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Coronavirus InfectionPhase 2CoronavirusNCT04349098

Evaluation of Activity and Safety of Oral Selinexor in Participants With Severe COVID-19 Infection

A Phase 2 study testing Selinexor in people with Coronavirus Infection, run by Karyopharm Therapeutics Inc at 33 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The main purpose of this study is to evaluate the activity of low dose oral selinexor (KPT-330) and to evaluate the clinical recovery, the viral load, length of hospitalization and the rate of morbidity and mortality in participants with severe COVID-19 compared to placebo. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coronavirus Infection
What is being tested?
Selinexor
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
190 participants
Where
33 sitesin 6 countries
Study dates
17 Apr 2020to 5 Oct 2020
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Confirmed laboratory diagnosis of SARS-CoV2 by standard FDA-approved reverse transcription polymerase chain reaction (RT-PCR) assay or equivalent FDA-approved testing (local labs).
  • Currently hospitalized.
  • Informed consent provided as above (it is recommended that participants are dosed with study drug within 12 hours of consent).
  • Has symptoms of severe COVID-19 as demonstrated by:
  • At least one of the following: fever, cough, sore throat, malaise, headache, muscle pain, shortness of breath at rest or with exertion, confusion, or symptoms of severe lower respiratory symptoms including dyspnea at rest or respiratory distress.
  • Clinical signs indicative of lower respiratory infection with COVID-19, with at least one of the following: SaO2 <92% on room air in last 12 hours or requires > 4 liters per minute (LPM) oxygen by nasal canula, non-rebreather/Ventimask or high flow nasal canula in order maintain SaO2 ≥92%, PaO2/FiO2 <300 millimeter per mercury (mm/hg).
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  • Elevated C-reactive protein (CRP) > 2 x upper limit of normal (ULN).
  • Concurrent anti-viral and/or anti-inflammatory agents (e.g., biologics, hydroxychloroquine) are permitted. If in the physician's judgment, it is in the best interest of the participant to use anti-viral or anti-inflammatory treatments, these treatments are to be documented in the participant's chart and entered in the electronic case report form.
  • Female participants of childbearing potential must have a negative serum pregnancy test at Screening. Female participants of childbearing potential and fertile male participants must use highly effective methods of contraception throughout the study and for 3 months following the last dose of study treatment.

Who cannot join

  • Evidence of critical COVID-19 based on:
  • Respiratory failure (defined by endotracheal intubation and mechanical ventilation, oxygen delivered by noninvasive positive pressure ventilation, or clinical diagnosis of respiratory failure in setting of resource limitations)
  • Septic shock (defined by Systolic blood pressure [BP] < 90 mm Hg, or Diastolic BP < 60 mm Hg)
  • Multiple organ dysfunction/failure
  • In the opinion of the investigator, unlikely to survive for at least 48 hours from screening or anticipate mechanical ventilation within 48 hours.
  • Inadequate hematologic parameters as indicated by the following labs:
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  • Participants with severe neutropenia (ANC <1000 x 10^9/L) or
  • Thrombocytopenia (e.g., platelets <100,000 per microliter of blood)
  • Inadequate renal and liver function as indicated by the following labs:
  • Creatinine clearance (CrCL) <20 mL/min using the formula of Cockcroft and Gault
  • Aspartate transaminase (AST) or alanine transaminase (ALT) > 5 x ULN
  • Hyponatremia defined as sodium < 135 milliequivalents per liter (mEq/L).
  • Unable to take oral medication when informed consent is obtained.
  • Participants with a legal guardian or who are incarcerated.
  • Treatment with strong CYP3A inhibitors or inducers.
  • Pregnant and breastfeeding women.

Trial locations and contacts

33 sites in 6 countries.

33 sites in 6 countries

United States20 sites
  • Lehigh Valley Hospital

    Allentown, Pennsylvania, 18103

  • Emory University

    Atlanta, Georgia, 30322

  • Boston Medical Center

    Boston, Massachusetts, 02118

  • Levine Cancer Institute-Atrium Health University City

    Charlotte, North Carolina, 28204

  • Baylor Scott & White Dallas

    Dallas, Texas, 75201

  • Karmanos

    Detroit, Michigan, 48201

  • Michigan Center of Medical Research

    Farmington Hills, Michigan, 48336

  • University of Kansas Medical Center

    Kansas City, Kansas, 64113

  • UCLA

    Los Angeles, California, 90095

  • Norton Healthcare

    Louisville, Kentucky, 40202

  • Miami Cancer Institute at Baptist Health

    Miami, Florida, 33176

  • Columbia University

    New York, New York, 10032

  • Weill Cornell Medical College

    New York, New York, 10065

  • Advocate Christ Medical Center

    Oak Lawn, Illinois, 60453

  • Kaiser Permanente Oakland

    Oakland, California, 94612

  • Michigan Center of Medical Research

    Royal Oak, Michigan, 48073

  • UC Davis Health

    Sacramento, California, 95817

  • Kaiser Permanente Sacramento

    Sacramento, California, 95825

  • Kaiser Permanente San Francisco

    San Francisco, California, 94115

  • MultiCare Institute for Research & Innovation (Puget Sound)

    Tacoma, Washington, 98405

Other trials in United States

United Kingdom4 sites
  • Princess Royal University Hospital

    Kent, BR6 8ND

  • Kings College Hospital

    London, SE5 9RS

  • The Royal Marsden Hospital

    London, SW3 6JJ

  • University Hospitals Plymouth NHS Trust

    Plymouth, PL6 5FP

Other trials in United Kingdom

France3 sites
  • CHU Bordeaux

    Bordeaux, 33076

  • CHU Lyon

    Lyon, 69004

  • CHU Nantes

    Nantes, 44093

Other trials in France

Israel3 sites
  • Hadassah MC

    Jerusalem

  • Hasharon Medical Center

    Petah Tikva

  • Sheba Medical Center

    Tel HaShomer

Other trials in Israel

Spain2 sites
  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

  • Servicio de Medicina Interna, Hospital Universitario de Salamanca, Universidad de Salamanca

    Salamanca, 37007

Other trials in Spain

Austria1 site
  • Hospital Hietzing, 2. Medical department - Center for Diagnosis and Therapy of Rheumatic Diseases

    Vienna

Other trials in Austria

About this study

Official title: A Phase 2 Randomized Single-Blind Study to Evaluate the Activity and Safety of Low Dose Oral Selinexor (KPT-330) in Patients With Severe COVID-19 Infection

The main purpose of this study is to evaluate the activity of low dose oral selinexor (KPT-330) and to evaluate the clinical recovery, the viral load, length of hospitalization and the rate of morbidity and mortality in participants with severe COVID-19 compared to placebo. The study had 2 arms and evaluated selinexor 20 mg + standard of care (SoC) and placebo + SoC. As the treatment for COVID-19 is rapidly evolving, the SoC varied over time and across regions of the world.

Being tested
Selinexor, Placebo
Keywords
COVID-19, SARS-CoV-2
Medical subject headings
Coronavirus Infections, COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SelinexorDrug

    Also called KPT-330, XPOVIO

    Participants will receive 20 mg of selinexor.

  • PlaceboOther

    Participants will receive 20 mg of placebo matched to selinexor.

Study groups in NCT04349098
Study groupRoleWhat they receive
Selinexor 20 mgExperimentalParticipants will receive 20 milligram (mg) of selinexor oral tablet on Days 1, 3, and 5 of each week for up to 2 weeks (14 days). If the participant is tolerating therapy and clinically benefitting, dosing can continue for an additional 2 weeks (28 days).
Receives: Drug: Selinexor
PlaceboPlacebo comparatorParticipants will receive 20 mg of placebo matched to selinexor oral tablet on Days 1, 3, and 5 of each week for up to 2 weeks (14 days). If the participant is tolerating therapy and clinically benefitting, dosing can continue for an additional 2 weeks (28 days).
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With At-least a 2-Point Improvement in Ordinal Scale

    Ordinal Scale 2-Point improvement was defined as percentage of participants with at least a 2-points improvement (increase from baseline) by Day 14. Baseline score was defined as the last score measured before first dosing. The 8-point ordinal scale ranges from 1 to 8: where 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 - requiring ongoing medical care (coronavirus disease 2019 [COVID-19] related or otherwise); 6= hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7= not hospitalized, limitation on activities and/or requiring home oxygen; 8= not hospitalized, no limitations on activities.

    Measured: Baseline up to Day 14

Secondary outcomes (12)
  1. Percentage of Participants With at Least a 2-Point Improvement in the Ordinal Scale up to Day 7

    Ordinal Scale 2-points improvement was defined as percentage of participants with at least a 2-points improvement (increase from baseline) by Day 7. Baseline score was defined as the last score measured before first dosing. The 8-point ordinal scale ranges from 1 to 8: where, 1= death, 2= hospitalized, on invasive mechanical ventilation or ECMO; 3= hospitalized, on non-invasive ventilation or high flow oxygen devices; 4= hospitalized, requiring supplemental oxygen; 5= hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 6= hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7= not hospitalized, limitation on activities and/or requiring home oxygen; 8= not hospitalized, no limitations on activities.

    Measured: Baseline up to Day 7

  2. Percentage of Participants With at Least a 1-Point Improvement in the Ordinal Scale

    Ordinal Scale 1-point improvement was defined as percentage of participants with at least 1-point improvement (increase from baseline) by Day 7 and 14. Baseline score was defined as the last score measured before first dosing. The 8-point ordinal scale ranges from 1 to 8: where 1= death, 2= hospitalized, on invasive mechanical ventilation or ECMO; 3= hospitalized, on non-invasive ventilation or high flow oxygen devices; 4= hospitalized, requiring supplemental oxygen; 5= hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise); 6= hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7= not hospitalized, limitation on activities and/or requiring home oxygen; 8= not hospitalized, no limitations on activities.

    Measured: Baseline up to Day 7 and 14

  3. Time to Clinical Improvement of 2-points Using Ordinal Scale (TTCI-2)

    TTCI-2 was defined as the time from randomization to an improvement of 2-points using 8-points Ordinal Scale. The 8-point ordinal scale ranges from 1 to 8: where 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 - requiring ongoing medical care (coronavirus disease 2019 [COVID-19] related or otherwise); 6= hospitalized, not requiring supplemental oxygen - no longer requires ongoing medical care; 7= not hospitalized, limitation on activities and/or requiring home oxygen; 8= not hospitalized, no limitations on activities.

    Measured: Baseline up to Day 28

  4. Overall Death Rate

    Overall death rate was defined as the percentage of participants who died on or before Day 28.

    Measured: Baseline up to Day 28

  5. Rate of Mechanical Ventilation (RMV)

    The rate of RMV was defined as the percentage of participants who ever used invasive mechanical ventilation or ECMO during the hospital stay.

    Measured: Baseline up to Day 28

  6. Rate of Intensive Care Unit (ICU) Admission

    The rate of ICU admission was defined as the percentage of participants with ICU admissions.

    Measured: Baseline up to Day 28

  7. Length of Hospitalization

    Length of hospitalization (days) was defined as (first hospital discharge date - date of randomization + 1).

    Measured: Baseline up to Day 67

  8. Change From Baseline in C-reactive Protein (CRP) Levels

    The anti-inflammatory and immune effects of selinexor were assessed by CRP levels. Baseline was defined as the most recent non-missing measurement prior to the first administration of study treatment. Change from Baseline at the indicated time points was calculated as the value at the indicated time points minus the value at Baseline.

    Measured: Baseline, Day 3, 5, 8, 12, 15, 19, 22 and 26

  9. Change From Baseline in Ferritin Levels

    The anti-inflammatory and immune effects of selinexor were assessed by ferritin levels. Baseline was defined as the most recent non-missing measurement prior to the first administration of study treatment. Change from Baseline at the indicated time points was calculated as the value at the indicated time points minus the value at Baseline.

    Measured: Baseline, Day 3, 5, 8, 12, 15, 19, 22 and 26

  10. Change From Baseline in Lactate Dehydrogenase (LDH) Levels

    The anti-inflammatory and immune effects of selinexor were assessed by LDH levels. Baseline was defined as the most recent non-missing measurement prior to the first administration of study treatment. Change from Baseline at the indicated time points was calculated as the value at the indicated time points minus the value at Baseline.

    Measured: Baseline, Day 3, 5, 8, 12, 15, 19, 22 and 26

  11. Changes From Baseline in Blood Plasma Cytokines Levels-Interleukin-6 (IL-6)

    The anti-inflammatory and immune effects of selinexor were assessed by blood plasma cytokines like IL-6. Baseline was defined as the most recent non-missing measurement prior to the first administration of study treatment. Change from Baseline at the indicated time points was calculated as the value at the indicated time points minus the value at Baseline.

    Measured: Baseline, Day 3, 5, 8, 12, 15, 22 and 26

  12. Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs

    Adverse events are defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment. Serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. TEAEs are defined as those AEs that develop or worsen after the first dose of study drug. TEAEs included both Serious and non-serious TEAEs.

    Measured: From start of study drug administration up to Day 58

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Apr 2020
  2. Study start17 Apr 2020
  3. Primary completion5 Oct 2020
  4. Study completion5 Oct 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
190 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04349098
Sponsor's protocol ID
XPORT-CoV-1001
Other IDs
2020-001411-25
Acronym
Coronavirus
Status last verified
Jan 2023
First submitted
14 Apr 2020
Last updated
20 Jan 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Selinexor in people with Coronavirus Infection, run by Karyopharm Therapeutics Inc at 33 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in United States, United Kingdom, France, Israel, Spain and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Nov 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With At-least a 2-Point Improvement in Ordinal Scale (time frame: Baseline up to Day 14). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jan 2023.

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