Trial Comparing High Versus Standard Dose Oseltamivir in Severe Influenza Infection in ICU (ROSII)
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Purpose
Primary Objectives:
The primary objective of the trial is to compare the antiviral efficacy of a 10 day course of standard (75 mg bid) and high-dose (225 mg bid) oseltamivir (or equivalent doses in mild-moderate renal failure) in the treatment of severe influenza infections.
The hypothesis is that high dose oseltamivir will increase the proportion of patients with negative reverse transcriptase (RT)-PCR detection of influenza viral RNA (and viral culture, at selected sites) at Day 5 post-treatment.
An important secondary objective of the trial, which reflects the main clinical objective, is to determine the difference in the numbers of ventilator days between the standard-dose and high-dose groups
| Condition | Intervention | Phase |
|---|---|---|
|
Influenza A Virus |
Drug: Oseltamivir |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Randomized, Double-Blinded Controlled Trial Comparing High vs Standard Dose Oseltamivir in Severe, Influenza Infection in ICU. "ROSII Study" |
- Negative reverse transcriptase (RT)-PCR detection of viral RNA in nasopharyngeal and tracheal aspirate (intubated) or oropharyngeal (non-intubated) samples at Day 5 among patients who require ICU admission due to respiratory distress. [ Time Frame: Day 5 on study ] [ Designated as safety issue: No ]
- Ventilator days up to 60 d (main clinical endpoint), [ Time Frame: 60 days ] [ Designated as safety issue: No ]
| Enrollment: | 59 |
| Study Start Date: | November 2009 |
| Study Completion Date: | May 2011 |
| Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Standard Oseltamivir dose 75 mg bid
Standard dosing
|
Drug: Oseltamivir
standard (75 mg bid) or high-dose (225 mg bid) oseltamivir
Other Name: Tamiflu
|
|
Experimental: High Dose Oseltamivir arm 225mg bid
High dose arm of the study
|
Drug: Oseltamivir
standard (75 mg bid) or high-dose (225 mg bid) oseltamivir
Other Name: Tamiflu
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 12 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients age 12 and older and 45 kg or more
- Suspected or confirmed influenza (Appendix A)
Requirement for ICU admission due to respiratory distress or critical illness defined as one of:
- Inspired oxygen need of >50% for at least 4 hours (For FiO2 for non-intubated patients see Appendix B)
- mechanical ventilation
- Patient is receiving inotrope or vasopressor
- Negative b-HCG test or negative bedside urine test pending a confirmatory b-HCG test for pregnancy in women of childbearing age (12-60 years of age) will allow study entry
Exclusion Criteria:
- Inability to obtain consent
- Patients receiving more than two doses of 150 mg or higher oseltamivir in 36 hours before study entry
- Patients having received more than 3 doses of 75 mg oseltamivir immediately in 36 hours before study entry
- Age less than 12 years, or age <16 and weight less than 45 kg
- Unlikely to absorb enteral study drug (e.g. patients with partial or complete mechanical bowel obstruction, intestinal ischemia, infarction, and short bowel syndrome)
- Known allergy or hypersensitivity to oseltamivir
- Pregnancy or breast feeding
- Previous enrollment in current study
- Concurrent involvement in an RCT examining an antiviral agent including other neuraminidase inhibitors, interferon-a and/or ribavirin
- Chronic renal failure requiring chronic hemodialysis
- Severe chronic liver disease (Child-Pugh Score 11-15)
- Anticipated death within 24 hours as judged by attending physician or local PI
- Patient carrying "do not intubate" order (a "no CPR" or "no defibrillate" or "no chest compressions" order alone is allowed)
Contacts and Locations| Canada, Manitoba | |
| Winnipeg Regional Health Authority; Health Sciences Centre | |
| Winnipeg, Manitoba, Canada, R3E 0Z3 | |
| Principal Investigator: | Anand Kumar, MD | University of Manitoba |
More Information
No publications provided
| Responsible Party: | Anand Kumar MD, Winnipeg Regional Health Authority; Health Sciences Centre |
| ClinicalTrials.gov Identifier: | NCT01010087 History of Changes |
| Other Study ID Numbers: | 133312 |
| Study First Received: | November 5, 2009 |
| Last Updated: | June 9, 2011 |
| Health Authority: | Canada: Health Canada |
Keywords provided by University of Manitoba:
|
patients admitted to ICU |
Additional relevant MeSH terms:
|
Influenza, Human Orthomyxoviridae Infections RNA Virus Infections Virus Diseases Respiratory Tract Infections Respiratory Tract Diseases Oseltamivir |
Antiviral Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on June 18, 2013