RECOVERY Update:

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)
Many thanks to all our funders and supporters, including @The_MRC @NIHRresearch @HDR_UK @NHSDigital @wellcometrust @OxfordBRC and many more across the whole UK.
COVID has played a devastating toll on patients, their families, colleagues, communities, & wider society.

Behind the numbers are so many personal stories.

We are humbled by the contribution of all involved.

Together we have made a difference - and will do so again.

Thank you

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More from @MartinLandray

14 Dec 20
Latest results from RECOVERY trial: Azithromycin does not benefit patients hospitalised with COVID-19

No improvement in 28-day mortality, duration of hospital stay, or progression to invasive mechanical ventilation/ death.

recoverytrial.net/news/recovery-…

7764 pts randomised:
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.
Read 9 tweets
2 Dec 20
WHO SOLIDARITY in full.

No significant improvement in survival with hydroxychloroquine, lopinavir, interferon, or remdesevir in hospitalised patients.

Negative results are important - allow us all to refocus drug development and health resources.

nejm.org/doi/full/10.10…
Consistent in subgroups:
Read 5 tweets
16 Oct 20
Results of the @WHO SOLIDARITY trial:

4 drugs tested in 11,266 patients with COVID in 405 hospitals in 30 countries:
- hydroxychloroquine
- lopinavir
- remdesevir
- interferon

No clear benefit of any of them on survival.

medrxiv.org/content/10.110…
Similar results in different age-groups and whether on mechanical ventilation or not:
We knew about hydroxychloroquine - these results are entirely consistent with RECOVERY:

nejm.org/doi/full/10.10…
Read 10 tweets
15 Oct 20
The @WHO SOLIDARITY trial is a major international achievement.

Knowing which treatments do not have meaningful impact on mortality is important - saves resources, refocuses scientific attention, benefits patients.
Doubtless there will be much discussion, not all of which will be as objective as we need in a pandemic.

But this trial is randomised, large, and focused on the ultimate clinical outcome - mortality.
Huge congratulations to all involved - from top to bottom, from around the world.
Read 4 tweets
8 Oct 20
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

nejm.org/doi/full/10.10… Image
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 Image
No evidence of benefit of HCQ on any of the pre-specified endpoints. Image
Read 14 tweets
7 Oct 20
Great summary of treatments for hospitalised patients with COVID-19 @rupert_pearse

threadreaderapp.com/thread/1312699…
My take on this:

Dexamethasone improves survival.
Remdesivir shortens time to recovery.
Hydroxychloroquine & lopinavir are ineffective.

** we know because the clinical trials have been done**
Tocilizumab, Convalescent plasma, and neutralising antibodies look promising

** we will know because we are doing the clinical trials**
Read 5 tweets

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