REMAP-CAP is a randomised, embedded, multifactorial, adaptive platform trial for community-acquired pneumonia.
The purpose of this study is to evaluate the effect of a range of interventions to improve outcome of patients admitted to intensive care with community-acquired pneumonia.
In addition, REMAP-CAP provides and adaptive research platform for evaluation of multiple treatment modalities in the event of a respiratory pandemic resulting in critical illness.
REMAP-COVID is a sub-platform of REMAP-CAP that evaluates treatments specific to COVID-19.
Community-acquired pneumonia (CAP) that is of sufficient severity to require admission to an intensive care unit (ICU) is associated with substantial mortality.
Patients with pneumonia who are being treated in an ICU will receive therapy that consists of many different treatments, as many as 20 or 30. These treatments act together to treat both the infection and its effects on the body. When treating a patient, doctors choose from many different treatments, most of which are known or believed to be safe and effective. However, doctors don't always know which treatment option is the better one, as individuals or groups of individuals may respond differently. This study aims to help doctors understand which treatments work best.
This clinical study has been designed in a way that allows the information from patients already in the study to help new patients joining the study. Most studies aren't able to do that. REMAP-CAP has been designed to:
It is reasonable to presume that any pandemic respiratory infection of major significance to public health will manifest as life-threatening respiratory infection including Severe Acute Respiratory illness and severe Community Acquired Pneumonia (CAP) with concomitant admission to hospital, and for some patients, admission to an Intensive Care Unit (ICU). Previous pandemics and more localized outbreaks of respiratory emerging infections have resulted in severe CAP and ICU admission.
Previous pandemics and outbreaks of emerging infectious diseases have outlined the urgent need for evidence, preferably from Randomized Controlled Trials (RCTs), to guide best treatment. However, there are substantial challenges associated with being able to organize such trials when the time of onset of a pandemic and its exact nature are unpredictable. As an adaptive platform trial that enrolls patients during the interpandemic period, REMAP-CAP is ideally positioned to adapt, in the event of a respiratory pandemic, to evaluate existing treatments as well as novel approaches.
|Treatment||Clopidogrel, Lopinavir/Ritonavir, prasugrel, Aspirin, Tocilizumab, Anakinra, Vitamin C, Amoxicillin-clavulanate, Apremilast, Hydrocortisone, Simvastatin, ceftriaxone, hydroxychloroquine, Ticagrelor, ECCO2R, Ceftaroline, Amoxicillin Clavulanate, Piperacillin-tazobactam, Antibiotic A, Antibiotic B, Minimal distension, Maximal recruitment, Piperacillin tazobactam, Sarilumab, Moxifloxacin or Levofloxacin, Macrolide administered for 3 days, Macrolide administered for up to 14 days, Fixed-duration Hydrocortisone, Shock-dependent hydrocortisone, Macrolide administered for 3-5 days, Five-days oseltamivir, Ten-days oseltamivir, Hydroxychloroquine + lopinavir/ritonavir, Convalescent plasma, Interferon-β1a, Fixed-duration higher dose Hydrocortisone, Therapeutic Anticoagulation, Protocolised mechanical ventilation strategy, Eritoran|
|Clinical Study Identifier||NCT02735707|
|Last Modified on||18 October 2020|
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