Article
作者: Jilg, Nikolaus ; Jagannathan, Prasanna ; Szurgot, Bob ; Currier, Judith S ; Murtaugh, William ; Corado, Katya ; Hughes, Michael D ; Chew, Kara W ; Chew, Kara ; Daar, Eric S ; Evering, Teresa ; Hoover, Keila ; Kantor, Amy ; Singh, Upinder ; Li, Jonathan ; Pillay, Sandy ; Jana, Atasi ; Colsh, Kelly ; Jennings, Cheryl ; Dragavon, Joan ; Rwakazina, Irene ; Newell, Matthew ; Kosmyna, Jan ; Riviere, Cynthia ; Smith, Davey M ; Greenfelder, Brian ; Hart, Phil A ; Fischer, William ; Smith, David ; Shahkolahi, Akbar ; Beck, Justine ; Greninger, Alexander L ; Patel, Nilam ; Giganti, Mark J ; Taiwo, Babafemi ; Eron, Joseph ; Perelson, Alan ; Gottesman, Joan ; Eron, Joseph J ; Fletcher, Courtney ; Cardoso, Sandra ; Coombs, Robert W ; Daar, Eric ; Currier, Judith ; Ritz, Justin ; Li, Jonathan Z ; Coombs, Robert ; Hosey, Lara ; Hughes, Michael ; Gapara, Morgan ; Moser, Carlee ; Javan, Arzhang Cyrus ; Roa, Jhoanna ; Wohl, David ; Ignacio, Rachel Bender ; Neytman, Gene ; Wohl, David A ; Sieg, Scott ; Pedersen, Susan ; Giganti, Mark
AbstractBackgroundCamostat inhibits severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in vitro. We studied the safety and efficacy of camostat in ACTIV-2/A5401, a phase 2/3 platform trial of therapeutics for COVID-19 in nonhospitalized adults.MethodsWe conducted a phase 2 study in adults with mild-to-moderate COVID-19 randomized to oral camostat for 7 days or a pooled placebo arm. Primary outcomes were time to improvement in COVID-19 symptoms through day 28, proportion of participants with SARS-CoV-2 RNA below the lower limit of quantification (LLoQ) from nasopharyngeal swabs through day 14, and grade ≥3 treatment-emergent adverse events (TEAEs) through day 28.ResultsOf 216 participants (109 randomized to camostat, 107 to placebo) who initiated study intervention, 45% reported ≤5 days of symptoms at study entry and 26% met the protocol definition of higher risk of progression to severe COVID-19. Median age was 37 years. Median time to symptom improvement was 9 days in both arms (P = .99). There were no significant differences in the proportion of participants with SARS-CoV-2 RNA <LLoQ on days 3, 7, and 14. Through day 28, 6 (5.6%) participants in the camostat arm and 5 (4.7%) in the placebo arm were hospitalized; 1 participant in the camostat arm subsequently died. Grade ≥3 TEAEs occurred in 10.1% of camostat versus 6.5% of placebo participants (P = .35).ConclusionsIn a phase 2 study of nonhospitalized adults with mild-to-moderate COVID-19, oral camostat did not accelerate viral clearance or time to symptom improvement, or reduce hospitalizations or deaths.Clinical Trials Registration. ClinicalTrials.gov identifier: NCT 04518410.