Among critically ill patients with COVID-19 randomized to receive one or more therapeutic interventions, treatment with an IL-6 receptor antagonist had a greater than 99.9% probability of improved 180-day mortality compared with the control group. Treatment with an antiplatelet had a 95.0% probability of improved 180-day mortality.
Administration of either tocilizumab or sarilumab was associated with lower 28-day all-cause mortality compared with usual care or placebo. The association is not dependent on the choice of interleukin-6 receptor antagonist.
Callum and Sam Spence are twins, but the way COVID-19 affected them was very different. Callum ended up on a ventilator in the ICU fighting for his life, while Sam was at home with aches and pains. Their dramatic experience, chronicled in the Irish Independent, led them to the REMAP-CAP trial.
In this trial, antiplatelet therapy met the prespecified criterion for futility in critically ill patients based on very similar outcomes for organ support–free days compared with control.
University Medical Center Utrecht
Heidelberglaan 100
3584 CX Utrecht
The Netherlands
Email:
EU.remapcap@umcutrecht.nl
REMAP-CAP ClinicalTrials.gov registration NCT02735707
REMAP-CAP EU Clinical Trials Register EUCT number: 2023-507889-89
REMAP-CAP is supported by the ECRAID-Base project which has received funding from the EU Horizon 2020 research and innovation programme (grant number 965313).
Inseparable to the design of this trial, platform conclusions are generated through frequent adaptive analyses as data accrues. To date, REMAP-CAP has contributed to the knowledge about the best treatment of COVID-19 with several results:
ACE2 RAS DOMAIN (27 Feb 2022)
Antiplatelet DOMAIN (23 Jun 2021)
CORTICOSTEROID DOMAIN
COVID-19 IMMUNE MODULATION DOMAIN
COVID-19 ANTI-COAGULATION DOMAIN
COVID-19 IMMUNOGLOBULIN DOMAIN
COVID-19 ANTIVIRAL DOMAIN
