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Completed

NCT Number: NCT05038488

Phase 2a MIB-626 vs. Placebo COVID-19

The proposed phase 2a trial will determine whether MIB-626 treatment in adults with COVID-19 infection and stage 1 acute kidney injury is more efficacious than placebo in preventing worsening of kidney function, as assessed by longitudinal changes in serum creatinine concentration, and in attenuating the inflammatory response to the infection.

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Key information

About this study

This is a two-center, randomized, double-blind, placebo-controlled, parallel-group, phase 2a study that will determine the efficacy and safety of MIB-626 treatment relative to placebo in adult patients with COVID-19 infection and stage 1 acute kidney injury.

Hospitalized adult patients with a confirmed or suspected diagnosis of COVID-19 infection will be screened for conformity to inclusion and exclusion criteria and those meeting eligibility criteria on screening will be offered participation in the study. Fifty participants, who meet all the eligibility criteria, and are able and willing to provide informed consent, will be randomized, stratified by sex, remdesivir use, and trial site, in a 3:2 ratio to receive either MIB-626 1.0 g orally or matching placebo twice daily for 14 days. The participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • A man or a woman, 18 years or older
  • Willing and able to provide informed consent, or with a legal representative who can provide informed consent with participant's assent
  • Has Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection confirmed by an approved diagnostic test before randomization
  • Currently hospitalized
  • Documented increase in serum creatinine of 0.3 mg/dL or 50%-99% over baseline (baseline either based on admission serum creatinine or known pre-admission baseline, defined as most recent previous measurement)
  • Participant or legal representative has read and signed the Informed Consent Form (ICF) after the nature of the study has been fully explained
  • Is willing and able to provide authorization for the use and disclosure of personal health information in accordance with Health Insurance Portability and Accountability Act (HIPAA)
  • Patients who are receiving remdesivir as a part of their clinical care or are in clinical trials of remdesivir or other antiviral drugs may be allowed if they meet other eligibility criteria
  • Patients, who are participating in observational studies or studies of nonpharmacological interventions, will be allowed to participate
  • Not be pregnant and not planning to become pregnant over the next 6 months

Exclusion criteria

  • In the intensive care unit at the time of screening or prior to randomization
  • Requiring mechanical ventilation at the time of screening or prior to randomization
  • Has baseline estimated glomerular filtration rate < 30 ml/min/1.73m2
  • Has a history of kidney transplantation or hemodialysis treatment or receiving or expected to receive hemodialysis or peritoneal dialysis at screening and prior to randomization
  • Is on mechanical ventilation
  • Has a contraindication for MIB-626 or its inert ingredients
  • Has a diagnosis of lupus nephritis, polycystic kidney disease, other glomerular disease (other than diabetes)
  • Has AST or ALT > 3 times the upper limit of normal
  • Has other medical condition which, in the opinion of the Principal Investigator, would jeopardize the safety of the study subject or impact the validity of the study results
  • Will exclude patients, who are receiving or are enrolled in placebo-controlled intervention trials of anti-inflammatory or immunomodulatory agents, such as tocilizumab. Occasional use of acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen, for fever or headache is permitted.

Treatment and study plan

MIB-626

Drug

Fifty participants will be randomized, stratified by sex, remdesivir use, and trial site, in a 3:2 ratio to receive either MIB-626 1.0 g orally or matching placebo twice daily for 14 days.

Other names: NAD-boosting drug

Placebo

Drug

Subjects will be randomized to receive either the placebo or 1000-mg MIB-626 twice daily orally.

Home treatment

Other

Participants, who are discharged from the hospital before the completion of the 14-day intervention period, will be provided sufficient study medication to take home with them so they can continue to take the medication twice daily for the remaining duration of the 14-day intervention period.

Primary outcomes

  1. Change from baseline in serum cystatin C levels

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline in serum cystatin C levels

Secondary outcomes

  1. Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline to peak concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)

  2. The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The trajectory of change from baseline in concentrations of inflammatory biomarkers (IL6, TNF-alpha, hsCRP, Angiotensin 2 to Angiotensin1, 7 ratio, ACE 2)

  3. Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline in markers of endothelial damage (vWF, VCAM, PAI-1)

  4. Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline in markers of microvascular thrombosis (D-dimer, fibrinogen)

  5. The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The trajectory of change in plasma (NGAL, KIM-1) and urinary (KIM-1, NGAL, albumin) biomarkers of acute kidney injury

  6. Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change in urinary albumin concentration (normalized to urine creatinine) from enrollment to peak during hospitalization

  7. Change from baseline in oxygen saturation

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline in oxygen saturation

  8. Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change in high sensitivity troponin-1 concentration from enrollment to peak during hospitalization (measured daily in stored biospecimens)

  9. Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline in intracellular NAD+ concentrations in blood during the 14-day treatment period in a subset of study participants

  10. Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Circulating concentrations of MIB-626 and its key metabolites P2Y, NAAD, NAM, 1-methylnicotinamide during the 14-day treatment period

Other outcomes

  1. Progression in the stage of acute kidney injury increase in serum creatinine OR serum creatinine > 4.0 mg/dL OR need

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Progression in the stage of acute kidney injury

  2. The WHO 8-point Ordinal Scale of Clinical Status

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The WHO 8-point Ordinal Scale of Clinical Status

  3. Change from baseline in Modified Sequential Organ Failure Assessment (SOFA) Score (SOFA) Score

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    Change from baseline in Modified Sequential Organ Failure Assessment (SOFA) Score

  4. The number and proportion of patients requiring mechanical ventilation, hemodialysis, or transferred to ICU

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The number and proportion of patients requiring mechanical ventilation, hemodialysis, or transferred to ICU

  5. The number and proportion of patients requiring hemodialysis

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The number and proportion of patients requiring hemodialysis

  6. The number and proportion of patients who die

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The number and proportion of patients who die

  7. The number of days it takes for the temperature to return to normal (<99F)

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The number of days it takes for the temperature to return to normal (<99F)

  8. The length of hospital stay

    Time frame: enrollment to 14 days or hospital discharge, or death, whichever comes first

    The length of hospital stay

Sponsors and collaborators

Lead sponsor

Metro International Biotech, LLC

Industry

Registry information

Official study title

A Phase 2a Randomized Controlled Trial of MIB-626 (NAD-boosting Drug) vs. Placebo in Adults With COVID-19 Infection and Early Acute Kidney Injury

Important dates

Study start
2021
Primary completion
2023
Study completion
2023
First posted
Sep 9, 2021
Registry last updated
Aug 27, 2024

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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