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Khaitov M, Nikonova A, Kofiadi I, Shilovskiy I, Smirnov V, Elisytina O, Maerle A, Shatilov A, Shatilova A, Andreev S, Sergeev I, Trofimov D, Latysheva T, Ilyna N, Martynov A, Rabdano S, Ruzanova E, Savelev N, Pletiukhina I, Safi A, Ratnikov V, Gorelov V, Kaschenko V, Kucherenko N, Umarova I, Moskaleva S, Fabrichnikov S, Zuev O, Pavlov N, Kruchko D, Berzin I, Goryachev D, Merkulov V, Shipulin G, Udin S, Trukhin V, Valenta R, Skvortsova V. Treatment of COVID-19 patients with a SARS-CoV-2-specific siRNA-peptide dendrimer formulation. Allergy 2023. [PMID: 36721963 DOI: 10.1111/all.15663] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome corona virus (SARS-CoV-2) infection frequently causes severe and prolonged disease but only few specific treatments are available. We aimed to investigate safety and efficacy of a SARS-CoV-2-specific siRNA-peptide dendrimer formulation MIR 19® (siR-7-EM/KK-46) targeting a conserved sequence in known SARS-CoV-2 variants for treatment of COVID-19. METHODS We conducted an open-label, randomized, controlled multicenter phase II trial (NCT05184127) evaluating safety and efficacy of inhaled siR-7-EM/KK-46 (3.7 mg and 11.1 mg/day: low and high dose, respectively) in comparison with standard etiotropic drug treatment (control group) in patients hospitalized with moderate COVID-19 (N = 52 for each group). The primary endpoint was the time to clinical improvement according to predefined criteria within 14 days of randomization. RESULTS Patients from the low-dose group achieved the primary endpoint defined by simultaneous achievement of relief of fever, normalization of respiratory rate, reduction of coughing, and oxygen saturation of >95% for 48 h significantly earlier (median 6 days; 95% confidence interval [CI]: 5-7, HR 1.75, p = .0005) than patients from the control group (8 days; 95% CI: 7-10). No significant clinical efficacy was observed for the high-dose group. Adverse events were reported in 26 (50.00%), 25 (48.08%), and 28 (53.85%) patients from the low-, high-dose and control group, respectively. None of them were associated with siR-7-EM/KK-46. CONCLUSIONS siR-7-EM/KK-46, a SARS-CoV-2-specific siRNA-peptide dendrimer formulation is safe, well tolerated and significantly reduces time to clinical improvement in patients hospitalized with moderate COVID-19 compared to standard therapy in a randomized controlled trial.
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Affiliation(s)
- Musa Khaitov
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - Alexandra Nikonova
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia.,RUDN University, Moscow, Russia
| | - Ilya Kofiadi
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - Igor Shilovskiy
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Valeriy Smirnov
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Olga Elisytina
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia.,RUDN University, Moscow, Russia
| | - Artem Maerle
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Artem Shatilov
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Anastasia Shatilova
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Sergey Andreev
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Ilya Sergeev
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Dmitry Trofimov
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Tatyana Latysheva
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Natalia Ilyna
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Alexander Martynov
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia
| | - Sevastyan Rabdano
- Federal State Unitary Enterprise "The Saint Petersburg Scientific Research Institute of Vaccines and Serums and the Enterprise for the Production of Bacterial Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA of Russia), St. Petersburg, Russia
| | - Ellina Ruzanova
- Federal State Unitary Enterprise "The Saint Petersburg Scientific Research Institute of Vaccines and Serums and the Enterprise for the Production of Bacterial Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA of Russia), St. Petersburg, Russia
| | - Nikita Savelev
- Federal State Unitary Enterprise "The Saint Petersburg Scientific Research Institute of Vaccines and Serums and the Enterprise for the Production of Bacterial Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA of Russia), St. Petersburg, Russia
| | - Iuliia Pletiukhina
- Federal State Unitary Enterprise "The Saint Petersburg Scientific Research Institute of Vaccines and Serums and the Enterprise for the Production of Bacterial Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA of Russia), St. Petersburg, Russia
| | - Ariana Safi
- Federal State Unitary Enterprise "The Saint Petersburg Scientific Research Institute of Vaccines and Serums and the Enterprise for the Production of Bacterial Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA of Russia), St. Petersburg, Russia
| | - Vyacheslav Ratnikov
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Viktor Gorelov
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Viktor Kaschenko
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Natalya Kucherenko
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Irina Umarova
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Svetlana Moskaleva
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Sergei Fabrichnikov
- North-West District Scientific and Clinical Center named after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg, Russia
| | - Oleg Zuev
- Federal Clinical Center of High Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - Nikolai Pavlov
- Federal Clinical Center of High Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - Daria Kruchko
- Federal Medico-biological Agency of Russia (FMBA Russia), Moscow, Russia
| | - Igor Berzin
- Federal Medico-biological Agency of Russia (FMBA Russia), Moscow, Russia
| | - Dmitriy Goryachev
- Centre for Evaluation and Control of Finished Pharmaceutical Products, Federal State Budgetary Institution "Scientific Centre for Expert Evaluation of Medicinal Products" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vadim Merkulov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Centre for Evaluation and Control of Finished Pharmaceutical Products, Federal State Budgetary Institution "Scientific Centre for Expert Evaluation of Medicinal Products" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - German Shipulin
- Centre for Strategic Planning of FMBA of Russia Federal State Budgetary Institution "Centre for Strategic Planning and Management of Biomedical Health Risks" of the Federal Medical Biological Agency, Moscow, Russia
| | - Sergey Udin
- Centre for Strategic Planning of FMBA of Russia Federal State Budgetary Institution "Centre for Strategic Planning and Management of Biomedical Health Risks" of the Federal Medical Biological Agency, Moscow, Russia
| | - Victor Trukhin
- Federal State Unitary Enterprise "The Saint Petersburg Scientific Research Institute of Vaccines and Serums and the Enterprise for the Production of Bacterial Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA of Russia), St. Petersburg, Russia
| | - Rudolf Valenta
- National Research Center (NRC) Institute of Immunology Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Medical University of Vienna, Vienna, Austria.,Karl Landsteiner University of Healthcare, Krems, Austria
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