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Cytokine Release Syndrome (CRS) in Patients With COVID-19-induced PneumoniaPhase 3CAN-COVIDNCT04362813

Study of Efficacy and Safety of Canakinumab Treatment for CRS in Participants With COVID-19-induced Pneumonia

A Phase 3 study testing Canakinumab in people with Cytokine Release Syndrome (CRS) in Patients With COVID-19-induced Pneumonia, run by Novartis Pharmaceuticals at 39 sites in 6 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 multicenter, randomized, double-blind, placebo-controlled study to assess the efficacy and safety of canakinumab plus standard-of-care (SOC) compared with placebo plus SOC in patients with COVID-19-induced pneumonia and cytokine release syndrome (CRS). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Canakinumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
454 participants
Where
39 sitesin 6 countries
Study dates
30 Apr 2020to 22 Dec 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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults ≥ 18 years old (for US only: patients ≥ 12 years old, although no children ever enrolled. This was an adult trial.)
  • Body weight ≥40 kg
  • Informed consent must be obtained prior to participation in this study. For US patients 12 - < 18 years old; parent/guardian consent must be obtained and assent if applicable.
  • Clinically diagnosed with SARS-CoV-2 virus by PCR or by other approved diagnostic methodology
  • Hospitalized with COVID-19-induced pneumonia evidenced by chest x-ray or CT scan with pulmonary infiltrates
  • SpO2 ≤ 93% on room air or arterial oxygen partial pressure (PaO2)/ fraction of inspired oxygen (FiO2) < 300mmHg
  • C-reactive protein ≥20 mg/L or ferritin level ≥600 µg/L

Who cannot join

  • History of hypersensitivity to canakinumab or to biologic drugs
  • Intubated and on mechanical ventilation (invasive) at time of randomization
  • Treatment with immunomodulators or immunosuppressant drugs, including but not limited to tocilizumab, TNF inhibitors and anti-IL-17 agents within 5 half-lives or 30 days (whichever is longer) prior to randomization with the exception of anakinra which is excluded within 5 half-lives only. Note: Immunomodulators (topical or inhaled) for asthma and atopic dermatitis and corticosteroids (any route of administration) are permitted.
  • Suspected or known untreated active bacterial, fungal, viral, or parasitic infection with the exception of COVID-19

Trial locations and contacts

39 sites in 6 countries.

39 sites in 6 countries

United States15 sites
  • Novartis Investigative Site

    Baltimore, Maryland, 21201

  • Novartis Investigative Site

    Birmingham, Alabama, 35294

  • Novartis Investigative Site

    Boston, Massachusetts, 02115

  • Novartis Investigative Site

    Boston, Massachusetts, 02118

  • Novartis Investigative Site

    Brooklyn, New York, 11219

  • Novartis Investigative Site

    Chapel Hill, North Carolina, 27599

  • Novartis Investigative Site

    Chicago, Illinois, 60611

  • Novartis Investigative Site

    Cleveland, Ohio, 44106-5000

  • Novartis Investigative Site

    Glendale, California, 91206

  • Novartis Investigative Site

    Houston, Texas, 77030

  • Novartis Investigative Site

    Philadelphia, Pennsylvania, 19140

  • Novartis Investigative Site

    Richmond, Virginia, 23298

  • Novartis Investigative Site

    San Francisco, California, 94110

  • Novartis Investigative Site

    San Francisco, California, 94143

  • Novartis Investigative Site

    Tacoma, Washington, 98405

Other trials in United States

Russia10 sites
  • Novartis Investigative Site

    Barnaul, 656045

  • Novartis Investigative Site

    Moscow, 111539

  • Novartis Investigative Site

    Moscow, 121309

  • Novartis Investigative Site

    Moscow, 123056

  • Novartis Investigative Site

    Moscow, 123182

  • Novartis Investigative Site

    Ryazan, 390039

  • Novartis Investigative Site

    S-Petersburg, 194354

  • Novartis Investigative Site

    Saint Petersburg, 193312

  • Novartis Investigative Site

    Saint Petersburg, 197022

  • Novartis Investigative Site

    Sestroretsk, 197706

Other trials in Russia

Spain6 sites
  • Novartis Investigative Site

    Barcelona, Catalonia, 08035

  • Novartis Investigative Site

    L'Hospitalet de Llobregat, Barcelona, 08907

  • Novartis Investigative Site

    Madrid, 28034

  • Novartis Investigative Site

    Madrid, 28040

  • Novartis Investigative Site

    Madrid, 28041

  • Novartis Investigative Site

    San Sebastián de los Reyes, Madrid, 28702

Other trials in Spain

United Kingdom5 sites
  • Novartis Investigative Site

    Barnet, EN5 3DJ

  • Novartis Investigative Site

    Coventry, CV2 2DX

  • Novartis Investigative Site

    Leeds, LS9 7TF

  • Novartis Investigative Site

    London, NW3 2QG

  • Novartis Investigative Site

    London, SE5 9RS

Other trials in United Kingdom

Italy2 sites
  • Novartis Investigative Site

    Bergamo, BG, 24127

  • Novartis Investigative Site

    Cona, FE, 44100

Other trials in Italy

France1 site
  • Novartis Investigative Site

    Toulouse, 31054

Other trials in France

About this study

Official title: Phase 3 Multicenter, Randomized, Double-blind, Placebo-controlled Study to Assess the Efficacy and Safety of Canakinumab on Cytokine Release Syndrome in Patients With COVID-19-induced Pneumonia (CAN-COVID)

This was a multicenter, randomized, double-blind, placebo-controlled study to assess the efficacy and safety of canakinumab plus standard-of-care (SOC) compared with placebo plus SOC in patients with COVID-19-induced pneumonia and cytokine release syndrome (CRS).

Read the detailed description

This was a Phase III, multicenter, randomized, double-blind, placebo-controlled study to assess the efficacy and safety of canakinumab in patients with COVID-19-induced pneumonia and cytokine release syndrome (CRS). The study enrolled patients to canakinumab or placebo, in addition to standard of care (SOC) per local practice, which may have included anti-viral treatment, corticosteroids and/or supportive care.

Patients who met the inclusion/exclusion criteria were randomized in a 1:1 ratio to either canakinumab + SOC or placebo + SOC and were dosed immediately after ensuring that the patient met all eligibility criteria. Patients in the canakinumab arm were dosed on Day 1 with canakinumab 450 mg for body weight of 40-<60 kg, 600 mg for 60-80 kg or 750 mg for >80 kg in 250 mL of 5% dextrose infused IV over 2 hours. Patients in the placebo arm were administered with 250 mL of 5% dextrose infused IV over 2 hours.

The study included:

  • Screening period of 0-1 day
  • Study period from initial dose on Day 1 to Day 29 or hospital discharge
  • Follow-up to Day 127 The primary objective was to demonstrate the benefit of canakinumab + SOC in increasing the chance of survival without ever requiring invasive mechanical ventilation among patients with COVID-19-induced pneumonia and CRS.
Being tested
Canakinumab, Placebo
Keywords
COVID-19, cytokine release syndrome, SARS-CoV-2, canakinumab, COVID, coronavirus, CAN-COVID, pneumonia, CRS
Medical subject headings
Cytokine Release Syndrome, COVID-19, Coronavirus Infections, Pneumonia

What participants receive

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

  • CanakinumabDrug

    Also called ACZ885

    Canakinumab 450 mg for body weight 40-<60 kg, 600 mg for 60-80 kg or 750 mg for >80 kg in 250 mL of 5% dextrose infused IV over 2 hours. Single dose on Day 1.

  • PlaceboDrug

    250 mL of 5% dextrose infused IV over 2 hours. Single dose on Day 1.

Study groups in NCT04362813
Study groupRoleWhat they receive
CanakinumabExperimentalCanakinumab 450 mg for body weight 40-<60 kg, 600 mg for 60-80 kg or 750 mg for >80 kg in 250 mL of 5% dextrose infused IV over 2 hours. Single dose on Day 1.
Receives: Drug: Canakinumab
PlaceboPlacebo comparator250 mL of 5% dextrose infused IV over 2 hours. Single dose on Day 1.
Receives: Drug: Placebo

What is being measured

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

  1. Participants Who Survived Without Requiring Invasive Mechanical Ventilation From Day 3 to Day 29, Primary Analysis

    Number of responders who survived without requiring invasive mechanical ventilation from Day 3 to Day 29. An early dropout without requiring invasive mechanical ventilation is considered as a responder if discharged from hospital with 9-point ordinal scale<=1 or with last 9-point ordinal scale on/after Day 15 better than baseline.

    Measured: Day 3 to Day 29

Secondary outcomes (5)
  1. COVID-19-related Death After Study Treatment

    Participants with COVID-19 related (as assessed by investigator) death up to Day 29

    Measured: 29 days

  2. Geometric Mean Ratio to Baseline in the C-reactive Protein (CRP)

    Measurement of C Reactive Protein (mg/L), Serum Or Plasma over time. The level of C-reactive protein (CRP), which can be measured in the blood, increases when there's inflammation in the body. Lower values of ratio to baseline in the CRP indicates less inflammation. The ratio to baseline at each time point (day) for each patient is calculated as the level of a specific biomarker at the time point divided by the baseline level of the biomarker, where baseline is the last non-missing value before study treatment. The geometric mean of ratio to baseline at each time point for each treatment group is calculated by first averaging the logarithms of the ratios to baseline and then take the exponential function of the same base.

    Measured: Over time and up to day 29: Baseline, Day 2, Day 3, Day 5, Day 7, Day 9, Day 11, Day 13, Day 15, Day 17, Day 19, Day 21, Day 23, Day 25, Day 27 and Day 29.

  3. Geometric Mean Ratio to Baseline in the D-dimer

    Clinical chemistry measurement D-Dimer (mg/L FEU), Blood in a blood sample over time

    D-dimer is one of the protein fragments produced when a blood clot gets dissolved in the body. The ratio to baseline at each time point (day) for each patient is calculated as the level of a specific biomarker at the time point divided by the baseline level of the biomarker, where baseline is the last non-missing value before study treatment. The geometric mean of ratio to baseline at each time point for each treatment group is calculated by first averaging the logarithms of the ratios to baseline and then take the exponential function of the same base.

    Measured: Over time and up to day 29: Baseline, Day 2, Day 3, Day 5, Day 7, Day 9, Day 11, Day 13, Day 15, Day 17, Day 19, Day 21, Day 23, Day 25, Day 27 and Day 29.

  4. Geometric Mean Ratio to Baseline in Ferritin

    Clinical chemistry measurement for amount of ferritin (ug/L) in Serum. The ratio to baseline at each time point (day) for each patient is calculated as the level of a specific biomarker at the time point divided by the baseline level of the biomarker, where baseline is the last non-missing value before study treatment. The geometric mean of ratio to baseline at each time point for each treatment group is calculated by first averaging the logarithms of the ratios to baseline and then take the exponential function of the same base.

    Measured: Over time and up to day 29: Baseline, Day 2, Day 3, Day 5, Day 7, Day 9, Day 11, Day 13, Day 15, Day 17, Day 19, Day 21, Day 23, Day 25, Day 27 and Day 29.

  5. Number of Participants With Treatment Emergent Adverse Events

    Number of participants with treatment emergent adverse events, including changes from baseline in vital signs and laboratory results qualifying and reported as adverse events.

    Safety was monitored from the canakinumab or placebo dose (Day 1) up to 126 days post-dose (Day 127).

    Measured: Up to day 127

Timeline

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

  1. First posted27 Apr 2020
  2. Study start30 Apr 2020
  3. Primary completion16 Sep 2020
  4. Study completion22 Dec 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
454 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04362813
Sponsor's protocol ID
CACZ885D2310
Other IDs
2020-001370-30
Acronym
CAN-COVID
Status last verified
Jan 2022
First submitted
24 Apr 2020
Last updated
24 Jan 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided: 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

  • Sedhai YR, Sears M, Vecchie A, Bonaventura A, Greer J, Spence K, Tackett H, Turner J, Pak M, Patel N, Black M, Wohlford G, Clary RE, Duke C, Hardin M, Kemp H, Priday A, Sims EK Jr, Mihalick V, Ho AC, Ibe I, Harmon M, Markley R, Van Tassell B, Abbate A. Clinical trial enrollment at a rural satellite hospital during COVID-19 pandemic. J Clin Transl Sci. 2021 Apr 8;5(1):e136. doi: 10.1017/cts.2021.777. eCollection 2021.

    PubMed 34367680
  • Caricchio R, Abbate A, Gordeev I, Meng J, Hsue PY, Neogi T, Arduino R, Fomina D, Bogdanov R, Stepanenko T, Ruiz-Seco P, Gonzalez-Garcia A, Chen Y, Li Y, Whelan S, Noviello S; CAN-COVID Investigators. Effect of Canakinumab vs Placebo on Survival Without Invasive Mechanical Ventilation in Patients Hospitalized With Severe COVID-19: A Randomized Clinical Trial. JAMA. 2021 Jul 20;326(3):230-239. doi: 10.1001/jama.2021.9508.

    PubMed 34283183

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Canakinumab in people with Cytokine Release Syndrome (CRS) in Patients With COVID-19-induced Pneumonia, run by Novartis Pharmaceuticals at 39 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 7 inclusion and 4 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 24 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 39 sites in United States, Russia, Spain, United Kingdom, Italy 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 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 16 Aug 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?

Participants Who Survived Without Requiring Invasive Mechanical Ventilation From Day 3 to Day 29, Primary Analysis (time frame: Day 3 to 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 NCT04362813, which also lists 2 linked publications.

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 24 Jan 2022.

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