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2020 ; 21
(1
): 635
Nephropedia Template TP
gab.com Text
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Test and treat COVID 65 plus - Hydroxychloroquine versus placebo in early
ambulatory diagnosis and treatment of older patients with COVID19: A structured
summary of a study protocol for a randomised controlled trial
#MMPMID32650818
Göpel S
; Bethge W
; Martus P
; Kreth F
; Iftner T
; Joos S
; Döbele S
; Mordmüller B
; Kremsner P
; Ettrich T
; Seufferlein T
; Bitzer M
; Malek N
Trials
2020[Jul]; 21
(1
): 635
PMID32650818
show ga
OBJECTIVES: The aim of this trial is to identify the effect of ambulatory
treatment in early COVID-19 disease with hydroxychloroquine on the rate of
hospitalization or death in older patients above the age of 64. TRIAL DESIGN:
Parallel, 2:1 randomization, double blind, placebo-controlled, multi-center
trial. PARTICIPANTS: Male and female patients above the age of 64 (i.e. ?65 years
of age) with COVID-19 diagnosis confirmed by SARS-CoV2 positive throat swab
(PCR). Patients can only be included within 3 days of symptom onset in ambulatory
care if they consent to the study procedure and are able to adhere to the study
visit schedule and protocol requirements (including telephone visits concerning
symptoms and side effects). Severity of disease at inclusion is mild to moderate
defined as not requiring hospital admission: SpO2 >94%, respiratory rate <20,
mental state alert, no signs of septic shock. Cardiac risk is minimised by
requiring a Tisdale score ? 6. Patients are recruited in the two german cities of
Ulm and Tübingen in various ambulatory care settings. INTERVENTION AND
COMPARATOR: Each patient will be given a first dose of 600 mg Hydroxychloroquine
or the equivalent number of placebo capsules (3 capsules) at the day of
inclusion. From the 2(nd) day on, each patient will get 200 mg or the equivalent
number of placebo capsules twice a day (400mg/day) until day 7 (6 more does of
400 mg); a cumulative dose of 3 g. MAIN OUTCOMES: Rate of hospitalization or
death at day 7 after study inclusion RANDOMISATION: All consenting adult patients
having confirmed COVID-19 are randomly and blindly allocated in a 2:1 ratio to
either IMP or placebo. The biostatistical center produced a randomization list
(block randomization) with varying block length and stratified for the study
center. This list is provided for packaging to the pharmaceutical unit which is
providing encapsulated placebo and IMP. Only the pharmaceutical unit is aware of
group allocation according to the randomization list. BLINDING (MASKING):
Patients and investigators, as well as treating physicians are blinded to the
treatment- allocation. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): In the first stage
of an adaptive design 120 patients in a 2:1 ration: 72 Verum and 36 Placebo, plus
an increase for 10% drop outs. After interim analysis, the total sample size will
be calculated based on the effect seen in the first stage. Total sample size is
estimated approximately n = 300-400 patients. TRIAL STATUS: Protocol version
number: V3, 19.05.2020 Recruitment not yet started but is anticipated to begin by
June 2020 and be complete by December 2020 TRIAL REGISTRATION:
ClinicalTrials.gov: NCT04351516 , date: 17 April 2020 EudraCT: 2020-001482-37,
date: 30 March 2020 FULL PROTOCOL: The full protocol is attached as an additional
file, accessible from the Trials website (Additional file 1). In the interest in
expediting dissemination of this material, the familiar formatting has been
eliminated; this Letter serves as a summary of the key elements of the full
protocol.