11 research outputs found
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.
- Abdul-Kadir R.
- Abdusamad K.
- Abernethy K.
- Aboelela H.
- Abouzaid M.
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- Publication venue
- Springer Science and Business Media LLC
- Publication date
- 31/01/2024
- Field of study
Get PDFDimethyl 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; pâ=â0.40). There was no significant effect of DMF on any secondary outcome
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.
- Abdul-Kadir R.
- Abdusamad K.
- Abernethy K.
- Aboelela H.
- Abouzaid M.
- Abraham M.
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- Abrams J.
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- 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.
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- Chiswick C.
- Chivima B.
- Chmiel C.
- Chrisopoulou A.
- Christian P.
- Christides A.
- Christmas D.
- Church E.
- Cianci N.
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- Clark E.
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- Clifford S.
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- Coker O.
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- Collini Paul
- Collins J.
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- Data Monitoring Committee of the RECOVERY Collaborative Group
- Daunt A.
- Dave V.
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- Duran B.
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- Dymond H.
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- Elgohary A.
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- Ezenduka C.
- 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
Get PDFDimethyl 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; pâ=â0.40). There was no significant effect of DMF on any secondary outcome
Grain-Car Door
- Publication venue
- United States. Patent Office.
- Publication date
- 19/05/1903
- Field of study
No full textPatent for a grain-car door
Thigh-length compression stockings and DVT after stroke
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- Publication date
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- Field of study
Get PDFControversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease
Parting Ways Revisited: Archaeology at a Nineteenth-Century African-American Community in Plymouth, Massachusetts
- Author
- Alterman Michael L.
- Ascher Robert
- Benton Josiah H.
- Bethel Elizabeth Rauh
- Bourne S.
- Brooks Catherine M.
- Bullen Adelaid K.
- Davis William T.
- Davis William T.
- Davis William T.
- Dawdy Shannon Lee
- Deagan Kathleen
- Deetz James
- Deetz James
- Department of Veterans Affairs (DVA)
- Department of Veterans Affairs (DVA)
- Diderot Denis
- Fairbanks Charles H.
- Ferguson Leland G.
- First Church of Plymouth
- Franklin John Hope
- Glassie Henry H.
- Horton James Oliver
- Joyner Brian D.
- Kelly Kenneth G.
- Long Edward
- Maxwell John Irving
- Melish Joanne Pope
- Moran Geoffrey P.
- Mullins Paul R.
- New England Historic Genealogical Society
- New England Historic Genealogical Society
- Pearson Richard
- Piersen William Dillon
- Quigley W. P.
- Sammons Mark
- Singleton Teresa A.
- Southwell Thomas
- Turner Victor
- Walling Henry Francis
- Wilkie Laurie A.
- Wilkie Laurie A.
- Wilkie Laurie A.
- Yvon Tristan
- Zimmerman Sarah
- Publication venue
- 'Maney Publishing'
- Publication date
- Field of study
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No full textBiological Psychiatry in the Nineteenth and Twentieth Centuries
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- Field of study
No full textAzithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
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- Thrasyvoulou L
- Thraves H
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- Vasu V
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- Verma A
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- Vilimiene N
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- Visentin E
- Vithian K
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- Willis J
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- Wilson J
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- Wiselka M
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- Yasmin S
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- Yelnoorkar F
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- Youssouf S
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- Zinyemba V
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- Zulaikha R
- Zullo C
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/02/2021
- Field of study
Get PDFBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. 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-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16â442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated 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 0·87â1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 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 0·98â1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87â1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research
Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial
- Author
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- Publication venue
- 'International AIDS Society'
- Publication date
- 01/01/2016
- Field of study
Get PDFMeeting abstract FRAB0101LB from 21st International AIDS Conference 18â22 July 2016, Durban, South Africa.
Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIVâinfected adults and children with advanced disease in subâSaharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown.
Methods:
The REALITY 2Ă2Ă2 factorial openâlabel trial (ISRCTN43622374) randomized ARTânaĂŻve HIVâinfected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (antiâtuberculosis) and fluconazole (antiâcryptococcal/candida), 5 days azithromycin (antiâbacterial/protozoal) and singleâdose albendazole (antiâhelminth)), versus standardâofâcare cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixedâdose combination. Two other randomizations investigated 12âweek adjunctive raltegravir or supplementary food. The primary endpoint was 24âweek mortality.
Results:
1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% lossâtoâfollowâup). Median baseline CD4 was 36 cells/mm3 (IQR: 16â62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54â0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58â0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2).
Conclusions:
Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIVâinfected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this lowâcost broad infection prevention package which could save 3.3 lives for every 100 individuals treated
The Birds of Kentucky
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- Aldrich John W
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- Audubon John James
- Bacon Brasher C
- Bailey Florence M
- Bailey Vernon
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- Baker Gerald F
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- Barbour Roger W
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- Barrows Walter B
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- Benson King
- Bent Arthur C
- Bigelow David M
- Binnewies Fred W
- Bishop Nathaniel H
- Bloch William
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- Borror Donald J
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- Monroe Burt L. Sr.
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