REMAP-CAP

Sites open

Global: 290  UK: 142

Patients randomised (all)

Global: 5250 UK: 3479

Patients randomised (COVID-19)

Global: 4475 UK: 3399

Individual COVID-19 site recruitment is available here. Last updated 14 January 2020 at 13:30.

What is this study about?

REMAP-CAP is an international (15 countries) adaptive platform trial in community acquired pneumonia, that was specifically designed to be employed in a pandemic to evaluate multiple interventions simultaneously in critically ill patients. In addition to recruiting patients with community acquired pneumonia who have been admitted to critical care, we are also recruiting patients with COVID-19 to understand optimal treatment strategies.

The trial is modular so that new domains (groups of similar treatment options) can be added over time.

COVID-19 treatment domains:

Ward and ICU

• Antiplatelet
  Three interventions: (1) No antiplatelet; (2) Asprin; (3) P2Y12 inhibitor (clopidogrel, prasugrel or ticagrelor)

Ward only

• Therapeutic anticoagulation
  Two interventions: (1) local standard venous thromboprophylaxis; (2) therapeutic anticoagulation with intravenous unfractionated heparin or subcutaneous low molecular weight heparin - no longer open for recruitment in 'severe state

ICU only

• immunomodulation
  Five interventions: (1) no immune modulation; (2) interferon beta 1a; (3) interleukin 1 receptor antagonist [anakinra]; (4 and 5) interleukin 6 inhibition [tocilizumab and sarilumab] - No immune modulation no longer open for recruitment (see press release regarding Tocilizumab)
• Immunoglobulin therapy
  Two interventions: (1) no immunoglobulin; (2) convalescent plasma
• Vitamin C
  Two interventions: (1) no vitamin C; (2) vitamin C
• Statin therapy
  Two interventions: (1) no statin therapy; (2) simvastatin
• Corticosteroids (three interventions: (1) no steroids; (2) steroids for 7 days (3) steroids if shock present) – no longer open for recruitment
• Antivirals Four interventions: (1) no antiviral; (2) lopinavir/ritonavir; (3) hydroxychloroquine; (4) lopinavir/ritonavir and hydroxychloroquine combination – no longer open for recruitment

Community Acquired Pneumonia treatment domains:

• Antibiotics
  Five interventions: (1) Ceftriaxone + Macrolide; (2) Moxifloxacin or Levofloxacin; (3) Piperacillin-tazobactam + Macrolide (4) Ceftaroline + Macrolide (5) Amoxicillin-clavulanate + Macrolide
• Macrolide duration
  Two interventions: (1) standard course (3-5 days); (2) extended course (14 days)
• Corticosteroids
  Three interventions: (1) no steroids; (2) steroids for 7 days (3) steroids if shock present
• Antivirals (influenza)
  Three interventions: (1) no antiviral for influenza; (2) Oseltamivir (5 days); (3) Oseltamivir (10 days)
• Vitamin C
  Two interventions: (1) no vitamin C; (2) vitamin C

 Further information can be found on the global REMAP-CAP website https://www.remapcap.org

 

Information for sites

Information is available for participating sites on set-up, randomisation, pharmacy arrangements and FAQs.