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Cytokine Storm (Covid-19)Phase 3RUXCOVIDNCT04362137

Study to Assess the Efficacy and Safety of Ruxolitinib in Patients With COVID-19 Associated Cytokine Storm

A Phase 3 study testing Ruxolitinib in people with Cytokine Storm (Covid-19), run by Novartis Pharmaceuticals at 61 sites in 12 countries.

Completed

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

Official record
Search all trials

Trial summary

This was a randomized, double-blind, placebo-controlled, 29-day, multicenter study to assess the efficacy and safety of ruxolitinib + standard-of-care (SoC) therapy, compared with placebo + SoC therapy, in patients aged ≥12 years with COVID-19 disease. Read more about this study

Who is it for?
Ages 12 years and older
Conditions the study is for
Cytokine Storm (Covid-19)
What is being tested?
Ruxolitinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
432 participants
Where
61 sitesin 12 countries
Study dates
2 May 2020to 17 Oct 2020
Phase
Phase 3
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 12 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patient or guardian/health proxy must provide informed consent (and assent if applicable) before any study assessment is performed.
  • Male and female patients aged ≥ 12 years (or ≥ the lower age limit allowed by Health Authority and/or Ethics Committee/Institutional Review Board approvals).
  • Patients with coronavirus (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) test or another rapid test from the respiratory tract prior to randomization.
  • Patients currently hospitalized or will be hospitalized prior to randomization.
  • Patients, who meet at least one of the below criteria:
  • Pulmonary infiltrates (chest X ray or chest CT scan);
Show all 10Show fewer
  • Respiratory frequency ≥ 30/min;
  • Requiring supplemental oxygen;
  • Oxygen saturation ≤ 94% on room air;
  • Arterial oxygen partial pressure (PaO2)/ fraction of inspired oxygen (FiO2) < 300mmHg (1mmHg=0.133kPa) (corrective formulation should be used for higher altitude regions (over 1000m).

Who cannot join

  • History of hypersensitivity to any drugs or metabolites of similar chemical classes as ruxolitinib.
  • Presence of severely impaired renal function defined by serum creatinine > 2 mg/dL (>176.8 μmol/L), or have estimated creatinine clearance < 30 ml/min measured or calculated by Cockroft Gault equation or calculated by the updated bedside Schwartz equation.
  • Suspected uncontrolled bacterial, fungal, viral, or other infection (besides COVID-19).
  • Currently intubated or intubated between screening and randomization. In intensive care unit (ICU) at time of randomization. Intubated or in ICU for COVID-19 disease prior to screening. Patients who are on anti-rejection, immunosuppressant or immunomodulatory drugs (i.e. tocilizumab, ruxolitinib, canakinumab, sarilumab, anakinra).
  • Unable to ingest tablets at randomization. Pregnant or nursing (lactating) women

Trial locations and contacts

61 sites in 12 countries.

61 sites in 12 countries

United States11 sites
  • Novartis Investigative Site

    Ann Arbor, Michigan, 48109

  • Novartis Investigative Site

    Atlanta, Georgia, 30312

  • Novartis Investigative Site

    Aurora, Colorado, 80045

  • Novartis Investigative Site

    Denver, Colorado, 80205

  • Novartis Investigative Site

    Fullerton, California, 92835

  • Novartis Investigative Site

    Idaho Falls, Idaho, 83404

  • Novartis Investigative Site

    Madison, Wisconsin, 53705-3611

  • Novartis Investigative Site

    Mesquite, Texas, 75149

  • Novartis Investigative Site

    Newark, New Jersey, 07103

  • Novartis Investigative Site

    Seattle, Washington, 98104

  • Novartis Investigative Site

    The Bronx, New York, 10461

Other trials in United States

Russia9 sites
  • Novartis Investigative Site

    Barnaul, 656045

  • Novartis Investigative Site

    Moscow, 111539

  • Novartis Investigative Site

    Moscow, 123056

  • Novartis Investigative Site

    Ryazan, 390039

  • Novartis Investigative Site

    S-Petersburg, 194354

  • Novartis Investigative Site

    Saint Petersburg, 193312

  • Novartis Investigative Site

    Saint Petersburg, 194044

  • Novartis Investigative Site

    Saint Petersburg, 199106

  • Novartis Investigative Site

    Sestroretsk, 197706

Other trials in Russia

Brazil6 sites
  • Novartis Investigative Site

    Barretos, São Paulo, 14784 400

  • Novartis Investigative Site

    Blumenau, Santa Catarina, 89030101

  • Novartis Investigative Site

    Rio de Janeiro, Rio de Janeiro, 22640-000

  • Novartis Investigative Site

    São Paulo, São Paulo, 01327 001

  • Novartis Investigative Site

    São Paulo, São Paulo, 04502 001

  • Novartis Investigative Site

    Sorocaba, São Paulo

Other trials in Brazil

France5 sites
  • Novartis Investigative Site

    Colombes, 92701

  • Novartis Investigative Site

    Eaubonne, 95600

  • Novartis Investigative Site

    Nantes, 44093

  • Novartis Investigative Site

    Pessac, 33604

  • Novartis Investigative Site

    Pierre-Bénite, 69495

Other trials in France

Spain5 sites
  • Novartis Investigative Site

    Badalona, Catalonia, 08916

  • Novartis Investigative Site

    Barcelona, Catalonia, 08035

  • Novartis Investigative Site

    Madrid, 28031

  • Novartis Investigative Site

    Madrid, 28034

  • Novartis Investigative Site

    Salamanca, Castille and León, 37007

Other trials in Spain

United Kingdom5 sites
  • Novartis Investigative Site

    Harrow, HA1 3UJ

  • Novartis Investigative Site

    Leeds, LS9 7TF

  • Novartis Investigative Site

    London, SE5 9RS

  • Novartis Investigative Site

    London, WC1E 6HX

  • Novartis Investigative Site

    Manchester, M13 9PL

Other trials in United Kingdom

Peru4 sites
  • Novartis Investigative Site

    Lima, 10

  • Novartis Investigative Site

    Lima, 1

  • Novartis Investigative Site

    San Isidro, Lima region, 27

  • Novartis Investigative Site

    San Miguel, Lima region, 32

Other trials in Peru

Turkey (Türkiye)4 sites
  • Novartis Investigative Site

    Ankara, 06100

  • Novartis Investigative Site

    Istanbul, TUR, 34098

  • Novartis Investigative Site

    Istanbul

  • Novartis Investigative Site

    Yenisehir/Izmir, 35110

Other trials in Turkey (Türkiye)

Argentina3 sites
  • Novartis Investigative Site

    Buenos Aires, C1426AAM

  • Novartis Investigative Site

    Buenos Aires, C1430BKC

  • Novartis Investigative Site

    C A B A, Buenos Aires, CP1405

Other trials in Argentina

Colombia3 sites
  • Novartis Investigative Site

    Barranquilla, Atlántico, 080005

  • Novartis Investigative Site

    Barranquilla

  • Novartis Investigative Site

    Rionegro, Antioquia, 054047

Other trials in Colombia

Germany3 sites
  • Novartis Investigative Site

    Lübeck, 23538

  • Novartis Investigative Site

    München, 81377

  • Novartis Investigative Site

    Nuremberg, 90419

Other trials in Germany

Mexico3 sites
  • Novartis Investigative Site

    Estado de México, 52787

  • Novartis Investigative Site

    Mexico City, Mexico City, 14050

  • Novartis Investigative Site

    Mexico City, Mexico CP, 14080

Other trials in Mexico

About this study

Official title: Phase 3 Randomized, Double-blind, Placebo-controlled Multi-center Study to Assess the Efficacy and Safety of Ruxolitinib in Patients With COVID-19 Associated Cytokine Storm (RUXCOVID)

This was a randomized, double-blind, placebo-controlled, 29-day, multicenter study to assess the efficacy and safety of ruxolitinib + standard-of-care (SoC) therapy, compared with placebo + SoC therapy, in patients aged ≥12 years with COVID-19 disease.

Read the detailed description

This was a Phase III, multicenter, double-blind, randomized, placebo-controlled study to assess the efficacy and safety of ruxolitinib in patients aged ≥12 years with COVID-19 disease. The study enrolled patients to ruxolitinib or placebo, in addition to standard of care (SoC) per local practice. Patients who meet the inclusion/exclusion criteria were randomized in a 2:1 ratio to either oral ruxolitinib 5 mg twice daily + SoC or oral matching-image placebo + SoC for a total of 14 days. An additional 14 days of study drug could be given if in the opinion of the investigator the patient's clinical signs and symptoms did not improve, or worsen, and the potential benefit outweighed the potential risk.

The study included:

  • Screening period of 0-2 days.
  • Study period of 29 days (treatment of 14 days with possible extension of treatment to 28 days).

The primary objective was to evaluate the efficacy (as measured by a composite endpoint of proportion of patients who die, develop respiratory failure [require mechanical ventilation], or require intensive care unit care) of ruxolitinib + standard-of-care (SoC) therapy compared with placebo + SoC therapy, for the treatment of COVID-19 by Day 29.

Being tested
Ruxolitinib, Placebo
Keywords
COVID-19 pneumonia, cytokine release syndrome, SARS-COV-2, ruxolitinib
Medical subject headings
Cytokine Release Syndrome, COVID-19

What participants receive

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

  • RuxolitinibDrug

    Also called INC424

    Ruxolitinib 5 mg tablets

  • PlaceboDrug

    Matching-image placebo

Study groups in NCT04362137
Study groupRoleWhat they receive
Ruxolitinib 5 mgExperimentalRuxolitinib 5 mg tablets twice daily (b.i.d.) for 14 days with possible extension of treatment to 28 days
Receives: Drug: Ruxolitinib
PlaceboPlacebo comparatorMatching-image placebo for 14 days with possible extension of treatment to 28 days
Receives: Drug: Placebo

What is being measured

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

  1. Proportion of Patients Who Die, Develop Respiratory Failure [Require Mechanical Ventilation] or Require Intensive Care Unit (ICU) Care

    Efficacy is measured by a composite endpoint of proportion of patients who die, develop respiratory failure [require mechanical ventilation], or require intensive care unit [ICU] care for the treatment of COVID-19. Analyses are cumulative, thus analysis on Day 29 includes all events till that day. Patients who developed respiratory failure and/or required ICU at randomization are excluded from the analysis.

    Measured: Day 1 - Day 29

Secondary outcomes (13)
  1. Clinical Status

    Clinical status is measured with the 9-point ordinal scale.

    The scoring is:

    • Uninfected patients have a score 0 (no clinical or virological evidence of infection).
    • Ambulatory patients (not in hospital or in hospital and ready for discharge) can have a score 1 (no limitation of activities) or 2 (limitation of activities).
    • Hospitalized patients with mild disease can have score 3 (no oxygen therapy defined as peripheral oxygen saturation (SpO2) ≥ 94% on room air) or 4 (oxygen by mask or nasal prongs).
    • Hospitalized patients with severe disease can have score 5 (non-invasive ventilation or high-flow oxygen), 6 (intubation and mechanical ventilation) or 7 (ventilation + additional organ support - pressors, RRT (renal replacement therapy), ECMO (extracorporeal membrane oxygenation)).
    • Patients who die have a score 8.

    Measured: Baseline, Day 15, Day 29

  2. Percentage of Patients With at Least Two-point Improvement From Baseline in Clinical Status

    Percentage of patients with at least two points improvement in clinical status on the 9-point ordinal scale. The baseline value of clinical status is defined as the last assessment prior to first dose of double-blind treatment. Patients with missing data at Day 15 and/or Day 29 are treated as non-responders.

    Measured: Baseline, Day 15, Day 29

  3. Percentage of Patients With at Least One-point Improvement From Baseline in Clinical Status

    Percentage of patients with at least one point improvement in clinical status on the 9-point ordinal scale. The baseline value of clinical status is defined as the last assessment prior to first dose of double-blind treatment. Patients with missing data at Day 15 and/or Day 29 are treated as non-responders.

    Measured: Baseline, Day 15, Day 29

  4. Percentage of Patients With at Least One-point Deterioration From Baseline in Clinical Status

    Percentage of patients with at least one point deterioration in clinical status on the 9-point ordinal scale. The baseline value of clinical status is defined as the last assessment prior to first dose of double-blind treatment. Patients with missing data at Day 15 and/or Day 29 are treated as non-responders.

    Measured: Baseline, Day 15, Day 29

  5. Time to Improvement in Clinical Status

    Time to improvement in clinical status from baseline category to one less severe category of the 9-point ordinal scale. The baseline value of clinical status is defined as the last assessment prior to first dose of double-blind treatment.

    Median time to improvement is estimated by Kaplan-Meier method, with dead patients being censored at the maximum follow-up time in the study. Patients who did not achieve improvement and did not die are censored at their last clinical status assessment date.

    Measured: 29 days

  6. Mean Change From Baseline in the Clinical Status

    Mean change from baseline in the 9-point ordinal scale. The baseline value of clinical status is defined as the last assessment prior to first dose of double-blind treatment. Patients with missing data at Day 15 and/or Day 29 are excluded from the analysis.

    A negative change from baseline in the clinical status is a favorable outcome.

    Measured: Baseline, Day 15, Day 29

  7. Mortality Rate

    Mortality rate is determined as the proportion of participants who died by study Day 15 and Day 29

    Measured: Day 15, Day 29

  8. Proportion of Patients Requiring Mechanical Ventilation

    Proportion of patients requiring mechanical ventilation. Analyses are cumulative, thus analysis on Day 29 includes all events till that day. Patients who required mechanical ventilation at randomization are excluded from the analysis.

    Measured: Day 1 - Day 29

  9. Duration of Hospitalization

    Duration of hospitalization is defined as time to hospital discharge. Median time to hospital discharge is estimated by Kaplan-Meier method, with dead patients being censored at the maximum follow-up time in the study. Patients who were not discharged and did not die are censored at their last assessment date.

    Measured: 29 days

  10. Time to Hospital Discharge or to a NEWS2 Score of ≤2

    The time to hospital discharge or to a National Early Warning Score 2 (NEWS2) of ≤2 and maintained for 24 hours whichever comes first.

    The NEWS2 is based on a simple aggregate scoring system in which a score is allocated to physiological measurements, already recorded in routine practice presentation or when a patient is being monitored in hospital. The score ranges from 0 (best) to 23 (worst).

    Median time is estimated by Kaplan-Meier method, with dead patients being censored at the maximum follow-up time in the study.

    Measured: 29 days

  11. Change From Baseline in NEWS2 Score

    The National Early Warning Score 2 (NEWS2) is based on a simple aggregate scoring system in which a score is allocated to physiological measurements, already recorded in routine practice presentation or when a patient is being monitored in hospital. The score ranges from 0 (best) to 23 (worst). At each visit, only patients with a value at both baseline and the respective visit are included.

    A negative change from baseline in NEWS2 score is a favorable outcome.

    Measured: Baseline, Days 3, 5, 8, 11, 15, and 29

  12. Change From Baseline in SpO2/FiO2 Ratio

    Change from baseline in peripheral oxygen saturation / fraction of inspired oxygen ratio (SpO2/FiO2 ratio). At each visit, only patients with a value at both baseline and the respective visit are included.

    A positive change from baseline in SpO2/FiO2 ratio is a favorable outcome.

    Measured: Baseline, Day 15, Day 29

  13. Proportion of Patients With no Oxygen Therapy

    Proportion of patients with no oxygen therapy (defined as oxygen saturation ≥ 94% on room air) at Days 15 and 29. Analyses are cumulative, thus analysis on each day includes all events till that day.

    Patients with missing data at Day 15 and/or Day 29 are excluded from the analysis.

    Measured: Day 15, Day 29

Timeline

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

  1. First posted24 Apr 2020
  2. Study start2 May 2020
  3. Primary completion17 Oct 2020
  4. Study completion17 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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
432 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04362137
Sponsor's protocol ID
CINC424J12301
Other IDs
INCB 18424-368, 2020-001662-11
Acronym
RUXCOVID
Status last verified
Oct 2021
First submitted
22 Apr 2020
Last updated
11 Oct 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Han MK, Antila M, Ficker JH, Gordeev I, Guerreros A, Bernus AL, Roquilly A, Sifuentes-Osornio J, Tabak F, Teijeiro R, Bandelli L, Bonagura DS, Shu X, Felser JM, Knorr B, Cao W, Langmuir P, Lehmann T, Levine M, Savic S. Ruxolitinib in addition to standard of care for the treatment of patients admitted to hospital with COVID-19 (RUXCOVID): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Rheumatol. 2022 May;4(5):e351-e361. doi: 10.1016/S2665-9913(22)00044-3. Epub 2022 Mar 29.

    PubMed 35368384

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ruxolitinib in people with Cytokine Storm (Covid-19), run by Novartis Pharmaceuticals at 61 sites in 12 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 10 inclusion and 5 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 11 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 61 sites in United States, Russia, Brazil, France, Spain and 7 more countries. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 2 Jun 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?

Proportion of Patients Who Die, Develop Respiratory Failure [Require Mechanical Ventilation] or Require Intensive Care Unit (ICU) Care (time frame: Day 1 - Day 29). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04362137, which also lists 1 linked publication.

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 11 Oct 2021.

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