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SARS-CoV-2Phase 1TRUSTNCT05281601

AZD7442 Pharmacokinetics, Pharmacodynamics, and Safety Evaluation in Pediatrics

A Phase 1 study testing AZD7442 in people with SARS-CoV-2, run by AstraZeneca at 11 sites in 5 countries.

Completed

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

Official record
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Trial summary

This study will evaluate the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of AZD7442 administered intramuscularly (IM) or intravenously (IV) in pediatric participants aged ≥ 29 weeks GA to < 18 years. Read more about this study

Who is it for?
Ages 0 to 17 years
Conditions the study is for
SARS-CoV-2
What is being tested?
AZD7442
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
11 sitesin 5 countries
Study dates
21 Mar 2022to 16 Apr 2024
Phase
Phase 1
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 0 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Participant must be aged ≥ 29 weeks gestational age (GA) to < 18 years of age.
  • Participant must weigh a minimum of 1.5 kg.
  • COHORT 1
  • Increased risk of severe COVID-19 because of immunocompromised state or one or more comorbid conditions that increase the risk of severe COVID-19.
  • Increased risk for SARS-CoV-2 infection.
  • Medically stable (disease not requiring significant change in therapy or hospitalization for worsening disease during the one month prior to enrollment).
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  • A negative RT-PCR test collected ≤ 3 days prior to Day 1 or a negative rapid SARS-CoV-2 antigen test at screening.
  • No COVID-19 symptoms prior to enrollment within 10 days of dosing.
  • Increased risk for SARS-CoV-2 infection.
  • COHORT 2
  • Increased risk of severe COVID-19 because of immunocompromised state or one or more comorbid conditions that increase the risk of severe COVID-19.
  • Medically stable (disease not requiring significant change in therapy or hospitalization for worsening disease during the one month prior to enrollment).
  • A positive RT-PCR test collected ≤ 3 days prior to Day 1 or a positive rapid SARS-CoV-2 antigen test at screening.
  • Symptomatic participants must be dosed with IMP no more than 7 days from the self-reported date of first reported sign/symptom.
  • Oxygenation saturation of ≥ 92% obtained at rest within 24 hours prior to Day 1 unless the potential participant regularly receives chronic supplementary oxygen for an underlying lung condition.
  • Note that Cohort 2 will only be included if the indication is progressed in adults.
  • COHORT 3
  • Participants hospitalized with COVID-19 with a time between onset of symptoms and dosing AZD7442 of ≤ 7 days.
  • A positive RT-PCR test collected ≤ 3 days before Day 1 or a positive rapid SARS-CoV-2 antigen test at screening.
  • Spontaneous blood Alanine Aminotransferase (ALT)/Aspartate Transaminase (AST) levels ≤ 5 times the ULN.
  • Glomerular Filtration Rate (GFR) ≥ 30 mL/min/1.73 m2.
  • Participants will receive IM AZD7442 unless they meet any of the following criteria for IV administration:
  • The participant has severe COVID-19.
  • Contraindication of intramuscular (IM) dose due to thrombocytopenia, coagulation defects or any other condition that would compromise the absorption of AZD7442 or safety of the participant.
  • Physician considers IV the appropriate route.

Who cannot join

  • All Cohorts
  • Cohort 1: Significant infection or other acute illnesses including fever on or the day prior to receiving AZD7442.
  • History of SARS-CoV-1 or Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
  • Cohorts 1 and 2: Current need for immediate medical attention or current need for hospitalization.
  • Mechanical ventilation or extracorporeal membrane oxygenation requirement for COVID-19.
  • History of allergic or reaction to any component of the study drug formulation.
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  • History of hypersensitivity, injection/infusion-relation reactions or severe adverse reactions following administration of a monoclonal antibody (mAb).
  • Co-morbidity requiring surgery within 7 days prior to study entry or is deemed life-threatening within 30 days prior to study entry.
  • Prior receipt of convalescent COVID-19 plasma/sera or hyperimmune globulin therapy.
  • Prior receipt of mAb/biologic indicated for the prevention of SARS-CoV-2, treatment of COVID-19, or expected receipt during the period of study follow-up.
  • Prior receipt of a COVID-19 vaccine ≤ 14 days before screening or plan to receive a COVID-19 vaccination ≤ 14 days after IMP administration at study Visit 1.
  • History of alcohol or drug abuse within the past 2 years.
  • Investigational Drugs or Devices: Treatment with investigational drug or device in another clinical trial within the last 30 days or 5 half-lives of the drug (whichever is longer) prior to screening. Note: Participation in observational studies (ie, studies that do not require medication, blood draws, or an additional intervention) is not exclusionary. Interventional trials which do not include investigational drugs (only include approved therapies), or investigational treatment regimens may be considered if the blood draw requirements and study interventions are minimal and not deemed by the Investigator to interfere with completion of the planned study sampling and follow-up.
  • Vulnerable persons (eg, ward of the state, kept in detention).

Trial locations and contacts

11 sites in 5 countries.

11 sites in 5 countries

United States7 sites
  • Research Site

    Aurora, Colorado, 80045

  • Research Site

    Idaho Falls, Idaho, 83404

  • Research Site

    Long Beach, California, 90806

  • Research Site

    Mt. Pleasant, South Carolina, 29464

  • Research Site

    Providence, Rhode Island, 02903

  • Research Site

    Stony Brook, New York, 11794

  • Research Site

    Washington D.C., District of Columbia, 20007

Other trials in United States

Belgium1 site
  • Research Site

    Leuven, 3000

Other trials in Belgium

Brazil1 site
  • Research Site

    Belo Horizonte, 30130-100

Other trials in Brazil

Germany1 site
  • Research Site

    Frankfurt am Main, 60590

Other trials in Germany

United Kingdom1 site
  • Research Site

    Southampton, SO16 6YD

Other trials in United Kingdom

About this study

Official title: Open-Label, Uncontrolled, Single Dose Study to Evaluate the Pharmacokinetics, Pharmacodynamics, and Safety of AZD7442 in Pediatric Participants Aged ≥ 29 Weeks Gestational Age to < 18 Years

This study will evaluate the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of AZD7442 administered intramuscularly (IM) or intravenously (IV) in pediatric participants aged ≥ 29 weeks GA to < 18 years.

Read the detailed description

This is a Phase I, open-label, uncontrolled, multi-country, multi-center, single-dose study. Initially, 2 cohorts of participants will be enrolled: 1) participants who are severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) negative at screening and have not knowingly been exposed to a SARS-CoV-2 positive individual (pre-exposure prophylaxis); and 2) participants who are SARS-CoV-2 RT-PCR positive at screening and have mild to moderate COVID-19 symptoms. A third cohort might be added for the treatment of severe COVID-19. If included, this third cohort will include participants who are SARS-CoV-2 positive at screening and have severe COVID-19.

Conditions
SARS-CoV-2
Being tested
AZD7442
Keywords
AZD7442, Monoclonal antibodies (mAb), COVID-19, EVUSHELD
Medical subject headings
COVID-19

What participants receive

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

  • AZD7442Drug

    Also called Evusheld

    IM Administration: AZD8895 and AZD1061 (comprising AZD7442), must both be administered separately to the participant in a sequential order.

    IV Administration: AZD7442 is dosed by co-administration of AZD8895 and AZD1061 in a single IV infusion.

Study groups in NCT05281601
Study groupRoleWhat they receive
AZD7442ExperimentalAll participants will receive a single dose of AZD7442 on Day 1, either IM (AZD8895 followed by AZD1061) or IV (AZD8895 + AZD1061 concurrently).
Receives: Drug: AZD7442

What is being measured

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

  1. Serum Concentrations of AZD7442

    The serum concentrations of AZD7442 after a single IM or IV dose in pediatric participants were evaluated. The serum concentrations for each scheduled time point were summarized by route of administration using appropriate descriptive statistics, based on the (Pharmacokinetic analysis) PK analysis set.

    Measured: IM - Day 4, Day 8, Day 11, Day 15 and Day 366; IV - Day 1, Day 4, Day 8, Day 11, Day 15 and Day 366

  2. Maximum Serum Concentration (Cmax)

    The Cmax of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approximately [approx.] 24 months)

  3. Time to Reach Maximum Serum Concentration (Tmax)

    The tmax of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  4. Terminal Half-life (t1/2)

    The t1/2 of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  5. Area Under the Serum Concentration Versus Time Curve From Time Zero to Time of Last Measurable Concentration (AUC0-last)

    The AUC0-last of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  6. Area Under the Serum Concentration Versus Time Curve Extrapolated to Infinity (AUC0-inf)

    The AUC0-inf of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  7. Time to Last Measurable Concentration (Tlast)

    The tlast of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  8. Percentage of AUC0-inf Extrapolated to Infinity (% AUCex)

    The %AUCex of AZD7442 after a single IM or IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  9. Apparent Total Clearance (CL/F)

    The CL/F of AZD7442 after a single IM dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  10. Apparent Volume of Distribution Based on Terminal Phase (Vz/F)

    The Vz/F of AZD7442 after a single IM dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  11. Systemic Clearance (CL)

    The CL of AZD7442 after a single IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  12. Volume of Distribution at Steady State (Vss)

    The Vss of AZD7442 after a single IV dose in pediatric participants was evaluated. The PK parameters were summarized by route of administration using appropriate descriptive statistics based on the PK analysis set.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  13. Number of Participants With Adverse Events (AE)

    The safety and tolerability of AZD7442 after a single IM or IV dose in pediatric participants was evaluated.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  14. Number of Participants With Adverse Event of Special Interest (AESI)

    Number of pediatric participants with AESI after a single IM or IV dose were evaluated.

    An AESI is a pre-specified medically significant event that has the potential to be causally associated with a vaccine product.

    Measured: Day 1 to day 366 or early discontinuation visit (approx. 24 months)

Secondary outcomes (5)
  1. Number of Participants With Positive Antidrug Antibodies (ADA) Result to AZD7442.

    The immunogenicity profile of AZD7442 after a single IM or IV dose in pediatric participants was evaluated.

    A participant is defined as ADA-positive to AZD7442 if they have a positive ADA result to AZD8895 and/or AZD1061 at any time, including baseline and all postbaseline.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  2. Cohort 2 - Percentage of Participants With Progression of COVID-19 Through Day 29

    Percentage of participants with progression of COVID-19 through Day 29 in Cohort 2 in pediatric participants was evaluated.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  3. Cohort 2 - Number of Participants With COVID-19 Related Death Occurring After Dosing With IMP Through 90 Days

    Number of participants with COVID-19 related death occurring after dosing with IMP through 90 days in Cohort 2 in pediatric participants were evaluated.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

  4. Titre of SARS-CoV-2 Neutralizing Antibodies

    The pharmacodynamics of AZD7442 after a single dose in pediatric participants was evaluated.

    The result for overall vaccination status were presented.

    Measured: Day 31 to Day 366 or early discontinuation visit (approx. 24 months)

  5. Cohort 1 (Prophylaxis) - Number of Participants With SARS-CoV-2 Infections

    Number of participants with SARS-CoV-2 infections with or without COVID-19 symptoms after a single IM or IV dose of AZD7442 in pediatric participants were evaluated.

    Measured: Day 1 to Day 366 or early discontinuation visit (approx. 24 months)

Timeline

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

  1. First posted16 Mar 2022
  2. Study start21 Mar 2022
  3. Primary completion16 Apr 2024
  4. Study completion16 Apr 2024

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 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
46 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05281601
Sponsor's protocol ID
D8850C00006
Other IDs
2021-006056-13
Acronym
TRUST
Status last verified
Apr 2025
First submitted
16 Feb 2022
Last updated
18 Apr 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing AZD7442 in people with SARS-CoV-2, run by AstraZeneca at 11 sites in 5 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 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 18 Apr 2025. 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, Belgium, Brazil, Germany, United Kingdom. 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 18 Apr 2025). 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?

Serum Concentrations of AZD7442 (time frame: IM - Day 4, Day 8, Day 11, Day 15 and Day 366; IV - Day 1, Day 4, Day 8, Day 11, Day 15 and Day 366). The study lists 14 primary outcomes in all. 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 18 Apr 2025.

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