While I have a science background, like many others I’m sure, statistical analysis of clinical trial data is definitely not part of my skillset. My thanks to those working on it in these threads.
With Covid-19 infections escalating rapidly in the U.S., I’ve been concerned to understand what appears to be the relatively slow enrolment rate in MSB’s ARDS trial.
And while MSB have maintained that the ventilated Covid ARDS mortality rate remains high, I haven’t been able to find solid U.S. data that throws light on this point, either way.
However, I am persuaded by growing evidence that standard of care has improved significantly over the course of the pandemic. Proning, ventilation flow rates, steroid and anti clotting drug usage, are among factors said to have been enhanced.
Australian Nobel Laureate immunologist, Professor Peter Doherty, said recently: “We are not seeing as many deaths as we were . . . Older people are being a lot more careful than they were at the beginning, so it's a younger cohort . . . The other thing is doctors have just got better at handling it . . . They're generally saving 30 to 50 percent of those who would have died."
I found this recent article, referencing a study by the New York University Grossman School of Medicine, quite instructive. (worth finding a few minutes to read it)
https://www.news-medical.net/news/2...nt-for-reduced-death-rates-from-COVID-19.aspx
An extract:
“Fewer New Yorkers are dying from the coronavirus than health experts had anticipated . . .
Regional death rates have dropped from the highs seen at the start of the outbreak, partially due to a shift in the population contracting the disease towards those who are more resilient.
After New York became the epicentre of the pandemic in early March, with tens of thousands dying of Covid-19, experts had expected that the infection would remain as deadly in the following months.
Instead, a new investigation showed that by mid-August the death rate in those hospitalised with corona-related illness had dropped from 27 percent to 3 percentage points."
So my gut feel is that despite increasing overall U.S. infections, improvements in standard of care, coupled with the lower average age and consequent greater resilience of the patient subset, has probably resulted in the numbers progressing to ARDS and ventilation being smaller than anticipated, and therefore a contributing factor to slower trial enrolment.
Regardless, even if it takes a little longer than expected, with many potential Covid treatments now being shown to lack efficacy, imo the door is wide open for a therapeutic with the rigour of a strong randomised blinded trial in it’s favour.
Imo MSB is in the box seat.
Usual bias. Herro
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