41 research outputs found
Hospitalisation of Type 2 diabetes mellitus patients with and without major depressive disorder in a private managed healthcare organisation
- Publication venue
- Medpharm Publications (Pty)
- Publication date
- 26/08/2021
- Field of study
Background: The relationship between Type 2 diabetes mellitus (T2DM) and associated co-morbidities, particularly major depressive disorder (MDD), is poorly acknowledged in chronic disease management practices in South Africa. Managed healthcare costs and hospitalisation rates may be influenced by the discrete management of co-morbid conditions. Therefore, the relationship between T2DM and MDD in terms of co-morbidity incidence and hospitalisation resource utilisation was investigated.Method: This retrospective descriptive study analysed the data of 902 adult patients with T2DM from the health system database of a private managed healthcare organisation for 2014.Results: The mean age was 57 ± 15 years and 85% of the identified T2DM patients had at least one recorded co-morbidity. Among this population 17% presented with MDD. A higher percentage of T2DM patients with MDD were admitted to hospital (42%, p = 0.004) compared with those without MDD (30%). The number of overnight admissions was higher among the T2DM with MDD (76%, p = 0.016) compared with T2DM without MDD (66%). The T2DM with MDD group (85%, p = 0.018) had greater non-diabetes related hospital events compared with the T2DM without MDD group (73%). The T2DM patients without MDD were more likely to be hospitalised for diabetes-related events (27%, p = 0.018) at significantly higher admission cost (p = 0.001).Conclusion: Patients with T2DM and MDD present with more co-morbid conditions and had a higher number of hospitalisations than their non-MDD counterparts. However, the hospitalisation costs were significantly higher for diabetes-related admissions in the non-MDD group due to a higher number of macrovascular events. Healthcare organisations need to focus on an integrated approach in the management of chronic conditions with emphasis on active surveillance of T2DM patients, where MDD is identified and treated to lessen the risk of macrovascular complications
Identification of diverse database subsets using property-based and fragment-based molecular descriptions
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2002
- Field of study
This paper reports a comparison of calculated molecular properties and of 2D fragment bit-strings when used for the selection of structurally diverse subsets of a file of 44295 compounds. MaxMin dissimilarity-based selection and k-means cluster-based selection are used to select subsets containing between 1% and 20% of the file. Investigation of the numbers of bioactive molecules in the selected subsets suggest: that the MaxMin subsets are noticeably superior to the k-means subsets; that the property-based descriptors are marginally superior to the fragment-based descriptors; and that both approaches are noticeably superior to random selection
Rapid Quantification of Molecular Diversity for Selective Database Acquisition
- Author
- Publication venue
- 'American Chemical Society (ACS)'
- Publication date
- 01/01/1997
- Field of study
There is an increasing need to expand the structural diversity of the molecules investigated in lead-discovery programs. One way in which this can be achieved is by acquiring external datasets that will enhance an existing database. This paper describes a rapid procedure for the selection of external datasets using a measure of structural diversity that is calculated from sums of pairwise intermolecular structural similarities
Milepost GCC: Machine Learning Enabled Self-tuning Compiler
- Author
- Abdul Wahid Memon
- Ayal Zaks
- Bilha Mendelson
- Christopher K. I. Williams
- Edwin Bonilla
- Elad Yom-Tov
- Elton Ashton
- Eric Courtois
- Francois Bodin
- G. Fursin
- Grigori Fursin
- J. Ullman
- John Thomson
- Michael O’Boyle
- Mircea Namolaru
- Olivier Temam
- P. Larra naga
- Phil Barnard
- R. Duda
- R. El-Yaniv
- R. Vuduc
- Yuriy Kashnikov
- Zbigniew Chamski
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2011
- Field of study
International audienceTuning compiler optimizations for rapidly evolving hardwaremakes porting and extending an optimizing compiler for each new platform extremely challenging. Iterative optimization is a popular approach to adapting programs to a new architecture automatically using feedback-directed compilation. However, the large number of evaluations required for each program has prevented iterative compilation from widespread take-up in production compilers. Machine learning has been proposed to tune optimizations across programs systematically but is currently limited to a few transformations, long training phases and critically lacks publicly released, stable tools. Our approach is to develop a modular, extensible, self-tuning optimization infrastructure to automatically learn the best optimizations across multiple programs and architectures based on the correlation between program features, run-time behavior and optimizations. In this paper we describeMilepostGCC, the first publicly-available open-source machine learning-based compiler. It consists of an Interactive Compilation Interface (ICI) and plugins to extract program features and exchange optimization data with the cTuning.org open public repository. It automatically adapts the internal optimization heuristic at function-level granularity to improve execution time, code size and compilation time of a new program on a given architecture. Part of the MILEPOST technology together with low-level ICI-inspired plugin framework is now included in the mainline GCC.We developed machine learning plugins based on probabilistic and transductive approaches to predict good combinations of optimizations. Our preliminary experimental results show that it is possible to automatically reduce the execution time of individual MiBench programs, some by more than a factor of 2, while also improving compilation time and code size. On average we are able to reduce the execution time of the MiBench benchmark suite by 11% for the ARC reconfigurable processor.We also present a realistic multi-objective optimization scenario for Berkeley DB library using Milepost GCC and improve execution time by approximately 17%, while reducing compilatio
Multi-messenger observations of a binary neutron star merger
- Author
- Aab A
- Aartsen MG
- Abbott BP
- Abbott R
- Abbott TD
- Abbott TMC
- Abdalla H
- Abe F
- Abeysekara AU
- Abramo LR
- Abramowski A
- Abreu P
- Acernese F
- Acero F
- Ackermann M
- Ackley K
- Ackley K
- Adams C
- Adams J
- Adams SM
- Adams T
- Addesso P
- Adhikari RX
- Adya VB
- Affeldt C
- Afrough M
- Agarwal B
- Agathos M
- Agatsuma K
- Aggarwal N
- Aglietta M
- Agliozzo C
- Agudo I
- Aguiar OD
- Aguilar JA
- Aharonian F
- Ahlers M
- Ahrens M
- Aiello L
- Ain A
- Ajith P
- Akras S
- Al Samarai I
- Albert A
- Albert A
- Albuquerque IFM
- Albury JM
- Alcaniz JS
- Alexander KD
- Alfaro R
- Alighieri S Di Serego
- Allam S
- Allekotte I
- Allen B
- Allen G
- Allison J
- Allison JR
- Allocca A
- Almela A
- Altin PA
- Altmann D
- Alvarez C
- Alvarez JD
- Alvarez M Dovale
- Alvarez-Muiz J
- Amati L
- Amato A
- An T
- Ananyeva A
- Anastasi GA
- Anchordoqui L
- Andeen K
- Anderson JP
- Anderson SB
- Anderson T
- Anderson WG
- Andrada B
- Andre M
- Andreoni I
- Andreoni I
- Andringa S
- Angelova SV
- Anghinolfi M
- Angner EO
- Angus CR
- Annis J
- Ansseau I
- Antier S
- Anton G
- Antonelli LA
- Antonelli LA
- Anupama GC
- Aoki K
- Aoki W
- Appert S
- Aptekar RL
- Arai K
- Arakawa M
- Aramo C
- Araya MC
- Arcavi I
- Arceo R
- Ardid M
- Areeda JS
- Aresu G
- Argan A
- Argelles C
- Arnaud N
- Array LWA Long Wavelength
- Array MWA Murchison Widefield
- Arrieta M
- Arsene N
- Arteaga-Velzquez JC
- Artola R
- Arun KG
- Asakura Y
- Asaoka Y
- Ascenzi S
- Ashall C
- Ashley MCB
- Ashton G
- Asorey H
- Assis P
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- Atallah DV
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- Atwood WB
- Aubert J-J
- Aubert P
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- Aufmuth P
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- 'American Astronomical Society'
- Publication date
- 01/01/2017
- Field of study
On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
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- Zullo C.
- Zuriaga-Alvaro A.
- Zuurbier W.
- Zyengi S.
- Publication venue
- 'Elsevier BV'
- Publication date
- 29/05/2021
- Field of study
Background:
Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.
Findings:
Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79).
Interpretation:
In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
- Author
- Abbas M.
- Abdul Rasheed A.
- Abdul A.
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- Wubetu J.
- Xavier B.
- Yaqoob N.
- Yasmin S.
- Yates B.
- Yates T.
- Yelnoorkar F.
- Yelnoorkar F.
- Yeoh A.
- Younes Ibrahim A.
- Young L.
- Yu C.
- Zaki K.
- Zammit-Mangion M.
- Zayed M.
- Zhu D.
- Zia M.
- Zitter L.
- Zuhra N.
- Zullo C.
- Publication venue
- Springer Science and Business Media LLC
- Publication date
- 31/01/2024
- Field of study
Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome
Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/05/2021
- Field of study
Background:
In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936).
Findings:
Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001).
Interpretation:
In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
- Author
- Abani Obbina
- Abbas Ali
- Abbas Fatima
- Abbas Mustafa
- Abbasi Sadia
- Abbass Hakam
- Abbott Alfie
- Abdallah Nabeel
- Abdelaziz Ashraf
- Abdelfattah Mohamed
- Abdelqader Bushra
- Abdo David
- Abdul Rasheed Althaf
- Abdul Basir
- Abdul-Kadir Rezan
- Abdul-Raheem Rasheed
- Abdulakeem Ajibode
- Abdulle Amina
- Abdulmumeen Abdulfatahi
- Abdulshukkoor Niyaz
- Abdusamad Kula
- Abed El Khaleq Yazeed
- Abedalla Mai
- Abeer Ul Amna Abeer Ul Amna
- Abernethy Katrina
- Abo-Leyah Hani
- Aboaba Adebanke
- Abou-Haggar Ahmed
- Abouibrahim Mahmoud
- Abraham Miriam
- Abraham Tizzy
- Abraheem Abraheem
- Abrams Judith
- Abu Hyacinth-John
- Abu-Arafeh Ahmed
- Abubacker Syed M
- Abung Akata
- Aceampong Yaa
- Achara Amaka
- Acharya Devikumar
- Acheampong Sarah
- Acheson Janet
- Acosta Andres
- Acton Catherine
- Adabie-Ankrah Jacqueline
- Adair Sara
- Adam Fiona
- Adam Matthew
- Adamali Huzaifa
- Adams Carol
- Adams Charlotte
- Adams Kate
- Adams Lisa
- Adams Richard
- Adams Tim
- Adcock Kirsty
- Addai Jemaimah
- Adebiyi Ade
- Adegoke Ken
- Adell Vicki
- Ademokun Debo
- Adenwalla Sherna
- Adesemoye Oluwasegun A
- Adewunmi Emmanuel O
- Adeyemi Joyce
- Adhikary Rina
- Adkins Gabrielle
- Adnan Adnan
- Aeron-Thomas John
- Affleck Debbie
- Affron Dominic
- Afnan Carmel
- Afridi Muhammad
- Aftab Zainab A
- Agarwal Meenakshi
- Agbeko Rachel
- Agbo Chris
- Agent Penny
- Aggarwal Sunil
- Aghababaie Arameh
- Ahamed Sadiq Shafana
- Ahammed Nazeer Mohamed H
- Ahmad Humayun
- Ahmad Mohammad
- Ahmad Syed
- Ahmed Ali Roa
- Ahmed Asim
- Ahmed Bilal
- Ahmed Forizuddin
- Ahmed Hamze
- Ahmed Iram
- Ahmed Irshad
- Ahmed Khaled
- Ahmed Liban
- Ahmed Mahin
- Ahmed Maria C
- Ahmed Muhammad S
- Ahmed Naseer
- Ahmed Nausheen
- Ahmed Osama
- Ahmed Rajia A
- Ahmed Rizwan
- Ahmed Saif
- Ahmed Sammiya
- Ahmed Sana
- Ahmed Sara
- Ahmed Sophia
- Ahmed Syed
- Ahmed Syed Haris
- Ahmer Sana
- Ail Dhiraj
- Ainsworth Mark
- Airoldi Giulia
- Aissa Myriam
- Aitken Lindianne
- Ajay Bini
- Ajeneye Francis
- Ajibode Abdulakeem
- Ajmi Ayesha
- Akbar Tahir
- Akhtar Naim
- Akhtar Nasim
- Akhtar Nauman
- Akili Suha
- Akindolie Oludoyinsola
- Akinfenwa Yinka
- Akinkugbe Olugbenga
- Akinpelu Ibrahim
- Akinwumiju Olajide
- Aktinade Olugbenro
- Al Aaraj Ahmad
- Al Balushi Asma
- Al Dakhola Majd
- Al Swaifi Aladdin
- Al-Abadi Eslam
- Al-Asadi Abbas
- Al-Asadi Karina
- Al-Bayati Manaf
- Al-Fori Julyan
- Al-Hakim Bahij
- Al-Hity Shams
- Al-Jibury Maithem
- Al-Juboori Saba
- Al-Khalil Majid
- Al-Moasseb Hassan
- Al-Obaidi Magda
- Al-Rabahi Akram
- Al-Ramadhani Bahar
- Al-Saadi Zayneb
- Al-Shahi Salman Rustam
- Al-Shamkhani Warkaq
- Al-Sheklly Bashar
- Aladangady Narendra
- Alam Ayaz
- Alam Sajid
- Alatzoglou Kyriaki
- Albert Paul
- Albon Lorraine
- Alcorn Gemma
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- Alderdice David
- Aldouri Rayan
- Aldridge Jonathan
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- Ali Asad
- Ali Fawzia R
- Ali Hoodo
- Ali Jawad
- Ali Mariam
- Ali Mohammad
- Ali Nayab
- Ali Oudai
- Ali Sabira
- Ali Sakina
- Ali Syed
- Alina Abid
- Aliyuda Fine
- Alizadeh Katrin
- Alkhusheh Moutaz
- Allameddine Allameddine
- Allan Fiona
- Allan Rachel
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- Amar Noor
- Ambalavanan Sakkarai
- Ambler Sarah-Jayne
- Ambrogetti Robert
- Ambrose Chris
- Ameen Amir
- Amenyah Kenneth
- Amezaga Maria R
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- Amin Amina
- Amin Kanish
- Amin Syed
- Amin Tara
- Amjad Amjad
- Amjad Neelma
- Ammoun Mariam
- Amosun Victoria
- Amsha Khaled
- Amy Pugh
- Anand Atul
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- Andrikopoulos Gregory
- Aneke Kanayochukwu
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- Aniruddhan Krishnan
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- Ashok Sundar
- Ashour Abd-El-Aziz
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- Babs-Osibodu Adetona O
- Bacciarelli Sammy
- Bachar Roudi
- Bacon Gina
- Bacon Jenny
- Badal Bibi
- Badhan Gurpreet R
- Badhrinarayanan Shreya
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- Bafekr Mishamandani Sibel
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- Banerjee Amit
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- Barton Greg
- Barton Jill
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- Barton Rachael
- Baruah Rosaleen
- Baryschpolec Sonia
- Bashyal Archana
- Basker Betsy
- Basoglu Ayten
- Bass Gilda
- Bassett G
- Bassett John
- Bassford Chris
- Bassi Pavinder
- Bassis Betsy
- Bassoy Bengisu
- Bastion Victoria
- Basumatary Anupam
- Bate Tristan
- Bateman Harry J
- Bateman Ian
- Bateman Kathryn
- Bateman Vhairi
- Bates Eleanor
- Bates Hayley
- Bates Michelle
- Bates Simon
- Batham Sally
- Batista Ana
- Batla Amit
- Batra Dushyant
- Batty Donna
- Batty Harry
- Batty Thomas
- Baughan Peter
- Baum Miranda
- Bautista Carina
- Bawa Fareha
- Bawani Fatima S
- Bax Simon
- Baxter Lydia
- Baxter Matt
- Baxter Nicola
- Baxter Zachary
- Bayes Hannah
- Baylem Charlotte
- Bayliss Lee
- Bays Eileen
- Bazari Farid
- Bazaz Rohit
- Bazli Ahmad
- Beacham Laura
- Beadles Wendy
- Beak Philip
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- Beard Kirk
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- Beazley Christy
- Beck Sarah
- Beckett Virginia
- Beckitt Rosie
- Beddall Heidi
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- Beeby Deborah
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- Beecroft Michelle
- Beer Sally
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- Bega Gabriela
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- Belgaumkar Ajay
- Bell Dina
- Bell Gareth
- Bell Gill
- Bell Gillian
- Bell Jennifer L
- Bell Joshua
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- Bell Louise
- Bell Nicholas
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- Bellis Amanda
- Bellis Fionn
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- Black Helen
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- Blackler Joanne
- Blackley Samantha
- Blackman Helen
- Blackmore Stuart
- Blackstock Caroline
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- Briggs Mark
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- Brooker Verity
- Brookes Ceri
- Brookes Matthew
- Brooks Alison
- Brooks Karen
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- Broomhead Natalie
- Broughton Chloe
- Broughton Nathaniel
- Brouns Matt
- Browett Marie
- Brown Alison
- Brown Ammani
- Brown Carly
- Brown Catrin
- Brown Chloe
- Brown Elizabeth
- Brown Ellen
- Brown Heather
- Brown Janet
- Brown Louise
- Brown Niall
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- Brown Rachel
- Brown Richard
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- Brown Steven
- Brown Tom
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- Browne Charlotte
- Browne Duncan
- Browne Mitchell
- Brownlee Stephen
- Brraka Alba
- Bruce David
- Bruce Johanna
- Bruce Michelle
- Brudlo Wojciech
- Brunskill Nigel
- Brunton Alan
- Brunton Margaret
- Bryan Mandy
- Bryant Meera
- Buazon April
- Buch Maya
- Buchan Julie
- Buchan Ruaridh
- Buchanan Alexis
- Buchanan Ruaridh
- Buche Danielle
- Buck Amanda
- Buckland Matthew
- Buckley Laura
- Buckley Philip
- Buckley Sarah
- Buckman Carol
- Buckmire Kathleen
- Bugg George
- Bujazia Ramadan
- Bukhari Marwan
- Bukhari Shanze
- Bulbulia Richard
- Bull Alex
- Bull Damian
- Bull Rhian
- Bull Thomas
- Bulteel Naomi
- Bumunarachchi Kasun
- Bungue-Tuble Roneleeh
- Burchett Caroline
- Burda Dorota
- Burden Christy
- Burden Thomas G
- Burgess Mika
- Burgess Paula
- Burgess Richard
- Burgess Sophia
- Burgett Paula
- Burman Adrian
- Burnard Sara
- Burnett Caroline
- Burnett John
- Burns Amanda
- Burns Amy
- Burns Collette
- Burns James
- Burns Karen
- Burns Samuel
- Burns Sarah
- Burrage Daniel
- Burrage Sadie
- Burrows Kate
- Burston Claire
- Burton Ben
- Burton Fiona
- Burton Matthew
- Busby Angela
- Butcher Deborah
- Butler Aaron
- Butler Jessica
- Butler Joanne
- Butler Joshua
- Butler Lesley
- Butler Peter
- Butler Susan
- Butt Al-Tahoor
- Butt Mohammad M
- Butt Sophia
- Butterworth Caryl
- Butterworth-Cowin Nicola
- Buttery Robert
- Buttle Tom
- Button Heather
- Buttress Daniel
- Publication venue
- 'Elsevier BV'
- Publication date
- 13/02/2021
- Field of study
SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication
Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
- Author
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- Abdul Rasheed A.
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- Caws C.
- Central Coordinating Office (for the RECOVERY Collaborative Group)
- Century H.
- Chadwick J.
- Chakkarapani E.
- Chakraborty A.
- Chamberlain S.
- Chambers E.
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- Chauhan R.
- Chawla V.
- Chen F.
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- Cherrie M.
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- Chilvers A.
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- Chiswick C.
- Chivima B.
- Chmiel C.
- Chrisopoulou A.
- Christian P.
- Christides A.
- Christmas D.
- Church E.
- Cianci N.
- Cicconi P.
- Clare E.
- Clark E.
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- Clemente de la Torre C.
- Clifford S.
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- Coe A.
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- Coker O.
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- Collini Paul
- Collins J.
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- Connell E.
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- Connor E.
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- Conteh V.
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- Cornwell J.
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- Data Monitoring Committee of the RECOVERY Collaborative Group
- Daunt A.
- Dave V.
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- Desai A.
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- Fairbairn I.
- Fairclough A.
- Falconer E.
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- Fancois V.
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- Farzana S.
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- Health records (for the RECOVERY Collaborative Group)
- Hector G.
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- Local Clinical Centre staff (for the RECOVERY Collaborative Group)
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- Publication date
- Field of study
Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome