Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial

YM Arabi; AC Gordon; LPG Derde; AD Nichol; S Murthy; FA Beidh; D Annane; LA Swaidan; A Beane; R Beasley; LR Berry; Z Bhimani; MJM Bonten; CA Bradbury; FM Brunkhorst; M Buxton; A Buzgau; A Cheng; M De Jong; MA Detry; EJ Duffy; LJ Estcourt; M Fitzgerald; R Fowler; TD Girard; EC Goligher; H Goossens; R Haniffa; AM Higgins; TE Hills; CM Horvat; DT Huang; AJ King; F Lamontagne; PR Lawler; R Lewis; K Linstrum; E Litton; E Lorenzi; S Malakouti; DF McAuley; A McGlothlin; S Mcguinness; BJ McVerry; SK Montgomery; SC Morpeth; PR Mouncey; K Orr; R Parke; JC Parker; AE Patanwala; KM Rowan; MS Santos; CT Saunders; CW Seymour; M Shankar-Hari; SYC Tong; AF Turgeon; AM Turner; FL Van de Veerdonk; R Zarychanski; C Green; S Berry; JC Marshall; C McArthur; DC Angus; SA Webb; F Al-Beidh; D Angus; W van Bentum-Puijk; P Lawler; A Turgeon; A Turner; L Campbell; A Forbes; D Gattas; S Heritier; P Kruger; S Peake; J Presneill; I Seppelt; T Trapani; A Turner; P Young; B Cuthbertson; V Manoharan

Journal article

Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial

YM Arabi, AC Gordon, LPG Derde, AD Nichol, S Murthy, FA Beidh, D Annane, LA Swaidan, A Beane, R Beasley, LR Berry, Z Bhimani, MJM Bonten, CA Bradbury, FM Brunkhorst, M Buxton, A Buzgau, A Cheng, M De Jong, MA Detry Show all

Intensive Care Medicine | Published : 2021

DOI: 10.1007/s00134-021-06448-5

Abstract

Purpose: To study the efficacy of lopinavir-ritonavir and hydroxychloroquine in critically ill patients with coronavirus disease 2019 (COVID-19). Methods: Critically ill adults with COVID-19 were randomized to receive lopinavir-ritonavir, hydroxychloroquine, combination therapy of lopinavir-ritonavir and hydroxychloroquine or no antiviral therapy (control). The primary endpoint was an ordinal scale of organ support-free days. Analyses used a Bayesian cumulative logistic model and expressed treatment effects as an adjusted odds ratio (OR) where an OR > 1 is favorable. Results: We randomized 694 patients to receive lopinavir-ritonavir (n = 255), hydroxychloroquine (n = 50), combination therapy..

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Funding Acknowledgements

Supported by the European Union-through FP7-HEALTH-2013-INNOVATION: the Platform for European Preparedness Against emerging Epidemics (PREPARE) consortium (602525), and Horizon 2020 research and innovation program: the Rapid European Covid-19 Emergency Research response (RECOVER) consortium (101003589)-and by the Australian National Health and Medical Research Council (APP1101719 and APP1116530), the Health Research Council of New Zealand (16/631), a Canadian Institutes of Health Research Strategy for Patient-Oriented Research Innovative Clinical Trials Program Grant (158584), the U.K. NIHR and the NIHR Imperial Biomedical Research Centre, the Health Research Board of Ireland (CTN 2014-012), the UPMC Learning While Doing Program, the Breast Cancer Research Foundation, the French Ministry of Health (PHRC-20-0147), the Minderoo Foundation, Amgen, Eisai, the Global Coalition for Adaptive Research, and the Wellcome Trust Innovations Project (215522). Dr. Gordon is funded by an NIHR Research Professorship (RP-2015-06-18), and Dr. Shankar-Hari by an NIHR Clinician Scientist Fellowship (CS-2016-16-011).