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Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome.

2041-1723
Horby, Peter W.
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Peto, Leon
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Staplin, Natalie
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Campbell, Mark
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Pessoa-Amorim, Guilherme
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Mafham, Marion
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Emberson, Jonathan R.
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Stewart, Richard
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Prudon, Benjamin
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Uriel, Alison
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Green, Christopher A.
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Dhasmana, Devesh J.
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Malein, Flora
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Majumdar, Jaydip
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Collini, Paul
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Shurmer, Jack
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Yates, Bryan
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Baillie, J. Kenneth
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Buch, Maya H.
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Day, Jeremy
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Faust, Saul N.
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Jaki, Thomas
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Jeffery, Katie
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Juszczak, Edmund
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Knight, Marian
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Lim, Wei Shen
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Montgomery, Alan
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Mumford, Andrew
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Rowan, Kathryn
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Thwaites, Guy
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Haynes, Richard
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Landray, Martin J.
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RECOVERY Collaborative Group
Horby, Peter W.
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Peto, Leon
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Staplin, Natalie
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Campbell, Mark
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Pessoa-Amorim, Guilherme
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Mafham, Marion
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Emberson, Jonathan R.
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Stewart, Richard
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Prudon, Benjamin
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Uriel, Alison
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Green, Christopher A.
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Dhasmana, Devesh J.
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Malein, Flora
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Majumdar, Jaydip
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Collini, Paul
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Shurmer, Jack
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Yates, Bryan
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Baillie, J. Kenneth
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Buch, Maya H.
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Day, Jeremy
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Faust, Saul N.
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Jaki, Thomas
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Jeffery, Katie
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Juszczak, Edmund
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Knight, Marian
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Lim, Wei Shen
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Montgomery, Alan
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Mumford, Andrew
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Rowan, Kathryn
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Thwaites, Guy
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Haynes, Richard
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Landray, Martin J.
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Horby, Peter W., Peto, Leon, Staplin, Natalie, Campbell, Mark, Pessoa-Amorim, Guilherme and Mafham, Marion , RECOVERY Collaborative Group (2024) Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Nature Communications, 15 (1), [924]. (doi:10.1038/s41467-023-43644-x).

Record type: Article

Abstract

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome.

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s41467-023-43644-x - Version of Record
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Accepted/In Press date: 15 November 2023
e-pub ahead of print date: 31 January 2024
Published date: 31 January 2024
Additional Information: Funding Information: The RECOVERY trial is supported by grants to the University of Oxford from UK Research and Innovation (UKRI) and NIHR (MC_PC_19056), the Wellcome Trust (Grant Ref: 222406/Z/20/Z) through the COVID-19 Therapeutics Accelerator, and by core funding provided by the NIHR Oxford Biomedical Research Centre, the Wellcome Trust, the Bill and Melinda Gates Foundation, the Foreign, Commonwealth and Development Office, Health Data Research UK, the Medical Research Council Population Health Research Unit, the NIHR Health Protection Unit in Emerging and Zoonotic Infections, and NIHR Clinical Trials Unit Support Funding. © 2024. The Author(s).

Identifiers

Local EPrints ID: 487443
URI: http://eprints.soton.ac.uk/id/eprint/487443
ISSN: 2041-1723
PURE UUID: 16bfd6a4-9af7-4006-8053-7d9588a8cd7c
ORCID for Saul N. Faust: ORCID iD orcid.org/0000-0003-3410-7642

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Date deposited: 20 Feb 2024 17:40
Last modified: 06 Jun 2024 01:44

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Contributors

Author: Peter W. Horby
Author: Leon Peto
Author: Natalie Staplin
Author: Mark Campbell
Author: Guilherme Pessoa-Amorim
Author: Marion Mafham
Author: Jonathan R. Emberson
Author: Richard Stewart
Author: Benjamin Prudon
Author: Alison Uriel
Author: Christopher A. Green
Author: Devesh J. Dhasmana
Author: Flora Malein
Author: Jaydip Majumdar
Author: Paul Collini
Author: Jack Shurmer
Author: Bryan Yates
Author: J. Kenneth Baillie
Author: Maya H. Buch
Author: Jeremy Day
Author: Saul N. Faust ORCID iD
Author: Thomas Jaki
Author: Katie Jeffery
Author: Edmund Juszczak
Author: Marian Knight
Author: Wei Shen Lim
Author: Alan Montgomery
Author: Andrew Mumford
Author: Kathryn Rowan
Author: Guy Thwaites
Author: Richard Haynes
Author: Martin J. Landray
Corporate Author: RECOVERY Collaborative Group

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