CATCO
Trial question
What is the role of remdesivir in patients with COVID-19 infection across Canada?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
40.0% female
60.0% male
N = 1281
1281 patients (515 female, 766 male).
Inclusion criteria: hospitalized adult patients with laboratory-confirmed COVID-19 infection.
Key exclusion criteria: allergy to study drug; anticipated transfer to a nonstudy site; expected to not survive beyond 24 hours; already receiving remdesivir at time of enrollment.
Interventions
N=634 remdesivir (IV dose of 200 mg on day 0, followed by 100 mg daily for 10 days plus standard care).
N=648 standard care (standard care alone).
Primary outcome
Death at day 28
18.7%
22.6%
22.6 %
17.0 %
11.3 %
5.7 %
0.0 %
Remdesivir
Standard
care
No significant
difference ↔
No significant difference in death at day 28 (18.7% vs. 22.6%; RR 0.83, 95% CI 0.67 to 1.03).
Secondary outcomes
Significant decrease in need for mechanical ventilation (8% vs. 15%; RR 0.53, 95% CI 0.38 to 0.75).
No significant difference in death at day 60 (24.8% vs. 28.2%; RR 0.88, 95% CI 0.72 to 1.07).
Significant increase in oxygen-free days at day 28 (15.9 days vs. 14.2 days; AD 1.7 days, 95% CI 0.4 to 3).
Safety outcomes
No significant differences in need for dialysis, creatinine levels, new hepatic dysfunction.
Conclusion
In hospitalized adult patients with laboratory-confirmed COVID-19 infection, remdesivir was not superior to standard care with respect to death at day 28.
Reference
Karim Ali, Tanweer Azher, Mahin Baqi et al. Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial. CMAJ. 2022 Feb 22;194(7):E242-E251.
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