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Case study: REMAP-CAP: which treatments will save lives in intensive care?

More than 240 intensive care units in 14 countries are trialling more than 20 pneumonia treatments to save the lives of critically ill COVID-19 patients.

The trial, REMAP-CAP, is an adaptive clinical trial built to deliver fast results in a pandemic and is one of three key national trials identified by the United Kingdom government.

REMAP-CAP grew from the experience of a group of intensive care clinician researchers who were trying to save lives during the H1N1 influenza pandemic in 2009. The trial started recruitment in 2018 and switched to pandemic mode in February 2020.

The trial is working to identify interventions that can reduce both mortality and length of stay in intensive care.

A clinician can enrol a patient in under 5 minutes and they can choose from a range of treatment options customised for their intensive care unit.

The complexity is hidden ‘under the bonnet’, with Bayesian statistics driving the simultaneous trial of multiple interventions.

NHMRC supported the development of REMAP-CAP with initial funding of $4.4 million in 2015 (as OPTIMISE-CAP) and has provided additional COVID-related support of $25,000 via APPRISE.

Read more about REMAP-CAP at www.nhmrc.gov.au/about-us/news-centre/which-treatments-will-save-lives-icu.