Title

A Triple Combination Antiviral Coronavirus Therapy (TriACT) for COVID-19
A Triple Combination Antiviral Coronavirus Therapy (TriACT) RCT Comparing Nitazoxanide, Ribavirin and Hydroxychloroquine vs. Placebo
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    7
New outpatient treatments for COVID-19 are urgently needed. There is some evidence that a combination of three medications currently used to treat other viral infections could be effective in fighting this new virus. The purpose of this trial is to evaluate the efficacy of Nitazoxanide (NTZ), Ribavirin (RBV) and Hydroxychloroquine (HCQ) versus placebo in participants with proven SARS-CoV-2 infection

The study will enroll 70 participants within the 7 days after having been diagnosed with coronavirus infection. The purpose is to determine if those randomized to 5-day dosing with the three medication combination have decreased viral load and severity of illness in the 10 days following treatment as compared to those taking placebo. Participants will be actively followed for 28 days.
Participants will be randomized into one of two treatment plans

Triple combination:

Nitazoxanide (500 mg po BID for day 1and then 500 mg BID for 4 days)
Ribavirin (600 mg po BID for day 1and then 400 mg BID for 4 days)
Hydroxychloroquine sulfate (400 mg po BID for day 1 and then 200 mg BID for 4 days)

No active Medication:

Placebo administered according to the above schedule

Viral load (qPCR via nasal swab) will be assessed at baseline (day 0) as well as at days 3, 6, and 10 to monitor response to antiviral treatment. Immune status will be determined by antibody testing of blood collected at baseline and day 28. Symptom questionnaires will be completed daily for 10 days and day 28.
Study Started
Dec 02
2020
Primary Completion
Jan 17
2021
Study Completion
Feb 04
2021
Results Posted
May 05
2022
Last Update
May 05
2022

Drug Nitazoxanide

Nitazoxanide (500 mg po BID for day 1and then 500 mg BID for 4 days)

Drug Placebo Nitazoxanide

Placebo Nitazoxanide (500 mg po BID for day 1and then 500 mg BID for 4 days)

Drug Ribavirin

Ribavirin (600 mg po BID for day 1and then 400 mg BID for 4 days)

Drug Placebo Ribavirin

Placebo Ribavirin (600 mg po BID for day 1and then 400 mg BID for 4 days)

Drug Hydroxychloroquine

Hydroxychloroquine sulfate (400 mg po BID for day 1 and then 200 mg BID for 4 days)

Drug Placebo Hydroxychloroquine

Placebo Hydroxychloroquine sulfate (400 mg po BID for day 1 and then 200 mg BID for 4 days)

Active Study Drug Active Comparator

5 day dosing of Nitazoxanide, Ribavirin & Hydroxychloroquine sulfate

Placebo Placebo Comparator

5 day dosing of placebo

Criteria

Inclusion Criteria:

Documented SARS-CoV-2 infection by qPCR assay performed within the past 7 days

Exclusion Criteria:

COVID-19 symptoms requiring hospitalization
PO2 < 92%
Short of breath at time of enrollment
Retinal eye disease
Known glucose-6 phosphate dehydrogenase (G-6-PD) deficiency
Known chronic kidney disease, stage - 5 or receiving dialysis

Current use of:

Class 3 AAD (amiodarone, dronaderone, dofetilide, sotalol)
Class 1A AAD (procainamide, quinidine, disopyramide)
Flecainide
SSRI: citalopram (Celexa), Escitalopram (Lexapro)
chlorpromazine
Cilostazol (Pletal)
Donepezil (Aricept)
Droperidol
Fluoconazole
Methadone
Ondansetron (Zofran)
Thioridazine
Macrolides (clarithromycin, erythromycin)
Fluroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)
Tamoxifen
Pregnancy or women who are breast feeding
Inability to tolerate oral medications
Allergy or prior adverse reaction to either hydroxychloroquine sulfate, ribavirin, or nitazoxanide
Allergy to adhesives
QTc interval > 450 mSEC for men and women
History of Torsade de Pointes VT or prior cardiac arrest or congenital long QT interval
Non-English-speaking

Summary

Active Study Drug

Placebo

All Events

Event Type Organ System Event Term

Rate of Decline in Viral Load Over the 10 Days After Randomization

qPCR measured via nasal swab

Active Study Drug

Placebo

Total

7
Participants

Age, Continuous

42
years (Mean)
Standard Deviation: 12.6

Race (NIH/OMB)

Sex: Female, Male

Overall Study

Active Study Drug

Placebo

Drop/Withdrawal Reasons

Active Study Drug