AzTrials
AzTrials

COVID-19Phase 2NCT04358068

Evaluating the Efficacy of Hydroxychloroquine and Azithromycin to Prevent Hospitalization or Death in Persons With COVID-19

A Phase 2 study testing Hydroxychloroquine (HCQ) and Azithromycin (Azithro) in people with COVID-19 and SARS-CoV 2, run by National Institute of Allergy and Infectious Diseases (NIAID) at 11 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

The purpose of this study was to evaluate the efficacy of hydroxychloroquine (HCQ) and azithromycin (Azithro) to prevent hospitalization or death in symptomatic adult outpatients with COVID-19 caused by SARS-CoV-2 infection. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID-19, SARS-CoV 2
What is being tested?
Hydroxychloroquine (HCQ) and Azithromycin (Azithro)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
11 sitesUnited States
Study dates
13 May 2020to 8 Jul 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

  • Documentation of confirmed active severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection from any respiratory specimen collected ≤7 days from when the first dose of study treatment was expected to be taken.
  • Experienced at least one of the following SARS-CoV-2 infection symptoms within 24 hours of screening (symptom(s) must be new or worse compared to pre-COVID-19 health status):
  • Fever (can be subjective) or feeling feverish
  • Cough
  • Shortness of breath or difficulty breathing at rest or with exertion
  • Sore throat
Show all 11Show fewer
  • Body pain or muscle pain
  • Fatigue
  • Headache
  • Agreed to not participate in another clinical trial for the treatment of COVID-19 or SARS-CoV-2 during the study period up until reaching hospitalization or 20 days, whichever is earliest.
  • Agreed to not obtain study medications outside of the A5395 study.

Who cannot join

  • Need for hospitalization or immediate medical attention in the clinical opinion of the study investigator.
  • History of or current hospitalization for COVID-19.
  • History of ventricular arrhythmia or use of antiarrhythmics within 30 days prior to entry.
  • Personal or family history of Long QT syndrome.
  • History of kidney disease.
  • History of ischemic or structural heart disease.
Show all 27Show fewer
  • History of hypokalemia or hypomagnesemia or taking potassium supplementation or magnesium supplementation
  • Personal medical history of porphyria, retinopathy, severe hepatic impairment, or glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Used drugs with possible anti-SARS-CoV-2 activity within 30 days prior to study entry, e.g., remdesivir, lopinavir/ritonavir fixed dose combination, ribavirin, chloroquine, hydroxychloroquine, and azithromycin, or participation in a clinical trial involving any of these drugs whether for treatment or prophylaxis.
  • Requirement or expected requirement for a medication that significantly prolongs QT intervals or increases risk for QT prolongation.
  • Loop diuretics are exceptions to above exclusion criterion but these cannot be used within 30 days prior to study entry.
  • Participated in a study where co-enrollment was not allowed.
  • Receipt of a SARS-CoV-2 vaccination prior to study entry.
  • Known allergy/sensitivity or any hypersensitivity to components of HCQ, azithromycin, or their formulation.
  • More than 10 days of any of the following symptoms attributed to the SARS-CoV-2 infection at study entry:
  • Fever (can be subjective) or feeling feverish
  • Cough
  • Shortness of breath or difficulty breathing at rest or with exertion
  • Sore throat
  • Body pain or muscle pain
  • Fatigue
  • Headache
  • Chills
  • Nasal obstruction or congestion
  • Loss of taste or smell
  • Nausea or vomiting
  • Diarrhea

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • Alabama CRS

    Birmingham, Alabama, 35294

  • Northwestern University CRS

    Chicago, Illinois, 60611

  • Rush University CRS

    Chicago, Illinois, 60612

  • Cincinnati Clinical Research Site

    Cincinnati, Ohio, 45219

  • Trinity Health and Wellness Center CRS

    Dallas, Texas, 75208

  • Greensboro CRS

    Greensboro, North Carolina, 27401

  • University of Pittsburgh CRS

    Pittsburgh, Pennsylvania, 15213

  • UCSD Antiviral Research Center CRS

    San Diego, California, 92103

  • University of Washington AIDS CRS

    Seattle, Washington, 98104-9929

  • Harbor-UCLA CRS

    Torrance, California, 90502

  • Whitman-Walker Health CRS

    Washington D.C., District of Columbia, 20009

Other trials in United States

About this study

Official title: A Randomized, Double-blind, Placebo-controlled Trial to Evaluate the Efficacy of Hydroxychloroquine and Azithromycin to Prevent Hospitalization or Death in Persons With COVID-19

The purpose of this study was to evaluate the efficacy of hydroxychloroquine (HCQ) and azithromycin (Azithro) to prevent hospitalization or death in symptomatic adult outpatients with COVID-19 caused by SARS-CoV-2 infection.

Read the detailed description

This Phase IIB study was designed to evaluate the efficacy of hydroxychloroquine (HCQ) and azithromycin (Azithro) to prevent hospitalization or death in symptomatic adult outpatients with COVID-19 caused by SARS-CoV-2 infection.

Participants were randomized 1:1 to receive active or placebo study treatment. The target sample size was 2000 participants, with approximately 1000 in each arm. Stratification was by "high" versus "low" risk of progression to severe COVID-19, where "high risk" was defined as a person age ≥60 years or having at least one of several specified comorbidities.

Participants were prescribed study treatment for 7 days and were to be followed for an additional 24 weeks. Assessments on a subset of participants were planned to include blood collection, self-collected nasal swabs, and nasopharyngeal swabs.

On June 23, 2020, sites were informed that the study was closing to follow-up due to slow enrollment and lack of community enthusiasm. Follow-up through week 24 was not completed for any participant. Participants were asked to complete the Day 20 visit and then were discontinued from the study. Due to the early termination, enrollment into the specimen collection subset did not occur, and results associated with those specimens are not available. Due to the small number of participants enrolled, some statistical tests were not able to be performed and only descriptive results are provided.

Conditions
COVID-19, SARS-CoV 2
Being tested
Hydroxychloroquine (HCQ), Azithromycin (Azithro), Placebo for Hydroxychloroquine, Placebo for Azithromycin
Medical subject headings
COVID-19

What participants receive

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

  • Hydroxychloroquine (HCQ)Drug

    Administered orally

  • Azithromycin (Azithro)Drug

    Administered orally

  • Placebo for HydroxychloroquineDrug

    Administered orally

  • Placebo for AzithromycinDrug

    Administered orally

Study groups in NCT04358068
Study groupRoleWhat they receive
Arm A: Hydroxychloroquine (HCQ) and Azithromycin (Azithro)ExperimentalHydroxychloroquine 400 mg (administered as two 200 mg capsules) orally twice daily for 2 doses starting on Day 0, followed by 200 mg (administered as one 200 mg capsule) orally twice daily for 12 doses (6 days), PLUS: Azithromycin 500 mg (administered as two 250 mg capsules) orally as a single dose on Day 0, followed by 250 mg (administered as one 250 mg capsule) orally once daily for 4 doses (4 days).
Receives: Drug: Hydroxychloroquine (HCQ); Drug: Azithromycin (Azithro)
Arm B: Placebo for Hydroxychloroquine and AzithromycinPlacebo comparatorPlacebo for Hydroxychloroquine (administered as two matching placebo capsules) orally twice daily for 2 doses starting on Day 0, followed by Placebo for HCQ (administered as one 200 mg capsule) orally twice daily for 12 doses (6 days), PLUS: Placebo for Azithromycin (administered as two matching placebo capsules) orally as a single dose on Day 0, followed by Placebo for Azithromycin (administered as one matching placebo capsule) orally once daily for 4 doses (4 days).
Receives: Drug: Placebo for Hydroxychloroquine; Drug: Placebo for Azithromycin

What is being measured

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

  1. Number of Participants Who Died From Any Cause or Were Hospitalized

    Hospitalization was defined as requiring at least 24 hours of acute care in a hospital or similar acute care facility, including Emergency Rooms or temporary facilities instituted to address needs during the COVID-19 pandemic. Evaluation at a hospital or similar facility with less than 24 hours of acute care was not considered a hospitalization. Formal statistical testing was not conducted due to the small number of participants and events.

    Measured: The 20-day period from and including the day of the first dose of study treatment

Secondary outcomes (12)
  1. Number of Participants Who Died From Any Cause

    Deaths reported due to any cause (COVID-related or not)

    Measured: The 20-day period from and including the day of the first dose of study treatment

  2. Number of Participants Who Died From Any Cause, or Were Hospitalized, or Had an Urgent Visit to Emergency Room or Clinic

    Hospitalization was defined as requiring at least 24 hours of acute care in a hospital or similar acute care facility, including Emergency Rooms or temporary facilities instituted to address needs during the COVID-19 pandemic. Evaluation at a hospital or similar facility with less than 24 hours of acute care was not considered a hospitalization, but was included for this outcome measure.

    Measured: The 20-day period from and including the day of the first dose of study treatment

  3. Number of Participants Who Died From Any Cause or Were Hospitalized Through the End of Follow-up

    Hospitalization was defined as requiring at least 24 hours of acute care in a hospital or similar acute care facility, including Emergency Rooms or temporary facilities instituted to address needs during the COVID-19 pandemic. Evaluation at a hospital or similar facility with less than 24 hours of acute care was not considered a hospitalization. Due to the early termination of the study, participant followup was discontinued at Day 20. Refer to the primary outcome above for results based on the time frame out to Day 20.

    Measured: From day of the first dose of study treatment to Week 24

  4. Number of Participants Who Prematurely Discontinue Study Treatment Due to an Adverse Event

    Premature discontinuation of study treatment is defined as a permanent discontinuation of either study treatment (HCQ/Placebo and/or Azithro/Placebo)

    Measured: From start of study treatment through Day 7

  5. Number of Participants Who Had Any Cardiac Adverse Events

    Cardiac adverse events included in the analysis were chosen a priori by the study chairs

    Measured: From start of study treatment through Day 20

  6. Duration of Fever

    Defined as the time from study treatment initiation to the last day in the participant's daily diary card on which a temperature greater than 100.4°F was recorded or a potentially antipyretic drug, such as acetaminophen or ibuprofen, was taken. Participants with at least one temperature who never reported fever or use of anti-pyretic medications were assigned a duration of zero days

    Measured: Day 0 to Day 20, 21 days total

  7. Duration of Symptoms Associated With COVID-19 Disease

    Defined as the time from start of study treatment to the last day in the participant's daily diary card on which a moderate or worse targeted symptom was recorded. The set of target symptoms were cough, shortness of breath, feeling feverish, fatigue, muscle aches, diarrhea, vomiting, nausea, headache, sore throat, nasal obstruction (stuffy nose), nasal discharge (runny nose), loss of smell, and loss of taste. Participants who had missing diary records due to hospitalization were assumed to have moderate symptoms during the period of hospitalization in the analysis. Missing diary card records not due to hospitalization were assumed to have absent symptoms.

    Measured: Day 0 to Day 20, 21 days total

  8. Participant-specific Area Under the Curve (AUC) of the Symptom Score Associated With COVID-19 Disease Over Time

    Defined as the sum of scores for the targeted symptoms (defined in the protocol) in the participant's daily diary record (each symptom was scored from 0-best to 3-worst). Participant-specific areas under the curve (AUC) over time were calculated using the trapezoidal rule and defined as the area below the line formed by joining total symptom scores on each daily diary card from the pre-treatment score on Day 0 through to Day 20. AUCs were rescaled by time by dividing by 21 (corresponding to the number of daily diary cards during follow-up between pre-treatment Day 0 and Day 20), in order to provide results on a symptom scale from 0-best to 42-worst (for non-hospitalized participants). Participants who were hospitalized were assigned a value equal to the sum of the maximum possible scaled AUC (42) and the duration of hospitalization, and thus values >42 were possible. Missing scores between pre-treatment and Day 20 were linearly interpolated. Higher AUCs indicate worse outcomes.

    Measured: Day 0 to Day 20, 21 days total

  9. Time to Self-reported Return to Usual (Pre-COVID) Health.

    Time to self-reported return to (pre-COVID) usual health was defined as the time from the start of study treatment to the first day in the participant's daily diary card on which they responded 'Yes' with no subsequent reports of 'No' to the question "Have you returned to your usual (pre-COVID) health today?" Participants who never reported a 'Yes' response were assigned a duration of 22 days.

    Measured: Day 0 to Day 20, 21 days total

  10. SARS-CoV-2 RNA Detection Status From Self-collected Nasal and Site-collected NP Swabs Among Subset

    The virology substudy did not open to enrollment and thus no data on virologic outcomes are available to report

    Measured: Measured at entry, Day 6, and Day 20

  11. SARS-CoV-2 RNA Level (Continuous) From Self-collected Nasal and Site-collected NP Swabs Among Subset

    The virology substudy did not open to enrollment and thus no data on virologic outcomes are available to report

    Measured: Measured at entry, Day 6, and Day 20

  12. Number of Participants With an Occurrence of Fainting

    Fainting was self-reported on the study diary card as absent (score 0), mild (1), moderate (2), or severe (3); scores of > 0 are defined as an occurrence of fainting

    Measured: From start of study treatment through Day 20

Timeline

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

  1. First posted22 Apr 2020
  2. Study start13 May 2020
  3. Primary completion8 Jul 2020
  4. Study completion8 Jul 2020

Why it stopped: Slow enrollment and lack of community enthusiasm

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
Double blind
Who is masked
Participant, Investigator
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04358068
Sponsor's protocol ID
ACTG A5395
Other IDs
38720
Status last verified
Oct 2021
First submitted
20 Apr 2020
Last updated
16 Nov 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data that underlie results in the publication, after deidentification.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Hydroxychloroquine (HCQ) and Azithromycin (Azithro) in people with COVID-19 and SARS-CoV 2, run by National Institute of Allergy and Infectious Diseases (NIAID) at 11 sites in United States.

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 11 inclusion and 27 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: stopped early, as of the sponsor's last update on 16 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. 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 Apr 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?

Number of Participants Who Died From Any Cause or Were Hospitalized (time frame: The 20-day period from and including the day of the first dose of study treatment). 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 16 Nov 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in