Posted on 12/21/2022 11:54:38 AM PST by ConservativeMind
The world's largest trial into the effect of multiple interventions for critically ill adults with COVID-19 on longer-term outcomes has released results from the 180-day (six month) follow-up of 4,869 critically ill patients.
The study is part of the ongoing Randomized Embedded Multifactorial Adaptive Platform for Community Acquired Pneumonia (REMAP-CAP) trial led by Dr. Lisa Higgins.
The study found that among critically ill patients with COVID-19 randomized to receive one or more therapeutic interventions, treatment with an IL-6 receptor antagonist (tocilizumab or sarilumab), led to a greater than 99.9% probability of improved 6-month mortality, while antiplatelet agents had a 95% probability of improving 6-month survival.
Moreover, the study also showed that treatments which improve survival, such as interleukin-6 receptor antagonists, do not come at the expense of survival with increased disability or poorer health-related quality of life.
In contrast, longer-term outcomes were not improved with therapeutic anticoagulation, convalescent plasma, or lopinavir-ritonavir, and were worsened with hydroxychloroquine alone or in combination with lopinavir-ritonavir. Corticosteroids did not confer a high probability of improved longer-term survival, although enrolment into this domain was closed early in response to external evidence.
"While we have been treating critically ill patients with COVID-19 for nearly three years, we are still very much in the early stages of understanding the long-term survival, health-related quality of life, and disability among patients with critical illness due to COVID-19," said Dr. Higgins.
"These findings have important clinical and research implications in COVID-19, and in critical care more generally, because they provide evidence that short-term within-hospital treatment effects are sustained longer-term."
The 4,869 critically ill adult patients with COVID-19 were enrolled into the trial between March 9, 2020, and June 22, 2021, from 197 sites in 14 countries. The final 180-day follow-up was completed on March 2, 2022.
(Excerpt) Read more at medicalxpress.com ...
Not helpful were: Convalescent plasma, lopinavir-ritonavir, hydroxychloroquine alone or in combination with lopinavir-ritonavir, and corticosteroids.
If your loved one is being treated, see if it aligns with what this found as helpful, focusing on the interleukin-6 receptor antagonists, it would seem.
Could not find the JAMA article in either current or previous issue.
It’s a link right at the bottom of the write up:
https://jamanetwork.com/journals/jama/fullarticle/2799870
What a weird way to quantify a benefit. How much "improvement" was there? Is there a 99.9% probability of a 10% improvement in mortality at 6 months? A 1% improvement? A 99% improvement?
Seems to me that statistic tells only part of the story and, by itself, is useless.
What the heck is an “interleukin-6 receptor antagonist?”
They are molecules that tamp down the immune response of your body against foreign substances or pathogens. Kind of like antihistamines.
An over responsive immune system can be the real killer in some diseases.
Thank you.
“What the heck is an “interleukin-6 receptor antagonist?””
tocilizumab and sarilumab are monoclonal antibodies ...
Does the monoclonal antibody Bebtelovimab fall into one of the categories discussed?
Interesting. Thanks.
These guys seem to know what they're doing:
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