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. 2022 Nov 17;12(11):e055205.
doi: 10.1136/bmjopen-2021-055205.

Prospective, randomised, parallel-group, open-label study to evaluate the effectiveness and safety of IMU-838, in combination with oseltamivir, in adults with COVID-19: the IONIC trial protocol

Kavi Sharma  1   2 , Lisa Berry  3 , Evangelos Vryonis  3 , Asad Ali  3 , Beatriz Lara  4 , Angela Noufaily  5 , Nicholas Parsons  6 , Christopher Bradley  3 , Becky Haley  3 , Maria Tabuso  3 , Ramesh P Arasaradnam  7   8
Affiliations

Prospective, randomised, parallel-group, open-label study to evaluate the effectiveness and safety of IMU-838, in combination with oseltamivir, in adults with COVID-19: the IONIC trial protocol

Kavi Sharma et al. BMJ Open. .

Abstract

Background: Globally, there is a scarcity of effective treatments for SARS-CoV-2 infections (causing COVID-19). Repurposing existing medications may offer the best hope for treating patients with COVID-19 to curb the pandemic. IMU-838 is a dihydroorotate dehydrogenase inhibitor, which is an effective mechanism for antiviral effects against respiratory viruses. When used synergistically with oseltamivir, therapeutic effects have been observed against influenza and SARS-CoV-2 in rodents. The IMU-838 and Oseltamivir in the Treatment of COVID-19 (IONIC) trial is a randomised controlled trial that will investigate whether time to clinical improvement in patients with COVID-19 is improved following a 14-day course of IMU-838+oseltamivir versus oseltamivir alone.

Methods: IONIC trial is an open-label study in which participants will be randomised 1:1 in two parallel arms: the intervention arm (IMU-838+oseltamivir) and the control arm (oseltamivir only). The primary outcome is time to clinical improvement; defined as the time from randomisation to a two-point improvement on WHO ordinal scale; discharge from hospital, or death (whichever occurs first). The study is sponsored by the University Hospitals Coventry and Warwickshire NHS Trust and funded by LifeArc.

Discussion: The IONIC protocol describes an overarching trial design to provide reliable evidence on the effectiveness of IMU-838 (vidofludimus calcium) when delivered in combination with an antiviral therapy (oseltamivir) (IONIC intervention) for confirmed or suspected COVID-19 infection in adult patients receiving usual standard of care.

Ethics and dissemination: This study has been independently reviewed and approved by Wales Research Ethics Committee. In addition, required regulatory approvals were received from Medicines and Healthcare products Regulatory Agency.

Trial registration number: EudraCT 2020-001805-21, ISRCTN53038326, NCT04516915.

Keywords: COVID-19; immunology; infectious diseases; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow of participants in trial. IONIC, IMU-838 and Oseltamivir in the Treatment of COVID-19.
Figure 2
Figure 2
Pharmacokinetic (PK) profile for 22.5 mg two times per day of IMU-838 over a 14-day treatment period.
See this image and copyright information in PMC

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