Three members of the
COMMUNITY is a randomized, double-blind, placebo-controlled, adaptive platform trial that enables an array of therapeutic candidates to be studied in hospitalized COVID-19 patients.
With worldwide COVID-19 deaths exceeding one million and a resurgence of cases globally, life science companies are working urgently to identify treatments that can potentially reduce clinical severity of COVID-19 in hospitalized patients. COMMUNITY is the first platform trial designed and launched by members of the
'As this insidious virus rapidly spreads around the globe, doctors need options to treat hospitalized patients who are actively sick and experiencing a range of symptoms as the disease progresses,' said
COMMUNITY uses an adaptive design which allows for the addition, removal and simultaneous study of multiple therapeutic candidates during the course of the trial. Multiple candidates will be tested against a shared placebo-controlled arm. The design allows for a streamlined approach which may accelerate execution of the study and save time as we search for therapeutics in the fight against the pandemic. Immunomodulating therapies will be the first candidates to enter COMMUNITY. Other therapies may join in the future, such as antivirals.
The trial's design and global footprint were selected to address potential barriers in the study of COVID-19 therapeutics. This includes anticipating and activating trial sites to align with the rise and fall of COVID cases across geographic regions as well as streamlining an influx in trial-related inquiries faced by some hospitals and health systems. COMMUNITY will onboard global sites in
'COVID is not confined to one country, making it imperative that we share the challenges, successes and insights in real-time' said
Uncontrolled vascular and immune inflammatory responses have proven to be hallmark symptoms in patients facing severe COVID-19 infections. These patients may face increased risk of acute respiratory distress syndrome (ARDS), stroke and death. Initial therapies entering into COMMUNITY were selected based upon their potential to suppress or control the immune response or the resulting inflammation. None of these therapies have been approved by the FDA, EMA, or other health authorities for the treatment of COVID-19 or its symptoms and are still investigational. These include:
OTEZLA entered COMMUNITY this week. It is expected lanadelumab and zilucoplan will enter in the coming weeks. Other anti-viral, immunomodulating and vascular agents may enter in the coming months.
COMMUNITY is studying hospitalized COVID-19 patients. This includes confirmed COVID-19 patients who may require either ongoing medical care, supplemental oxygen, noninvasive ventilation or high-flow oxygen devices, or invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO). By enrolling both hospitalized Intensive Care Unit and non-Intensive Care Unit patients, the trial seeks to yield greater understanding of how therapeutic interventions may be used with hospitalized COVID-19 patients experiencing a range of symptoms.
About COMMUNITY
COMMUNITY is an adaptive, randomized, double-blind, placebo-controlled platform study designed to assess multiple candidates as a potential treatment for hospitalized patients with COVID-19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2). The focus of the trial is to identify an effective treatment(s) for hospitalized COVID-19 patients, who are Grade 2 to Grade 5 on a Clinical Severity Status 8-Point Ordinal Scale.
The primary endpoint of COMMUNITY is time to confirmed clinical recovery without being re-hospitalized through Day 29 based on the clinical severity status scale, which is defined as achieving a score of 6, 7, or 8. Key secondary endpoints are oxygen-free recovery, improvement from baseline or fit for discharge from baseline, and all-cause mortality.
Patients will be randomized equally to either the candidate agent plus the standard of care or a placebo plus standard of care in a double-blind fashion. Patients who are randomized to placebo plus standard of care will be subsequently randomized equally to a matching placebo corresponding to an available agent.
About the
Organized in
About Otezla (apremilast)
OTEZLA (apremilast) is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP). PDE4 inhibition results in increased intracellular cAMP levels, which is thought to indirectly modulate the production of inflammatory mediators. The specific mechanism(s) by which OTEZLA exerts its therapeutic action in patients is not well defined.
Otezla is currently approved for use in more than 50 countries as an oral treatment for inflammatory diseases such as psoriasis and psoriatic arthritis. By inhibiting PDE4, Otezla is thought to modulate the production of inflammatory cytokines and other mediators, which may prove helpful in inhibiting the inflammatory response associated with the signs, symptoms and pulmonary involvements observed in some COVID-19 patients.
About lanadelumab
Lanadelumab is a fully human monoclonal antibody that specifically binds and inhibits plasma kallikrein activity. Lanadelumab is produced in Chinese Hamster Ovary (CHO) cells by recombinant DNA technology.
Based on its mechanism of action, lanadelumab may prevent the pro-inflammatory effects of SARS-COV2 and the extravasation and accumulation of fluid within the lungs during a serious and prolonged COVID-19 illness by decreasing plasma kallikrein activity and regulating excess bradykinin signaling. In addition, lanadelumab-induced plasma kallikrein inhibition may help to reduce inflammation and coagulation driven by FXII, which is activated by plasma kallikrein through a positive feedback loop. An investigational intravenous administration of lanadelumab is being studied.
Lanadelumab (marketed under the tradename TAKHZYRO) is approved as a subcutaneous formulation for prophylaxis to prevent attacks of hereditary angioedema (
About Zilucoplan
Zilucoplan, an investigational drug product, is a once-daily self-administered, subcutaneous peptide inhibitor of C5 which is in Phase III development for the treatment of generalized Myasthenia Gravis (gMG). Zilucoplan is also being investigated in immune-mediated necrotizing myopathy (IMNM), amyotrophic lateral sclerosis (ALS) and other tissue-based complement-mediated disorders. Zilucoplan has not been approved by any regulatory authority for any indication.
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