REMAP-CAP, a long-term study established by Monash University researchers and backed by the European Union, is continuously updating the best set of treatments for COVID patients in intensive care.
The trial’s research into blood-thinning drugs, such as aspirin, found that they were not of much value as an acute treatment but, promisingly, COVID-19 patients given them were more likely to survive in the following three months.
The REMAP-CAP trial design delivers fast results by simultaneously evaluating multiple treatments. It was designed to tackle life-threatening pneumonia, which can overwhelm intensive care units during pandemics. It was initially a response to issues that arose during the 2009 swine flu pandemic. The team turned rapidly to the challenges for COVID patients in February 2020.
The design of REMAP-CAP makes it ideal in a pandemic as it can quickly assess many options, often finding the most optimal use of certain treatments.
“We need to identify interventions that can reduce mortality and reduce ICU length of stay,” says Professor Steve Webb, who is both an ICU clinician at the Royal Perth Hospital and a Monash University researcher.
“In the ICU a clinician can enrol a patient in less than five minutes, and they can choose from a smorgasbord of treatment options customised for their intensive care unit.”
The European Union was the first major supporter of REMAP-CAP, followed by Australia’s National Health and Medical Research Council, the Health Research Council of New Zealand, the Canadian Institutes of Health Research, the Irish Health Research Board, and the UK National Institute for Health Research.
REMAP-CAP’s Australian investigators include Steve Webb, Allen Cheng, and Alistair Nichol, all from Monash; Ed Litton (UWA); Jeff Presneill (University of Melbourne); and Peter Kruger (University of Queensland). They are working with leading clinicians and researchers from Canada, the US, Saudi Arabia, Germany, the Netherlands, France, Ireland, and the UK.
REMAP-CAP is an adaptive clinical trial built to deliver fast results in a pandemic
- 55 interventions tested
- With over 11,000 patients
- in over 360 hospitals across 21 countries