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


We are delighted to share with you that REMAP-CAP has been selected by the NIHR as the 
platform trial to evaluate therapeutic interventions for influenza! It is great that they have recognised all the fantastic work you have helped achieve with COVID-19 and now we can continue to use our exciting trial design to study flu in a wider population. 

Sites open

Global: 332  UK: 143

Patients randomised (all)

Global: 11,519 UK: 5,666

Patients randomised (COVID-19)

Global: 9,945 UK: 5,539


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.

Community Acquired Pneumonia treatment domains:

  • Antivirals (influenza) Three interventions: (1) No antiviral for influenza; (2) Oseltamivir (5 days); (3) Oseltamivir (10 days)
  • Corticosteroids Three interventions: (1) No steroids; (2) Steroids for 7 days (3) Steroids if shock present
  • 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)
  • Cysteamine Two interventions: (1) No cysteamine; (2) Cysteamine

Domains closed/paused to recruitment:

COVID-19 treatment domains:

ICU only

  • Anticoagulation 
    • No prior therapeutic anticoagulation - Two interventions: (1) Conventional low dose thromboprophylaxis; (2) Intermediate dose thromboprophylaxis 
    • Prior therapeutic anticoagulation - Two interventions (previously three): (1) Conventional low dose thromboprophylaxis; (2) Intermediate dose thromboprophylaxis
  • Cysteamine Two interventions: (1) No cysteamine; (2) Cysteamine

ICU and Ward

  • Updated Immunoglobulin Two interventions: (1) High titer convalescent plasma; (2) No immunoglobulin

Domains closed/paused to recruitment:

  • Continuation of therapeutic dose anticoagulation (1) Letter to sites 06JUL2022

Further information can be found on the global REMAP-CAP website

Summary of study results (19MAY2021)

Privacy Notice:-

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.


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 NIHR as a COVID19 study

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