E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Severe Community Acquired Pneumonia |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10010120 |
E.1.2 | Term | Community acquired pneumonia |
E.1.2 | System Organ Class | 100000004862 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this REMAP is, for adult patients with severe CAP who are admitted to an ICU, to identify the effect of a range of interventions to improve outcome as defined by the occurrence of death during the index hospital admission censored 90 days (or 21 days in case of pandemic) from the date of enrolment.
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to determine, for adult patients with severe CAP who are admitted to an ICU, the effect of interventions on ICU mortality, ICU length of stay (LOS), hospital LOS, ventilator free days (VFDs) censored at 28 days, organ failure free days (OFFDs) censored at 28 days, other endpoints as indicated for specific domains, and, where feasible or specified in a DSA, survival at 6 months (in case of a pandemic, 90 days outcome will be a secondary objective), health related quality of life (HRQoL) assessed after 6 months using the EQ5D and disability assessed after 6 months using the World Health Organization Disability Assessment Schedule (WHODAS). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Adult patient admitted to an ICU for acute severe CAP within 48 hours of hospital admission with
a. symptoms or signs or both that are consistent with lower respiratory tract infection (for example, acute onset of dyspnea, cough, pleuritic chest pain) AND
b. Radiological evidence of new onset infiltrate of infective origin (in patients with pre-existing radiological changes, evidence of new infiltrate)
2. Up to 48 hours after ICU admission, receiving organ support with one or more of:
a. Non-invasive or invasive ventilatory support;
b. Receiving infusion of vasopressor or inotropes or both
3. Proven or suspected COVID-19 infection
Precisions for the French part :
1. Patients under guardianship or curatorship
2. Informed written consent of the patient or a legally authorized close relative, or emergency procedure.
In view of the exceptional and urgent situation, affiliation to a social security scheme will not be a criterion for inclusion.
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E.4 | Principal exclusion criteria |
Any of:
1. Non COVID-19 pneumonia
Precisions for the French part :
1. Patients under guardianship or curatorship
2. Informed written consent of the patient or a legally authorized close relative, or emergency procedure.
In view of the exceptional and urgent situation, affiliation to a social security scheme will not be a criterion for inclusion.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary objective of this REMAP is, for adult patients with severe CAP who are admitted to an ICU, to identify the effect of a range of interventions to improve outcome as defined by all-cause mortality at 90 days (or the number of whole and part study days for which the patient is alive and not admitted to an ICU up until the end of study at 21 days in case of a pandemic) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
90 Days from the date of enrolment (or 21 days in case of a pandemic) |
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E.5.2 | Secondary end point(s) |
The secondary objectives are to determine, for adult patients with severe CAP who are admitted to an ICU, the effect of interventions on ICU mortality, ICU length of stay (LOS), hospital LOS, ventilator free days (VFDs) censored at 28 days, organ failure free days (OFFDs) censored at 28 days, other endpoints as indicated for specific domains, and, where feasible or specified in a DSA, survival at 6 months, health related quality of life (HRQoL) assessed after 6 months using the EQ5D and disability assessed after 6 months using the World Health Organization Disability Assessment Schedule (WHODAS). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
The secondary objectives are to determine, for adult patients with severe CAP who are admitted to an ICU, the effect of interventions on ICU mortality, ICU length of stay (LOS), hospital LOS, ventilator free days (VFDs) censored at 28 days, organ failure free days (OFFDs) censored at 28 days, other endpoints as indicated for specific domains, and, where feasible or specified in a DSA, survival at 6 months (in case of a pandemic, 90 days outcome will be a secondary objective), health related quality of life (HRQoL) assessed after 6 months using the EQ5D and disability assessed after 6 months using the World Health Organization Disability Assessment Schedule (WHODAS). |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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E.8.2.4 | Number of treatment arms in the trial | 20 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 100 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
Croatia |
Czech Republic |
Denmark |
Germany |
Greece |
Hungary |
Ireland |
Netherlands |
New Zealand |
Portugal |
Romania |
Spain |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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last visit of the last subject undergoing the trial |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 4 |