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With the .@NIAIDNews #ACCT1 trial final report published on 05 Nov 2020 and the .@WHO's #SolidarityTrial Preliminary report published on 02 December 2020, thought it would be good to take another look at both trials and find ways forward for the patients we are dealing with today 
Motivated by a patient I am dealing with who will survive very severe #COVID19 in the setting of transplant, but her father, who was hospitalized earlier than her with moderate COVID, was left to progress and died before her discharge, given #remdesivir only after going on #BiPAP
Here is the link to the prior analysis and I think the new publications give some interesting details which will follow
Time to share some thoughts and questions following the .@medrxivpreprint first release of results from the #SolidarityTrial that compared local standard care to #remdesivir, #HydroxyChloroquine #lopinavir_ritonavir and #interferon for treatment of patients with #COVID19
I have read the #solidarityTrial preprint: medrxiv.org/content/10.110…
Its supplementary material:medrxiv.org/content/10.110…
its posted protocol: who.int/publications/m…
The CRF: who.int/publications/i…
The final report from #ACTT1 for contrast: nejm.org/doi/full/10.10…
Its supplementary material:medrxiv.org/content/10.110…
its posted protocol: who.int/publications/m…
The CRF: who.int/publications/i…
The final report from #ACTT1 for contrast: nejm.org/doi/full/10.10…
Everyone has focused on the results, which is understandable, yet understanding the specifics in #SolidarityTrial design compared to the #ACTT1 design, may bring light into the differences reported between trials and may give a way to do better in #COVID19 #therapeutics
Posting some reflections on the #ACTT & #RECOVERY trials related to #remdesivir & #dexamethasone for the treatment of #COVID19
Those results feel like definitive advances, but we need to realize their limitations and need for confirmation despite everyone's #pandemic fatigue
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Those results feel like definitive advances, but we need to realize their limitations and need for confirmation despite everyone's #pandemic fatigue
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There are lot of skeptics in and outside of #Twitter on the results of both trials, strong emotions regarding big-pharma made medications, the way the #EUA was made, also about use of #steroids in the #ICU that has a quite rocky history among those who run those units.
And we need to acknowledge from the outset all sorts of basic, and not so basic, emotions that come in the doing clinical trials, exacerbated by academic cliques, national defense issues (and nationalisms) that can get exacerbated with the strains in health systems.
