NEW YORK, January 22, 2021 / PRNewswire / – Full-dose anti-coagulation (thinner blood) treatment given to critically ill hospitalized patients for COVID-19 reduced the need for vital organ support in a large-scale clinical trial conducted throughout the world. the world. A trend in potential mortality reductions is also being seen and is being further investigated. With large numbers of COVID-19 patients requiring hospitalization, these findings could help reduce the overcrowding of intensive care units worldwide.
Three clinical trial platforms spanning five continents in more than 300 hospitals have worked together to determine whether full doses of heparin (blood thinners) are more beneficial to adults treat moderately ill patients with COVID-19 compared to the lowest heparin dose. administered to prevent blood clots in hospitalized patients. Moderately ill patients are those who are not in intensive care and have not received organ support such as mechanical ventilation at the time of trial registration.
Based on the interim results of more than 1000 moderately ill patients admitted to the hospital, findings showed that full doses of blood thinners, as well as being safe, were better than the doses taken. usually passed to prevent blood clots in hospitalized patients. The trial investigators are now working as quickly as possible to provide the full results of the study so that clinicians can make informed decisions about the treatment of their COVID-19 patients.
As is typical for clinical trials, these trials are led by independent boards that regularly review the data and are made up of experts in ethics, biostatistics, clinical trials, and falls. -blooding orders. Informed by the consideration of these boards of directors, all test sites have ceased to register.
However, research questions remain about how you can improve the clinical care of COVID-19 patients. This adaptive protocol was designed to allow different drugs to be initiated, discontinued or combined during the study in response to emerging scientific data. This approach enables rapid testing of additional agents without safety involvement and the investigation proceeds accordingly.
The results of the test reported today add to the group’s conclusions announced in December that normal use of full-dose anti-coagulation when initiated in the ICU in patients with severe COVID-19 deficiency did not occur. beneficial and may be harmful in some patients.
“In a disease with a limited number of effective treatments, our results represent a game-changer that affects use for moderately ill COVID-19 patients worldwide,” he said. Ryan Zarychanski, MD, M.Sc., associate professor, hematologist and critical care physician at the University of Manitoba and CancerCare Manitoba, Canada, and chair of the Antithrombotic Therapy platform to reduce complications on the COVID-19 (ATTACC) platform and on the ground of therapeutic anticoagulation of the Randomized, Rooted, Multi-Factor Appropriate Platform Test for Community-Acquired Pneumonia (REMAP-CAP).
Early in the pandemic, doctors around the world saw higher levels of blood clots and inflammation among COVID-19 patients that affected multiple organs and caused complications such as lung failure, heart attack and stroke. It was unknown at this time whether he would prescribe higher doses of blood thinners that were routinely administered to hospitalized patients.
“These results are very encouraging and lead us to better understand the impact of taking the right treatments at the right time in the course of this challenging disease,” he said. Judith Hochman, MD, chair of the COVID-19 Therapeutic Intervention Accelerator and Vaccines-4 (ACTIV-4a) platform, Harold Snyder Family Professor & Associate Director of Cardiology, Associate Dean of Clinical Sciences and Co Director, NYU-HHC Clinical and Translational Institute of Science, NYU Grossman School of Medicine.
“These are the first ever multi-platform international clinical trials ever conducted and the rapid discovery of the positive effect of Heparin on patient outcomes in the midst of COVID-19 pandemic disease, i don’t think this is the last time researchers, clinicians and patients will come together across continents to test treatments that may be against any number any diseases, “he said Patrick Lawler, MD, MPH cardiologist at the University of Toronto and the Peter Munk Cardiac Center at the University Health Network, who was a co-principal investigator at ATTACC and a member of the international trial steering committee for REMAP-CAP.
“Early in the pandemic we saw a high frequency of circulating Covid19 patients in the hospital, which caused real complications,” he said. Jeffrey Berger MD, ACTIV-4a co-PI, Associate Professor of Medicine and Surgery, and Director of the Center for the Prevention of Cardiovascular Diseases at NYU Grossman School of Medicine. “It is remarkable to lead a clinical trial that demonstrates that early intervention welding can improve results and avoid many Covid19-related complications.”
Three international partners have come together in an unprecedented collaboration that resulted in a randomized platform-controlled trial. The three international tests include: the Applied, Embedded, Multifactorial Platform Test for Community-Infectious Pneumonia (REMAP-CAPexternal link) Therapeutic Anticoagulation; Accelerated COVID-19 therapeutic interventions and vaccines-4a (ACTIV-4a) Patient Antithrombotics; and Antithrombotic Medicine to reduce COVID-19 complications (ATTACCexternal link). The sole purpose of trials running across four continents is to evaluate the benefit of full doses of blood thinners in the treatment of moderately ill or severely ill adults. hospitalized patients for COVID-19, as opposed to a lower dose that is often used to prevent blood clots in hospitalized patients. To meet the challenge of this pandemic, researchers from all over the world have come together to answer this question as soon as possible. In the United States, the ACTIV-4a trial is led by a collaborative effort by several universities, including the University of Pittsburgh and New York University Grossman School of Medicine, New York City.
The trials are supported by a number of international funding bodies including the Canadian Institutes of Health Research (CAN), the LifeArc Foundation, the National Institute of Heart, Lung & Blood NIH (USA), the National Institutes of Health Research (UK) , National Health and Medical Research Council (AUS) and the PREPARE and RECOVER consortium (EU).
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Rob Magyar
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SOU NYU Grossman School of Medicine
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