Early findings from the REMAP-CAP trial have shown that critically ill patients with Covid-19 treated with a drug that reduces inflammation by modifying the immune system have improved outcomes.
The REMAP-CAP trial looked at the effect of treatments on a combination of survival and length of time patients need support in an ICU.
The results show that treatment with the immune modulator, tocilizumab met an efficacy endpoint among critically ill patients with severe Covid-19, compared to patients who did not receive any immune modulation treatment.
Though the relative contribution of survival and reduced length of time needing organ support in ICU has not yet been analysed, the trial showed that patients receiving tocilizumab were more likely to improve compared to patients who received no immune modulator.
However, it is not yet known what the relative benefits of this medication are compared to other immune modulators. Data on this is expected in the coming weeks and months.
While the findings are yet to be peer-reviewed and published, due to the clinical implications for patients, the researchers have released findings and are now working to analyse and publish the full results as soon as possible.
“These early findings show that treatment with this immune-modulating drug [tocilizumab] is effective for critically ill Covid-19 patients in intensive care units,” says Professor Steve Webb, an intensive care specialist and Professor of Critical Care Research at Monash University – the global coordinating centre for the trial, which has been supported by the Minderoo Foundation and the National Health and Medical Research Council (NHMRC).
“When we have the results available from all participants, we hope our findings will offer clear guidance to clinicians for improving the outcomes of the sickest Covid-19 patients.”
Dr Lennie Derde, a consultant in Intensive Care Medicine at the University Medical Centre in Utrecht, the sponsor of the study in Europe, and the Immune Modulation Domain Specific Working Group Chair says that “this is an absolutely amazing result”.
“To have a second effective therapy for critically ill patients within months of the start of the pandemic is unprecedented,” continues Dr Derde.
“Specific targeting of the immune response is theoretically attractive, and now we have shown it works.”
With Minderoo a proud support of the REMAP-CAP trial, Dr Steve Burnell who leads Minderoo Foundation’s Covid-19 response says that “these latest findings … represent the second effective therapy for patients with serious Covid-19”.
“REMAP-CAP’s agility and flexibility are what makes it so innovative – its design enables researchers to collaborate, test and share data quickly.
“Australia is fortunate to currently have so few Covid-19 cases, but the pandemic continues to have a devastating impact in many countries.
“These latest results will ensure more critically ill patients around the world receive the life-saving treatments they need and, importantly, avoid treatments that do not help.”
About the trial
The REMAP-CAP trial began investigating treatments for Covid-19 in March 2020, enrolling hospitalised patients with either moderate or severe (requiring ICU care) Covid-19 disease.
The study design randomises patients to multiple combinations of treatments, enabling researchers to evaluate different treatments for Covid-19, including antivirals, drugs which modulate the immune response, and therapies that modulate or support other vital aspects of the body’s response to the virus.
In total, more than 2,000 patients in 15 countries have been enrolled at more than 260 hospitals worldwide and randomised to multiple treatment combinations.
The effects of interventions are assessed separately for moderate and severely ill patients.
For more about the REMAP-CAP trial, visit: remapcap.org.
