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.
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.
Hydroxycloroquine in COVID-19
See REMAP-CAPs response to the recent Lancet article regarding the use of hydroxycloroquine in COVID-19.
Registration
REMAP-CAP is registered at 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