Supporting delivery of the REMAP-CAP trial
Introduction to the REMAP-CAP trial at NUH
Dr Dan Harvey, Intensive Care Consultant and Principal Investigator for REMAP-CAP at NUH explains the way this trial is benefitting our patients.
The REMAP-CAP trial
This trial is the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia. It has been adapted to include research into potential treatments for COVID-19 infections. As part of this, five specific treatment areas have now been approved for research across over 260 sites worldwide:
Antiviral therapy: evaluating no antiviral therapy for COVID-19 (and no placebo), lopinavir/ritonavir (Kaletra), hydroxychloroquine, and the combination of hydroxychloroquine and lopinavir/ritonavir
Immune Modulation therapy: evaluating no immune-modulating therapy for COVID-19 (and no placebo), Interferon-beta-1a, interleukin-1 receptor antagonist (Anakinra), tocilizumab and sarilumab.
Antibody therapy: evaluating the use of convalescent plasma for COVID-19
Therapeutic anticoagulation: evaluating the use of low molecular-weight heparin or unfractionated heparin compared to standard pharmacologic thromboprophylaxis
Vitamin C: evaluating the use of high-dose vitamin C for patients with severe CAP including CAP caused by COVID-19
Additional interventions against COVID-19 are being considered and may be introduced.
Community Acquired Pneumonia
Community-acquired pneumonia (CAP) is a syndrome in which individuals who have not been hospitalised recently develop an acute infection of the lungs. Bacterial and viral infections are responsible for the vast majority of CAP.
CAP is a leading cause of death from infection globally, with lower respiratory tract infection implicated in approximately 3 million deaths in 2016. This makes it the fourth most common cause of death world-wide, and the leading cause of death in developing countries.
CAP that is severe enough to require admission to an Intensive Care Unit (ICU) is associated with substantial risk of mortality.