WE4YOU

Extra information on the WE4YOU video's

With the inclusion of new sites and countries, the REMAP-CAP family continues to grow. WE4YOU is a 45 minutes montly webinar on Wednesdays at 16:00 (Amsterdam time) to keep you up to date and exchange knowledge on all that is REMAP-CAP. A different topic is presented each webinar after which there is panel discussion where you can have your questions answered by REMAP-CAP experts.

We look forward to seeing you there! Contact us at eu.remap@umcutrecht.nl for any questions

About

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Contact

Europe University Medical Center, Utrecht Heidelberglaan 100 3584 CX, The Netherlands

Email: EU.remapcap@umcutrecht.nl

Tel: +31 88 75 551 96

Registration

REMAP-CAP ClinicalTrials.gov registration NCT02735707

REMAP-CAP EU Clinical Trials Register EudraCT number: 2015-002340-14

Funding and support

UMC Utrecht is the Sponsor for the trial in Europe and some countries outside Europe.

Sponsor is a consortium member in the project “Rapid European COVID-19 Emergency Research Response (RECOVER)” funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 101003589.

REMAPCAP Global website

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Summary of platform conclusions

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:

CORTICOSTEROID DOMAIN

Glucocorticoids improve outcomes for hospitalized patients with COVID-19. Published in the Journal of the American Medical Association (1). Results also included in the WHO meta-analysis published in JAMA on the same day (2).

COVID-19 IMMUNE MODULATION DOMAIN

Tocilizumab and sarilumab reduce mortality and prevent progression to invasive mechanical ventilation or ECMO in critically ill patients with COVID-19. Results published in the New England Journal of Medicine (5).
Tocilizumab and Sarilumab have reached the statistical trigger for equivalence and are the best interventions in the domain. This domain is paused while the full analysis of all interventions included in this domain, including Anakinra and Interferon-β1a, is being completed.

COVID-19 ANTI-COAGULATION DOMAIN

Therapeutic anticoagulation is futile, and possibly harmful, in critically ill patients with COVID-19. Conclusion from the multi-platform RCT collaboration between REMAP-CAP ATTACC and ACTIV-4, pre-print available from MedRxiv (3)
Therapeutic anticoagulation improves outcomes in hospitalized patients with COVID-19 who are not admitted to an ICU with organ support. Conclusion from the multi-platform RCT collaboration between REMAP-CAP, ATTACC and ACTIV-4, pre-print available from MedRxiv (4).

COVID-19 IMMUNOGLOBULIN DOMAIN

Convalescent plasma does not improve outcomes for critically ill patients with COVID-19. Shortly after this REMAP-CAP platform conclusion, the RECOVERY trial announced no significant difference in 28-day mortality in that trial. In light of these results, the REMAP-CAP ITSC decided to pause recruitment in the Moderate State of this domain.

COVID-19 ANTIVIRAL DOMAIN

Lopinavir/ritonavir does not improve outcomes for critically ill patients with COVID-19. The manuscript is in preparation.
Hydroxychloroquine does not improve outcomes, and potentially harms patients with COVID-19. Results available in a collaborative meta-analysis as a preprint (6).

1. Angus DC, Derde L, Al-Beidh F, Annane D, Arabi Y, Beane A, et al. Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial. Jama. 2020;324(13):1317-29.

2. The WHO Rapid Evidence Appraisal for COVID-19 Therapies Working Group. Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis. JAMA. 2020;324(13):1330-41.

3. The REMAP-CAP, ACTIV4-a, ATTACC Investigators, Zarychanski R. Therapeutic Anticoagulation in Critically Ill Patients with Covid-19 – Preliminary Report. medRxiv. 2021:2021.03.10.21252749.

4. Lawler PR, Goligher EC, Berger JS, Neal MD, McVerry BJ, Nicolau JC, et al. Therapeutic Anticoagulation in Non-Critically Ill Patients with Covid-19. medRxiv. 2021:2021.05.13.21256846.

5. The REMAP-CAP Investigators. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. New England Journal of Medicine. 2021;384(16):1491-502.

6. Axfors C, Schmitt AM, Janiaud P, Van’t Hooft J, Abd-Elsalam S, Abdo EF, et al. Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nat Commun. 2021;12(1):2349.

NEW WE4YOU available! REMAP-CAP platform: The road so far and yet to come.