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SARS-CoV-2 Infection, COVID-19Phase 2NCT04405570

Safety, Tolerability and Efficacy of Molnupiravir (EIDD-2801) to Eliminate Infectious Virus Detection in Persons With COVID-19

A Phase 2 study testing Molnupiravir 200 mg, Molnupiravir 400 mg and Molnupiravir 800 mg in people with SARS-CoV-2 Infection, COVID-19, run by Ridgeback Biotherapeutics, LP at 10 sites in United States.

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 phase IIa, double-blind, placebo-controlled, randomized trial, designed to compare the safety, tolerability, and antiviral activity of EIDD-2801 (molnupiravir) versus placebo as measured by SARS-CoV-2 viral RNA detection in symptomatic adult outpatients with COVID-19. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
SARS-CoV-2 Infection, COVID-19
What is being tested?
Molnupiravir 200 mg, Molnupiravir 400 mg and Molnupiravir 800 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
204 participants
Where
10 sitesUnited States
Study dates
19 Jun 2020to 21 Feb 2021
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

  • Able to provide informed consent prior to initiation of any study procedures.
  • ≥18 years of age at Screening.
  • Study treatment is expected to begin within ≤168 hours from first symptom onset.
  • Ability to swallow pills.
  • Documentation of confirmed active SARS-CoV-2 infection, as determined by a molecular or non-molecular ("rapid") test conducted at any clinic or laboratory that had a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent from a sample collected ≤96 hours prior to study entry.
  • Was experiencing at least one of the following SARS-CoV-2 infection symptoms at the time of enrollment: fever (could be subjective including feeling feverish or having chills) OR signs/symptoms of respiratory illness (including but not limited to upper respiratory congestion, loss of sense of smell or taste, sore throat OR lower respiratory illness - cough, shortness of breath).
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  • Agreed to not participate in another interventional clinical trial for the treatment of SARS-CoV-2 during the study period (28 days) unless hospitalized.
  • Agreed to not obtain investigational medications outside of the molnupiravir study.
  • Agreed to the sampling detailed in the schedule of evaluations and to comply with study requirements including contraception requirements.
  • A female participant was eligible to participate if she was not pregnant or breastfeeding and at least one of the following conditions applied:
  • Was not a woman of childbearing potential (WOCBP) OR
  • Was a WOCBP and using a contraceptive method that is highly effective (a low user dependency method OR a user-dependent method in combination with a barrier method), or was abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis), as described in Appendix 2 of the study protocol during the intervention period and for at least 50 days after the last dose of study intervention. The investigator evaluated the potential for contraceptive method failure (ie, noncompliance, recently initiated) in relationship to the first dose of study intervention.
  • A WOCBP must have had a negative highly sensitive pregnancy test (serum or urine) within 24 hours before the first dose of study intervention.
  • Additional requirements for pregnancy testing during and after study intervention were provided in the study protocol.
  • The investigator was responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
  • Contraceptive use by women was to be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
  • Given the elevated risk of venous thrombotic events in patients hospitalized with COVID-19 (Benson et al, 2020; Spratt et al, 2020), estrogen-containing contraceptives could not be started to fulfill the contraceptive requirement of this study at any time during participant's participation. If contraceptives were interrupted as standard of care management of COVID-19 patients and resumed at a later time point, such as at hospital discharge, then abstinence was practiced for the defined period of back-up contraception per the contraceptive product labeling. After this period, contraceptive use had to adhere to the guidance in Appendix 2 of the study protocol.
  • Male participants were eligible to participate if they agreed to the following during the intervention period and for at least 100 days after the last dose of study intervention:
  • Refrained from donating sperm
  • PLUS either:
  • Were abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agreed to remain abstinent.
  • OR
  • Had to agree to use contraception unless confirmed to be azoospermic (vasectomized or secondary to medical cause [Appendix 2 of the study protocol]) as detailed below:
  • Agreed to use a male condom plus partner use of an additional contraceptive method when having penile-vaginal intercourse with a WOCBP who was not pregnant. Note: Men with a pregnant or breastfeeding partner had to agree to remain abstinent from penile-vaginal intercourse or use a male condom during each episode of penile-vaginal penetration.
  • Contraceptive use by men was to be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Who cannot join

  • Need for hospitalization or immediate medical attention in the clinical opinion of the study investigator.
  • Hemoglobin <10 g/dL in men and <9 g/dL in women.
  • Platelet count <100,000/ µL or received a platelet transfusion within 5 days prior to enrollment.
  • Was on dialysis or has an estimated glomerular filtration rate <30 mL/min/1.73 m^2
  • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) >3x upper limit normal (ULN).
  • History of or current hospitalization for COVID-19. Note: Individuals hospitalized and then discharged, even if only hospitalized for 1 day, were excluded.
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  • History of kidney disease as evidenced by estimated creatinine clearance value <30 mL/min.
  • History of significant liver disease in the opinion of the site investigator or active hepatitis B or active hepatitis C. Human immunodeficiency virus (HIV) that is advanced (CD4<200/mm^3) and/or on treatment with nucleos(t)ide analogues.
  • Use of therapeutic interventions 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 convalescent plasma), or participation in a clinical trial involving any of these drugs whether for treatment or prophylaxis.
  • Receipt of a SARS-CoV-2 vaccination prior to study entry.
  • Known allergy/sensitivity or any hypersensitivity to components of molnupiravir, or its formulation.
  • Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
  • History of recent (within the past 3 months) hemorrhagic cerebrovascular accident) or major bleed.
  • Presence of a condition, that in the opinion of the investigator, would place the subject at increased risk from study participation.

Trial locations and contacts

10 sites in 1 country.

10 sites in 1 country

United States10 sites
  • University of North Carolina School of Medicine

    Chapel Hill, North Carolina, 27599

  • Duke University Medical Center

    Durham, North Carolina, 27710

  • Care United Research, LLC

    Forney, Texas, 75126

  • Indago Research and Health Center, Inc.

    Hialeah, Florida, 33012

  • NOLA Research Works, LLC

    New Orleans, Louisiana, 70115

  • Valley Clinical Trials, Inc.

    Northridge, California, 91325

  • FOMAT Medical Research

    Oxnard, California, 93030

  • Fred Hutchinson Cancer Research Center

    Seattle, Washington, 98109

  • Wake Forest Baptist Medical Center

    Winston-Salem, North Carolina, 27157

  • Southern California Emergency Medicine

    Yucaipa, California, 92399

Other trials in United States

About this study

Official title: A Phase IIa Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety, Tolerability and Efficacy of EIDD-2801 to Eliminate SARS-CoV-2RNA Detection in Persons With COVID-19

This was a phase IIa, double-blind, placebo-controlled, randomized trial, designed to compare the safety, tolerability, and antiviral activity of EIDD-2801 (molnupiravir) versus placebo as measured by SARS-CoV-2 viral RNA detection in symptomatic adult outpatients with COVID-19.

Read the detailed description

This was a phase IIa, double-blind, placebo-controlled, randomized trial, designed to compare the safety, tolerability, and antiviral activity of molnupiravir versus placebo as measured by SARS-CoV-2 viral RNA detection in symptomatic adult outpatients with COVID-19. The study was a multicenter trial that was conducted in the United States.

In this study, 204 participants were randomized and 202 received molnupiravir or placebo orally twice a day (BID) for 5 days. The study enrolled participants in 5 parts with each part evaluating molnupiravir doses of either 200 mg BID, 400 mg BID, or 800 mg BID. Doses were chosen based on emerging virology and safety data from this and ongoing studies. New dose groups were started after the selected dose had been studied for safety in a Phase 1 study.

Being tested
Molnupiravir 200 mg, Molnupiravir 400 mg, Molnupiravir 800 mg, Placebo (PBO)
Medical subject headings
COVID-19

What participants receive

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

  • Molnupiravir 200 mgDrug

    Oral capsule of molnupiravir

  • Molnupiravir 400 mgDrug

    Oral capsule of molnupiravir

  • Molnupiravir 800 mgDrug

    Oral capsule of molnupiravir

  • Placebo (PBO)Drug

    placebo oral capsule

Study groups in NCT04405570
Study groupRoleWhat they receive
Molnupiravir 200 mgExperimentalMolnupiravir 200 mg, twice daily (BID) for 5 days
Receives: Drug: Molnupiravir 200 mg
Molnupiravir 400 mgExperimentalMolnupiravir 400 mg, twice daily (BID) for 5 days
Receives: Drug: Molnupiravir 400 mg
Molnupiravir 800 mgExperimentalMolnupiravir 800 mg, twice daily (BID) for 5 days
Receives: Drug: Molnupiravir 800 mg
Placebo (PBO) twice daily (BID) for 5 daysPlacebo comparatorNot described
Receives: Drug: Placebo (PBO)

What is being measured

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

  1. Number of Participants Until First Non-detectable SARS-CoV-2 in Nasopharyngeal (NP) Swabs

    The number of participants until first non-detectable SARS-CoV-2 in nasopharyngeal (NP) swabs will be estimated for each randomized arm (drug versus placebo), using Kaplan-Meier methods with a corresponding log-rank test.

    Non detectable defined as "a viral load below the limit of quantification

    Measured: 28 days

  2. Time to Clearance of SARS-CoV-2 in Nasopharyngeal Swabs

    The distribution of days until first non-detectable SARS-CoV-2 in nasopharyngeal (NP) swabs will be estimated for each randomized arm (drug versus placebo), using Kaplan-Meier methods with a corresponding log-rank test.

    Non detectable defined as "a viral load below the limit of quantification

    Measured: 28 days

  3. Number of Participants With Adverse Events (AEs) Grade 3 or Higher or Leading to Discontinuation of Study Treatment

    1. any AEs leading to early discontinuation of blinded treatment (active or placebo), 2) study drug-related discontinuation of treatment, 3) new grade 3 or higher AEs (not already present at baseline), and 4) study drug-related new grade 3 or higher AEs.

    Measured: 28 days

Secondary outcomes (1)
  1. Number of Participants With Any Adverse Events (AEs), Grade 2 or Higher

    Measure the safety and tolerability of EIDD-2801 by estimating the occurrence of Grade 2 or higher AE and drug related AEs.

    Measured: 28 days

Timeline

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

  1. First posted28 May 2020
  2. Study start19 Jun 2020
  3. Primary completion21 Feb 2021
  4. Study completion21 Feb 2021

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
204 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04405570
Sponsor's protocol ID
EIDD-2801-2003
Status last verified
Feb 2022
First submitted
26 May 2020
Last updated
16 Feb 2022
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: There is not a plan to make IPD available.

Publications

  • Mollan KR, Eron JJ, Krajewski TJ, Painter W, Duke ER, Morse CG, Goecker EA, Premkumar L, Wolfe CR, Szewczyk LJ, Alabanza PL, Loftis AJ, Degli-Angeli EJ, Brown AJ, Dragavon JA, Won JJ, Keys J, Hudgens MG, Fang L, Wohl DA, Cohen MS, Baric RS, Coombs RW, Sheahan TP, Fischer WA. Infectious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in Symptomatic Coronavirus Disease 2019 (COVID-19) Outpatients: Host, Disease, and Viral Correlates. Clin Infect Dis. 2022 Aug 24;75(1):e1028-e1036. doi: 10.1093/cid/ciab968.

    PubMed 35022711
  • Fischer W, Eron JJ, Holman W, Cohen MS, Fang L, Szewczyk LJ, Sheahan TP, Baric R, Mollan KR, Wolfe CR, Duke ER, Azizad MM, Borroto-Esoda K, Wohl DA, Loftis AJ, Alabanza P, Lipansky F, Painter WP. Molnupiravir, an Oral Antiviral Treatment for COVID-19. medRxiv [Preprint]. 2021 Jun 17:2021.06.17.21258639. doi: 10.1101/2021.06.17.21258639.

    PubMed 34159342
  • Mollan KR, Eron JJ, Krajewski TJ, Painter W, Duke ER, Morse CG, Goecker EA, Premkumar L, Wolfe CR, Szewczyk LJ, Alabanza PL, Loftis AJ, Degli-Angeli EJ, Brown AJ, Dragavon JA, Won JJ, Keys J, Hudgens MG, Fang L, Wohl DA, Cohen MS, Baric RS, Coombs RW, Sheahan TP, Fischer WA 2nd. Infectious SARS-CoV-2 Virus in Symptomatic COVID-19 Outpatients: Host, Disease, and Viral Correlates. medRxiv [Preprint]. 2021 Jun 25:2021.05.28.21258011. doi: 10.1101/2021.05.28.21258011.

    PubMed 34100024
  • Cox RM, Wolf JD, Plemper RK. Therapeutically administered ribonucleoside analogue MK-4482/EIDD-2801 blocks SARS-CoV-2 transmission in ferrets. Nat Microbiol. 2021 Jan;6(1):11-18. doi: 10.1038/s41564-020-00835-2. Epub 2020 Dec 3.

    PubMed 33273742

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Molnupiravir 200 mg, Molnupiravir 400 mg and Molnupiravir 800 mg in people with SARS-CoV-2 Infection, COVID-19, run by Ridgeback Biotherapeutics, LP at 10 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 25 inclusion and 14 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 16 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 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 16 Feb 2022). 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 Until First Non-detectable SARS-CoV-2 in Nasopharyngeal (NP) Swabs (time frame: 28 days). The study lists 3 primary outcomes in all. 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 NCT04405570, which also lists 4 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 16 Feb 2022.

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