While public health measures and vaccines have reduced the impact of SARS-CoV-2 on hospitalization and death, most scientists predict this virus will become endemic and new variants will continue to emerge. Effective and affordable medications in community settings are needed to accelerate recovery, prevent hospitalization and/or death, and to minimize the development of long COVID.
Most randomized controlled trial evidence to date has been generated in patients who have not been vaccinated and who did not already have natural infection. The Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID) will evaluate the clinical- and cost-effectiveness of medications for SARS-CoV-2 in non-hospitalized patients. In Canada and worldwide, the majority of patients have now been vaccinated and/or had prior infection. Adaptive platform trials (APTs) are designed to compare multiple therapies in an efficient manner, which will allow us to respond to the dynamic nature of the COVID-19 pandemic and study new medications as they emerge
Therapeutics to be evaluated will be identified through a transparent Canadian COVID-19 Out-Patient Therapeutics Committee. The primary outcome is all-cause hospitalization and/or death at 28 days, and key secondary outcomes include time to recovery, symptom severity, incidence of long COVID, quality of life, and cost-effectiveness of each therapeutic. CanTreatCOVID uses numerous approaches to recruit participants to the study, including a multi-faceted public communication strategy and outreach through primary care, out-patient clinics, and emergency departments. A unique strength of this trial is additional prospective recruitment using Electronic Medical Record data from primary care research and learning networks in Ontario, Quebec, Alberta, British Columbia, Manitoba, and Newfoundland.
The results of this study will help Canada and other countries in deciding which treatments are most effective in reducing hospitalization and death among patients with COVID-19, while also being cost-effective, adding to our current knowledge on medications and therapeutics during the COVID-19 pandemic. Our findings will directly influence standards of care for COVID-19 infection in community settings in Canada and around the world.
This study will also build experience within Canada with conducting APTs, something that is currently lacking. Beyond COVID-19, our APT infrastructure can be adapted to study therapeutics for influenza, other upper respiratory pathogens and other diseases in the future.