Launching a comparative effectiveness adaptive platform trial of monoclonal antibodies for COVID-19 in 21 days.


Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
02 2022
Historique:
received: 18 06 2021
revised: 04 12 2021
accepted: 05 12 2021
pubmed: 14 12 2021
medline: 17 2 2022
entrez: 13 12 2021
Statut: ppublish

Résumé

Outpatient treatments that limit progression to severe coronavirus disease 2019 (COVID-19) are of vital importance to optimise patient outcomes and public health. Monoclonal antibodies (mAb) demonstrated ability to decrease hospitalizations in randomized, clinical trials. However, there are many barriers to mAb treatment such as patient access and clinician education. There are no data comparing efficacy or safety of available mAbs. We sought to rapidly launch an adaptive platform trial with the goals of enhancing access to treatment, regardless of geography and socioeconomic status, and evaluating comparative efficacy and safety of available mAbs. Within 21 days from idea genesis, we allocated mAb treatment to all patients within the context of this clinical trial. Within 2 months, we closed the gap of the likelihood of receiving mAb, conditional on background positivity rate, between Black and White patients (Black patients 0.238; White patients 0.241). We describe trial infrastructure, lessons learned, and future directions for a culture of learning while doing.

Identifiants

pubmed: 34896293
pii: S1551-7144(21)00388-8
doi: 10.1016/j.cct.2021.106652
pmc: PMC8654455
pii:
doi:

Substances chimiques

Antibodies, Monoclonal 0
Antibodies, Monoclonal, Humanized 0
Antineoplastic Agents, Immunological 0

Types de publication

Clinical Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106652

Subventions

Organisme : NIGMS NIH HHS
ID : R35 GM119519
Pays : United States

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Références

J Health Polit Policy Law. 2020 Dec 1;45(6):921-935
pubmed: 32464654
Open Forum Infect Dis. 2021 Mar 26;8(7):ofab151
pubmed: 34322560
N Engl J Med. 2021 Jan 21;384(3):229-237
pubmed: 33113295
JAMA. 2021 Feb 16;325(7):632-644
pubmed: 33475701
Open Forum Infect Dis. 2021 May 17;8(7):ofab254
pubmed: 34250192
JAMA. 2021 Mar 23;325(12):1159-1161
pubmed: 33635309
N Engl J Med. 2021 Jan 21;384(3):238-251
pubmed: 33332778
J Exp Med. 2021 May 3;218(5):
pubmed: 33871567
Am J Health Syst Pharm. 2021 Jun 23;78(13):1166-1168
pubmed: 33599712
JAMA. 2020 May 19;323(19):1895-1896
pubmed: 32227198

Auteurs

Erin K McCreary (EK)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: mccrearye3@upmc.edu.

J Ryan Bariola (JR)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Tami Minnier (T)

Wolff Center, UPMC, Pittsburgh, PA, USA.

Richard J Wadas (RJ)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Judith A Shovel (JA)

Wolff Center, UPMC, Pittsburgh, PA, USA.

Debbie Albin (D)

UPMC Supply Chain Management/HC Pharmacy, UPMC, Pittsburgh, PA, USA.

Oscar C Marroquin (OC)

Clinical Analytics, UPMC, Pittsburgh, PA, USA.

Mark Schmidhofer (M)

Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Mary Kay Wisniewski (MK)

Wolff Center, UPMC, Pittsburgh, PA, USA.

David A Nace (DA)

Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Colleen Sullivan (C)

Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Meredith Axe (M)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Russell Meyers (R)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Tina Khadem (T)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

William Garrard (W)

Clinical Analytics, UPMC, Pittsburgh, PA, USA.

Kevin Collins (K)

Clinical Analytics, UPMC, Pittsburgh, PA, USA.

Alan Wells (A)

Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Robert D Bart (RD)

UPMC Health Services Division, Pittsburgh, PA, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Kelsey Linstrum (K)

Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; UPMC Health System Office of Healthcare Innovation, Pittsburgh, PA, USA.

Stephanie K Montgomery (SK)

Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; UPMC Health System Office of Healthcare Innovation, Pittsburgh, PA, USA.

Ghady Haidar (G)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Graham M Snyder (GM)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Bryan J McVerry (BJ)

Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, UPMC, Pittsburgh, PA, USA.

Christopher W Seymour (CW)

Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; UPMC Health System Office of Healthcare Innovation, Pittsburgh, PA, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Donald M Yealy (DM)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

David T Huang (DT)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Derek C Angus (DC)

Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; UPMC Health System Office of Healthcare Innovation, Pittsburgh, PA, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

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