Denna sida har översatts automatiskt och översättningens korrekthet kan inte garanteras. Vänligen se engelsk version för en källtext.

Randomiserad, inbäddad, multifaktoriell adaptiv plattformsprövning för gemenskapsförvärvad lunginflammation (REMAP-CAP)

30 oktober 2026 uppdaterad 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.

Studieöversikt

Status

Rekrytering

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

20000

Fas

  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

4 veckor och äldre (Barn, Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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:

  1. Hospitalised patient
  2. Acute respiratory tract infection
  3. Aged 28 days or older

PLATFORM EXCLUSION CRITERIA:

  1. 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
  2. Patient is expected to be discharged from hospital within the next 24 hours
  3. 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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Faktoriell uppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Övrig: 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.

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

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.

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

Övrig: 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

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.

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.
Övrig: 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

Patients are not to receive any systemic corticosteroids, including hydrocortisone, to study day 28 or hospital discharge (whichever occurs first).

50mg of intravenous hydrocortisone will be administered every 6 hours for up to 7 days.

Note: this intervention is now closed.

50mg IV hydrocortisone every 6 hours while the patient is in septic shock

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.

6 mg of IV or enteral dexamethasone will be administered daily for up to 10 days while in hospital.

Övrig: Influenza Antiviral Domain

Patients with microbiological testing confirmed influenza infection will be randomised to one of six interventions.

No antiviral agent intended to be active against influenza infection is to be administered

Oseltamivir administered enterally twice daily for 5 days or until hospital discharge (whichever occurs first)

Oseltamivir administered enterally twice daily for 10 days or until hospital discharge (whichever occurs first)

Baloxavir marboxil administered on days 1 and 4 post-randomisation.

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.

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.

Övrig: 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.

No antiviral agent intended to be active against SARS-CoV-2 infection is to be administered

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.

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.

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.

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.

Övrig: 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.

No immune modulating agent intended to be active against COVID-19 is to be administered.

Note: this intervention is now closed.

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.

Andra namn:
  • IFN-pla

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.

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.

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.

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.

Övrig: 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.

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.

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.

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.

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.

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.

Övrig: 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.

No immunoglobulin intended to be active against SARS-CoV-2 infection is to be administered.

Patients will receive at least one and no more than two units of ABO compatible convalescent plasma within 48 hours of randomisation.

Note: this intervention is now closed.

Övrig: 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.

No high dose intravenous vitamin C is to be administered

Note: this intervention is now closed.

Intravenous Vitamin C 50mg/kg administered every 6 hours for 16 doses

Note: this intervention is now closed.

Övrig: 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.

No simvastatin intended to be active against COVID-19 is to be administered

Note: this intervention is now closed.

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.

Övrig: 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.

No antiplatelet agent or NSAID to be administered.

Note: this intervention is now closed.

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.

Andra namn:
  • acetylsalicylsyra

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.

Andra namn:
  • Prasugrel
  • Clopidogrel
  • Ticagrelor
Övrig: 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

Clinician-preferred ventilation strategy, including mode of ventilation and all ventilatory parameters

Invasive mechanical ventilation strategy delivered as outlined in relevant protocol documents for this domain.

Övrig: 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.

No immune modulating agent intended to be active against COVID-19 is to be administered.

Note: this intervention is now closed.

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.

Apremilast administered 30mg twice daily for 14 days or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.

Övrig: 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.

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.

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.

Andra namn:
  • Lisinopril
  • Perindopril
  • Ramipril
  • Captopril
  • Enalapril
  • Trandolapril

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.

Andra namn:
  • Valsartan
  • Losartan
  • Candesartan
  • Irbesartan
  • Olmesartan
  • Telmisartan

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.

Övrig: 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.

No cysteamine to be administered until the end of study day 10 or hospital discharge, whichever occurs first.

Note: this intervention is now closed.

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.

Övrig: 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.

No endothelial modulator (imatinib or another tyrosine kinase inhibitor targeting the same pathway as imatinib) is to be administered.

Enteral imatinib will be administered as a single 800mg loading dose (study day 1) followed by 400mg daily until study day 14 or discharge.

Övrig: 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.

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.

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.

No immune modulating agent intended to be active against influenza is to be administered.

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).

Övrig: 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.

No antiviral agent intended to be active against SARS-CoV-2 infection is to be administered

Nirmatrelvir-ritonavir will be administered at a dose that is dependent on renal function, for five days.

Andra namn:
  • Paxlovid

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.

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.

Övrig: 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

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Survival and Recovery Trajectory up to day 90
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
All-cause mortality
Tidsram: Day 90

All-cause mortality to day 90 post-randomisation

Day 90
Days alive and free from organ-failure support
Tidsram: 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
Tidsram: Day 28

Days alive and out of hospital for the index hospitalisation, to day 28

Day 28
Health-related Quality of life assessment
Tidsram: 6 months

EQ5D-5L and WHODAS 2.0 (not completed in all regions)

6 months

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Domain-Specific Secondary Outcome
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Utredare

  • 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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

11 april 2016

Primärt slutförande (Beräknad)

1 juni 2028

Avslutad studie (Beräknad)

1 februari 2029

Studieregistreringsdatum

Först inskickad

11 december 2015

Först inskickad som uppfyllde QC-kriterierna

6 april 2016

Första postat (Beräknad)

13 april 2016

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

4 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

30 oktober 2026

Senast verifierad

1 oktober 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

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

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

produkt tillverkad i och exporterad från U.S.A.

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

Prenumerera