I’m just going to post my stock research findings here, was in...

I’m just going to post my stock research findings here, was in the middle of a long post explaining things, but it disappeared into HC land cyberspace & was still working on it. I don’t have time to re-type all of this.

CLARITY TRIAL - INDIA & possibly Australia now again with huge case numbers with Delta strain.

So take from it what you want, it’s all looking very positive. I guess the take home here is that there have been multiple global trials where ARB has improved death rates, severity of disease & hospital length of stay.

If CLARITY is showing benefit (ARB alone at n=700) the trial can be stopped & put into clinical practice in a country of need & that data will be taken onboard by WHO. Or inconclusive to continue the trial, or futility to stop it. DSMB review will follow.

https://www.researchgate.net/publication/354064043_Controlled_evaLuation_of_Angiotensin_Receptor_Blockers_for_COVID-19_respIraTorY_disease_CLARITY_Statistical_analysis_plan_for_a_randomised_controlled_Bayesian_adaptive_sample_size_trial

Another question is which ARB to use, are they all interchangeable? Telmisartan was the one on CLARITY. CLARITY 2.0 was meant to be Candesartan + DMX-200, that may change. It makes sense to have this data b4 moving on. There have been multiple trials looking at ARBs with some positive results in LOS, severity of disease & organ support in ICU…more data is needed, so that’s exactly what’s happening on REMAP CAP as well.

You can see from the last newsletter on CLARITY last year to now, that they have 14 active recruitment sites in India. I’m guessing that that will move forward into the next phase of the trial with DMX-200.

https://www.claritytrial.org/wp-content/uploads/2020/12/CLARITY-Newsletter-Issue-6-9th-November-2020.pdf

The biggest challenge now is when we can treat & with what, timing is everything with COVID, or getting the opportunity to when people present late with severe symptoms to ED… *Please if you have COVID-19, feeling breathless or dizzy, just go to ED, call an ambulance. COVID-19 deterioration can be rapid & that can be turned around with prompt treatment.

Being vaccinated will save your life & I’m so sorry to @dyeman who his beloved wife passed away after the 1st dose of AZ vaccine, but for the majority of people in hospital, they aren’t, & that is saddening that the youngest patients were not eligible at the time with vaccines. So to me that’s pretty sad also.

We are looking at weeks in retrospect here, where large families are all in isolation & with Delta strain, your are pretty much guaranteed to be positive if a family member has it, so no chance for these >16yos to get a vaccine over the last month if their primary contact wasn’t cleared or themselves testing positive later on. Long COVID is a big concern for young people & teens.

The trial is ADAPTIVE & Bayesian analysis - like REMAP CAP. It’s run through The George Institute. The paper I found was very impressive, good steed for CLARITY 2.0.

Very disappointing we are now having to triage patients outside in tents in major hospitals in Sydney, but we all knew this was coming once Delta strain got out. I personally can’t look at the pressers anymore without wanting to karate kick the TV. Hello India from Australia.