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Jun 4, 2020 • 3 tweets • 4 min read
Remote, siteless, virtual, digitized clinical trials are taking hold, even for drug interventions
Lots of buzz yesterday about the @NEJM hydroxychloroquine trial without noting it was done remotely
nejm.org/doi/10.1056/NE…
And a feature @NatureNews
nature.com/articles/d4158…
This succinct essay @TheLancet provides perspective on this model of clinical trials, by @SteveSteinhubl @ScrippsRTI @scrippsresearch
thelancet.com/journals/lance…
The 1st published siteless clinical trial at scale
jamanetwork.com/journals/jama/… @JAMA_current @ScrippsRTI

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More from @EricTopol

Eric Topol Profile picture
Feb 13
We've learned a lot about Prior Covid ("Natural Immunity") over the past year, but the US/CDC continues to negate the abundant evidence for it providing any protection
erictopol.substack.com/p/ground-truth… w/links
And there's substantial new data, I'll review🧵here /1
Last week, the large J&J 1- shot, placebo-controlled trial w/ >2,000 participants who had Prior Covid published @NEJM
Vaccine effectiveness vs moderate/severe disease
Prior Covid 90%
J&J Vaccine 56%
Yet 1-shot J&J vaccine = "fully vaccinated" @CDCgov
Nothing for Prior Covid /2
Neutralizing antibodies after Prior Covid are present out to 16 months in 214 people (graph)
And another study showing persistence of memory B cells at 15 months /3
Read 13 tweets
Eric Topol Profile picture
Feb 9
Today >3,400 Covid deaths reported in the United States, a 7-day average exceeding 2,600 lost lives.
This likely represents the current wave peak; 80% of the US pandemic peak when there were no vaccines. Compared to 20% in countries with high % vaccination and booster rates Image
OTOH at least we're seeing a rapid descent of hospitalizations to the 100,000 level Image
washingtonpost.com/health/2022/02… by @FenitN @dtkeating
Read 4 tweets
Eric Topol Profile picture
Feb 7
🆕 Omicron [O] and Delta [D] outcomes for hospitalizations, deaths and by vaccines in > 1 million O and ~450,000 D cases in England
papers.ssrn.com/sol3/papers.cf…
—75% reduced hospitalization risk for O vs D
—For O, Booster >70% protection vs hospitalizations and deaths across all ages
2 and 3 dose vaccine effects vs hospitalization (both AZ and mRNA)
and
Prior Covid, without vaccination, had moderate protection (HR 0.53) vs hospitalization for Omicron, and high protection vs death.
Children age < 10 had infrequent hospital admissions and the incidence did not differ significantly between Delta and Omicron
Read 4 tweets
Eric Topol Profile picture
Feb 4
New: Assessment of an Omicron-specific booster vs Moderna original (vs ancestral) booster in macaques: no difference
"An Omicron boost may not provide greater immunity or protection compared to a boost with the current mRNA-1273 vaccine"
biorxiv.org/content/10.110… Image
Interesting to note that the same was seen for the Beta variant with the Pfizer vaccine, original vaccine booster vs Beta-specific booster, which led to abandoning that strategy.
3rd shots of the original vaccines are performing far better than expected 👍
A very good thread on the new Omicron-specific booster study and the overarching issue by @erlichya
Read 4 tweets
Eric Topol Profile picture
Feb 4
New @CDCgov
Reduction of death by vaccination and booster by age, per 100,00 people, vs unvaccinated, relative, with absolute data below
covid.cdc.gov/covid-data-tra…
Age 65+
2 shot 92% reduced
3 shot 99% reduced
Age 50-64
2 shot 95% reduced
3 shot 99% reduced
By age: cases and vaccination/booster status
As cases were rising steeply in December with emergence of Omicron, booster vs 2-shot was associated with 50% or more reduction of cases across the 3 age groups
And much higher % drop for vaccination vs unvaccinated
Which goes along with this new data posted showing booster had vaccine effectiveness of >60% vs Omicron infections
covid.cdc.gov/covid-data-tra…
Read 5 tweets
Eric Topol Profile picture
Jan 31
New @FT
"Almost half of the US Covid hospitalisations this winter could have been averted if the country had matched the vaccination coverage of leading European countries"
ft.com/content/03aa46… by @mroliverbarnes @jburnmurdoch @JamieSmythF
US lagging European peers by vaccine doses and boosters, especially notable in age 60+
"On December 20, 30% of people in the US over-65 had gone six months since receiving a second dose, compared with just 2% in Portugal; 5 per cent in England; and 7% in Denmark."
Graphic that shows differences in vaccination waning for US vs England, Denmark and Portugal, age 60+
Read 5 tweets

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