NCT04659772
Trial name or title	A study to evaluate clazakizumab in patients with life‐threatening COVID‐19 infection.
Methods	RCT, placebo‐controlled, blind‐label study Date of study: December 2020 Location: USA Phase 2
Participants	Randomised: 30 participants Inclusion criteria ≥ 18 years of age. Confirmed COVID‐19 disease (by Cobas SARS‐CoV‐2 real time RT‐PCR using nasopharyngeal swab sample, or equivalent test available to be performed by Mayo Clinic clinical laboratory). Effort will be made to have the confirmatory test result < 72 hours prior to enrolment however given overall clinical demand this may not be feasible in all cases. Respiratory failure manifesting as: acute respiratory distress syndrome (defined by a P/F ratio of < 200), OR SpO2 < 90% on 4L (actual or expected given higher O2 requirement) OR increasing O2 requirements over 24 hours, PLUS 2 or more of the following predictors for severe disease: CRP > 35 mg/L; ferritin > 500 ng/mL; D‐dimer > 1 mcg/L; neutrophil‐lymphocyte ratio > 4; LDH > 200 U/L; increase in troponin in patient w/out known cardiac disease. Has a consent designee willing to provide informed consent on behalf of the patient (this assumes that a mechanically‐ventilated patients lacks capacity to consent on his/her own behalf. Should it be deemed that the patient has capacity to consent, consent may be obtained from the patient) Women of childbearing potential must be willing and able to use at least 1 highly effective contraceptive method for a period of 5 months following the study drug administration. In the context of this study, an effective method is defined as those which result in low failure rate (i.e. less than 1% per year) when used consistently and correctly such as: combined (oestrogen and progestogen containing) hormonal contraception combined (oestrogen and progestogen containing) hormonal contraception (oral, intravaginal, or transdermal); progestogen‐only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable); IUD; IUS; vasectomised partner; bilateral tubal occlusion; true abstinence. when this is in line with the preferred and usual lifestyle of the participant. Periodic abstinence, such as calendar, ovulation, symptothermal, postovulation methods, and withdrawal are not acceptable methods of contraception. Men must be willing to use a double‐barrier contraception from enrolment until at 5 months after the last dose of study drug, if not abstinent A participant, or an appropriate representative to the participant, will have the opportunity to consent with regard to the inclusion criteria above Exclusion criteria < 18 years of age Evidence of irreversible injury deemed non‐survivable even if the pulmonary failure recovers (for example severe anoxic brain injury) Known active inflammatory bowel disease Known active, untreated diverticulitis Known untreated bacteraemia Pregnancy (the protocol will exclude pregnant participants given the lack of overall data on use of clazakizumab in pregnancy however the study team would consider a protocol revision should more than 3 potential pregnant study participants be excluded on this basis) Known hypersensitivity to the clazakizumab Vulnerable participants will not be excluded. This study is designed to include any patients deemed at risk for imminent death, and the opportunity to enrol will not be withheld provided the participant meets the above inclusion and exclusion criteria
Interventions	Intervention: clazakizumab(IV, single dose, 25 mg, repeated dose for patients who fail expected decrease in inflammatory markers) Control interventions: placebo
Outcomes	Primary outcome Adverse events (60 days) Secondary outcomes
Starting date	Study start date: ‐
Contact information	Mayo Clinic in Arizona, Ayan Sen
Notes	Ongoing