for people ages 18 years and up (full criteria)
at San Diego, California and other locations
study started
completion around



Treatments are needed to improve outcomes among patients hospitalized for COVID-19, including direct-acting antiviral (DAA) agents to mitigate the pathology driven by ongoing viral replication. This trial will evaluate S-217622 (ensitrelvir), an anti-SARS-CoV2 3C-like protease inhibitor (PI) developed by Shionogi &; Co. Ltd.

The study design is a randomized, placebo-controlled, multi-center international clinical trial that will evaluate the clinical efficacy of ensitrelvir when given in addition to standard of care (SOC) for inpatients with COVID-19. The SOC will be determined by local established guidelines and may include additional DAA (e.g., remdesivir) and immunomodulatory treatment strategies. Certain SOC treatments will be pre-specified prior to randomization.

Official Title

Strategies and Treatments for Respiratory Infections & Viral Emergencies (STRIVE): Shionogi Protease Inhibitor


COVID-19, Respiratory Tract Infections, Emergencies, HIV Protease Inhibitors, Protease Inhibitors, Shionogi Protease Inhibitor (S-217622)


You can join if…

Open to people ages 18 years and up

  • Age ≥18 years.
  • Informed consent for trial participation.
  • Hospital admission (or boarding in an emergency department or other area awaiting hospital admission) with signs and/or symptoms of a respiratory infection.
  • Confirmation of SARS-CoV2 infection by nucleic acid test (NAT) or equivalent non- NAT test [list of approved tests is in the PIM] collected within the prior 14 days.
  • Onset of symptoms attributable to SARS-CoV2 infection occurred within 14 days before randomization.
  • Hospitalized for the management of COVID-19, with signs and/or symptoms suggestive of lower respiratory tract infection.

You CAN'T join if...

  • The patient is expected to be discharged from the hospital within the next 24 hours.
  • Medical condition other than the acute respiratory infection (and its manifestations) that is likely to result in death within 7 days of randomization.
  • Use of a strong CYP3A inducer within 14 days prior to enrollment
  • Moribund condition, defined as prior cardiac arrest during this hospitalization and life expectancy less than 48 hours of randomization.
  • Patient undergoing comfort care measures only such that treatment focuses on end-of- life symptom management over prolongation of life.
  • Expected inability or unwillingness to participate in study procedures.
  • In the opinion of the investigator, participation in a trial is not in the best interest of the patient.
  • Allergy to investigational agent or vehicle
  • Use of a concomitant medication that is contraindicated due to a drug-drug interaction with S-217622
  • Moderate to severe hepatic impairment (i.e., Child-Pugh class B or C) or acute liver failure.
  • Known estimated glomerular filtration rate (eGRF) <30 mL/min/1.73m 2
  • Continuous renal replacement therapy or chronic dialysis
  • Current pregnancy
  • Current breastfeeding and unwillingness to defer breastfeeding for 30 days after the last dose of investigational agent.
  • Women of child-bearing potential who are unwilling to abstain from sexual intercourse with men or practice appropriate contraception through 30 days from the last dose of the investigational agent.
  • Men who are unwilling to abstain from sexual intercourse with women of child- bearing potential or to use barrier contraception through 30 days from the last dose of the investigational agent.
  • Inability to take investigational agent in tablet form by mouth.


  • VA San Diego Healthcare System (Site 074-016) accepting new patients
    San Diego California 92161 United States
  • Hoag Memorial Hospital Presbyterian (Site 080-026) accepting new patients
    Newport Beach California 92663 United States


accepting new patients
Start Date
Completion Date
University of Minnesota
Phase 3 research study
Study Type
Expecting 1500 study participants
Last Updated