REMAP-CAP, the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia, has recently hit a significant date in its trial history, celebrating two years since the first Covid-19 ICU patient was randomised into the trial.

Looking back on the trial and the COVID-19 climate which we still find ourselves in, it’s incredible to see how quickly things happened. On the 10th of March 2020, the first patient was enrolled at Royal Melbourne Hospital, with the second following on the 13th of March. On the 17th we saw another 4 patients enrol before the floodgates opened. 

Now two years on since the first enrolment, we have watched as the total number of patients has climbed to an astounding 11,032 with almost 20,000 randomisations. 17,581 of these were with suspected or proven Covid-19. There are now 357 active sites across the globe working within this trial and 55 current or completed interventions in 16 domains. 

We’ve seen some remarkable and promising results gained from these domains during these two years. Therapeutic-dose anticoagulation with heparin has shown to increase the probability of survival for those hospitalised as non-critically ill patients with Covid-19. We’ve also learnt how full-dose blood thinners benefit moderately ill COVID-19 patients and have seen how tocilizumab and sarilumab are equally effective for the treatment of patients with severe COVID-19 -  the most effective interventions included in this particular domain.

Before Covid-19 first made itself known, the world of clinical trials was at a remarkably different place. The challenges that existed then are still present now, but the global pandemic has highlighted just how easily health risks can cross borders. We’ve also witnessed the speed at which things can change, demonstrating a need for global cooperation and unity within the medical community. This pandemic has mobilised researchers worldwide on a scale and timeframe that has never before been witnessed for one disease. 

The immense pressure that has been placed upon researchers, regulators, trial technicians, doctors and nurses (the list goes on) has been undeniable. We’ve seen how important well-designed randomised clinical trials are for both patients and medical staff as well as a need to move quickly in a time of incredible uncertainty.

Spiral has been involved in the REMAP-CAP clinical trial for the past two years. We have dedicated several members of staff to developing and delivering the software needed to perform this study within our Spinnaker platform. Being highly adaptable and flexible in this current global environment has been a crucial aspect for our team, ensuring that we deliver exactly what is needed to those working on the frontline, making trials like REMAP-CAP faster, easier and smarter.

To put it simply, worldwide, REMAP-CAP has been one of the most important critical care trials of the pandemic, one that Spiral continues to be proud to be a part of.

‘It’s an absolute privilege to be working on this project with the global REMAP-CAP family. The past two years have been crazy - although we were preparing the platform for a pandemic nothing prepared us for the global nature of this pandemic, the speed of its spread or how often the disease adapted. The dedication of the team at Spiral to meet these challenges has been astounding’ - Audrey Shearer, Spiral Founder and CEO