Mushroom-based Product for COVID-19 (MACH19)

• ClinicalTrials.gov Identifier: NCT04667247
• Recruitment Status: Active, not recruiting
• First Posted: December 14, 2020
• Last Update Posted: November 2, 2022
• Sponsor: Gordon Saxe
• Collaborators: University of California, Los Angeles; University of California, Irvine
• Information provided by (Responsible Party): Gordon Saxe, University of California, San Diego

Study Description

Brief Summary:

This is a multi-center, randomized, double-blind, placebo-controlled clinical trial to evaluate two polypore mushrooms, Fomitopsis officinalis and Trametes versicolor (FoTv), to treat COVID-19-positive outpatients with mild-to-moderate symptoms assigned to self-quarantined and home management. The study aims to establish the safety and feasibility of the use of FoTv vs placebo in 66 total subjects.

Condition or disease	Intervention/treatment	Phase
COVID-19	Drug: FoTv	Phase 1; Phase 2

Detailed Description:

Despite biomedical advances, medical intervention for COVID-19 is largely limited to vaccinations and supportive care during the later stages of disease. While antiviral, anti-inflammatory, and antimalarial options have been explored for later stages of disease, fewer studies have been conducted on medications to reduce the risk of outpatient cases progressing to severe disease. Therefore, it is important that we broaden the search to include agents outside of our usual pharmacopeia. Integrative Medicine offers several promising therapeutics that are available today and warrant investigation.

Some of the botanicals used for their possible immune modulating functions include polypore mushrooms. Among these, Turkey Tail (Trametes versicolor) has a long history of use for its immune supporting properties. An RCT examining the effects of Trametes versicolor in breast cancer patients detected increases in lymphocyte counts and natural killer cell functional activity (Torkelson et al, 2012 and Benson et al, 2019) both of which are key to host COVID-19 response. Further investigations into other relevant mushroom species demonstrated that Agarikon (Fomitopsis officinalis) can strongly induce an array of differential cytokine responses associated with both immune-activation and resolution of host defense- induced inflammatory reactions (unpublished). This homeostatic effect deserves attention for COVID-19 given the high mortality rate associated with cytokine storm.

This is a multi-center, randomized, double blind, placebo-controlled clinical trial to evaluate two polypore mushrooms, Fomitopsis officinalis and Trametes versicolor (FoTv), to treat COVID-19-positive outpatients with mild-to-moderate symptoms assigned to self-quarantined and home management. This study aims to establish the safety and feasibility of the use of FoTv vs placebo in 66 total subjects. Subsequent trials will evaluate Chinese herbal medicine as well as the efficacy of FoTv in a larger study population.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 54 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Triple (Participant, Care Provider, Investigator)
• Primary Purpose: Treatment
• Official Title: Multicenter Double Blind, Placebo Controlled RCT of Fomitopsis Officinalis and Trametes Versicolor to Treat COVID-19
• Actual Study Start Date: December 3, 2020
• Actual Primary Completion Date: May 15, 2022
• Estimated Study Completion Date: December 1, 2022

Arms and Interventions

Arm	Intervention/treatment
Experimental: Mushrooms; Fomitopsis officinalis and Trametes versicolor	Drug: FoTv; 8 capsules three times a day for 14 consecutive days.; Other Name: Fomitopsis officinalis and Trametes versicolor
Placebo Comparator: Placebo; Organic brown rice	Drug: FoTv; 8 capsules three times a day for 14 consecutive days.; Other Name: Fomitopsis officinalis and Trametes versicolor

Outcome Measures

Primary Outcome Measures :

1. Adverse Events [ Time Frame: 2 months ]
   The safety of the study medication will be assessed by number and severity of participants with treatment-related adverse events as assessed by Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events Corrected Version 2.1 July 2017 between the two study arms.
2. Creatinine [ Time Frame: 2 months ]
   The safety of the study medication will also assessed by a comparison of the serum creatinine level of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients)
3. Aspartate transaminase [ Time Frame: 2 months ]
   The safety of the study medication will also assessed by a comparison of the aspartate transaminase of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients)
4. Alanine transaminase [ Time Frame: 2 months ]
   The safety of the study medication will also assessed by a comparison of the alanine transaminase of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients)
5. Prothrombin time [ Time Frame: 2 months ]
   The safety of the study medication will also assessed by a comparison of the prothrombin time of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients)
6. Partial Thromboplastin Time [ Time Frame: 2 months ]
   The safety of the study medication will also assessed by a comparison of the Partial Thromboplastin Time of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients)

Secondary Outcome Measures :

1. Duration of viral illness [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by duration of COVID-19 acute viral illness (as measured by fever and self-reported symptom scores)
2. Hospitalization rate [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by hospitalization rate.
3. ICU admission [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by ICU admission rate.
4. Ventilatory requirement [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by maximum ventilatory requirement during hospitalization, if applicable.
5. Lymphocyte count [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the lymphocyte count of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
6. Neutrophil count [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the neutrophil count of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
7. Ferritin [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the serum ferritin level of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
8. D-Dimer [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the serum d-dimer level of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
9. Lactate Dehydrogenase [ Time Frame: 6 months ]
   A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the serum Lactate Dehydrogenase level of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
10. C-Reactive Protein [ Time Frame: 6 months ]
    A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the serum C-Reactive Protein level of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
11. Troponin [ Time Frame: 6 months ]
    A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by comparing the serum troponin level of baseline laboratory data with end-of-treatment labs or on hospital admission labs (for hospitalized patients).
12. Mid-turbinate nasal swabs [ Time Frame: 6 months ]
    A secondary exploratory objective will be to evaluate COVID-19 severity among subjects in each of the two medication arms, compared with placebo, as ascertained by changes in the SARS CoV-2 viral loads among mid-turbinate nasal swabs taken on days 0, 4, 7 and 14.
13. Peripheral Blood Mononuclear Cell (PBMC) immune profiling [ Time Frame: 6 months ]
    A secondary exploratory objective will be to evaluate immune response to FoTv in the setting of COVID-19 infection by comparing the PBMC transcriptome between subjects in each of the two arms.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• Positive COVID-19 diagnosis within the prior 72 hours
• Age 18 years and older
• Women of childbearing potential must have a negative urine or serum hCG. Women of childbearing potential must have a negative serum pregnancy test at screening and agree to use contraception throughout the study period.
• Capable of documenting vitals, symptoms, and study product intake daily and communicating this information to the study team
• Willing to avoid alcohol, cannabis, and dairy products during the study period.

Exclusion Criteria:

• Any of the following symptoms which, according to the CDC, require hospitalization:

  1. Trouble breathing
  2. Persistent pain or pressure in the chest
  3. New confusion or inability to arouse
  4. Bluish lips or face
• Current use of investigational agents to prevent or treat COVID-19
• Known liver disease (ALT/AST >3x ULN or diagnosis of cirrhosis)
• Known renal disease (eGFR < 60 ml/min) or acute nephritis.
• Uncontrolled hypertension (SBP>140 or DBP>90 while on medications)
• Pregnant or breastfeeding women

Contacts and Locations

Locations

United States, California

University of California, Los Angeles

Los Angeles, California, United States, 90095

University of California, San Diego

San Diego, California, United States, 92093

Sponsors and Collaborators

Gordon Saxe

University of California, Los Angeles

University of California, Irvine

Investigators

• Principal Investigator: Andrew Shubov, MD; University of California, Los Angeles

More Information

• Responsible Party: Gordon Saxe, Director, Krupp Center for Integrative Research, University of California, San Diego
• ClinicalTrials.gov Identifier: NCT04667247
• Other Study ID Numbers: 200633-1a
• First Posted: December 14, 2020
• Last Update Posted: November 2, 2022
• Last Verified: April 2022

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

COVID-19; Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases