Imperial College London
Portrait Picture

Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
//

Contact

 

anthony.gordon

 
 
//

Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Arabi:2021:10.1007/s00134-021-06448-5,
author = {Arabi, Y and Gordon, A and Derde, L and Nichol, A and Murthy, S and Al-Beidh, F and Annane, D and Al, Swaidan L and Beane, A and Beasley, R and Berry, L and Bhimani, Z and Bonten, M and Bradbury, C and Brunkhorst, F and Buxton, M and Buzgau, A and Cheng, A and De, Jong M and Detry, M and Duffy, E and Estcourt, L and Fitzgerald, M and Fowler, R and Girard, T and Goligher, E and Goossens, H and Haniffa, R and Higgins, A and Hills, T and Horvat, C and Huang, D and King, A and Lamontagne, F and Lawler, P and Lewis, R and Linstrum, K and Litton, E and Lorenzi, E and Malakouti, S and McAuley, D and McGlothlin, A and Mcguinness, S and McVerry, B and Montgomery, S and Morpeth, S and Mouncey, P and Orr, K and Parke, R and Parker, J and Patanwala, A and Rowan, K and Santos, M and Saunders, C and Seymour, C and Shankar-Hari, M and Tong, S and Turgeon, A and Turner, A and Van, de Veerdonk FL and Zarychanski, R and Green, C and Berry, S and Marshall, J and McArthur, C and Angus, D and Webb, S},
doi = {10.1007/s00134-021-06448-5},
journal = {Intensive Care Medicine},
pages = {867--886},
title = {Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized control trial},
url = {http://dx.doi.org/10.1007/s00134-021-06448-5},
volume = {47},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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 (n=27) or control (n=362). The median (IQR) organ support-free days among patients in lopinavir-ritonavir, hydroxychloroquine, and combination therapy groups was 4 (–1 to 15), 0 (–1 to 9) and –1 (–1 to 7), respectively, compared to 6 (–1 to 16) in the control group with in-hospital mortality of 88/249 (35%), 17/49 (35%), 13/26 (50%), respectively, compared to 106/353 (30%) in the control group. The three interventions decreased organ support-free days compared to control (OR [95% credible interval]: 0.73 [0.55, 0.99], 0.57 [0.35, 0.83] 0.41 [0.24, 0.72]), yielding posterior probabilities that reached the threshold futility (≥99.0%), and high probabilities of harm (98.0%, 99.9% and >99.9%, respectively). The three interventions reduced hospital survival compared with control (OR [95% CrI]: 0.65 [0.45, 0.95], 0.56 [0.30, 0.89], and 0.36 [0.17, 0.73]), yielding high probabilities of harm (98.5% and 99.4% and 99.8%, respectively). Conclusion: Among critically ill patients with COVID-19, lopinavir-ritonavir, hydroxychloroquine, or combination therapy worsened outcomes compared to no antiviral therapy.Trial registration Clinicaltrials.gov identifier: NCT02735707
AU  - Arabi,Y
AU  - Gordon,A
AU  - Derde,L
AU  - Nichol,A
AU  - Murthy,S
AU  - Al-Beidh,F
AU  - Annane,D
AU  - Al,Swaidan L
AU  - Beane,A
AU  - Beasley,R
AU  - Berry,L
AU  - Bhimani,Z
AU  - Bonten,M
AU  - Bradbury,C
AU  - Brunkhorst,F
AU  - Buxton,M
AU  - Buzgau,A
AU  - Cheng,A
AU  - De,Jong M
AU  - Detry,M
AU  - Duffy,E
AU  - Estcourt,L
AU  - Fitzgerald,M
AU  - Fowler,R
AU  - Girard,T
AU  - Goligher,E
AU  - Goossens,H
AU  - Haniffa,R
AU  - Higgins,A
AU  - Hills,T
AU  - Horvat,C
AU  - Huang,D
AU  - King,A
AU  - Lamontagne,F
AU  - Lawler,P
AU  - Lewis,R
AU  - Linstrum,K
AU  - Litton,E
AU  - Lorenzi,E
AU  - Malakouti,S
AU  - McAuley,D
AU  - McGlothlin,A
AU  - Mcguinness,S
AU  - McVerry,B
AU  - Montgomery,S
AU  - Morpeth,S
AU  - Mouncey,P
AU  - Orr,K
AU  - Parke,R
AU  - Parker,J
AU  - Patanwala,A
AU  - Rowan,K
AU  - Santos,M
AU  - Saunders,C
AU  - Seymour,C
AU  - Shankar-Hari,M
AU  - Tong,S
AU  - Turgeon,A
AU  - Turner,A
AU  - Van,de Veerdonk FL
AU  - Zarychanski,R
AU  - Green,C
AU  - Berry,S
AU  - Marshall,J
AU  - McArthur,C
AU  - Angus,D
AU  - Webb,S
DO  - 10.1007/s00134-021-06448-5
EP  - 886
PY  - 2021///
SN  - 0342-4642
SP  - 867
TI  - Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized control trial
T2  - Intensive Care Medicine
UR  - http://dx.doi.org/10.1007/s00134-021-06448-5
UR  - https://link.springer.com/article/10.1007%2Fs00134-021-06448-5
UR  - http://hdl.handle.net/10044/1/89260
VL  - 47
ER  -
Download