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


Sites open

Global: 359  UK: 143

Patients randomised (all)

Global: 11,122 UK: 5,632

Patients randomised (COVID-19)

Global: 9,772 UK: 5,513


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
  • Cysteamine Two interventions: (1) No cysteamine; (2) Cysteamine

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
  • Cysteamine Two interventions: (1) No cysteamine; (2) Cysteamine

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

Summary of study results (19MAY2021)

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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