- To evaluate the effect of hydroxychloroquine treatment on the endosomal TLR response in young and elderly healthy male volunteers- To evaluate the effect of hydroxychloroquine treatment on the general T and B cell activity (proliferation,…
ID
Source
Brief title
Condition
- Viral infectious disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Tolerability / safety endpoints
- Adverse events (AEs)
- Concomitant medication
- Vital signs
- ECG
Pharmacokinetic endpoints
- Hydroxychloroquine plasma concentration
- Hydroxychloroquine whole blood concentration
Pharmacodynamic endpoints
- Endosomal TLR responses
o TLR3-driven cytokine production
o TLR7-driven cytokine production
o TLR8-driven cytokine production
o TLR9-driven cytokine production
- T cell responses
o Proliferation
o Activation marker expression
o Cytokine production
- B cell responses
o Activation marker expression
o Proliferation
- Leukocyte differentiation
- Flow cytometry phenotyping of dendritic cells, monocytes, T cells and B cells
Secondary outcome
NA
Background summary
In December 2019, a novel coronavirus (SARS-CoV-2) emerged in China leading to
a global pandemic and subsequent urgent need for a proven prophylactic and
therapeutic drug to treat this infection. Currently there are no drugs
available to treat COVID-19, although many investigations for potential
treatments are under way. Hydroxychloroquine (HCQ) sulfate, a less toxic
derivative of a known antimalarial drug chloroquine (CQ), is currently used to
treat moderate to severe COVID-19 patients in the Netherlands. The in vitro
effect of HCQ on inhibition of SARS-CoV-2 replication has been investigated
with promising results both in a pre-treatment and treatment setting, and also
the first available clinical data show a beneficial effect on viral
elimination.
To study HCQ in a prophylactic and therapeutic setting for COVID-19, several
clinical trials are currently ongoing. From in vitro studies it is known that
HCQ inhibits the innate IFN response via blocking of endosomal TLRs or
lysosomal pH increase and subsequent T and B cell activity, which are essential
steps in the antiviral response. This seems to beneficial in COVID-19 patients
where the endosomal-TLR mediated immune response causes immunopathological
damage to the lung. But inhibition of the response could theoretically also
increase susceptibility to viral infections. This is especially relevant in the
elderly population as their IFN response is already reduced. In this clinical
study we therefore aim to provide mechanistic insight into the effects of HCQ
on general immunocompetence in young and elderly healthy volunteers which,
together with currently ongoing clinical trials evaluating the prophylactic and
therapeutic effect of HCQ on COVID-19 incidence, should guide future use of HCQ
in SARS-CoV-2 infections or other viral infections.
Study objective
- To evaluate the effect of hydroxychloroquine treatment on the endosomal TLR
response in young and elderly healthy male volunteers
- To evaluate the effect of hydroxychloroquine treatment on the general T and B
cell activity (proliferation, activation and cytokine production) in young and
elderly healthy male volunteers
- To compare the effect of hydroxychloroquine treatment on immuno-competence
(endosomal TLR response and general T and B cell activity) between young and
elderly healthy male volunteers
Study design
This is a randomized, placebo-controlled multiple dose study in young (18-30
years) and elderly (65-75 years) healthy male volunteers. Eligible participants
will be randomized to the active (hydroxychloroquine) or placebo group. Dosing
will be started on day 1 and continue for 5 days in total. Before, during and
after the treatment-period, the participants will regularly visit the CHDR for
safety checks and immune-competence measurements. 28 days after the start of
treatment, all participants will have a follow-up visit for a final check of
the safety endpoints.
Intervention
Hydroxychloroquine sulfate (Plaquenil) will be administered orally as a loading
dose of 800 mg (two times 400 mg) on day 1 and 400 mg QD from day 2 to 5. A
dose of 400 mg hydroxychloroquine sulfate contains 310 mg chloroquine base.
Study burden and risks
No medical benefit can be expected from this study for the participating
subjects.The study drug is a registered medicinal product for various diseases
and is currently used as treatment for COVID-19 in a similar dose and regimen.
The first study drug administration and administration at day 2 will be done in
the clinic under medical supervision. During the study the subjects will be
closely monitored for any adverse signs.
Zernikedreef 8
Leiden 2333CL
NL
Zernikedreef 8
Leiden 2333CL
NL
Listed location countries
Age
Inclusion criteria
1. Signed informed consent prior to any study-mandated procedure
2. Healthy male subjects, 18 to 30 years or 65 to 75 years of age, inclusive at
screening.
3. Body mass index (BMI) between 18 and 32 kg/m2, inclusive, and with a minimum
weight of 50 kg.
4. Has the ability to communicate well with the Investigator in the Dutch
language and willing to comply with the study restrictions.
Exclusion criteria
1. Known hypersensitivity reaction to chloroquine, hydroxychloroquine or
4-aminoquinolines;
2. Evidence of any active or chronic disease or condition that could interfere
with, or for which the treatment of might interfere with, the conduct of the
study, or that would pose an unacceptable risk to the subject in the opinion of
the investigator, following a detailed medical history (including a known
history of long QT syndrome, known history of retinal disease, G6PD deficiency,
porphyria, psoriasis, myasthenia gravis, liver disease, diabetes mellitus type
I and II, existing hearing loss and current or previous history of a relevant
psychiatric disorder i.e. major depressive disorder, bipolar disorder,
schizophrenia or another psychotic disorder or current of previous suicidality
irrespective of an associated psychiatric disorder);
3. Clinically significant abnormalities, as judged by the investigator, in
laboratory test results (including hepatic and renal panels, complete blood
count, chemistry panel and urinalysis). In the case of uncertain or
questionable results, tests performed during screening may be repeated before
randomization to confirm eligibility or judged to be clinically irrelevant for
healthy subjects;
4. Signs or symptoms of any active infection within two weeks prior to first
dosing.
5. Positive SARS-CoV-2 qPCR test pre-dose.
6. Positive Hepatitis B surface antigen (HBsAg), Hepatitis C antibody (HCV Ab),
or human immunodeficiency virus antibody (HIV Ab) at screening;
7. Systolic blood pressure (SBP) greater than 140 or less than 90 mm Hg, and
diastolic blood pressure (DBP) greater than 90 or less than 50 mm Hg and
considered to be of clinical relevance by the investigator;
8. Abnormal findings in the resting ECG, including but not limited to QTcF> 450
msec.
9. Use of any medications (prescription or over-the-counter [OTC]), within 14
days of study drug administration, or less than 5 half-lives (whichever is
longer). Exceptions will only be made if the rationale is clearly documented by
the investigator;
10. Participation in an investigational drug study (last dosing of previous
study was within 90 days prior to first dosing of this study);
11. History of abuse of addictive substances (alcohol, illegal substances) or
current use of more than 14 units alcohol per week, drug abuse, or regular user
of sedatives, hypnotics, tranquillizers, or any other addictive agent and
unable to abstain from alcohol use from at least 24 hours before every visit;
12. Positive test for drugs of abuse at screening or pre-dose. Drugs test may
be repeated;
13. Smoker of more than 10 cigarettes per week prior to screening or who use
tobacco products equivalent to more than 10 cigarettes per week and unable to
abstain from smoking from at least 7 days before first dosing until the last
return visit (day 10);
14. Any confirmed significant allergic reactions (urticaria or anaphylaxis)
against any drug, or multiple drug allergies (non-active hay fever is
acceptable);
15. Loss or donation of blood over 500 mL within three months prior to
screening or intention to donate blood or blood products during the study;
16. Any known factor, condition, or disease that might interfere with treatment
compliance, study conduct or interpretation of the results such as drug or
alcohol dependence or psychiatric disease.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2020-001912-11-NL |
CCMO | NL73816.056.20 |
OMON | NL-OMON22387 |