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Randomisert, innebygd, multifaktoriell adaptiv plattformprøve for fellesskapservervet lungebetennelse (REMAP-CAP)

30. oktober 2026 oppdatert av: Lennie Derde, UMC Utrecht

REMAP-CAP is a randomised, embedded, multifactorial, adaptive platform trial for community-acquired pneumonia.

The purpose of this study is to evaluate the effect of a range of interventions to improve outcome of hospitalised patients admitted to intensive care with respiratory tract infections.

In addition, REMAP-CAP provides and adaptive research platform for evaluation of multiple treatment modalities in the event of a respiratory pandemic such as COVID-19.

REMAP-COVID is a sub-platform of REMAP-CAP that evaluates treatments specific to COVID-19 in the United States of America.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Background: Respiratory tract infections that are of sufficient severity to require admission to hospital are associated with substantial mortality. All hospitalized patients with respiratory tract infections will receive therapy that consists of a combination of multiple different treatments. For many of these treatments, different options are available currently. For example, several antibiotics exist that are active against the microorganisms that commonly cause pneumonia but it is not known if one antibiotic strategy is best, or whether all suitable antibiotic strategies have similar levels of effectiveness. Of all the treatments that clinicians use for patients with respiratory tract infections, only a small minority have been tested in randomized controlled trials to determine their comparative effectiveness. As a consequence, the standard treatments that are administered vary between and within countries. Current conventional clinical trials methods to assess the efficacy of treatments for respiratory tract infections generally compare two treatment options (either two options for the same treatment modality, where both are in common use; or a new treatment against no treatment or placebo, where the effectiveness of the new treatment is not known). Using this approach, in a series of separate and sequential trials, it will take an inordinate length of time to study all the treatment options. Additionally, with conventional trial designs it is not possible to evaluate interactions between treatment options.

Aim: The primary objective of this platform trial is, for patients hospitalized with respiratory tract infection, to identify the effect of a range of interventions to improve patient outcomes.

Methods: The study will enroll hospitalized patients with respiratory tract infection using a trial design known as a REMAP, which is a type of platform trial. Within this platform trial, eligible participants will be randomized to receive one intervention in each of one or more domains. The primary outcome is a composite of 90-day all-cause mortality and, among survivors, a daily ordinal scale analyzed as a trajectory of illness and recovery to 28-days. There will also be both Platform and domain-specific secondary outcome measures.

In a conventional trial enrollment continues until a pre-specified sample size is obtained, at which time enrollment ceases and the trial data are analyzed to obtain a result. The possible results are that a difference is detected, or no that no difference is detected. However, when the conclusion of the statistical test is "no difference", this could reflect that there truly is no meaningful difference or that the result is indeterminate (i.e., it is possible that if more patients had been enrolled a clinically relevant difference may have been detected).

In comparison to a conventional trial this Platform uses an adaptive design that:

avoids indeterminate results by concluding an answer to a question when sufficient data have accrued (not when a pre-specified sample is reached);
utilizes already accrued data to increase the likelihood that patients within the trial are more likely to be randomized to treatments that are more likely to be beneficial;
is intended to be perpetual (or at least open-ended), substituting new questions in series as initial questions are answered; and
can evaluate the interaction between interventions in different domains, added at different timepoints into the Platform.

Bayesian statistical methods will be used to define Statistical Triggers that reflect thresholds for decision making within a domain. While a limited number of initial treatments and treatment domains were specified at initiation, other interventions and domains have been evaluated over time, and it is planned that this platform trial will continue to evaluate other treatments in the future. Furthermore, in the event of a future epidemic, this Platform is able to adapt to evaluate the most relevant treatment options.

Studietype

Intervensjonell

Registrering (Antatt)

20000

Fase

Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Navn: Cameron Green, MSc
E-post: info@remapcap.org

Studer Kontakt Backup

Navn: Svenja Peters, MSc
E-post: EU.remapcap@umcutrecht.nl

Studiesteder

Australia
- Australian Capital Territory
  - Canberra, Australian Capital Territory, Australia, 2605
    - Rekruttering
    - Canberra Hospital
- New South Wales
  - Bankstown, New South Wales, Australia, 2200
    - Rekruttering
    - Bankstown-Lidcombe Hospital
  - Blacktown, New South Wales, Australia, 2148
    - Rekruttering
    - Blacktown Hospital
  - Campbelltown, New South Wales, Australia, 2560
    - Rekruttering
    - Campbelltown Hospital
  - Caringbah, New South Wales, Australia, 2229
    - Rekruttering
    - Sutherland Hospital
  - Concord, New South Wales, Australia, 2139
    - Rekruttering
    - Concord Hospital
  - Dubbo, New South Wales, Australia, 2830
    - Rekruttering
    - Dubbo Base Hospital
  - Frenchs Forest, New South Wales, Australia, 2086
    - Rekruttering
    - Northern Beaches Hospital
  - Kingswood, New South Wales, Australia, 2750
    - Rekruttering
    - Nepean Hospital
  - Kogarah, New South Wales, Australia, 2217
    - Rekruttering
    - St. George Hospital
  - Liverpool, New South Wales, Australia, 2170
    - Rekruttering
    - Liverpool Hospital
  - Newcastle, New South Wales, Australia, 2305
    - Rekruttering
    - John Hunter Hospital
  - Orange, New South Wales, Australia, 2800
    - Har ikke rekruttert ennå
    - Orange Health Service
  - Sydney, New South Wales, Australia, 2065
    - Rekruttering
    - Royal North Shore Hospital
  - Sydney, New South Wales, Australia, 2010
    - Rekruttering
    - St Vincent's Hospital Sydney
  - Sydney, New South Wales, Australia, 2031
    - Rekruttering
    - Prince of Wales Hospital
  - Sydney, New South Wales, Australia, 2050
    - Har ikke rekruttert ennå
    - Royal Prince Alfred Hospital
  - Sydney, New South Wales, Australia, 2500
    - Rekruttering
    - Wollongong Hospital
  - Wagga Wagga, New South Wales, Australia, 2650
    - Har ikke rekruttert ennå
    - Wagga Wagga Base Hospital
  - Westmead, New South Wales, Australia, 2145
    - Rekruttering
    - Westmead Hospital
- Northern Territory
  - Darwin, Northern Territory, Australia, 0810
    - Har ikke rekruttert ennå
    - Royal Darwin Hospital,
- Queensland
  - Birtinya, Queensland, Australia, 4575
    - Har ikke rekruttert ennå
    - Sunshine Coast University Hospital
  - Brisbane, Queensland, Australia, 4102
    - Rekruttering
    - Princess Alexandra Hospital
  - Brisbane, Queensland, Australia, 4032
    - Rekruttering
    - The Prince Charles Hospital
  - Brisbane, Queensland, Australia, 4101
    - Rekruttering
    - Mater Hospital Brisbane
  - Caboolture, Queensland, Australia, 4510
    - Rekruttering
    - Caboolture Hospital
  - Coopers Plains, Queensland, Australia, 4110
    - Rekruttering
    - Queen Elizabeth II Jubilee Hospital
  - Logan City, Queensland, Australia, 4129
    - Har ikke rekruttert ennå
    - Logan Hospital
  - Redcliffe, Queensland, Australia, 4020
    - Har ikke rekruttert ennå
    - Redcliffe Hospital
  - Rockhampton, Queensland, Australia, 4700
    - Har ikke rekruttert ennå
    - Rockhampton Hospital
  - Southport, Queensland, Australia, 4215
    - Rekruttering
    - Gold Coast University Hospital
  - Toowoomba, Queensland, Australia, 4350
    - Rekruttering
    - Toowoomba Hospital
  - Townsville, Queensland, Australia, 4814
    - Rekruttering
    - Townsville Hospital
- South Australia
  - Adelaide, South Australia, Australia, 5000
    - Rekruttering
    - Royal Adelaide Hospital
  - Adelaide, South Australia, Australia, 5011
    - Rekruttering
    - The Queen Elizabeth Hospital
  - Adelaide, South Australia, Australia, 5112
    - Rekruttering
    - Lyell McEwin Hospital
  - Bedford Park, South Australia, Australia, 5042
    - Rekruttering
    - Flinders Medical Centre
- Tasmania
  - Launceston, Tasmania, Australia, 7250
    - Rekruttering
    - Launceston Hospital
- Victoria
  - Ballarat, Victoria, Australia, 3350
    - Rekruttering
    - Ballarat Base Hospital
  - Bendigo, Victoria, Australia, 3550
    - Rekruttering
    - Bendigo Hospital
  - Berwick, Victoria, Australia, 3806
    - Rekruttering
    - Casey Hospital
  - Box Hill, Victoria, Australia, 3128
    - Rekruttering
    - Box Hill Hospital
  - Clayton, Victoria, Australia, 3168
    - Rekruttering
    - Monash Medical Centre
  - Dandenong, Victoria, Australia, 3175
    - Rekruttering
    - Dandenong Hospital
  - Ferntree Gully, Victoria, Australia, 3156
    - Har ikke rekruttert ennå
    - Angliss Hospital
  - Footscray, Victoria, Australia, 3011
    - Rekruttering
    - Footscray Hospital
  - Geelong, Victoria, Australia, 3220
    - Rekruttering
    - University Hosptial Geelong
  - Melbourne, Victoria, Australia, 3004
    - Rekruttering
    - The Alfred Hospital
  - Melbourne, Victoria, Australia, 3050
    - Rekruttering
    - Royal Melbourne Hospital
  - Melbourne, Victoria, Australia, 3065
    - Rekruttering
    - St Vincent's Hospital Melbourne
  - Ringwood East, Victoria, Australia, 3135
    - Rekruttering
    - Maroondah Hospital
  - Sunshine, Victoria, Australia, 3021
    - Rekruttering
    - Sunshine Hospital
  - Werribee, Victoria, Australia, 3030
    - Rekruttering
    - Werribee Mercy Hospital
- Western Australia
  - Midland, Western Australia, Australia, 6056
    - Rekruttering
    - St John of God Hospital Midland
  - Murdoch, Western Australia, Australia, 6150
    - Har ikke rekruttert ennå
    - St John of God Hospital Murdoch
  - Perth, Western Australia, Australia, 6000
    - Rekruttering
    - Royal Perth Hospital
  - Perth, Western Australia, Australia, 6150
    - Rekruttering
    - Fiona Stanley Hospital
  - Perth, Western Australia, Australia, 6009
    - Rekruttering
    - Sir Charles Gairdner Hospital
  - Subiaco, Western Australia, Australia, 6008
    - Rekruttering
    - St John of God Subiaco
Belgia
- - Charleroi, Belgia, 6042
    - Rekruttering
    - CHU de Charleroi - Hôpital Civil Marie Curie
    - Ta kontakt med:
      
      Patrick Biston, MD
  - Ghent, Belgia, 9000
    - Rekruttering
    - Universitair Ziekenhuis Gent
    - Ta kontakt med:
      
      Pieter Depuydt, Prof.
  - Namur, Belgia, 5530
    - Rekruttering
    - CHU Namur site Godinne
    - Ta kontakt med:
      
      Pierre Bulpa, MD
Canada
- Alberta
  - Calgary, Alberta, Canada, T2W 1S7
    - Aktiv, ikke rekrutterende
    - Foothills Medical Centre
  - Calgary, Alberta, Canada, T2W 1S7
    - Aktiv, ikke rekrutterende
    - Peter Lougheed Centre
  - Calgary, Alberta, Canada, T2W 1S7
    - Aktiv, ikke rekrutterende
    - Rockyview General Hospital
  - Calgary, Alberta, Canada, T2W 1S7
    - Aktiv, ikke rekrutterende
    - South Health Campus
  - Edmonton, Alberta, Canada, T5H 3V9
    - Rekruttering
    - Royal Alexandra Hospital, Alberta
    - Ta kontakt med:
      
      Demetrios Kutsogiannis, MD
  - Edmonton, Alberta, Canada, T6G 2C8
    - Rekruttering
    - University of Alberta Hospital
    - Ta kontakt med:
      
      Wendy Sligl, MD
- British Columbia
  - Surrey, British Columbia, Canada, V3V 1Z2
    - Har ikke rekruttert ennå
    - Surrey Memorial Hospital
    - Ta kontakt med:
      
      Anish Mitra, MD
- Manitoba
  - Winnipeg, Manitoba, Canada, R3A 1R9
    - Rekruttering
    - Health Sciences Centre Winnipeg
    - Ta kontakt med:
      
      Ryan Zarychanski, MD
  - Winnipeg, Manitoba, Canada, R2H 2A6
    - Rekruttering
    - St Boniface General Hospital
    - Ta kontakt med:
      
      Ryan Zarychanski, MD
  - Winnipeg, Manitoba, Canada, R3J 3M7
    - Rekruttering
    - Grace Hospital
    - Ta kontakt med:
      
      Gloria Vazquez-Grande, MD
- New Brunswick
  - Fredericton, New Brunswick, Canada, E3B 4R3
    - Har ikke rekruttert ennå
    - Dr. Everett Chalmers Regional Hospital
    - Ta kontakt med:
      
      Zeeshan Aslam, MD
  - Fredericton, New Brunswick, Canada, E3B 4R3
    - Har ikke rekruttert ennå
    - The Moncton Hospital
    - Ta kontakt med:
      
      Daniel Smyth, MD
  - Fredericton, New Brunswick, Canada, E3B 4R3
    - Har ikke rekruttert ennå
    - The Saint John General Hospital
    - Ta kontakt med:
      
      Stephen Robinson, MD
- Ontario
  - Brampton, Ontario, Canada, L6R 3J7
    - Rekruttering
    - William Osler Health System
    - Ta kontakt med:
      
      Alexandra Binnie, MD
  - Brantford, Ontario, Canada, N3R 1G9
    - Rekruttering
    - Brantford General Hospital
    - Ta kontakt med:
      
      Brenda Reeve, MD
  - Hamilton, Ontario, Canada, L8N 4A6
    - Rekruttering
    - St. Joseph's Healthcare Hamilton
    - Ta kontakt med:
      
      Deborah Cook, MD
  - Hamilton, Ontario, Canada, L8L 8E7
    - Rekruttering
    - Juravinski Hospital
    - Ta kontakt med:
      
      Bram Rochwerg, MD
  - Hamilton, Ontario, Canada, L8L 8E7
    - Rekruttering
    - Hamilton general Hospital
    - Ta kontakt med:
      
      Alison Fox-Robichaud, MD
  - Kingston, Ontario, Canada, K7L 2V7
    - Aktiv, ikke rekrutterende
    - Kingston Health Sciences Centre
  - Kitchener, Ontario, Canada, N2G 4K9
    - Rekruttering
    - Grand River Hospital
    - Ta kontakt med:
      
      Theresa Liu, MD
  - Kitchener, Ontario, Canada, N2M 1B2
    - Rekruttering
    - St Mary's General Hospital
    - Ta kontakt med:
      
      Rebecca Kruisselbrink, MD
  - Ottawa, Ontario, Canada, K1H 8L6
    - Rekruttering
    - The Ottawa Hospital
    - Ta kontakt med:
      
      Lauralyn McIntyre, MD
  - Saint Catharines, Ontario, Canada, L2S 0A9
    - Rekruttering
    - Niagara Health
    - Ta kontakt med:
      
      Jennifer Tsang, MD
  - Thunder Bay, Ontario, Canada, P7B 6V4
    - Aktiv, ikke rekrutterende
    - Thunder Bay General Hospital
  - Toronto, Ontario, Canada, M5G 2C4
    - Rekruttering
    - Toronto General Hospital
    - Ta kontakt med:
      
      Lorenzo del Sorbo, MD
  - Toronto, Ontario, Canada, M4N 3M5
    - Rekruttering
    - Sunnybrook Health Sciences Centre
    - Ta kontakt med:
      
      Rob Fowler, MD
  - Toronto, Ontario, Canada, M5T 2S8
    - Rekruttering
    - Toronto Western Hospital
    - Ta kontakt med:
      
      Elizabeth Wilcox, MD
  - Toronto, Ontario, Canada, M5G 1X5
    - Rekruttering
    - Mount Sinai Hospital
    - Ta kontakt med:
      
      Sangeeta Mehta, MD
  - Toronto, Ontario, Canada, M5B 1W8
    - Rekruttering
    - St. Michael's Hospital Unity Health Toronto
    - Ta kontakt med:
      
      John Marshall, MD
  - Toronto, Ontario, Canada, M6R 1B5
    - Aktiv, ikke rekrutterende
    - St Joseph's Health Centre
- Quebec
  - Lévis, Quebec, Canada, G6V 3Z1
    - Har ikke rekruttert ennå
    - CIUSS Chaudieres-Appalaches (Levis)
    - Ta kontakt med:
      
      Patrick Archambault, MD
  - Montreal, Quebec, Canada, H3H 2R9
    - Rekruttering
    - McGill University Health Centre
    - Ta kontakt med:
      
      Kosar Khwaja, MD
  - Montreal, Quebec, Canada, H2X 0A9
    - Rekruttering
    - Centre Hospitalier de l'Universite de Montreal
    - Ta kontakt med:
      
      Michael Chasse, MD
  - Montreal, Quebec, Canada, H1T 2M4
    - Aktiv, ikke rekrutterende
    - Hospital Maisonneuve-Rosemont
  - Montreal, Quebec, Canada, H2B 1K3
    - Har ikke rekruttert ennå
    - Hôpital Fleury
    - Ta kontakt med:
      
      Thomas Hemmerling, MD
  - Montreal, Quebec, Canada, H4J 1C5
    - Rekruttering
    - Hopital du Sacre-Coeur de Montreal
    - Ta kontakt med:
      
      Martin Albert, MD
  - Québec, Quebec, Canada, G1V 4G5
    - Rekruttering
    - IUCPQ-UL
    - Ta kontakt med:
      
      Francois Lellouche, MD
  - Québec, Quebec, Canada, G1R 2J6
    - Rekruttering
    - CHU de Québec - Université Laval
    - Ta kontakt med:
      
      Alexis Turgeon, MD
  - Sherbrooke, Quebec, Canada, J1J 3H5
    - Rekruttering
    - Centre Hospitalier de l'Université de Sherbrooke
    - Ta kontakt med:
      
      Francois Lamontagne, MD
- Saskatchewan
  - Saskatoon, Saskatchewan, Canada, S7K 0M7
    - Rekruttering
    - Regina General Hospital
    - Ta kontakt med:
      
      Eric Sy, MD
Colombia
- Cundinamarca
  - Chía, Cundinamarca, Colombia
    - Rekruttering
    - Universidad de La Sabana
Estland
- - Tartu, Estland, 50406
    - Suspendert
    - Tartu University Hospital
Finland
- - Helsinki, Finland, 00290
    - Suspendert
    - Helsinki University Hospital
  - Tampere, Finland, 33520
    - Suspendert
    - Tampere University Hospital
Forente stater
- Florida
  - Jacksonville, Florida, Forente stater, 32209
    - Rekruttering
    - University of Florida
    - Ta kontakt med:
      
      Hadi Hatoum, MD
- Georgia
  - Augusta, Georgia, Forente stater, 30912
    - Har ikke rekruttert ennå
    - Augusta University
    - Ta kontakt med:
      
      Jose Vazquez, MD
- Illinois
  - Chicago, Illinois, Forente stater, 60612
    - Rekruttering
    - University of Illinois Health
    - Ta kontakt med:
      
      Jeffrey Jacobson, MD
- Louisiana
  - New Orleans, Louisiana, Forente stater, 70112
    - Har ikke rekruttert ennå
    - Tulane Medical Center
    - Ta kontakt med:
      
      Joshua Denson, MD
- Michigan
  - Ann Arbor, Michigan, Forente stater, 48109
    - Rekruttering
    - University of Michigan
    - Ta kontakt med:
      
      Robert Hyzy, MD
- New York
  - New York, New York, Forente stater, 10065
    - Rekruttering
    - Memorial Sloan Kettering Cancer Center
    - Ta kontakt med:
      
      Stephen Pastores, MD
- North Carolina
  - Winston-Salem, North Carolina, Forente stater, 27157-1009
    - Har ikke rekruttert ennå
    - Wake Forest Baptist Health
    - Ta kontakt med:
      
      Ashish Khanna, MD
- Ohio
  - Columbus, Ohio, Forente stater, 43210
    - Rekruttering
    - The Ohio State University Wexner Medical Center
    - Ta kontakt med:
      
      Matthew Exline, MD
- Oregon
  - Portland, Oregon, Forente stater, 97239-3098
    - Rekruttering
    - Oregon Health and Science University
    - Ta kontakt med:
      
      Akram Khankhana, MD
- Pennsylvania
  - Pittsburgh, Pennsylvania, Forente stater
    - Rekruttering
    - University of Pittsburgh Medical Centre
    - Ta kontakt med:
      
      Stephanie Mongomery
- Rhode Island
  - Providence, Rhode Island, Forente stater, 02903
    - Har ikke rekruttert ennå
    - Brown University - Rhode Island Hospital
    - Ta kontakt med:
      
      Mitchell Levy, MD
Frankrike
- - Argenteuil, Frankrike, 95107
    - Aktiv, ikke rekrutterende
    - CH Argenteuil
  - Aurillac, Frankrike, 15000
    - Fullført
    - Centre Hospitalier Henri Mondor d'Aurillac
  - Beauvais, Frankrike, 60000
    - Aktiv, ikke rekrutterende
    - Beauvais General Hospital
  - Belfort, Frankrike, 90400
    - Suspendert
    - Hopital Nord Franche-Comte
  - Boulogne-Billancourt, Frankrike, 92100
    - Rekruttering
    - Ambroise Pare Hospital
    - Ta kontakt med:
      
      Antoine Vieillard Baron, MD
  - Béthune, Frankrike, 62660
    - Rekruttering
    - Centre hospitalier Bethune Beuvry
    - Ta kontakt med:
      
      Christophe Vinsonneau, MD
  - Dax, Frankrike, 40100
    - Rekruttering
    - CH de Dax
    - Ta kontakt med:
      
      Adrien Auvet, MD
  - Dieppe, Frankrike, 76202
    - Rekruttering
    - Centre Hospitalier de Dieppe
    - Ta kontakt med:
      
      Peierre-Louis Declercq, MD
  - Dijon, Frankrike, 21000
    - Rekruttering
    - CHU Dijon Bourgogne
    - Ta kontakt med:
      
      Jean-Pierre Quenot, MD
  - Eaubonne, Frankrike, 95600
    - Aktiv, ikke rekrutterende
    - Hopital Simone Veil Eaubonne
  - Garches, Frankrike, 92380
    - Rekruttering
    - Hospital Raymond Poincare
    - Ta kontakt med:
      
      Djillali Annane, MD
  - La Roche-sur-Yon, Frankrike, 85000
    - Rekruttering
    - CHD Vendee
    - Ta kontakt med:
      
      Gwenael Colin, MD
  - Le Mans, Frankrike, 72027
    - Rekruttering
    - Centre Hospitalier Le Mans
    - Ta kontakt med:
      
      Christophe Guitton, MD
  - Limoges, Frankrike, 87000
    - Rekruttering
    - CHU Dupuytren
    - Ta kontakt med:
      
      Francois Bruno, MD
  - Melun, Frankrike, 77000
    - Aktiv, ikke rekrutterende
    - Centre Hospitalier de Melun
  - Mont-de-Marsan, Frankrike, 40024
    - Rekruttering
    - Centre Hospitalier Layne - Mont-de-Marsan
    - Ta kontakt med:
      
      Arnaud Sement, MD
  - Morlaix, Frankrike, 29600
    - Rekruttering
    - Centre Hospitalier des Pays de Morlaix
    - Ta kontakt med:
      
      Pierre Yves Egreteau, MD
  - Orléans, Frankrike, 45100
    - Aktiv, ikke rekrutterende
    - CHR d'Orleans
  - Paris, Frankrike, 75010
    - Aktiv, ikke rekrutterende
    - Lariboisiere Hospital
  - Paris, Frankrike, 75020
    - Aktiv, ikke rekrutterende
    - Hopital Tenon
  - Strasbourg, Frankrike, 67200
    - Aktiv, ikke rekrutterende
    - Hopital de Hautepierre Strasbourg
  - Strasbourg, Frankrike, 67000
    - Rekruttering
    - Nouvel Hopital Civil Strasbourg
    - Ta kontakt med:
      
      Ferhat Meziani, MD
  - Tours, Frankrike, 37000
    - Rekruttering
    - CHRU Tours Hopital Bretonneau
    - Ta kontakt med:
      
      Emmanuelle Mercier, MD
  - Étampes, Frankrike, 91150
    - Aktiv, ikke rekrutterende
    - Sud Essonne Hospital Etampes
India
- Tamil Nadu
  - Chennai, Tamil Nadu, India, 600006
    - Aktiv, ikke rekrutterende
    - Apollo Main Hospital
  - Chennai, Tamil Nadu, India, 600010
    - Rekruttering
    - Apollo First Med Hospital
    - Ta kontakt med:
      
      Meghena Mathew, MD
  - Chennai, Tamil Nadu, India, 600095
    - Aktiv, ikke rekrutterende
    - Apollo Vanagaram Hospital
  - Chennai, Tamil Nadu, India, 600096
    - Rekruttering
    - Apollo Speciality Hospital - OMR
    - Ta kontakt med:
      
      Deva Jayakumar, MD
Irland
- - Cork, Irland, T12 DC4A
    - Aktiv, ikke rekrutterende
    - Cork University Hospital
  - Dublin, Irland
    - Rekruttering
    - Beaumont Hospital
    - Ta kontakt med:
      
      Ger Curley, Prof.
  - Dublin, Irland
    - Rekruttering
    - St. Vincent's University Hospital
    - Ta kontakt med:
      
      Alistair Nichol, Prof.
  - Galway, Irland
    - Rekruttering
    - University Hospital Galway
    - Ta kontakt med:
      
      John Laffey, M.D.
  - Waterford, Irland, X91 ER8E
    - Aktiv, ikke rekrutterende
    - University Hospital Waterford
Israel
- - Haifa, Israel, 3109601
    - Tilbaketrukket
    - Rambam Medical Center
  - Petah Tikva, Israel, 4941492
    - Suspendert
    - Beilinson Hospital, Rabin Medical Center
  - Poria – Neve Oved, Israel, 1528001
    - Tilbaketrukket
    - The Baruch Padeh Medical Center
Italia
- - Brescia, Italia, 25123
    - Rekruttering
    - AO Spedali Civili di Brescia
    - Ta kontakt med:
      
      Simone Piva, MD
  - Milan, Italia, 20132
    - Rekruttering
    - IRCCS Ospedale San Raffaele
    - Ta kontakt med:
      
      Giovanni Landoni, MD
  - Milan, Italia, 20089
    - Rekruttering
    - Humanitas Research Hospital
    - Ta kontakt med:
      
      Maurizio Cecconi, MD
  - Milan, Italia, 20122
    - Rekruttering
    - Ca' Granda Ospedale Maggiore Policlinico
    - Ta kontakt med:
      
      Francesco Blasi, MD
  - Palermo, Italia, 90127
    - Rekruttering
    - Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone
    - Ta kontakt med:
      
      Andrea Cortegiani, MD
  - Palermo, Italia, 90127
    - Rekruttering
    - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione
    - Ta kontakt med:
      
      Gennaro Martucci, MD
  - Reggio Emilia, Italia, 42123
    - Rekruttering
    - Arcispedale S. Maria Nuova
    - Ta kontakt med:
      
      Elena Mantovani, MD
  - Rimini, Italia, 47923
    - Har ikke rekruttert ennå
    - Ospedale Infermi di Rimini
    - Ta kontakt med:
      
      Jonathan Montomoli, MD
Japan
- Kanagawa
  - Kawasaki, Kanagawa, Japan, 216-8511
    - Rekruttering
    - St Marianna University School of Medicine
  - Yokohama, Kanagawa, Japan, 236-0004
    - Rekruttering
    - Yokohama City University Hospital
  - Yokohama, Kanagawa, Japan, 241-0811
    - Rekruttering
    - St. Marianna University Yokohama City Seibu Hospital
- Kumamoto
  - Minami, Kumamoto, Japan, 861-4193
    - Rekruttering
    - Saiseikai Kumamoto Hospital
- Osaka
  - Osaka, Osaka, Japan, 534-0021
    - Rekruttering
    - Osaka City General Hospital
- Tokyo
  - Tokyo, Tokyo, Japan, 130-8575
    - Rekruttering
    - Nerima Hikarigaoka Hospital
  - Tokyo, Tokyo, Japan, 130-8575
    - Rekruttering
    - Tokyo Metropolitan Bokutoh Hospital
  - Tokyo, Tokyo, Japan, 174-0051
    - Rekruttering
    - Itabashi Chuo Medical Center
  - Tokyo, Tokyo, Japan, 279-0001
    - Rekruttering
    - Tokyo bay Urayasu-Ichikawa Medical Center
- Wakayama
  - Wakayama, Wakayama, Japan, 641-8509
    - Rekruttering
    - Wakayama Medical University
Kroatia
- - Požega, Kroatia, 34000
    - Rekruttering
    - General County Hospital Požega
    - Ta kontakt med:
      
      Zdravko Andrić, MD
  - Zagreb, Kroatia, 10000
    - Rekruttering
    - University Hospital Centre Zagreb
    - Ta kontakt med:
      
      Ana Vujaklija Brajković, MD
  - Zagreb, Kroatia, 10000
    - Tilbaketrukket
    - University Hospital for Infectious Diseases
Nederland
- - 's-Hertogenbosch, Nederland
    - Rekruttering
    - Jeroen Bosch Ziekenhuis
    - Ta kontakt med:
      
      Koen Simons, M.D.
  - Almelo, Nederland, 7609PP
    - Rekruttering
    - ZGT Almelo
    - Ta kontakt med:
      
      Bastiaan Wittekamp, MD
  - Amersfoort, Nederland
    - Rekruttering
    - Meander Medisch Centrum
    - Ta kontakt med:
      
      Laura van Gulik, M.D.
  - Amsterdam, Nederland, 1091AC
    - Aktiv, ikke rekrutterende
    - OLVG
  - Arnhem, Nederland, 6815AD
    - Rekruttering
    - Rijnstate Hospital
    - Ta kontakt med:
      
      Robert-Jan Hassing, MD
  - Deventer, Nederland, 7416SE
    - Aktiv, ikke rekrutterende
    - Deventer Hospital
  - Ede, Nederland, 6716RP
    - Aktiv, ikke rekrutterende
    - Ziekenhuis Gelderse Vallei
  - Eindhoven, Nederland, 5631BM
    - Aktiv, ikke rekrutterende
    - Maxima Medisch Centrum Eindhoven
  - Groningen, Nederland
    - Tilbaketrukket
    - Martini Hospital Groningen
  - Groningen, Nederland
    - Aktiv, ikke rekrutterende
    - University Medical Center Groningen
  - Leeuwarden, Nederland, 8934AD
    - Aktiv, ikke rekrutterende
    - Medisch Centrum Leeuwarden
  - Leiden, Nederland
    - Rekruttering
    - Leiden University Medical Center
    - Ta kontakt med:
      
      Evert De Jonge, Prof.
  - Nijmegen, Nederland
    - Rekruttering
    - Radboud University Medical Center
    - Ta kontakt med:
      
      Frank van de Veerdonk, Prof.
  - Nijmegen, Nederland
    - Rekruttering
    - Canisius Wilhelmina Ziekenhuis
    - Ta kontakt med:
      
      Oscar Hoiting, M.D.
  - Roermond, Nederland, 6043CV
    - Aktiv, ikke rekrutterende
    - Laurentius Hospital
  - Rotterdam, Nederland, 3079DZ
    - Rekruttering
    - Maasstad Ziekenhuis
    - Ta kontakt med:
      
      Corstiaan den Uil, MD
  - The Hague, Nederland, 2545AA
    - Rekruttering
    - Hagaziekenhuis
    - Ta kontakt med:
      
      Thomas Ottens, MD
  - Uden, Nederland, 5406PT
    - Aktiv, ikke rekrutterende
    - Bernhoven Hospital
- Utrecht
  - Utrecht, Utrecht, Nederland, 3584 CX
    - Rekruttering
    - University Medical Center Utrecht
    - Ta kontakt med:
      
      Marc Bonten, Prof.
    - Ta kontakt med:
      
      Lennie Derde, MD
Nepal
- - Bharatpur, Nepal, 44200
    - Rekruttering
    - Chitwan Medical College
    - Ta kontakt med:
      
      Basanta Gauli, MD
  - Kathmandu, Nepal, 44600
    - Rekruttering
    - Grande International Hospital
    - Ta kontakt med:
      
      Sushil Khanal, MD
  - Kathmandu, Nepal, 44600
    - Rekruttering
    - Hospital for Advanced Medicine and Surgery (HAMS)
    - Ta kontakt med:
      
      Hem Paneru, MD
  - Kathmandu, Nepal, 44600
    - Rekruttering
    - Nepal Mediciti
    - Ta kontakt med:
      
      Diptesh Aryal, MD
New Zealand
- - Auckland, New Zealand, 0620
    - Rekruttering
    - North Shore Hospital
    - Ta kontakt med:
      
      Robert Everitt, MD
  - Auckland, New Zealand, 1023
    - Rekruttering
    - CVICU, Auckland City Hospital
    - Ta kontakt med:
      
      Shay McGuinness, MD
  - Auckland, New Zealand, 1023
    - Rekruttering
    - DCCM, Auckland City Hospital
    - Ta kontakt med:
      
      Colin McArthur, MD
  - Auckland, New Zealand, 2104
    - Rekruttering
    - Middlemore Hospital
    - Ta kontakt med:
      
      Tony Williams, MD
  - Christchurch, New Zealand, 8011
    - Rekruttering
    - Christchurch Hospital
    - Ta kontakt med:
      
      Jay Ritzema-Carter, MD
  - Hamilton, New Zealand, 3204
    - Rekruttering
    - Waikato Hospital
    - Ta kontakt med:
      
      Robert Martynoga, MD
  - New Plymouth, New Zealand, 4310
    - Rekruttering
    - Taranaki Base Hospital
    - Ta kontakt med:
      
      Jonathan Albrett, MD
  - Rotorua, New Zealand, 3010
    - Rekruttering
    - Rotorua Hospital
    - Ta kontakt med:
      
      Ulrike Buehner, MD
  - Tauranga, New Zealand, 3112
    - Rekruttering
    - Tauranga Hospital
    - Ta kontakt med:
      
      Troy Browne, MD
  - Wellington, New Zealand, 6021
    - Rekruttering
    - Wellington Regional Hospital
    - Ta kontakt med:
      
      Paul Young, MD
  - Whangarei, New Zealand, 0148
    - Rekruttering
    - Whangarei Hospital
    - Ta kontakt med:
      
      Ralph Fuchs, MD
Pakistan
- Sindh
  - Karachi, Sindh, Pakistan, 75000
    - Rekruttering
    - Ziauddin University Hospital Clifton Campus
    - Ta kontakt med:
      
      Madiha Hashmi, MD
  - Karachi, Sindh, Pakistan, 75300
    - Rekruttering
    - Abbasi Shaheed Hospital
    - Ta kontakt med:
      
      Aneela Kidwai, MD
  - Karachi, Sindh, Pakistan, 75510
    - Rekruttering
    - National Institute of Cardiovascular Diseases, Karachi
    - Ta kontakt med:
      
      Nawal Salahuddin, MD
  - Karachi, Sindh, Pakistan, 75600
    - Rekruttering
    - South City Hospital, Karachi
    - Ta kontakt med:
      
      Nasir Khoso, MD
  - Karachi, Sindh, Pakistan
    - Rekruttering
    - Ziauddin University North Nazimabad Campus
    - Ta kontakt med:
      
      Quratul Ain, MD
Portugal
- - Abrantes, Portugal
    - Rekruttering
    - Centro Hospitalar do Medio Tejo
    - Ta kontakt med:
      
      Nuno Catorze, M.D.
  - Lisbon, Portugal, 1169-050
    - Suspendert
    - Hospital Ocidental
  - Lisbon, Portugal
    - Suspendert
    - Hospital Lusíadas Lisbon
Romania
- - Bucharest, Romania, 030303
    - Suspendert
    - Clinical Hospital of Infectious and Tropical Diseases "Dr. Victor Babes"
Saudi-Arabia
- - Riyadh, Saudi-Arabia, 14611
    - Rekruttering
    - King Abdulaziz Medical City
    - Ta kontakt med:
      
      Yaseen Arabi, MD
Serbia
- - Belgrade, Serbia, 11000
    - Suspendert
    - University Hospital Center Dr Dragiša Mišović
  - Belgrade, Serbia, 11000
    - Suspendert
    - University Clinical Centre of Serbia
  - Niš, Serbia, 18000
    - Rekruttering
    - Clinical Centre of Niš
    - Ta kontakt med:
      
      Tanja Pejčić, MD
Slovenia
- - Golnik, Slovenia, 4204
    - Suspendert
    - University Clinic of Respiratory and Allergic Diseases Golnik
  - Maribor, Slovenia, 2000
    - Rekruttering
    - University Medical Centre Maribor
    - Ta kontakt med:
      
      Andre Markota, MD
Spania
- - Barcelona, Spania
    - Rekruttering
    - Hospital del Mar
    - Ta kontakt med:
      
      Rosana Munoz-Bermúdez, M.D.
  - Cadiz, Spania, 11407
    - Rekruttering
    - Hospital Universitario de Jerez
    - Ta kontakt med:
      
      Ángel Estella, MD
  - Córdoba, Spania, 14004
    - Rekruttering
    - Reina Sofia University Hospital
    - Ta kontakt med:
      
      Eduardo Aguilar Alonso, M.D.
  - Madrid, Spania, 28034
    - Rekruttering
    - Ramon y Cajal University Hospital
    - Ta kontakt med:
      
      Cruz Soriano, MD
  - Málaga, Spania, 29010
    - Rekruttering
    - Hospital Regional de Málaga
    - Ta kontakt med:
      
      Manuel Herrera Gutiérrez, MD
  - Ourense, Spania, 32005
    - Rekruttering
    - Hospital Universitario de Ourense
    - Ta kontakt med:
      
      Pablo Vidal, MD
  - Santander, Spania, 39008
    - Rekruttering
    - Hospital Marqués de Valdecilla
    - Ta kontakt med:
      
      Borja Suberviola, MD
  - Tortosa, Spania, 43500
    - Rekruttering
    - Hospital Verge de la Cinta
    - Ta kontakt med:
      
      Ferran Roche Campo, MD
  - Valencia, Spania, 46026
    - Rekruttering
    - Hospital La Fe
    - Ta kontakt med:
      
      Paula Ramírez, MD
  - Valencia, Spania, 46017
    - Rekruttering
    - Doctor Peset University Hospital
    - Ta kontakt med:
      
      Rafael Zaragoza, MD
Storbritannia
- - Belfast, Storbritannia, BT16 1RH
    - Rekruttering
    - Ulster Hospital
    - Ta kontakt med:
      
      Christopher Murray, MD
  - Bristol, Storbritannia, BS2 8BJ
    - Rekruttering
    - Bristol Royal Childrens Hospital
    - Ta kontakt med:
      
      Jolanta Bernatoniene, MD
  - Bury, Storbritannia, BL9 7TD
    - Rekruttering
    - Fairfield General Hospital
    - Ta kontakt med:
      
      Andrew Claxton, MD
  - Crewe, Storbritannia, CW1 4QJ
    - Rekruttering
    - Leighton Hospital
    - Ta kontakt med:
      
      Richard Lowsby, MD
  - Dorchester, Storbritannia, DT1 2JY
    - Fullført
    - Dorset County Hospital
  - Gloucester, Storbritannia, GL1 3NN
    - Fullført
    - Gloucester Royal Hospital
  - Haywards Heath, Storbritannia, RH16 4EX
    - Aktiv, ikke rekrutterende
    - The Princess Royal Hospital Haywards Heath
  - Leeds, Storbritannia, LS9 7TF
    - Rekruttering
    - St. James University Hospital
    - Ta kontakt med:
      
      E Paramasivam, MD
  - London, Storbritannia, NW1 2BU
    - Rekruttering
    - University College London Hospital
    - Ta kontakt med:
      
      Michael Marks, MD
  - London, Storbritannia, SW10 9NH
    - Rekruttering
    - Chelsea and Westminster Hospital
    - Ta kontakt med:
      
      Roger Davies, MD
  - London, Storbritannia, E9 6SR
    - Suspendert
    - Homerton Hospital
  - Margate, Storbritannia, CT9 4AN
    - Suspendert
    - Queen Elizabeth and Queen Mother Hospital
  - Newcastle upon Tyne, Storbritannia, NE1 4LP
    - Rekruttering
    - Newcastle Royal Victoria Infirmary (Paediatrics)
    - Ta kontakt med:
      
      Marieke Emonts, MD
  - North Shields, Storbritannia, Ne29 8NH
    - Suspendert
    - North Tyneside General Hospital
  - Warwick, Storbritannia, CV34 5BW
    - Aktiv, ikke rekrutterende
    - Warwick Hospital
  - West Bromwich, Storbritannia, B71 4HJ
    - Rekruttering
    - Sandwell General Hospital
    - Ta kontakt med:
      
      Jonathan Hulme, MD
- England
  - Basildon, England, Storbritannia, SS16 5NL
    - Aktiv, ikke rekrutterende
    - Basildon Hospital
  - Basingstoke, England, Storbritannia, RG24 9NA
    - Rekruttering
    - Basingstoke and North Hampshire Hospital
    - Ta kontakt med:
      
      Irena Grecu, MD
  - Bath, England, Storbritannia, BA1 3NG
    - Aktiv, ikke rekrutterende
    - Royal United Hospital, Bath
  - Birmingham, England, Storbritannia, B15 2TH
    - Rekruttering
    - Queen Elizabeth Hospital Birmingham
    - Ta kontakt med:
      
      Dhruv Parekh
  - Birmingham, England, Storbritannia, B18 7QH
    - Rekruttering
    - Birmingham City Hospital
    - Ta kontakt med:
      
      Jonathan Hulme
  - Blackburn, England, Storbritannia, BB2 3HH
    - Rekruttering
    - Royal Blackburn Teaching Hospital
    - Ta kontakt med:
      
      Srikanth Chukkambotla, MD
  - Boston, England, Storbritannia, PE21 9QS
    - Suspendert
    - Pilgrim Hospital ULHT
  - Bournemouth, England, Storbritannia, BH7 7DW
    - Aktiv, ikke rekrutterende
    - Royal Bournemouth Hospital
  - Brighton, England, Storbritannia, BN2 5BE
    - Suspendert
    - Royal Sussex County Hospital
  - Bristol, England, Storbritannia, BS10 5NB
    - Suspendert
    - Southmead Hospital
  - Bristol, England, Storbritannia, BS2 8EX
    - Aktiv, ikke rekrutterende
    - Bristol Royal Infirmary
  - Burton-on-Trent, England, Storbritannia, DE13 0RB
    - Aktiv, ikke rekrutterende
    - Queen's Hospital, Burton
  - Cambridge, England, Storbritannia, CB2 0AY
    - Aktiv, ikke rekrutterende
    - Royal Papworth Hospital
  - Cambridge, England, Storbritannia, CB2 0QQ
    - Aktiv, ikke rekrutterende
    - Addenbrookes Hospital
  - Carlisle, England, Storbritannia, CA2 7HY
    - Suspendert
    - North Cumberland Infirmary
  - Chertsey, England, Storbritannia, KT16 0P
    - Aktiv, ikke rekrutterende
    - St Peter's Hospital
  - Chester, England, Storbritannia, CH2 1UL
    - Aktiv, ikke rekrutterende
    - Countess of Chester Hospital
  - Chesterfield, England, Storbritannia, S44 5BL
    - Rekruttering
    - Chesterfield Royal Hospital
    - Ta kontakt med:
      
      Euan Mackay
  - Colchester, England, Storbritannia, CO4 5JL
    - Rekruttering
    - Colchester Hospital
    - Ta kontakt med:
      
      Mohamed Ramali
  - Coventry, England, Storbritannia, CV2 2DX
    - Aktiv, ikke rekrutterende
    - University Hospital Coventry
  - Darlington, England, Storbritannia, DL3 6HX
    - Suspendert
    - Darlington Memorial Hospital
  - Dartford, England, Storbritannia, DA2 8DA
    - Tilbaketrukket
    - Darent Valley Hospital
  - Dudley, England, Storbritannia, DY1 2HQ
    - Aktiv, ikke rekrutterende
    - Russells Hall Hospital
  - Exeter, England, Storbritannia, Ex2 5DW
    - Suspendert
    - Royal Devon and Exeter Hospital
  - Frimley, England, Storbritannia, GU16 7 UJ
    - Suspendert
    - Frimley Park Hospital
  - Gateshead, England, Storbritannia, NE9 6SX
    - Aktiv, ikke rekrutterende
    - Queen Elizabeth Hospital Gateshead
  - Gillingham, England, Storbritannia, ME7 5NY
    - Fullført
    - Medway Maritime Hospital
  - Great Yarmouth, England, Storbritannia, NR31 6LA
    - Fullført
    - James Paget University Hospital
  - Guildford, England, Storbritannia, GU2 7XX
    - Rekruttering
    - Royal Surrey County Hospital
    - Ta kontakt med:
      
      Ben Creagh-Brown
  - Harrow, England, Storbritannia, HA1 3UJ
    - Aktiv, ikke rekrutterende
    - Northwick Park Hospital
  - Hereford, England, Storbritannia, HR1 2ER
    - Rekruttering
    - Hereford County Hospital
    - Ta kontakt med:
      
      Charlotte Small
  - High Barnet, England, Storbritannia, EN5 3DJ
    - Aktiv, ikke rekrutterende
    - Barnet Hospital
  - Huddersfield, England, Storbritannia, HD3 3EA
    - Aktiv, ikke rekrutterende
    - Huddersfield Royal Infirmary
  - Ilford, England, Storbritannia, IG3 8YB
    - Aktiv, ikke rekrutterende
    - King George Hospital
  - Ipswich, England, Storbritannia, IP4 5PD
    - Tilbaketrukket
    - Ipswich Hospital
  - Kettering, England, Storbritannia, NN16 8UZ
    - Rekruttering
    - Kettering Hospital
    - Ta kontakt med:
      
      Dhinesh Sundaran
  - Leeds, England, Storbritannia, LS9 7TF
    - Aktiv, ikke rekrutterende
    - Leeds General Infirmary
  - Leicester, England, Storbritannia, LE1 5WW
    - Suspendert
    - Leicester Royal Infirmary
  - Leicester, England, Storbritannia, LE3 9QP
    - Suspendert
    - Glenfield Hospital
  - Lincoln, England, Storbritannia, LN2 5QY
    - Suspendert
    - Lincoln County Hospital
  - Liverpool, England, Storbritannia, L7 8XP
    - Aktiv, ikke rekrutterende
    - Royal Liverpool University Hospital
  - Liverpool, England, Storbritannia, L14 3PE
    - Fullført
    - Liverpool Heart and Chest Hospital
  - Liverpool, England, Storbritannia, L14 5AB
    - Fullført
    - Alder Hey Hospital
  - Liverpool, England, Storbritannia, L9 7AL
    - Suspendert
    - University Hospital Aintree
  - London, England, Storbritannia, SE5 9RS
    - Rekruttering
    - King's College Hospital
    - Ta kontakt med:
      
      Phillip Hopkins
  - London, England, Storbritannia, W12 0HS
    - Rekruttering
    - Hammersmith Hospital
    - Ta kontakt med:
      
      Stephen Brett
  - London, England, Storbritannia, W2 1NY
    - Rekruttering
    - St Mary's Hospital
    - Ta kontakt med:
      
      Anthony Gordon
  - London, England, Storbritannia, W6 8RF
    - Rekruttering
    - Charing Cross Hospital
    - Ta kontakt med:
      
      David Antcliffe
  - London, England, Storbritannia, CR7 7YE
    - Aktiv, ikke rekrutterende
    - Croydon University Hospital
  - London, England, Storbritannia, E1 1FR
    - Aktiv, ikke rekrutterende
    - Royal London Hospital
  - London, England, Storbritannia, E11 1NR
    - Aktiv, ikke rekrutterende
    - Whipps Cross Hospital
  - London, England, Storbritannia, E13 8SL
    - Aktiv, ikke rekrutterende
    - Newham University Hospital
  - London, England, Storbritannia, EC1A 7BE
    - Aktiv, ikke rekrutterende
    - St Bartholomew's Hospital
  - London, England, Storbritannia, N18 1QX
    - Aktiv, ikke rekrutterende
    - North Middlesex University Hospital
  - London, England, Storbritannia, NW3 2QG
    - Aktiv, ikke rekrutterende
    - Royal Free Hospital
  - London, England, Storbritannia, SE1 7EH
    - Rekruttering
    - St Thomas Hospital
    - Ta kontakt med:
      
      Marlies Ostermann
  - London, England, Storbritannia, SE1 9RT
    - Aktiv, ikke rekrutterende
    - Guy's Hospital
  - London, England, Storbritannia, SE18 4QH
    - Aktiv, ikke rekrutterende
    - Queen Elizabeth Hospital, Woolwich
  - London, England, Storbritannia, SW3 6JJ
    - Aktiv, ikke rekrutterende
    - Royal Marsden Hospital
  - London, England, Storbritannia, SW3 6NP
    - Aktiv, ikke rekrutterende
    - Royal Brompton Hospital
  - London, England, Storbritannia, SW17 0QT
    - Rekruttering
    - St George's University Hospital
    - Ta kontakt med:
      
      Susannah Leaver
  - Luton, England, Storbritannia, LU4 0DZ
    - Suspendert
    - Luton and Dunstable University Hospital
  - Maidstone, England, Storbritannia, ME16 9QQ
    - Rekruttering
    - Maidstone Hospital
    - Ta kontakt med:
      
      David Golden, MD
  - Manchester, England, Storbritannia, M13 9WL
    - Suspendert
    - Manchester Royal Infirmary
  - Manchester, England, Storbritannia, M20 4BX
    - Fullført
    - The Christie Hospital
  - Manchester, England, Storbritannia, M23 9LT
    - Suspendert
    - Wythenshawe Hospital
  - Manchester, England, Storbritannia, M8 5RB
    - Aktiv, ikke rekrutterende
    - North Manchester General Hospital
  - Metropolitan Borough of Wirral, England, Storbritannia, CH49 5PE
    - Rekruttering
    - Arrowe Park Hospital
    - Ta kontakt med:
      
      Craig Denmade, MD
  - Middlesbrough, England, Storbritannia, TS4 3BW
    - Rekruttering
    - The James Cook University Hospital
    - Ta kontakt med:
      
      Jeremy Henning, MD
  - Milton Keynes, England, Storbritannia, MK6 5LD
    - Rekruttering
    - Milton Keynes University Hospital
    - Ta kontakt med:
      
      Richard Stewart, MD
  - Newcastle, England, Storbritannia, NE1 4LP
    - Suspendert
    - Royal Victoria Infirmary, Newcastle
  - Newcastle, England, Storbritannia, NE7 7DN
    - Suspendert
    - Newcastle Freeman Hospital
  - Northampton, England, Storbritannia, NN1 5BD
    - Suspendert
    - Northampton General Hospital
  - Norwich, England, Storbritannia, NR4 7UY
    - Fullført
    - Norfolk and Norwich University Hospital
  - Nottingham, England, Storbritannia, NG5 1PB
    - Rekruttering
    - City Hospital Nottingham
    - Ta kontakt med:
      
      Daniel Harvey, MD
  - Nottingham, England, Storbritannia, NG7 2UH
    - Rekruttering
    - Queen's Medical Centre - Nottingham University Hospitals NHS Trust
    - Ta kontakt med:
      
      Daniel Harvey, MD
  - Nuneaton, England, Storbritannia, CV10 7DJ
    - Aktiv, ikke rekrutterende
    - George Eliot Hospital
  - Oldham, England, Storbritannia, Ol1 2JH
    - Rekruttering
    - Royal Oldham Hospital
    - Ta kontakt med:
      
      Redmond Tully, MD
  - Orpington, England, Storbritannia, BR6 8ND
    - Suspendert
    - Princess Royal University Hospital
  - Oxford, England, Storbritannia, OX3 9DU
    - Aktiv, ikke rekrutterende
    - John Radcliffe Hospital
  - Plymouth, England, Storbritannia, PL6 8DH
    - Rekruttering
    - Derriford Hospital
    - Ta kontakt med:
      
      Nikitas Nikitas, MD
  - Poole, England, Storbritannia, BH15 2JB
    - Rekruttering
    - Poole Hospital NHS Foundation Trust
    - Ta kontakt med:
      
      Henrik Reschreiter, MD
  - Portsmouth, England, Storbritannia, PO6 3LY
    - Rekruttering
    - Queen Alexandra Hospital
    - Ta kontakt med:
      
      David Pogson, MD
  - Prescot, England, Storbritannia, L35 5DR
    - Avsluttet
    - Whiston Hospital
  - Preston, England, Storbritannia, PR2 9HT
    - Suspendert
    - Royal Preston Hospital
  - Reading, England, Storbritannia, RG1 5AN
    - Rekruttering
    - Royal Berkshire Hospital
    - Ta kontakt med:
      
      Andrew Walden, MD
  - Redditch, England, Storbritannia, B98 7UB
    - Aktiv, ikke rekrutterende
    - Alexandra Hospital, Redditch
  - Romford, England, Storbritannia, RM7 0AG
    - Aktiv, ikke rekrutterende
    - Queen's Hospital Romford
  - Rotherham, England, Storbritannia, S60 2UD
    - Rekruttering
    - Rotherham Hospital
    - Ta kontakt med:
      
      Anil Hormis, MD
  - Royal Tunbridge Wells, England, Storbritannia, TN2 4QJ
    - Rekruttering
    - Tunbridge Wells Hospital - Maidstone and Tunbridge Wells NHS Trust
    - Ta kontakt med:
      
      David Golden, MD
  - Salford, England, Storbritannia, M6 8HD
    - Rekruttering
    - Salford Royal Hospital
    - Ta kontakt med:
      
      Paul Dark, MD
  - Salisbury, England, Storbritannia, SP2 8BJ
    - Rekruttering
    - Salisbury District Hospital
    - Ta kontakt med:
      
      Phil Donnison, MD
  - Sheffield, England, Storbritannia, S10 2JF
    - Rekruttering
    - Royal Hallamshire Hospital
    - Ta kontakt med:
      
      Gary Mills, MD
  - Sheffield, England, Storbritannia, S5 7AU
    - Rekruttering
    - Northern General Hospital
    - Ta kontakt med:
      
      Gary Mills, MD
  - Slough, England, Storbritannia, SL2 4HL
    - Aktiv, ikke rekrutterende
    - Wexham Park Hospital
  - South Shields, England, Storbritannia, NE34 0PL
    - Rekruttering
    - South Tyneside District Hospital
    - Ta kontakt med:
      
      Alistair Roy, MD
  - Southampton, England, Storbritannia, SO16 6YD
    - Rekruttering
    - Southampton General Hospital
    - Ta kontakt med:
      
      Ahilanandan Dushianthan, MD
  - Stockport, England, Storbritannia, SK2 7JE
    - Rekruttering
    - Stepping Hill Hospital
    - Ta kontakt med:
      
      Hywel Garrard, MD
  - Stockton-on-Tees, England, Storbritannia, TS19 8PE
    - Rekruttering
    - University Hospital of North Tees
    - Ta kontakt med:
      
      Farooq Brohi, MD
  - Stoke-on-Trent, England, Storbritannia, ST4 6QG
    - Rekruttering
    - Royal Stoke University Hospital
    - Ta kontakt med:
      
      Ramprasad Matsa, MD
  - Sunderland, England, Storbritannia, SR4 7TP
    - Rekruttering
    - Sunderland Royal Hospital
    - Ta kontakt med:
      
      Alistair Roy, MD
  - Sutton in Ashfield, England, Storbritannia, NG17 4JL
    - Rekruttering
    - King's Mill Hospital
    - Ta kontakt med:
      
      Sandaruwan Herath, MD
  - Swindon, England, Storbritannia, SN3 6BB
    - Rekruttering
    - Western General Hospital
    - Ta kontakt med:
      
      Jonathan Rhodes, MD
  - Swindon, England, Storbritannia, SN3 6BB
    - Aktiv, ikke rekrutterende
    - Great Western Hospital
  - Taunton, England, Storbritannia, TA1 5DA
    - Rekruttering
    - Musgrove Park Hospital
    - Ta kontakt med:
      
      Richard Innes, MD
  - Torquay, England, Storbritannia, TQ2 7AA
    - Rekruttering
    - Torbay Hospital
    - Ta kontakt med:
      
      Adam Revill, MD
  - Truro, England, Storbritannia, TR1 3LJ
    - Rekruttering
    - Royal Cornwall Hospital
    - Ta kontakt med:
      
      Michael Spivey, MD
  - Uxbridge, England, Storbritannia, UB9 6JH
    - Fullført
    - Harefield Hospital
  - Watford, England, Storbritannia, WD18 0HB
    - Rekruttering
    - Watford General Hospital
    - Ta kontakt med:
      
      Valarie Page, MD
  - Westcliff-on-Sea, England, Storbritannia, ISS0 0RY
    - Aktiv, ikke rekrutterende
    - Southend Hospital
  - Whitehaven, England, Storbritannia, CA28 8JG
    - Tilbaketrukket
    - West Cumberland Hospital
  - Wigan, England, Storbritannia, WN1 2NN
    - Aktiv, ikke rekrutterende
    - Royal Albert Edward Infirmary
  - Winchester, England, Storbritannia, SO22 5DG
    - Rekruttering
    - Royal Hampshire County Hospital
    - Ta kontakt med:
      
      Irina Grecu, MD
  - Wolverhampton, England, Storbritannia, WV10 0QP
    - Aktiv, ikke rekrutterende
    - New Cross Hospital Wolverhampton
  - Worcester, England, Storbritannia, WR5 1DD
    - Aktiv, ikke rekrutterende
    - Worcestershire Royal Hospital
  - York, England, Storbritannia, Y031 8HE
    - Rekruttering
    - York Teaching Hospital
    - Ta kontakt med:
      
      Joseph Carter, MD
- Northern Ireland
  - Antrim, Northern Ireland, Storbritannia, BT41 2RL
    - Rekruttering
    - Antrim Area Hospital
    - Ta kontakt med:
      
      Paul Johnston, MD
  - Belfast, Northern Ireland, Storbritannia, BT14 6AB
    - Rekruttering
    - Mater Hospital
    - Ta kontakt med:
      
      Michael McGinlay, MD
  - Belfast, Northern Ireland, Storbritannia, BT9 7AB
    - Rekruttering
    - Belfast City Hospital
    - Ta kontakt med:
      
      Michael McGinlay, MD
  - Belfast, Northern Ireland, Storbritannia, BT12 6BA
    - Rekruttering
    - Royal Victoria Hospital Belfast
    - Ta kontakt med:
      
      Michael McGinlay, MD
  - Londonderry, Northern Ireland, Storbritannia, BT47 6SB
    - Rekruttering
    - Altnagelvin Hospital
    - Ta kontakt med:
      
      Adrian Donnelly, MD
- Scotland
  - Aberdeen, Scotland, Storbritannia, AB25 2ZN
    - Fullført
    - Aberdeen Royal Infirmary
  - Dundee, Scotland, Storbritannia, DD1 9SY
    - Rekruttering
    - Ninewells Hospital
    - Ta kontakt med:
      
      James Chambers, MD
  - Edinburgh, Scotland, Storbritannia, EH16 4SA
    - Rekruttering
    - Royal Infirmary of Edinburgh
    - Ta kontakt med:
      
      Thomas Craven, MD
  - Glasgow, Scotland, Storbritannia, G4 0SF
    - Rekruttering
    - Glasgow Royal Infirmary
    - Ta kontakt med:
      
      Kathryn Puxty, MD
  - Glasgow, Scotland, Storbritannia, G51 4TF
    - Rekruttering
    - Queen Elizabeth University Hospital, Glasgow
    - Ta kontakt med:
      
      Malcolm Sim, MD
  - Paisley, Scotland, Storbritannia, PA2 9PN
    - Rekruttering
    - Royal Alexandra Hospital
    - Ta kontakt med:
      
      Kevin Rooney, MD
- Wales
  - Abergavenny, Wales, Storbritannia, NP7 7EG
    - Aktiv, ikke rekrutterende
    - Neville Hall Hospital
  - Bodelwyddan, Wales, Storbritannia, LL18 5UJ
    - Aktiv, ikke rekrutterende
    - Glan Clwyd Hospital
  - Bridgend, Wales, Storbritannia, CF31 1RQ
    - Aktiv, ikke rekrutterende
    - Princess of Wales Hospital
  - Cardiff, Wales, Storbritannia, CF14 4XW
    - Aktiv, ikke rekrutterende
    - Cardiff and Vale University Hospital Wales
  - Carmarthen, Wales, Storbritannia, SA31 2AF
    - Suspendert
    - Glangwilli Hospital
  - Cwmbran, Wales, Storbritannia, NP44 8YN
    - Aktiv, ikke rekrutterende
    - Grange University Hospital
  - Newport, Wales, Storbritannia, NP20 2UB
    - Suspendert
    - Royal Gwent Hospital
  - Pont-y-clun, Wales, Storbritannia, CF72 8XR
    - Aktiv, ikke rekrutterende
    - Royal Glamorgan Hospital
  - Swansea, Wales, Storbritannia, SA6 6NL
    - Aktiv, ikke rekrutterende
    - Morriston Hospital
  - Wrexham, Wales, Storbritannia, LL13 7TD
    - Rekruttering
    - Wrexham Maelor Hospital
    - Ta kontakt med:
      
      David Southern, MD
Sveits
- - Zurich, Sveits, 8091
    - Suspendert
    - University Hospital Zürich
Tsjekkia
- - Prague, Tsjekkia, 10000
    - Rekruttering
    - Fakultní nemocnice Královské Vinohrady
    - Ta kontakt med:
      
      František Duška, MD
  - Teplice, Tsjekkia, 41501
    - Suspendert
    - Teplice Hospital
Tyskland
- - Berlin, Tyskland, 10117
    - Tilbaketrukket
    - Charité - Universitätsmedizin Berlin - Infektiologie und Pneumologie
  - Berlin, Tyskland, 12351
    - Fullført
    - Vivantes Klinikum Neukölln
  - Berlin, Tyskland, 13509
    - Tilbaketrukket
    - Vivantes Humboldt-Klinikum
  - Berlin, Tyskland, 13353
    - Suspendert
    - Charite Universitätsmedizin Berlin
  - Cologne, Tyskland, 50937
    - Tilbaketrukket
    - University Hospital of Cologne
  - Cottbus, Tyskland, 03058
    - Fullført
    - Carl-Thiem-Klinikum Cottbus
  - Dortmund, Tyskland, 44137
    - Fullført
    - Klinikum Dortmund
  - Essen, Tyskland, 45138
    - Fullført
    - Elisabeth Hospital Essen
  - Frankfurt, Tyskland, 60590
    - Tilbaketrukket
    - Universitätsklinikum Frankfurt
  - Hamburg, Tyskland, 20251
    - Suspendert
    - University Medical Center Hamburg-Eppendorf (UKE)
  - Jena, Tyskland, 07747
    - Suspendert
    - Universitätsklinikum Jena
  - Leipzig, Tyskland, 04103
    - Suspendert
    - University Hospital Leipzig
  - Leipzig, Tyskland, 04103
    - Suspendert
    - Universitätsklinikum Leipzig
  - München, Tyskland, 81675
    - Suspendert
    - Klinikum rechts der Isar der TU München
  - Münster, Tyskland, 48149
    - Suspendert
    - Universitätsklinikum Münster
  - Tübingen, Tyskland, 72076
    - Fullført
    - Universitäts Klinikum Tübingen
  - Würzburg, Tyskland, 97080
    - Suspendert
    - Universitätsklinikum Würzburg
Ungarn
- - Nyíregyháza, Ungarn, 4400
    - Fullført
    - Jósa András County Hospital
  - Ózd, Ungarn, 3600
    - Fullført
    - Almási Balogh Pál Kórház

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

4 uker og eldre (Barn, Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

The eligibility criteria for the Platform are applied at multiple levels. One level is that there are inclusion and exclusion criteria that determine eligibility for randomization within the Platform. Another level is that, once eligible for inclusion within the Platform, additional criteria (typically exclusion criteria) are applied that are specific to each domain. Finally, intervention-level eligibility criteria may be applied for interventions within a domain. A patient is eligible for inclusion within a domain when:

All Platform inclusion criteria are met
None of the Platform exclusion criteria are met
Domain-specific eligibility criteria are met
The patient is eligible for at least two interventions within a domain

As such, the key "inclusion criteria" for being eligible for a domain are that the patient is eligible for the Platform.

PLATFORM INCLUSION CRITERIA:

Hospitalised patient
Acute respiratory tract infection
Aged 28 days or older

PLATFORM EXCLUSION CRITERIA:

Death is deemed to be imminent and inevitable during the next 24 hours AND one or more of the patient, substitute decision maker or attending physician are not committed to full active treatment
Patient is expected to be discharged from hospital within the next 24 hours
Previous participation in this REMAP within the last 90 days

DOMAIN-SPECIFIC ELIGIBILITY CRITERIA:

Each domain may have additional eligibility criteria. Refer to the study website for more information (www.remapcap.org).

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Primært formål: Behandling
Tildeling: Randomisert
Intervensjonsmodell: Faktoriell oppgave
Masking: Ingen (Open Label)

Antall våpen

Våpen og intervensjoner

Deltakergruppe / Arm	Intervensjon / Behandling
Annen: Antibiotic Domain Patients with community-acquired pneumonia and requiring empiric antibiotic therapy will be randomised one of five antibiotic interventions. Note: the ceftaroline + macrolide intervention has been closed to recruitment.	Legemiddel: Ceftriaxone + Macrolide The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice. Legemiddel: Moxifloxacin or Levofloxacin The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice. Legemiddel: Piperacillin-tazobactam + Macrolide The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice. Legemiddel: Ceftaroline + Macrolide The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice. Note: this intervention is now closed. Legemiddel: Amoxicillin-clavulanate + Macrolide The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.
Annen: Macrolide Duration Domain Patients with community-acquired pneumonia who have been allocated to receive a beta-lactam + macrolide intervention in the Antibiotic Domain will be randomised to either a standard course or extended course of macrolide therapy	Legemiddel: Standard course macrolide Standard course of macrolide therapy, discontinued between study day 3 and the end of study day 5. The dosing of and route of administration is not protocolised, the following guidance is provided: Initial IV administration of a macrolide is strongly preferred The preferred IV macrolide is azithromycin, but IV clarithromycin may be substituted. The preferred enteral macrolide is azithromycin, but enteral clarithromycin or roxithromycin may be substituted. Legemiddel: Extended course macrolide Extended course of macrolide therapy discontinued at the end of study day 14 or hospital discharge (whichever occurs first). The dosing of and route of administration is not protocolised, the following guidance is provided: Initial IV administration of a macrolide is strongly preferred The preferred IV macrolide is azithromycin, but IV clarithromycin may be substituted. The preferred enteral macrolide is azithromycin, but enteral clarithromycin or roxithromycin may be substituted.
Annen: Corticosteroid Domain Patients with severe lower-respiratory tract infection will be randomised to a steroid use strategy. Note: this domain is now closed to patients with suspected or proven COVID-19. It remains open to patients with CAP without COVID-19. Note: the fixed-course hydrocortisone has been closed to recruitment	Annen: No systemic corticosteroid Patients are not to receive any systemic corticosteroids, including hydrocortisone, to study day 28 or hospital discharge (whichever occurs first). Legemiddel: Fixed-duration Hydrocortisone 50mg of intravenous hydrocortisone will be administered every 6 hours for up to 7 days. Note: this intervention is now closed. Legemiddel: Shock-dependent hydrocortisone 50mg IV hydrocortisone every 6 hours while the patient is in septic shock Legemiddel: Fixed-duration higher dose Hydrocortisone 100mg of intravenous hydrocortisone will be administered every 6 hours for up to 7 days. Note: this intervention was only available to patients with suspected or proven COVID-19 and is now closed. Legemiddel: Fixed-duration dexamethasone 6 mg of IV or enteral dexamethasone will be administered daily for up to 10 days while in hospital.
Annen: Influenza Antiviral Domain Patients with microbiological testing confirmed influenza infection will be randomised to one of six interventions.	Annen: No antiviral agent for influenza No antiviral agent intended to be active against influenza infection is to be administered Legemiddel: Five-days oseltamivir Oseltamivir administered enterally twice daily for 5 days or until hospital discharge (whichever occurs first) Legemiddel: Ten-days oseltamivir Oseltamivir administered enterally twice daily for 10 days or until hospital discharge (whichever occurs first) Legemiddel: Baloxavir Marboxil Baloxavir marboxil administered on days 1 and 4 post-randomisation. Legemiddel: Five-days oseltamivir + baloxavir marboxil Oseltamivir administered enterally twice daily for 5 days or until hospital discharge (whichever occurs first), in addition to baloxavir marboxil administered on days 1 and 4 post-randomisation. Legemiddel: Ten-days oseltamivir + baloxavir marboxil Oseltamivir administered enterally twice daily for 10 days or until hospital discharge (whichever occurs first), in addition to baloxavir marboxil administered on days 1 and 4 post-randomisation.
Annen: COVID-19 Antiviral Domain Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to no ivermectin or ivermectin. Note: an earlier version of this domain evaluated lopinavir-ritonavir, hydroxychloroquine, and combination lopinavir-ritonavir and hydroxychloroquine against a 'no antiviral' control. This domain is now closed.	Annen: No antiviral agent for COVID-19 No antiviral agent intended to be active against SARS-CoV-2 infection is to be administered Legemiddel: Lopinavir / Ritonavir Lopinavir/ritonavir 400/100mg administered enterally, or 5ml 80/20mg per mL solution suspension via gastric tube, every 12 hours. Administered for a minimum of 5 days, including if discharged from ICU prior to end of study day 5. For patients discharged from ICU between study day 6 and study day 14, lopinavir/ritonavir is ceased at ICU discharge. Lopinavir/ritonavir is ceased at the end of study day 14 if the patient remains in ICU. Note: this intervention is now closed. Legemiddel: Hydroxychloroquine Loading dose of 800mg hydroxychloroquine administered enterally every 6 hours until 2 doses have been administered. Subsequently, 400mg hydroxychloroquine will be administered enterally every 12 hours for 12 doses or ICU discharge (whichever occurs first). Note: this intervention is now closed. Legemiddel: Hydroxychloroquine + lopinavir/ritonavir Lopinavir/ritonavir 400/100mg administered enterally, or 5ml 80/20mg per mL solution suspension via gastric tube, every 12 hours. Administered for a minimum of 5 days, including if discharged from ICU prior to end of study day 5. For patients discharged from ICU between study day 6 and study day 14, lopinavir/ritonavir is ceased at ICU discharge. Lopinavir/ritonavir is ceased at the end of study day 14 if the patient remains in ICU. Loading dose of 800mg hydroxychloroquine administered enterally every 6 hours until 2 doses have been administered. Subsequently, 400mg hydroxychloroquine will be administered enterally every 12 hours for 12 doses or ICU discharge (whichever occurs first). Note: this intervention is now closed. Legemiddel: Ivermectin Ivermectin administered enterally at a dose of 0.2 mg/kg once daily with a maximum daily dose of 24mg/day. Note: this intervention is now closed.
Annen: COVID-19 Immune Modulation Domain Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to one of up to five interventions. Note: this domain is now closed.	Annen: No immune modulation for COVID-19 No immune modulating agent intended to be active against COVID-19 is to be administered. Note: this intervention is now closed. Legemiddel: Interferon beta-1a IFN-β1a 10 μg will be administered as an intravenous bolus injection via a central or peripheral line. IFN-β1a will be administered once daily for 6 days or until ICU discharge, whichever occurs first. Note: this intervention is now closed. Andre navn: IFN-pla Legemiddel: Anakinra A loading dose of 300mg anakinra will be administered as a bolus via central or peripheral line. This is followed by maintenance doses of 100mg of anakinra administered every 6 hours. In patients with renal impairment, anakinra will be administered on alternate days. Note: this intervention is now closed. Legemiddel: Tocilizumab Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg. Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period. Note: this intervention is now closed. Legemiddel: Sarilumab Sarilumab will be administered as a single dose of 400mg, via IV infusion through peripheral or central line over a one-hour period. Note: this intervention is now closed. Legemiddel: Tocilizumab Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg. In children weighing less than 30kg, tocilizumab dose will be 12mg/kg. Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period.
Annen: Anticoagulation Domain Patients admitted to participating intensive care units with suspected or microbiological testing confirmed COVID-19 will be randomised to an anticoagulation strategy. Note: A previous version of this domain evaluated local standard venous thromboprophylaxis against therapeutic dose anticoagulation. This domain is now closed.	Legemiddel: Local standard venous thromboprophylaxis Standard venous thromboprophylaxis that complies with local guidelines or usual practice will be administered for 14 days following randomisation or until hospital discharge, whichever occurs first. Note: this intervention is now closed. Legemiddel: Therapeutic dose anticoagulation Patients will be administered either low molecular weight heparin (LMWH) or unfractionated heparin (UFH) to achieve systemic anticoagulation. Either agent may be used and the same patient may be switched between UFH and LMWH at the discretion of the treating clinician. Note: this intervention is now closed. Legemiddel: Conventional low dose thromboprophylaxis Low dose thromboprophylaxis will be administered for 14 days following randomisation or until hospital discharge, whichever occurs first. Dosing is outlined in the relevant protocol documents for this domain. Legemiddel: Intermediate dose thromboprophylaxis Intermediate dose thromboprophylaxis will be administered for 14 days following randomisation or until hospital discharge, whichever occurs first. Dosing is outlined in the relevant protocol documents for this domain. Legemiddel: Continuation of therapeutic dose anticoagulation Patients already receiving therapeutic dose anticoagulation at the time of randomisation to this intervention will be administered either unfractionated heparin by IV infusion or low-molecular weight heparin to achieve systemic anticoagulation according to local practice for acute VTE treatment for 14 days following randomisation or until hospital discharge, whichever occurs first. Note: this intervention is now closed.
Annen: Immunoglobulin Domain Immunosuppressed patients admitted to participating hospitals with microbiological testing confirmed COVID-19 will be randomised to receive no immunoglobulin for COVID-19, or to receive high-titre convalescent plasma. Note: an earlier version of this domain was not restricted to immunosuppressed patients.	Annen: No immunoglobulin No immunoglobulin intended to be active against SARS-CoV-2 infection is to be administered. Biologisk: Convalescent plasma Patients will receive at least one and no more than two units of ABO compatible convalescent plasma within 48 hours of randomisation. Biologisk: Delayed administration of convalescent plasma Note: this intervention is now closed.
Annen: Vitamin C Domain Patients admitted to participating hospitals with community-acquired pneumonia will be randomised to receive no vitamin C, or vitamin C. Note: this domain is now closed.	Annen: No vitamin C No high dose intravenous vitamin C is to be administered Note: this intervention is now closed. Legemiddel: Vitamin C Intravenous Vitamin C 50mg/kg administered every 6 hours for 16 doses Note: this intervention is now closed.
Annen: Simvastatin Domain Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to receive no simvastatin, or simvastatin. Note: this domain is now closed.	Annen: No simvastatin No simvastatin intended to be active against COVID-19 is to be administered Note: this intervention is now closed. Legemiddel: Simvastatin Simvastatin 80mg administered once daily via enteral route, while the patient remains in hospital up to 28 days after randomisation Note: this intervention is now closed.
Annen: Antiplatelet Domain Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to receive no antiplatelet, aspirin, or site-preferred P2Y12 inhibitor. Note: this domain is now closed.	Annen: No antiplatelet No antiplatelet agent or NSAID to be administered. Note: this intervention is now closed. Legemiddel: Aspirin Aspirin administered at either 75mg or 100mg once per day for 14 days or until hospital discharge, whichever occurs first. Note: this intervention is now closed. Andre navn: acetylsalisylsyre Legemiddel: P2Y12 inhibitor Site-selected P2Y12 inhibitor: Clopidogrel: administered 75 mg once per day for 14 days or until hospital discharge, whichever occurs first. Prasugrel: If patient is aged less than 75 years and measured or estimated weight if 60kg or more, and initial loading dose of prasugrel 60 mg will be administered, followed by maintenance dose of 10 mg per day. Ticagrelor: administered enterally at 60mg twice daily for 14 days or until hospital discharge, whichever occurs first. Note: this intervention is now closed. Andre navn: Prasugrel Klopidogrel Ticagrelor
Annen: Mechanical Ventilation Domain Patients with community-acquired pneumonia admitted to participating intensive care units who are intubated and receiving invasive mechanical ventilation will be randomised to protocolised mechanical ventilation strategy, or clinician-preferred mechanical ventilation strategy	Fremgangsmåte: Clinician-preferred mechanical ventilation strategy Clinician-preferred ventilation strategy, including mode of ventilation and all ventilatory parameters Fremgangsmåte: Protocolised mechanical ventilation strategy Invasive mechanical ventilation strategy delivered as outlined in relevant protocol documents for this domain.
Annen: COVID-19 Immune Modulation (2) Domain Patients admitted to participating hospitals with microbiological testing confirmed COVID-19 will be randomised to receive one of three interventions. Note: this domain is now closed.	Annen: No immune modulation for COVID-19 No immune modulating agent intended to be active against COVID-19 is to be administered. Note: this intervention is now closed. Legemiddel: Eritoran Eritoran initiated with a 26.24 mg loading dose (6.56 mg/h IV for 4 hours), followed by a second 13.12 mg loading dose (6.56 mg/h IV for 2 hours) at 12 hours after initiation. Patients will then receive twenty-six 6.56 mg maintenance doses (3.28 mg/h IV for 2 hours) every 12 hours thereafter (total of 14 days). Dosing will be stopped if the patient is discharged from hospital Note: this intervention is now closed. Legemiddel: Apremilast Apremilast administered 30mg twice daily for 14 days or until hospital discharge, whichever occurs first. Note: this intervention is now closed.
Annen: ACE2 RAS Domain Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to one of up to five renin-angiotensin system blockade strategies. Note: this domain is now closed.	Annen: No renin-angiotensin system inhibitor No RAS inhibitor (i.e. no ACEi or ARB) is to be administered up to the end of study day 10. Note: this intervention is now closed. Legemiddel: Angiotensin converting enzyme inhibitor Site-preferred ACEi agent administered as directed by the treating clinician for 10 days or until hospital discharge, whichever occurs first. Note: this intervention is now closed. Andre navn: Lisinopril Perindopril Ramipril Captopril Enalapril Trandolapril Legemiddel: Angiotensin Receptor Blockers Site-preferred ARB agent administered as directed by the treating clinician for 10 days or until hospital discharge, whichever occurs first. Note: this intervention is now closed. Andre navn: Valsartan Losartan Candesartan Irbesartan Olmesartan Telmisartan Legemiddel: ARB + DMX-200 Site-preferred ARB agent administered in combination with DMX-200 for 10 days or until hospital discharge, whichever occurs first. ARB administered as directed by the treating clinician. DMX-200 administered enterally at a dose of 120mg twice daily. Note: this intervention is now closed.
Annen: Cysteamine Domain Patients admitted to participating hospitals with severe community-acquired pneumonia, including patients with suspected or proven influenza or COVID-19, will be randomised to receive no cysteamine, or cysteamine. Note: this domain is now closed.	Annen: No cysteamine No cysteamine to be administered until the end of study day 10 or hospital discharge, whichever occurs first. Note: this intervention is now closed. Legemiddel: Cysteamine Cysteamine administered every 8 hours at a dose of 5 mg/kg estimated or measured body weight (maximum dose of 500mg), for ten days or until ICU discharge, whichever occurs first. Note: this intervention is now closed.
Annen: Endothelial Domain Patients admitted to participating hospitals with severe community-acquired pneumonia, including patients with suspected or proven influenza or COVID-19, will be randomised to receive no endothelial modulator or enteral imatinib.	Annen: No endothelial modulator No endothelial modulator (imatinib or another tyrosine kinase inhibitor targeting the same pathway as imatinib) is to be administered. Legemiddel: Imatinib Enteral imatinib will be administered as a single 800mg loading dose (study day 1) followed by 400mg daily until study day 14 or discharge.
Annen: Influenza Immune Modulation Patients with community-acquired pneumonia admitted to participating intensive care units with microbiological testing confirmed influenza infection will be randomised to one of three interventions.	Legemiddel: Tocilizumab Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg. Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period. Note: this intervention is now closed. Legemiddel: Tocilizumab Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg. In children weighing less than 30kg, tocilizumab dose will be 12mg/kg. Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period. Annen: No Immune Modulator for Influenza No immune modulating agent intended to be active against influenza is to be administered. Legemiddel: Baricitinib Baricitinib will be administered at a dose that is determined by age and renal function, for up to 10 days or hospital discharge (whichever occurs first).
Annen: COVID-19 Antiviral (II) Domain Patients admitted to participating hospitals with microbiological testing confirmed COVID-19 will be randomised to one of up to four interventions.	Annen: No antiviral agent for COVID-19 No antiviral agent intended to be active against SARS-CoV-2 infection is to be administered Legemiddel: Nirmatrelvir/ritonavir Nirmatrelvir-ritonavir will be administered at a dose that is dependent on renal function, for five days. Andre navn: Paxlovid Legemiddel: Remdesivir Remdesivir is administered at 200 mg on day one followed by 100 mg daily for a further four doses (i.e., for five doses in total) or until hospital discharge, whichever occurs first. Legemiddel: Nirmatrelvir/ritonavir + remdesivir Nirmatrelvir-ritonavir will be administered at a dose that is dependent on renal function, for five days. Remdesivir is administered at 200 mg on day one followed by 100 mg daily for a further four doses (i.e., for five doses in total) or until hospital discharge, whichever occurs first.
Annen: Tropical Antibiotic Domain Patients with community-acquired pneumonia in regions at locations where or when empiric cover for melioidosis is appropriate, and requiring empiric antibiotic therapy including cover for melioidosis, will be randomised one of two antibiotic interventions	Legemiddel: Amoxicillin-clavulanate + Ceftazidime + Macrolide The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice. Legemiddel: Meropenem + Macrolide The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

Hva måler studien?

Primære resultatmål

Resultatmål	Tiltaksbeskrivelse	Tidsramme
Survival and Recovery Trajectory up to day 90 Tidsramme: Day 90	The primary endpoint, named Survival and Recovery Trajectory, is a composite of: 90-day all-cause mortality and, among survivors, the number of days on which the patient was not receiving organ failure support during the index hospitalisation, up to the end of study day 28; and, among survivors who never receive organ failure support, hospital free days for the index hospitalisation up to the end of study day 28. For the purposes of this endpoint, organ failure support is defined as: Extracorporeal life support Invasive mechanical ventilation Non-invasive ventilation High-flow nasal oxygen Continuous infusion of vasopressors, inotropes or both	Day 90

Sekundære resultatmål

Resultatmål	Tiltaksbeskrivelse	Tidsramme
All-cause mortality Tidsramme: Day 90	All-cause mortality to day 90 post-randomisation	Day 90
Days alive and free from organ-failure support Tidsramme: Day 28	Days alive and free from organ failure support during the index hospitalisation to day 28	Day 28
Days alive and out of hospital Tidsramme: Day 28	Days alive and out of hospital for the index hospitalisation, to day 28	Day 28
Health-related Quality of life assessment Tidsramme: 6 months	EQ5D-5L and WHODAS 2.0 (not completed in all regions)	6 months

Andre resultatmål

Resultatmål	Tiltaksbeskrivelse	Tidsramme
Domain-Specific Secondary Outcome Tidsramme: During the index hospitalisation to Day 90 post-randomisation, unless otherwise specified	Each domain may specify domain-specific secondary outcomes. Please see relevant Domain-Specific Protocol Documents for details.	During the index hospitalisation to Day 90 post-randomisation, unless otherwise specified

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

UMC Utrecht

Samarbeidspartnere

National University Hospital, Singapore

Berry Consultants

University of Pittsburgh Medical Center

Global Coalition for Adaptive Research

Australian and New Zealand Intensive Care Research Centre

Intensive Care National Audit & Research Centre

Nat Intensive Care Surveillance - MORU

Medical Research Institute of New Zealand

St. Marianna University School of Medicine

Unity Health

Universidad de La Sabana, Colombia

Etterforskere

Studiestol: Steve Webb, Prof, Monash University, Study Chair REMAP-CAP Australia
Studiestol: Colin McArthur, Dr, Medical Research Institute of New Zealand, Study Chair REMAP-CAP New Zealand
Studiestol: Marc Bonten, Prof, UMC Utrecht, Study Chair REMAP-CAP Europe
Studiestol: Lennie Derde, MD, UMC Utrecht, Coordinating Investigator REMAP-CAP Europe
Studiestol: John Marshall, Prof, Unity Health Toronto, Study Chair REMAP-CAP Canada
Studiestol: Derek Angus, Prof, University of Pittsburgh Medical Center, Study Chair REMAP-CAP USA
Studiestol: Luis Felipe Reyes, MD, MSc, PhD, Clínica Universidad de la Sabana, Study Chair REMAP-CAP Colombia

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

11. april 2016

Primær fullføring (Antatt)

1. juni 2028

Studiet fullført (Antatt)

1. februar 2029

Datoer for studieregistrering

Først innsendt

11. desember 2015

Først innsendt som oppfylte QC-kriteriene

6. april 2016

Først lagt ut (Antatt)

13. april 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

4. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. oktober 2026

Sist bekreftet

1. oktober 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

U1111-1189-1653
2015-002340-14 (EudraCT-nummer)
602525 (Annet stipend/finansieringsnummer: European Union, FP7-HEALTH-2013-INNOVATION-1, PREPARE)
16/631 (Annet stipend/finansieringsnummer: Health Research Council of New Zealand)
APP1101719 (Annet stipend/finansieringsnummer: National Health and Medical Research Council, Australia)
158584 (Annet stipend/finansieringsnummer: Canadian Institute of Health Research)
2023-507889-89-00 (Ctis)
2023 (U.S. NIH-stipend/kontrakt)
2015 (U.S. NIH-stipend/kontrakt)
965313 (Annet stipend/finansieringsnummer: European Union, Horizon 2020 research and innovation programme, ECRAID-Base)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Randomisert, innebygd, multifaktoriell adaptiv plattformprøve for fellesskapservervet lungebetennelse (REMAP-CAP)

Studieoversikt

Status

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Studietype

Registrering (Antatt)

Fase

Kontakter og plasseringer

Studiekontakt

Studer Kontakt Backup

Studiesteder

Deltakelseskriterier

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

Tar imot friske frivillige

Kjønn som er kvalifisert for studier

Beskrivelse

Studieplan

Hvordan er studiet utformet?

Designdetaljer

Antall våpen

Våpen og intervensjoner

Deltakergruppe / Arm

Intervensjon / Behandling

Hva måler studien?

Primære resultatmål

Resultatmål

Tiltaksbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Tiltaksbeskrivelse

Tidsramme

Andre resultatmål

Resultatmål

Tiltaksbeskrivelse

Tidsramme

Samarbeidspartnere og etterforskere

Sponsor

Samarbeidspartnere

Etterforskere

Publikasjoner og nyttige lenker

Generelle publikasjoner

Hjelpsomme linker

Studierekorddatoer

Studer hoveddatoer

Studiestart (Faktiske)

Primær fullføring (Antatt)

Studiet fullført (Antatt)

Datoer for studieregistrering

Først innsendt

Først innsendt som oppfylte QC-kriteriene

Først lagt ut (Antatt)

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

Siste oppdatering sendt inn som oppfylte QC-kriteriene

Sist bekreftet

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Studerer et amerikansk FDA-regulert enhetsprodukt

produkt produsert i og eksportert fra USA