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Today seems like a good day to talk about the Recovery trial ( http://recoverytrial.net ). Mortality for patients hospitalised with COVID-19 locally remains c30% and, until yesterday, no treatment was shown to reduce it. The study is led nationally 21/n
by @PeterHorby and @MartinLandray , funded by @NIHRresearch. The design of the study has features allowing it to recruit quickly.
These include broad recruitment criteria, an ability for interested clinicians to train online to recruit patients and the option for investigators to choose study interventions they consider suitable for an individual patient’s randomisation.
>11,000 patients have been randomised nationally. Locally a large team has delivered the study (including @NurseLouiseY, @NETResearchIC, @ImperialNHS @samullaney, @grahamscooke, Alan Winston, Sarah Fidler, @lizWWyld, @ObstetricsJones @barnaby_flower, @malickgibani )
Four interventions remain open to recruitment (lopinavir/ritonavir, azithromycin, tocilizumab and convalescent plasma). Two have closed- hydroxychloroquine (failed to show a benefit, trend to harm) and now dexamethasone (6mg a day orally or IV).
The press release http://bit.ly/3hDgHOE has the available data. Overall comparison of dex (N=2104) v standard of care (N=4321) is not provided, but dex reduced mortality by 35% in those ventilated, RR 0.65(0.48-0.88), and 20% in those requiring O2, RR 0.80[0.67-0.96)
As a widely accessible, generic manufactured medication, dexamethasone can be affordable part of a bundle of interventions to improve clinical outcome
