Using defibrotide to treat severe COVID-19 pneumonia

A Single-Arm Safety and Feasibility Study of Defibrotide for the Treatment of Severe COVID-19

Phase 2 Interventional Brigham and Women's Hospital · NCT04652115

This study is testing if the drug defibrotide can safely help hospitalized patients with severe COVID-19 pneumonia who need oxygen support.

Quick facts

PhasePhase 2
Study typeInterventional
Enrollment42 (estimated)
Ages18 Years to 100 Years
SexAll
SponsorBrigham and Women's Hospital Academic / other
Locations1 site (Boston, Massachusetts)
Trial IDNCT04652115 on ClinicalTrials.gov

What this trial studies

This study evaluates the safety and efficacy of defibrotide in patients with clinically severe COVID-19 pneumonia. It is a prospective, single-arm, two-cohort, phase 2 pilot study that includes hospitalized patients requiring oxygen support. The study will utilize a dose de-escalation design in one of the cohorts to assess the drug's safety profile and potential effectiveness in this patient population. The FDA-approved dosing regimen for defibrotide will be administered to participants.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with confirmed COVID-19 pneumonia requiring hospitalization and oxygen support.

Not a fit: Patients with clinically significant acute bleeding or those requiring multiple vasopressors for hemodynamic stability may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients suffering from severe COVID-19 pneumonia.

How similar studies have performed: While this approach is novel in the context of COVID-19, similar studies using defibrotide for other conditions have shown promise.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Age ≥18 years.
2. Active COVID-19 infection confirmed by positive SARS-CoV-2 PCR.
3. Radiographic evidence of bilateral pulmonary infiltrates.
4. A life expectancy of at least 24 hours.
5. Score of 4-7 on the WHO ordinal scale.
6. Prophylactic dose anticoagulation is allowed for enrollment into cohort 1. Therapeutic dose anticoagulation for active thrombosis, ECMO, and/or continuous renal replacement therapy (CRRT) is allowed for enrollment into cohort 2 if there is no evidence of bleeding after at least 24 hours of anticoagulation.
7. Patient or surrogate able to provide informed consent

Exclusion Criteria:

1. Clinically significant acute bleeding.
2. Concomitant use of thrombolytic therapy (e.g. t-PA).
3. Hemodynamic instability, defined as a requirement for \>1 vasopressor agent for enrollment into cohort 1, and a requirement for \>2 vasopressor agents for enrollment into cohort 2
4. Known allergy or hypersensitivity to DF.
5. Pregnant or lactating.

Where this trial is running

Boston, Massachusetts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Covid19
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.