Hi All &
@singhgu it’s nice to hear from you, I hope you haven’t heard anymore bad news from home personally? It’s just unprecedented.
I was reading a news article last night about a young man from Australia that speaks Hindi & he grew up in India in part & lives & volunteers there in the slums in Northern India. He has had COVID-19 twice & symptoms prompted him to get tested (many months apart). It’s anecdotal but says something about immunity from prior infection & variants of the virus & how long any kind of conferred immunity lasts. I’m not sure if he had any immunisation, but he was more worried about his neighbours than himself (who resisted testing as not being able to avoid earning money just to be able to afford to live & eat, & of course as we know, here is a big problem for India. Can they afford masks? Probably not, are they being provided in these circumstances? Even surgical masks (not reused multiple times) make a difference. An interesting article for this who want to read it:
https://www.google.com.au/amp/s/amp.brisbanetimes.com.au/world/asia/i-don-t-feel-stranded-australian-volunteer-in-india-busy-helping-his-neighbours-20210503-p57ohb.htmlWhat you have said about CLARITY (ARB or placebo) & CLARITY 2.0 (DMX-200 + ARB) is a very good point!
The trial sites are established already in India for CLARITY, they will be familiar with the trial protocol & ALREADY have ARB or placebo in the first arm of the study (updated Dec 2020 to 1500 patients on CLARITY). We don’t know they may have increased their recruitment?
It’s 600 patient recruitment on CLARITY 2.0 (DMX-200 plus ARB). So to me that kind of balances out with CLARITY (ARB vs placebo), so unlike REMAP cap, they already have the comparator in CLARITY (1). Unlike REMAP-CAP over 4 Arms in RAAS Arm (both trials are super important).
https://www.remapcap.euUpdates on USA Clinical Trials Website here (DEC 2020): I hope the link works.
https://clinicaltrials.gov/ct2/history/NCT04394117?A=1&B=4&C=merged#StudyPageTopIt’s not overseen by the FDA either. This would be one of the trials you would want to see move forward in India, as patients who “are intended for hopitalisation” to be recruited. If ARB alone is making a difference...we have further downstream blockade for Cytokines with CCR2 that may just keep people well enough to recover at home. Please note the secondary renal indications in CLARITY Trials (ie high risk patients).
You would hope, all health staff are fully immunised by now in India, being frontline workers. I doubt that. India are far ahead of Australia in numbers in testing & vaccinations, but so are their population.
I think that all needs to be considered including laboratories overwhelmed with testing, as well as people presenting to hospitals & being turned away & dying outside. We have all seen the awful footage.
I do work in clinical research & we use dedicated research labs to send off trial samples to. God speed for anything that will help the current situation. If patients can be at home & recover all the better.
(20min delay)