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Completed

NCT Number: NCT04321096

The Impact of Camostat Mesilate on COVID-19 Infection

SARS-CoV-2, one of a family of human coronaviruses, was initially identified in December 2019 in Wuhan city. This new coronavirus causes a disease presentation which has now been named COVID-19. The virus has subsequently spread throughout the world and was declared a pandemic by the World Health Organisation on 11th March 2020. As of 18 March 2020, there are 198,193 number of confirmed cases with an estimated case-fatality of 3%. There is no approved therapy for COVID-19 and the current standard of care is supportive treatment.

SARS-CoV-2 exploits the cell entry receptor protein angiotensin converting enzyme II (ACE-2) to access and infect human cells. The interaction between ACE2 and the spike protein is not in the active site. This process requires the serine protease TMPRSS2. Camostat Mesilate is a potent serine protease inhibitor. Utilizing research on severe acute respiratory syndrome coronavirus (SARS-CoV) and the closely related SARS-CoV-2 cell entry mechanism, it has been demonstrated that SARS-CoV-2 cellular entry can be blocked by camostat mesilate. In mice, camostat mesilate dosed at concentrations similar to the clinically achievable concentration in humans reduced mortality following SARS-CoV infection from 100% to 30-35%.

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Key information

Age range

18 year–110 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

Region Hospital North Jutland, Hjørring, Region Nord, Denmark

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About this study

Cohort 1 - enrolment into the cohort of hospitalized patients has been completed (31 Dec 2020). Study results are publicly available at EClinicilMedicine, see link https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00129-2/fulltext Cohort 2 - outpatients - remains open for enrolment

Who can participate

Healthy volunteers accepted: No

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

Cohort 1)

  • Documented COVID-19 infection as evidenced by positive PCR (or comparable clinical assay) for SARS-CoV-2
  • Less than 48 hours since time of hospital admission OR if hospital-acquired COVID-19 is suspected, less than 48 hrs since onset of symptoms
  • Adolescents and adults age >=18 years
  • Subject or legally authorized representative able to give informed consent
  • Admitted to hospital

Cohort 2)

  • Documented COVID-19 infection as evidenced by positive PCR (or comparable clinical assay) for SARS-CoV-2
  • One or more of the following symptoms of COVID-19 infection: fever, cough, expectoration, shortness of breath, myalgia, fatigue, or head ache
  • No more than 5 days since the beginning of symptom onset
  • Adolescents and adults age >=18 years
  • Subject (or legally authorized representative, for Cohort 1 only) able to give informed consent
  • Do not require immediate hospitalization (newly diagnosed COVID-19 patients who are discharged within 24 hrs of hospital admission are eligible for enrollment)
  • Must be willing to fill out a daily symptom diary
  • Must be available for a daily phone call
  • Must be willing to take their own temperature at least once a day

Exclusion criteria

  • Any condition that, in the Investigator's opinion, will prevent adequate compliance with study therapy (e.g. the patient is considered to be moribund within the next 72 hrs or has uncontrolled substance abuse that prevents adherence to study medication). Patients needing ventilator treatment are eligible to be enrolled if they fulfill the other in/exclusion criteria.
  • The following laboratory values at baseline (Day 0):
  • Serum total bilirubin ≥3 ULN
  • Estimated glomerular filtration rate (eGFR) ≤30 mL/min (based on serum creatinine)
  • Known hypersensitivity to Camostat Mesilate
  • Women who are pregnant or breastfeeding, or with a positive pregnancy test as determined by a positive urine or blood beta- human chorionic gonadotropin test during screening or women of child bearing potential* who are unwilling or unable to use an acceptable method of contraception (combined estrogen and progestogen hormonal contraception (oral, intravaginal or transdermal), progesteron-only hormonal contraception (oral, injectable or implantable), intrauterine device or intrauterine hormone-releasing system) to avoid pregnancy during the study. Sexual abstinence will only be accepted in cases where this reflect the usual lifestyle.

Treatment and study plan

Camostat Mesilate

Drug

Serine protease inhibitor that blocks TMPRSS-2 mediated cell entry of SARS-CoV-2

Other names: Foipan

Placebo oral tablet

Drug

Placebo

Other names: Placebo

Primary outcomes

  1. Cohort 1: Days to clinical improvement from study enrolment

    Time frame: 30 days

    Clinical improvement defined as live hospital discharge OR a 2 point improvement (from time of enrolment) in disease severity rating on the 7-point ordinal scale

  2. Cohort 2: Days to clinical improvement from study enrolment

    Time frame: 30 days

    Days to clinical improvement from study enrolment defined no fever for at least 48 hrs AND improvement in other symptoms (e.g. cough, expectoration, myalgia, fatigue, or head ache)

Secondary outcomes

  1. Safety evaluation, as measured by AEs, Adverse Reactions (ARs), SAEs, Serious ARs (SARs)

    Time frame: 30 days

  2. Cohort 1: Clinical status as assessed by the 7-point ordinal scale at day 7, 14 and 30

    Time frame: 30 days

    The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities.

  3. Cohort 1: Day 30 mortality

    Time frame: 30 days

    Mortality

  4. Cohort 1: Change in NEW(2) score from baseline to day 30

    Time frame: 30 days

    NEWS2

  5. Cohort 1: Admission to ICU

    Time frame: 30 days

    ICU

  6. Cohort 1: Use of invasive mechanical ventilation or ECMO

    Time frame: 30 days

    invasive mechanical ventilation or ECMO

  7. Cohort 1: Duration of supplemental oxygen (days)

    Time frame: 30 days

    Nasal or high-flow oxygen

  8. Cohort 1+2: Days to self-reported recovery (e.g. limitations in daily life activities) during telephone interviews conducted at day 30

    Time frame: 30 days

    Subjective clinical improvement

  9. Cohort 2: Number participant-reported secondary infection of housemates

    Time frame: 30 days

    No of new COVID-19 infections in the household

  10. Cohort 2: Time to hospital admission related to COVID-19 infection

    Time frame: 30 days

    Hospital admission

Sponsors and collaborators

Lead sponsor

University of Aarhus

Other

Registry information

Official study title

The Impact of Camostat Mesilate on COVID-19 Infection: An Investigator-initiated Randomized, Placebo-controlled, Phase IIa Trial

Acronym: CamoCO-19

Important dates

Study start
2020
Primary completion
2022
Study completion
2023
First posted
Mar 25, 2020
Registry last updated
Apr 18, 2025

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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