BMJ Open (Nov 2023)

Inhibition of bradykinin in SARS-CoV-2 infection: a randomised, double-blind trial of icatibant compared with placebo (ICASARS)

  • Daniel Francis McAuley,
  • Tunde Peto,
  • Melanie Bailey,
  • Dermot Linden,
  • Olivia Earley,
  • Hong Guo Parke,
  • Cliff Taggart,
  • Joe Kidney

DOI
https://doi.org/10.1136/bmjopen-2023-074726
Journal volume & issue
Vol. 13, no. 11

Abstract

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Methods and analysis In this study, hypoxic patients with COVID-19 with symptom onset ≤7 days will be randomised to either a bradykinin inhibitor (icatibant) or placebo. Patients and investigators will be blinded. The primary outcome will be blood oxygenation, measured by arterial blood sampling. The secondary outcome will be cardiovascular status. Retinal imaging will be performed to assess vessel size. Blood samples will be taken for measurement of inflammatory analyses including IL-6. As a separate substudy, we will also take comparator blood inflammatory samples from a COVID-19-negative cohort.Ethics and dissemination The study has received the following approvals: West Midlands–Edgbaston Research Ethics Committee. Medicines and Healthcare products Regulatory Agency has issued a clinical trial authorisation. Belfast Health and Social Care Trust is the study sponsor. Results will be made available to participants upon request and findings will be presented and published.Trial registration number NCT05407597