30,000 patients now enrolled in one country in 10 months.
The most extraordinary effort.
And still ongoing.
In the words of the independent Data Monitoring Committee:
"Thank you for your continuing help and support."
"RECOVERY is a beacon of light in these difficult times."
Here is what that recruitment looks like:
Four results now published and changing practice:
Hydroxychloroquine, Lopinavir-ritonavir, and Azithromycin ineffective - so no longer used.
...and dexamethasone shown to reduce mortality for patients requiring oxygen or artificial ventilation.
A complete game-changer, and saving hundreds of thousands of lives.
With further results to follow:
Convalescent plasma (11,500 patients; now stopped; no effect on mortality)
Tocilizumab (3,800 patients ongoing)
REGN-COV2 monoclonal antibody combination (4,700 patients ongoing)
Aspirin (8,600 patients ongoing)
Colchicine (5,800 patients ongoing)
Why do we need randomised trials?
To discover which of the many promising treatments actually save lives and improve outcomes for patients
- some treatments will work - and can then be widely used
- some treatments will not - and can then be abandoned
And why do trials need to be so big?
- to distinguish treatments with modest benefits (e.g. reducing risk of death by one-fifth) from those with no benefit
- and for those that work, to understand how well they work and in whom do they work (critical for implementation)
This is an important result:
Azithromycin is on the WHO Watch Group of Antibiotics: antibiotics.
Widespread use of azithromycin for COVID-19 for which it is ineffective risks the development of resistance by bacterial infections for which it is effective.
We have seen time and again during this epidemic the importance of large randomised clinical trials in determining which of the many promising treatments deliver real benefits for patients.
If in doubt:
- don’t guess
- don’t prescribe & hope
- randomise & learn.
More results from the RECOVERY trial - Hydroxychloroquine:
Among patients hospitalised with COVID-19, hydroxychloroquine (HCQ) did not improve 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death
1561 patients were randomised to HCQ + usual care
3155 patients were randomised to usual care alone
in the largest randomised trial of HCQ for treatment of COVID
No evidence of benefit of HCQ on any of the pre-specified endpoints.