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REMAP-CAP: New Results for Antiplatelets in Critical COVID-19

“Essentially, I think the results are very interesting and promising, particularly as antiplatelet therapy is widely available and cheap and COVID is a worldwide issue, with many countries unable to afford expensive new immunomodulation therapies, for example.” - Charlotte Bradbury, Consultant Senior Lecturer at Bristol University 

The efficacy of antiplatelet therapy in critically ill patients with COVID-19 has always been uncertain.

However recent findings have shown that it’s unlikely that adding an antiplatelet agent to anticoagulation will increase the number of organ support-free days in critically ill patients with COVID-19. Although it’s possible that survival in the first 90 days can be improved, according to the results of the REMAP-CAP trial.

This bayesian randomized clinical trial included 1557 critically ill adult patients with COVID-19 who were enrolled between October 30, 2020, and June 23, 2021, from 105 sites in 8 countries and followed up for 90 days. The findings have shown that antiplatelet therapy with either aspirin or a P2Y12 inhibitor, compared with no antiplatelet therapy, resulted in a 95.7% posterior probability of futility with regard to the odds of improvement in organ support–free days within 21 days.

Some secondary outcomes suggested antiplatelets could be beneficial, however. There was a 97.0% probability that adding aspirin or a P2Y12 inhibitor improved survival to discharge and a 99.7% likelihood that it would boost the chances of surviving to 90 days.

As remarked upon by Charlotte Bradbury, Consultant Senior Lecturer at Bristol University, antiplatelet therapy could make a difference to Covid-19 patients worldwide due to its affordability and ease of availability, marking these results a significant progress in the treatment of Covid-19.

Spiral has been involved in the REMAP-CAP trial since day one and continues to be proud of the contribution it is making in the fight against Covid-19 worldwide. 

Read the full report here.

You can also watch Charlotte Bradbury, Consultant Senior Lecturer at Bristol University present the findings here.

Sources:

Jama Network

TCTMD

ISICM