6/29/23, 1:10 AM REMAP-CAP IL-6 Pathway Feedback Search Clinical Topics Home Studies REMAP CAP IL 6 REMAP CAP IL 6 Disease COVID 19 infection Trial question What is the effect of IL-6 receptor antagonists, tocilizumab and sarilumab, in critically ill patients with COVID-19? Study design Multi-center Open label RCT Population Characteristics of study participants 27.0% female N = 865 73.0% male 865 patients (236 female, 629 male) Inclusion criteria: adult patients with COVID-19, within 24 hours after starting organ support in the ICU Key exclusion criteria: imminent death, or previous participation in REMAP-CAP within 90 days Interventions N=353 + 48 IL-6 receptor antagonists (intravenous infusion of tocilizumab at a dose of 8 mg/kg of body weight or sarilumab 400 mg once only) N=402 control (standard care) Primary outcome https://web.pathway.md/studies/recq0l3XSW6W1RsYU 1/2 6/29/23, 1:10 AM REMAP-CAP IL-6 Pathway Borderline significant increase in median organ support-free days (OR 1.64, 95% CI 1.25 to 2.14) Secondary outcomes Borderline significant increase in death in the hospital at 90 days (28% vs. 36%; OR 1.64, 95% CI 1.14 to 2.35) Borderline significant increase in respiratory support-free days (OR 1.73, 95% CI 1.31 to 2.27) Borderline significant increase in cardiovascular support-free days (19 days vs. 15 days; OR 1.68, 95% CI 1.25 to 2.24) Safety outcomes No significant difference in serious adverse events with tocilizumab and control. Significant difference in serious adverse events with sarilumab and control (0% vs. 2.7%). Conclusion In adult patients with COVID-19, within 24 hours after starting organ support in the ICU, IL-6 receptor antagonists were superior to control with respect to median organ support-free days. Reference REMAP-CAP Investigators, Anthony C Gordon, Paul R Mouncey et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med. 2021 Apr 22;384(16):1491-1502. Open reference URL https://web.pathway.md/studies/recq0l3XSW6W1RsYU 2/2