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Full blood thinners reduce the need for life support and improve outcomes in hospitalized patients with COVID-19



News release

Friday, January 22, 2021

In a large clinical study conducted worldwide, full-dose anticoagulation (blood thinner) treatment given to moderately ill patients hospitalized for COVID-19 reduced the need for vital organ maintenance – such as the need for ventilation. There is also a trend towards a possible reduction in mortality, which is being further studied. In a large number of COVID-19 patients in need of hospitalization, these results may also help reduce the overcrowding of intensive care units worldwide.

At the beginning of the pandemic, doctors around the world observed elevated levels of blood clots and inflammation among patients with COVID-1

9, which affected multiple organs and led to complications such as lung failure, heart attack and stroke. It was not known at this time whether the provision of increased doses of blood thinners routinely administered to hospitalized patients would be safe and effective.

Three clinical trial platforms spanning five continents in more than 300 hospitals are working together to test whether there is a greater benefit from full doses of heparin (blood thinners) for the treatment of moderately ill hospitalized adults with COVID-19 compared to a lower dose of heparin is usually used to prevent blood clots in hospitalized patients. Moderately ill patients are those who are not in intensive care and who have not received organ support such as mechanical ventilation when enrolling in the sample.

Based on the interim results of more than 1,000 moderately ill patients admitted to hospital, the findings show that full doses of blood thinners, in addition to being safe, exceed the doses usually given to prevent blood clots in hospitalized patients. with regard to the primary endpoint, which is the need for ventilation or other supporting organ interventions. Trial researchers are now working as quickly as possible to provide the full results of the study so that clinicians can make informed decisions about the treatment of their patients with COVID-19.

As is normal for clinical trials, these trials are monitored by independent councils, which regularly review the data and are composed of experts in ethics, biostatistics, clinical trials and coagulation disorders. Informed of the discussions of these supervisory boards, all test sites have stopped recording.

However, research questions remain on how to further improve the clinical care of patients with COVID-19. This adaptive protocol is designed to allow the initiation, suspension or combination of different drugs during the study in response to emerging scientific data. This approach allows for rapid testing of additional agents without compromising safety and the study will evolve accordingly.

The results of today’s study complement the group’s findings, announced in December, that routine use of full-dose anticoagulates in the intensive care unit of critically ill patients with COVID-19 was not helpful and may have been harmful in some patients.

The three international studies include: A randomized, embedded, multifactorial adaptive trial of a community-acquired pneumonia platform (REMAP-CAP) Therapeutic Anticoagulation; Acceleration of therapeutic interventions of COVID-19 and vaccines-4 (ACTIV-4) Antithrombotic drugs in hospital; and antithrombotic therapy to relieve complications of COVID-19 (ATTACC). Studies across four continents have the overall goal of evaluating the benefit of full-dose blood thinners for the treatment of moderately or critically ill adults hospitalized for COVID-19 compared to a lower dose often used to prevent the formation of COVID-19. blood clots in hospitalized patients. To meet the challenge of this pandemic, investigators around the world have joined forces to answer this question as soon as possible. In the United States, the ACTIV-4 trial has been led by joint efforts with several universities, including the University of Pittsburgh and the University of New York, New York.

The trials are supported by a number of international funding organizations, including the Canadian Institutes of Health (CAN), the National Institutes of Health, the Lung and Blood Institutes (USA), the Translational Breast Cancer Research Consortium and the University of Pittsburgh Medical Center. program (USA), LifeArc Foundation, National Institutes of Health Research (UK), National Council for Health and Medical Research (AUS), Minderoo Foundation (AUS) and PREPARE and RECOVER (EU) consortia.

For the National Heart, Lung and Blood Institute (NHLBI): NHLBI is a global leader in conducting and supporting research into heart, lung and blood disorders and sleep disorders that advances scientific knowledge, improves public health and saves lives. For more information, visit www.nhlbi.nih.gov.

For National Institutes of Health (NIH):
The NIH, the National Agency for Medical Research, includes 27 institutes and centers and is a component of the U.S. Department of Health and Human Services. NIH is the main federal agency that conducts and supports basic, clinical, and translational medical research and investigates the causes, treatment, and treatment of both common and rare diseases. For more information about the NIH and its programs, visit www.nih.gov.

NIH … Turning Discovery Into Health®

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