First MFT patient enrolled in ‘REMAP-CAP’ COVID-19 research trial

Our first patient has taken part in an interventional research trial testing potential treatments for people with severe COVID-19 infection, being cared for in an Intensive Care Unit.

The Randomised, Embedded, Multifactorial, Adaptive Platform trial for Community-Acquired Pneumonia (REMAP-CAP) trial is part of the NIHR list of nationally-prioritised COVID-19 studies. It is funded by the European Commission and sponsored by the University Medical Centre Utrecht, in the Netherlands.

The primary aim of this international trial – which is taking place at 50 sites across the world – is to generate evidence that can be applied during the coronavirus pandemic in order to reduce deaths, Intensive Care Unit (ICU) use, and morbidity in severely ill patients with COVID-19 infection.

In the UK, REMAP-CAP is taking place in 20 hospitals and aims to enrol 800 patients, including at Manchester Royal Infirmary and Wythenshawe Hospital, where our first patient was enrolled on 23 April.

Dr Peter Alexander, a Consultant in Anaesthesia and Intensive Care Medicine, is leading REMAP-CAP at Wythenshawe Hospital on behalf of Manchester University NHS Foundation Trust (MFT).

Dr Alexander said: “One of the key aspects REMAP-CAP’s design is that it is a fully adaptive, platform trial. This means that several different treatments can be tested at the same time under one ‘platform’ – and more treatments can be added as new evidence emerges.

Crucially, if evidence suggests a particular treatment is proving beneficial, more patients will be treated with that drug within the trial, improving outcomes and reducing ICU stays – even before the results are declared and the trial ends. It provides a type of self-learning healthcare system, which is important in this fast-moving COVID-19 pandemic.

A photo of Dr Peter Alexander

Dr Peter Alexander

At MFT, a number of treatments are currently being trialled as part of REMAP-CAP including Lopinavir/Ritonavir, which is commonly used to treat HIV, and Anakinra, which is used as a treatment for rheumatoid arthritis.

Patients taking part in REMAP-CAP will be followed up to six months after their enrolment in the trial to monitor their health and progress.

Our COVID-19 research spans four workstreams; data, diagnostics, observational and treatments. Eight studies are currently open, including REMAP-CAP – one of our interventional ‘treatments’ trials – and more studies are  in set-up, due to open imminently.

Dr Tim Felton, our Clinical Lead for all MFT COVID-19-related research studies, said: “We are running several coronavirus studies at MFT, this one is aimed specifically at those patients who are admitted to ICU with severe Community-Acquired Pneumonia (CAP).

We carry out research when we don’t have all the answers, but as this trial is fully adaptive, we hope it can improve outcomes for our patients in real time.

“We are grateful to our first REMAP-CAP participant and to all patients who take part in COVID-19 research at our Trust and across the world, as every person who takes part in research is helping improve global understanding of this virus.”

Dr Felton explains more about the COVID-19 research taking place at MFT in this short video.

REMAP-CAP is a randomised trial with patients, allocated to different arms: the ‘treatment group’ receiving the trial drug and standard care and the ‘control group’, receiving standard care. All participants, whether they are randomly allocated to the treatment or control group, will receive the best available standard care.

Read more about REMAP-CAP on the NIHR website.