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COVID-19Phase 3MORNINGSKYNCT04889040

Study to Evaluate the Effects of RO7496998 (AT-527) in Non-Hospitalized Adult and Adolescent Participants With Mild or Moderate COVID-19

A Phase 3 study testing RO7496998 in people with COVID-19, run by Hoffmann-La Roche at 50 sites in 12 countries.

Terminated

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

Official record
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Trial summary

This study will evaluate the efficacy, safety, antiviral activity, and pharmacokinetics of study drug RO7496998 (AT-527) compared to placebo in non-hospitalized adult and adolescent participants with mild to moderate coronavirus disease 2019 (COVID-19) in the outpatient setting. Read more about this study

Who is it for?
Ages 12 years and older
Conditions the study is for
COVID-19
What is being tested?
RO7496998
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
216 participants
Where
50 sitesin 12 countries
Study dates
28 Apr 2021to 2 Dec 2021
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

  • Positive SARS-CoV-2 diagnostic test (RT-PCR or validated rapid antigen test) ≤72 hours prior to randomization
  • At least three of the following symptoms of at least moderate (score ≥2 as per COVID-19 Symptom Diary) intensity: nasal congestion or runny nose, sore throat, cough, shortness of breath, muscle or body aches, fatigue, headache, chills or sweats, feeling hot or feverish, nausea, vomiting, or diarrhea.
  • Has symptoms consistent with mild or moderate COVID-19, as determined by the investigator, with onset ≤5 days before dosing on Day 1

Who cannot join

  • Clinical signs indicative of COVID-19 illness requiring hospitalization
  • Admitted to a hospital prior to randomization or is hospitalized (inpatient) at randomization due to COVID-19
  • In the opinion of the investigator, is likely to experience imminent deterioration and require hospitalization
  • Treatment with an investigational drug within 5 half-lives or 3 months (whichever is longer) of randomization
  • Treatment with a COVID-19 therapeutic agent including, but not limited to, other direct or indirect acting antivirals against SARS-CoV-2 (such as remdesivir or favipiravir), systemic or inhaled steroids (such as dexamethasone or inhaled budesonide), colchicine, ivermectin, interferons, convalescent plasma, monoclonal antibodies against SARS CoV-2 or interleukin 6 (IL-6), intravenous immunoglobulin or other EUA-approved treatments within 3 months or less than 5 drug elimination half-lives (whichever is longer) prior to the screening visit
  • Concomitant use of P-glycoprotein inhibitors or inducers listed as prohibited therapy in the protocol
Show all 12Show fewer
  • Known allergy or hypersensitivity to components of study drug
  • Abnormal laboratory test results at screening
  • Requirement of any prohibited medications during the study
  • Other known active viral or bacterial infection at the time of screening, such as influenza
  • Any clinically significant medical condition or laboratory abnormality that, in the opinion of the investigator, could jeopardize the safety of the patient or affect patient compliance or safety/efficacy observations during the study
  • COVID-19 vaccination within ≤ 40-days prior to enrollment (second dose if applicable)

Trial locations and contacts

50 sites in 12 countries.

50 sites in 12 countries

Japan13 sites
  • Higashiosaka city Medical Center

    Higashiosaka-Shi, 578-0947

  • Rinku General Medical Center

    Izumisano, 598-0048

  • Sagamihara Kyodo Hospital

    Kanagawa, 252-5188

  • Misyuku hospital

    Meguro-Ku, 153-0051

  • IUHW Narita Hospital

    Narita, 286-8520

  • Houjin Syadan Kouhoukai Takagi Hospital

    Okawa-Shi, 831-0016

  • Okayama City Hospital

    Okayama, 700-8557

  • Ome Municipal General Hospital

    Ome-Shi, 198-0042

  • National Hospital Organization Kinki-Chuo Chest Medical Center

    Sakaishi, 591-8555

  • Tokyo Shinagawa Hospital Medical Corporation Association Tokyokyojuno-kai

    Shinagawa City, 140-8522

  • Edogawa Medicare Hospital

    Tokyo, 133-0071

  • Center Hospital of the National Center for Global Health and Medicine

    Tokyo, 162-0052

  • Tokyo Medical University Hachioji Medical Center

    Tokyo, 193-0998

Other trials in Japan

Ukraine9 sites
  • CNPE City Clinical Hospital #6 of DCC

    Dnipro, Kholm Governorate, 49074

  • Municipal Non-profit Enterprise ?City Clinical Hospital #13? of Kharkiv City Council

    Kharkiv, Kharkiv Governorate, 61124

  • Public Non-Profit Enterprise ?City Outpatient Clinic #9? of Kharkiv City Council

    Kharkiv, Kharkiv Governorate, 61172

  • Medical Center LLC "Harmony of Beauty"

    Kyiv, KIEV Governorate, 01135

  • CNE Kyiv City Clinical Hospital#1 of Exec. Body

    Kyiv, KIEV Governorate, 02091

  • Kyiv Railway Clinical Hospital No2 of Branch Health Center of the JSC Ukrainian Rail

    Kyiv, KIEV Governorate, 03049

  • Polyclinic of Center of Medical Service and Rehabilitation of State JSHC Artem

    Kyiv, KIEV Governorate, 04050

  • Communal Non-Commercial Enterprise Vinnytsia City Clinical Hospital 1

    Vinnytsia, Podolia Governorate

  • Communal Non-Profit Enterprise City Hospital #7 of Zaporizhzhia City Council

    Zaporizhzhya, Tavria Okruha, 69118

Other trials in Ukraine

Mexico6 sites
  • Panamerican Clinical Research S.A de C.V.

    Guadalajara, Jalisco, 44670

  • Instituto Jalisciense de Investigacion Clinica S.A. de C.V.

    Guadalajara, 44100

  • Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

    México

  • Clinstile S.A de C.V.

    Mexico City, Mexico CITY (federal District), 06700

  • PanAmerican Clinical Research, Querétaro

    Queréaro, Querétaro, 76230

  • CIMAB SA de CV

    Torreón, Coahuila, 27000

Other trials in Mexico

Brazil5 sites
  • L2 Ip Instituto de Pesquisas Clinicas Ltda ME; Centro Medico Hospitalar

    Brasília, Federal District, 70200-730

  • Hospital Nossa Senhora das Graças

    Curitiba, Paraná, 80810-040

  • Hospital Agamenon Magalhães

    Recife, Pernambuco, 52051-380

  • Conjunto Hospitalar do Mandaqui

    São Paulo, São Paulo, 02401-400

  • Chronos Pesquisa Clinica

    Taguatinga, Federal District, 72145-450

Other trials in Brazil

Turkey (Türkiye)4 sites
  • Gazi Universitesi Tip Fakultesi

    Ankara, 06100

  • Ankara University Medical Faculty - PPDS

    Çankaya, 06590

  • Ege University Medical Faculty

    Izmir, 35100

  • Karadeniz Technical University Faculty of Medicine

    Trabzon, 61080

Other trials in Turkey (Türkiye)

Belgium3 sites
  • Maison Médicale La Brèche

    Châtelineau, 6200

  • Private Practice Dr Jean Benoit Martinot

    Erpent, 5101

  • Medif

    Gozée, 6534

Other trials in Belgium

Romania3 sites
  • Prof. Dr. Matei Bals Institute of Infectious Diseases

    Bucharest, 021105

  • County Hospital Caracal

    Caracal, 235200

  • Sibiu Emergency Clinical County Hospital

    Sibiu, 550245

Other trials in Romania

Denmark2 sites
  • Aalborg Universitetshospital

    Aalborg, 9000

  • Rigshospitalet Copenhagen University Hospital

    Copenhagen, DK-2100

Other trials in Denmark

Switzerland2 sites
  • Hôpital Universitaire de Genève (HUG)

    Geneva, 1211

  • Universitätsspital Zürich

    Zurich, 8091

Other trials in Switzerland

Argentina1 site
  • Instituto Ave Pulmo

    Mar del Plata, B7602DCK

Other trials in Argentina

Germany1 site
  • Praxis am Ebertplatz

    Cologne, 50668

Other trials in Germany

Portugal1 site
  • Unidade Local de Saude de Matosinhos SA

    Matosinhos Municipality, 4454-509

Other trials in Portugal

About this study

Official title: A Multicenter, Phase III Randomized, Double-Blind, Placebo-Controlled, Outpatient Study to Evaluate the Efficacy, Safety, Antiviral Activity of RO7496998 (AT-527) in Patients With Mild or Moderate COVID-19

This study will evaluate the efficacy, safety, antiviral activity, and pharmacokinetics of study drug RO7496998 (AT-527) compared to placebo in non-hospitalized adult and adolescent participants with mild to moderate coronavirus disease 2019 (COVID-19) in the outpatient setting.

Conditions
COVID-19
Being tested
RO7496998, Placebo
Keywords
Coronavirus Disease 2019; COVID-19; antiviral drug; SARS-CoV-2; Mild to Moderate COVID-19; antiviral efficacy
Medical subject headings
COVID-19

What participants receive

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

  • RO7496998Drug

    Also called AT-527

    275 mg tablets

  • PlaceboDrug

    Matching tablets

Study groups in NCT04889040
Study groupRoleWhat they receive
PlaceboPlacebo comparatorThe dose and regimen of the placebo will match that of AT-527.
Receives: Drug: Placebo
RO7496998 (AT-527)ExperimentalOrally administered, 550 mg twice daily (BID) for 5 days
Receives: Drug: RO7496998

What is being measured

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

  1. Time to Alleviation or Improvement of COVID-19 Symptoms (21.5 Hours)

    COVID-19 symptoms will be evaluated using the COVID-19 Symptom Diary (questions 1-12). The severity of each COVID-19 symptom will be recorded on a Likert scale (i.e none/mild/moderate/severe).

    The time to alleviation or improvement of COVID-19 symptoms is defined as follows: for new symptoms, it is defined as the length of time taken from randomization to the point at which a Score of 0 or 1 has been maintained for a duration of at least 21.5 hours. For preexisting symptoms, it is defined as the time from randomization to when a patient's symptoms have been maintained or improved (requires at least a single category improvement from baseline on the COVID-19 Symptom Diary Likert scale) for a duration of 21.5 hours.

    Measured: Up to 29 days

Secondary outcomes (19)
  1. Time to Alleviation or Improvement of COVID-19 Symptoms (43 Hours)

    COVID-19 symptoms will be evaluated using the COVID-19 Symptom Diary (questions 1-12). The severity of each COVID-19 symptom will be recorded on a Likert scale (i.e none/mild/moderate/severe).

    The time to alleviation or improvement of COVID-19 symptoms is defined as follows: for new symptoms, it is defined as the length of time taken from randomization to the point at which a Score of 0 or 1 has been maintained for a duration of at least 43 hours. For preexisting symptoms, it is defined as the time from randomization to when a patient's symptoms have been maintained or improved (requires at least a single category improvement from baseline on the COVID-19 Symptom Diary Likert scale) for a duration of 43 hours.

    Measured: Up to 29 days

  2. Time to Alleviation of COVID-19 Symptoms (21.5 Hours)

    Time from randomization to the point at which the following criterion is met and maintained for at least 21.5 hours.

    • Score of 0 or 1 on Items 1-12 of the COVID-19 Symptom Diary.

    Measured: Up to 29 days

  3. Time to Alleviation of COVID-19 Symptoms (43 Hours)

    Time from randomization to the point at which the following criterion is met and maintained for at least 43 hours.

    • Score of 0 or 1 on Items 1-12 of the COVID-19 Symptom Diary.

    Measured: Up to 29 days

  4. Time to One-Category Improvement of Baseline Presenting COVID-19 Symptoms

    Time from randomization to the point at which symptoms (Items 1-12 of the COVID-19 Symptom Diary) have improved by at least one category from baseline on the COVID-19 Symptom Diary Likert scale, maintained for at least 21.5 hours.

    Measured: Up to 29 days

  5. Time to Alleviation of Individual Symptoms

    Time from randomization to the point at which the following criterion is met and maintained (for each individual symptom) for at least 21.5 hours.

    • Score of 0 or 1 for Items 1-14 of the COVID-19 Symptom Diary

    Measured: Up to 29 days

  6. Percentage of Participants Requiring Hospitalization for COVID-19

    Hospitalizations for COVID-19 are defined as SAEs for which the investigator has cited that the suspected cause was the disease under study and where there is a non-missing hospital admission date.

    Measured: Up to Day 33 visit

  7. Percentage of Participants With Greater Than or Equal to 1 COVID-19 Related Medically Attended Visit

    Medically attended visit is defined as hospitalization, emergency room (ER) visit, urgent care visit, physician's office visit, or telemedicine visit, with the primary reason for the visit being COVID-19.

    Measured: Up to Day 33 visit

  8. Duration of Fever

    Time to return to an afebrile state (temperature ≤ 37.5°C) maintained for at least 21.5 hours.

    Measured: Up to 29 days

  9. Percentage of Participants With COVID-19 Related Complications

    COVID-related complications are defined as death, hospitalization, pneumonia, sepsis, coagulopathy, pericarditis/myocarditis and cardiac failure.

    Pneumonia, acute respiratory failure, sepsis, coagulopathy, pericarditis/myocarditis, and cardiac failure were adjudicated per blinded manual medical review of events by an internal adjudication team before study readout.

    Measured: Up to Day 33 visit

  10. Percentage of Participants With Any Post-Treatment Infection

    Post-treatment infections were defined as any treatment-emergent adverse event with a primary system organ class of infections and infestations.

    Measured: Up to Day 33 visit

  11. Change From Baseline in the Amount of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Virus RNA

    SARS-CoV-2 virus RNA will be measured by reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR)

    Measured: Baseline and on Days 3, 5, 7 and 14

  12. Time to Cessation of SARS-CoV-2 Viral Shedding

    Defined as time from randomization to the first time when a negative qualitative virus RNA by RT-PCR test result is obtained.

    Measured: Up to 14 days

  13. Percentage of Participants Positive for SARS-CoV-2 Virus RNA at Specified Timepoints

    Defined as percentage of participants with a positive qualitative virus RNA by RT-PCR.

    Measured: Baseline and on Days 3, 5, 7 and 14

  14. Area Under the Curve (AUC) in the Amount of SARS-CoV-2 Virus RNA

    Measured: Day 1 prior to dosing, Day 3, Day 5, Day 7 and Day 14

  15. Percentage of Participants With Adverse Events (AEs)

    Measured: Up to Day 33 visit

  16. Plasma Concentration of AT-511 at Specified Timepoints

    AT-511 is the free base form of RO7496998 (AT-527).

    Measured: Up to 7 days

  17. Plasma Concentration of AT-551 at Specified Timepoints

    AT-511 is the free base form of RO7496998 (AT-527). Major metabolites are AT-551, AT-229, and AT-273 (a surrogate for the intracellular concentration of the active triphosphate metabolite AT-9010)

    Measured: Up to 7 days

  18. Plasma Concentration of AT-229 at Specified Timepoints

    AT-511 is the free base form of RO7496998 (AT-527). Major metabolites are AT-551, AT-229, and AT-273 (a surrogate for the intracellular concentration of the active triphosphate metabolite AT-9010)

    Measured: Up to 7 days

  19. Plasma Concentration of AT-273 at Specified Timepoints

    AT-511 is the free base form of RO7496998 (AT-527). Major metabolites are AT-551, AT-229, and AT-273 (a surrogate for the intracellular concentration of the active triphosphate metabolite AT-9010)

    Measured: Up to 7 days

Timeline

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

  1. First posted17 May 2021
  2. Study start28 Apr 2021
  3. Primary completion2 Dec 2021
  4. Study completion2 Dec 2021

Why it stopped: Based on program revaluation and in agreement with the co-development partner the sponsor took the decision to terminate this study.

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
216 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04889040
Sponsor's protocol ID
CV43043
Other IDs
2020-005759-18
Acronym
MORNINGSKY
Status last verified
Mar 2023
First submitted
10 May 2021
Last updated
5 Jan 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/ourmember/roche/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research\_and\_development/who\_we\_are\_how\_we\_work/clinical\_trials/our\_commitment\_to\_data\_sharing.htm)

Publications

  • Horga A, Saenz R, Yilmaz G, Simon-Campos A, Pietropaolo K, Stubbings WJ, Collinson N, Ishak L, Zrinscak B, Belanger B, Granier C, Lin K, C Hurt A, Zhou XJ, Wildum S, Hammond J. Oral bemnifosbuvir (AT-527) vs placebo in patients with mild-to-moderate COVID-19 in an outpatient setting (MORNINGSKY). Future Virol. 2023 Oct:10.2217/fvl-2023-0115. doi: 10.2217/fvl-2023-0115. Epub 2023 Nov 1.

    PubMed 37928891

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing RO7496998 in people with COVID-19, run by Hoffmann-La Roche at 50 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 3 inclusion and 12 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 5 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 50 sites in Japan, Ukraine, Mexico, Brazil, Turkey (Türkiye) 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 5 Jan 2024). 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?

Time to Alleviation or Improvement of COVID-19 Symptoms (21.5 Hours) (time frame: Up to 29 days). 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 NCT04889040, 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 5 Jan 2024.

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