COVID后综合征治疗的随机适应性评估(RAPID):一项针对患者身体功能的COVID后综合征(PCS)治疗方案的多中心、随机、对照适应性平台试验的研究方案,包括第一干预特异性阑尾RAPID_REVIVE(降低PCS患者的炎症活性)。

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2025-08-19 DOI:10.1186/s13063-025-09008-0
Lisa Weipert, Ralph G Telgmann, Gabriele Anton, Thomas Asendorf, Irina Chaplinskaja-Sobol, Sandra Ciesek, Oliver A Cornely, Sonja Drescher, Carsten Finke, Tim Friede, Julia Groth, Sabine Hanß, Wolfgang Hoffmann, Cynthia Huber, Thomas Illig, Monika Kraus, Dagmar Krefting, Sebastian Kuhn, Andreas Muehler, Matthias Nauck, Jens Schaller, Ann-Cathrin Schmidt, Georg Schmidt, Birgit Sawitzki, Ralf Tostmann, Heike Valentin, Maria Vehreschild
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引用次数: 0

摘要

背景:大多数患者从严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)冠状病毒病2019 (COVID-19)中康复,无明显后遗症,但相当一部分患者会出现长期后果,这些后果被称为COVID后综合征(PCS)。尽管对PCS的治疗方案有广泛的考虑,并且开展了大量的试验,但目前只有很少的随机对照试验结果可获得。总之,有明显的医学需要确定治疗的PCS患者。方法:平台试验RAPID的主要目的是评估不同PCS治疗对患者整体身体功能的影响。RAPID被设计为一个主协议,它包含了这个自适应平台试验的所有通用信息。当前和未来研究的治疗方法在干预特异性附录(ISA)中有详细说明。本文介绍了第一个ISA, RAPID_REVIVE。主协议的一般部分就是这样命名的。RAPID_REVIVE是一项双盲、安慰剂对照、II期临床试验,评估使用维多氟迪慕钙(IMU-838)进行抗病毒PCS治疗。在初始阶段,患者按1:1的比例随机分配给45 mg/天的vidofludimus钙(前7天22.5 mg)或安慰剂,此后使用反应适应性随机化程序。试验包括筛选期7天,双盲治疗期56天,随访期28天。主要终点是通过sf -36生理功能量表(SF-36-PF)从基线到第56天测量的患者体内生理功能的变化。次要终点包括精神和身体健康、疲劳程度、精神障碍症状的严重程度和认知功能。讨论:PCS是全球卫生保健的一个主要问题,迫切需要确定治疗方案。目前,PCS患者处于一种没有循证治疗选择的情况,生活质量和精神健康往往受到严重损害。RAPID的目的是建立一个适应性平台试验方案,该方案将协调和加快临床试验,以评估不同潜在治疗PCS的有效性和安全性,目的是扩大非常有限的治疗PCS的证据基础。试验注册:欧盟临床试验注册(CTIS) ID: 2024-511628-16-00 (RAPID_REVIVE)。2024年3月18日注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Randomized adaptive assessment of post COVID syndrome treatments (RAPID): a study protocol for a multicenter, randomized, controlled adaptive platform trial of treatment options for Post Covid Syndrome (PCS) on patients physical function including the first intervention specific appendix RAPID_REVIVE (reducing inflammatory activity in patients with PCS).

Randomized adaptive assessment of post COVID syndrome treatments (RAPID): a study protocol for a multicenter, randomized, controlled adaptive platform trial of treatment options for Post Covid Syndrome (PCS) on patients physical function including the first intervention specific appendix RAPID_REVIVE (reducing inflammatory activity in patients with PCS).

Randomized adaptive assessment of post COVID syndrome treatments (RAPID): a study protocol for a multicenter, randomized, controlled adaptive platform trial of treatment options for Post Covid Syndrome (PCS) on patients physical function including the first intervention specific appendix RAPID_REVIVE (reducing inflammatory activity in patients with PCS).

Background: The majority of patients recovers from severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) coronavirus disease 2019 (COVID-19) without obvious sequelae, but a significant proportion suffers long-term consequences which have been termed post COVID syndrome (PCS). Despite a wide range of considerations on treatment options in PCS and a significant number of trials initiated, only very few results from randomized controlled trials are currently available. In conclusion, there is an evident medical need to identify treatments for patients with PCS.

Methods: The primary objective of the platform trial RAPID is to assess the impact of different PCS treatments on the overall physical function of patients. Designed as a master protocol, RAPID contains all information that is generic to this adaptive platform trial. Current and future study treatments are specified in intervention-specific appendices (ISA). The first ISA, RAPID_REVIVE is presented in this manuscript. General sections of the master protocol are named as such. RAPID_REVIVE is a double-blind, placebo-controlled, phase II clinical trial evaluating antiviral PCS treatment with vidofludimus calcium (IMU-838). Patients are randomized at a 1:1 ratio to 45 mg/day vidofludimus calcium (22.5 mg for the first 7 days) or placebo during an initialization phase and thereafter using a response-adaptive randomization procedure. The trial includes a screening period of 7 days, a double-blind treatment period of 56 days and a follow-up period of 28 days. The primary outcome is the intra-patient change in physical function measured by the Short Form-36 Physical Function (SF-36-PF) from baseline to day 56. Secondary endpoints include mental and physical health, intensity of fatigue, severity of mental disorder symptoms, and cognitive function.

Discussion: PCS is a major problem for global health care and the identification of treatment options is urgently needed. Currently, PCS patients are in a situation without evidence-based treatment options, and quality of life, and often mental health are significantly impaired. The purpose of RAPID is to establish an adaptive platform trial protocol which will concert and quicken clinical trials to evaluate the efficacy and safety of different potential treatments for PCS with the aim to expand the very limited evidence base for the treatment of PCS.

Trial registration: EU Clinical Trials Register (CTIS) ID: 2024-511628-16-00 (RAPID_REVIVE). Registered on 18.03.2024.

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来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
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