REMAP-CAP

A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia






Sites open

Global: 327  UK: 143

Patients randomised (all)

Global: 8033 UK: 4687

Patients randomised (COVID-19)

Global: 7115 UK: 4593

Individual COVID-19 site recruitment is available here

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
:

ICU only

  • Vitamin C Two interventions: (1) no vitamin C; (2) vitamin C
  • Statin therapy Two interventions: (1) no statin therapy; (2) simvastatin
  • ACE-2 RAS Four interventions: (1) no RAS; (2) Angiotensin converting enzyme inhibitor (ACEi); (3) Angiotensin-II receptor blocker (ARB); (4) ARB in combination with DMX-200, a chemokine receptor-2 (CCR2) inhibitor
  • Anticoagulation No prior therapeutic anticoagulation - Two interventions: (1) Conventional low dose thromboprophylaxis; (2) Intermediate dose thromboprophylaxis  Prior therapeutic anticoagulation - Three interventions: (1) Conventional low dose thromboprophylaxis; (2) Intermediate dose thromboprophylaxis; (3) Continuation of therapeutic dose anticoagulation

 Domains closed/paused to 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

COVID-19
Summary of study results (19MAY2021)

COVID-19 Newsletter:

Information for sites

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

Chief Medical Officers' letter of support

REMAP-CAP has been named as one of the three national randomised trials in COVID-19. Please find the letter of support encouraging participation of all hospitals into these studies.

Registration

REMAP-CAP is registered NCT02735707
EudraCT number: 2015-002340-14

Funding and support

European Commission FP7: Platform foR European Preparedness Against (Re-)emerging Epidemics
Prioritised by the National Institute For Health Research as a COVID19 study

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