Article
作者: Jilg, Nikolaus ; Coombs, Robert W ; Jana, Atasi ; Szurgot, Bob ; Li, Jonathan Z ; Moser, Carlee ; Javan, Arzhang Cyrus ; Greninger, Alexander L ; Giganti, Mark J ; Currier, Judith S ; Neytman, Gene ; Hughes, Michael D ; Wohl, David A ; Eron, Joseph J ; Chew, Kara W ; Daar, Eric S ; Smith, Davey M ; Hoover, Keila ; Hart, Phil A ; Kantor, Amy
BACKGROUNDCamostat 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 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: NCT04518410.