inflammation and expression of adhesion molecules in the endothelium, leukocyte tissue infiltration and epithelial destruction, and to promote immune tolerance through a change in the Cytokine balance, which is decisive in preventing multiorgan failure and death in patients with SARS-CoV-2 infection with clinical status grade 4 or 5 according to the WHO classification

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Acceptance of participation in the study by the patient or legal representative.
  • Patients of any gender, 18 years or older.
  • Confirmed diagnosis by PCR+ of SARS-CoV-2 infection.
  • COVID-19 positive patients WHO grades 4, 5 or 6.
  • Grade 4: hospitalized requiring oxygen therapy.
  • Grade 5: hospitalized requiring high-flow oxygen therapy, noninvasive mechanical ventilation, or both.
  • Levels of IL-6 ≥ 3 times the upper limit of normality

Exclusion criteria

  • Acute bleeding.
  • Thrombolytic treatment and anticoagulant treatment at therapeutic doses.
  • Pregnancy or lactation.
  • Patients with active malignant tumour, other serious systemic or neuropsychiatric diseases.
  • Patients participating in other clinical trials in the last month.
  • Inability to give informed consent or to accomplish the requirements of the diagnostic tests.
  • Patients with hypersensitivity to Defibrotide.

Treatment and study plan

Defibrotide

Drug

6.25 mg/kg every 6 hours in 2 hours infusion for 7 or 15 days

Placebo

Drug

Placebo 250 cc every 6 hours for 7 or15 days

Primary outcomes

  1. Clinical improvement.

    Time frame: 7,15, 30 day

    Number of days that the patient maintains the clinical improvement. The patient achieves a change of al least 1 category on WHO scale.

Secondary outcomes

  1. 1. Mortality rate

    Time frame: : up to 30 days

    All cause mortality

  2. Rate os serious adverse events .

    Time frame: 7, 15, 30 and 60 Day

    Number of adverse events with possible, probable or definite relationship with the study.

  3. Clinical improvement by WHO

    Time frame: 7, 15, 30 and 60 Day

    Decrease ventilation days in grade 6 patients

  4. Clinical improvement by NEWS2 scales

    Time frame: 7, 15, 30 and 60 Day

    Decrease the rate of grades 4-5 patients requiring mechanical ventilation.

  5. Clinical improvement by NEWS2 scales

    Time frame: 7, 15, 30 and 60 Day

    Decrease ventilation days in grade 6 patients

  6. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Decrease of IL-6 levels with respect to the basal ones > 50%.

  7. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Absolute lymphocytes count: 50% increase with respect to the baseline

  8. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Normal D-dimer (DD) or decrease of 50% with respect to the baseline

  9. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Normal CRP or decrease of 50% with respect to the baseline

  10. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Normal LDH or decrease of 50% with respect to the baseline

  11. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Normal CPK or decrease of 50% with respect to the baseline

  12. Biologic response

    Time frame: 7, 15, 30 and 60 Day

    Normal Ferritin or decrease of 50% with respect to the baseline

  13. Radiological response

    Time frame: 7, 15, 30 and 60 Day

    Improvement of radiological images by conventional radiology

  14. Collection and storage of biological samples

    Time frame: 15,30 days

    improve the knowledge of the disease at the inclusion of the patients

  15. Clinical improvement by WHO

    Time frame: 7, 15, 30 and 60 Day

    Decrease the rate of grades 4-5 patients requiring mechanical ventilation.

Sponsors and collaborators

Lead sponsor

Fundacion para la Formacion e Investigacion Sanitarias de la Region de Murcia

Other

Registry information

Official study title

Phase IIb Prospective, Multi-center, Randomized, Parallel, Double Blind, Placebo Controlled Trial to Evaluate Defibrotide Intravenous Infusion in the Prevention and Treatment of COVID-19 Respiratory Distress and Cytokine Release Syndrome

Acronym: DEFACOVID

Important dates

Study start
2020
Primary completion
2023
Study completion
2023
First posted
Apr 16, 2020
Registry last updated
Jun 7, 2023

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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