List of COVID-19 ARB trials

Adding AT2R agonist trial

philipn authored on Dec. 10, 2020, 6:13 p.m.

C21, an AT2R agonist, showed promise in a ~100 person RCT.

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While not a trial of ARBs as therapy, BRACE CORONA was a randomized controlled trial exploring stopping-versus-continuing ACE inhibitors/ARBs in patients with hypertension. It showed no harm in continuation of ACE inhibitors and ARBs with COVID-19. There was a non-statistically significant hint of a benefit in the ACEi/ARB group but the trial was not powered to detect this. The first randomized controlled trial of an ARB for treatment of COVID-19 returned preliminary results showing possible improvements in time to discharge, need for supplementary oxygen and CRP. See "Telmisartan for treatment of Covid-19 patients: an open randomized clinical trial. Preliminary report." See independent critical appraisal of trial. List of Angiotensin-receptor blocker (ARB) trials for COVID-19: Do Angiotensin Receptor Blockers Mitigate Progression to Acute Respiratory Distress Syndrome With SARS-CoV-2 Infection. Intervention: Losartan 12.5mg bid, can be increased based on SBP. Valsartan for Prevention of Acute Respiratory Distress Syndrome in Hospitalized Patients With SARS-COV-2 (COVID-19) Infection Disease. Intervention: Valsartan titrated based on BP, maximum of 160mg bid. COVID MED Trial - Comparison Of Therapeutics for Hospitalized Patients Infected With SARS-CoV-2 (COVIDMED). Intervention: Losartan, 25 mg po QD X 5-14 days "depending on availability." Study of Open Label Losartan in COVID-19. Intervention: Losartan 25mg qd, escalated to 50mg od. Losartan for Patients With COVID-19 Requiring Hospitalization. Intervention: Losartan 50mg od. Losartan for Patients With COVID-19 Not Requiring Hospitalization. Intervention: Losartan 25mg od. Telmisartan for Treatment of COVID-19 Patients. Intervention: Telmisartan 80mg bid. Results: Preliminary results Treatments to Decrease the Risk of Hospitalization or Death in Elderly Outpatients With Symptomatic SARS-CoV-2 Infection (COVID-19) (COVERAGE). Intervention: Telmisartan 20mg od. Trial description paper. Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY Disease (CLARITY). Intervention: ARB, dose/medication not specified. CLARITY 2.0. Intervention: ARB, dose/medication unknown, plus CCR2-inhibitor, DMX-200. Chloroquine + Losartan Compared to Chloroquine Alone for the Treatment of COVID-19 Pneumonia. Intervention: Losartan 25mg bid. Early Treatment With Ivermectin and LosarTAN for Cancer Patients With COVID-19 Infection (TITAN). Intervention: Losartan 50mg od. Austrian CoronaVirus Adaptive Clinical Trial (COVID-19) (ACOVACT). Intervention: Candesartan 4mg od, titrated up based on BP. Pilot Clinical Trial of the Safety and Efficacy of Telmisartan for the Mitigation of Pulmonary and Cardiac Complications in COVID-19 Patients. Intervention: Telmisartan 40mg od. Host Response Mediators in Coronavirus (COVID-19) Infection (ARBS CORONA I). Intervention: observational study of existing ACEi/ARB users. Host response mediators in Coronavirus (COVID-19) infection - Is there a protective effect of ARBs on outcomes of Coronavirus infection? (ARBs CORONA II). Intervention: Losartan 25mg, then 24 hours later 50mg, then 24 hours later 100mg. News article on trial. The McGill RAAS-COVID-19 Randomized Controlled Trial (RAAS-COVID). Intervention: observational study of existing ACEi/ARB users. Will suspend or hold ACEi/ARB. Telmisartan in Respiratory Failure Due to COVID-19 (STAR-COVID). Intervention: Telmisartan 40mg od. Evaluation of the effects of Losartan in patients with corona virus disease 2019. Intervention: Losartan 25mg bid. The COVID-RASi Trial (COVID-19). Intervention: ACEi or ARB of choice (unspecified). Losartan and Spironolactone Treatment for ICU Patients With COVID-19 Suffering From ARDS (COVIDANCE). Intervention: Losartan 50mg od, Spironolactone 25mg od. Combination Therapies to Reduce Carriage of SARS-Cov-2 and Improve Outcome of COVID-19 in Ivory Coast: a Phase Randomized IIb Trial (INTENSE-COV). Intervention: Lopinavir/ritonavir + telmisartan. Telmisartan 40mg od for 10 days. ACE inhibitor trials: Ramipril for the Treatment of COVID-19 (RAMIC). Intervention: Ramipril 2.5 od. Efficacy of Captopril in Covid-19 Patients With Severe Acute Respiratory Syndrome (SARS) CoV-2 Pneumonia (CAPTOCOVID) (CAPTOCOVID). Intervention: captopril 25mg od. Efficacy of Aerosol Combination Therapy of 13 Cis Retinoic Acid and Captopril for Treating Covid-19 Patients Via Indirect Inhibition of Transmembrane Protease, Serine 2 (TMPRSS2). Intervention: captopril 25mg alongside "aerosolized 13 cis retinoic acid plus Inhalation administration by nebulization." Other trials of renin-angiotensin modulation for COVID-19: Treatment of Angiotensin Peptide (1-7) for COVID-19 Angiotensin-(1,7) Treatment in COVID-19: the ATCO Trial (ATCO) Angiotensin 1-7 in the Therapy of Covid19 TXA COVID-19 Clinical Trial RAS and Coagulopathy in COVID19 Angiotensin (1-7) for the Treatment of COVID-19 in Hospitalized Patients See also Dosing ARBs for COVID-19 COVID-19 therapeutics	While not a trial of ARBs as therapy, BRACE CORONA was a randomized controlled trial exploring stopping-versus-continuing ACE inhibitors/ARBs in patients with hypertension. It showed no harm in continuation of ACE inhibitors and ARBs with COVID-19. There was a non-statistically significant hint of a benefit in the ACEi/ARB group but the trial was not powered to detect this. The first randomized controlled trial of an ARB for treatment of COVID-19 returned preliminary results showing possible improvements in time to discharge, need for supplementary oxygen and CRP. See "Telmisartan for treatment of Covid-19 patients: an open randomized clinical trial. Preliminary report." See independent critical appraisal of trial. List of Angiotensin-receptor blocker (ARB) trials for COVID-19: Do Angiotensin Receptor Blockers Mitigate Progression to Acute Respiratory Distress Syndrome With SARS-CoV-2 Infection. Intervention: Losartan 12.5mg bid, can be increased based on SBP. Valsartan for Prevention of Acute Respiratory Distress Syndrome in Hospitalized Patients With SARS-COV-2 (COVID-19) Infection Disease. Intervention: Valsartan titrated based on BP, maximum of 160mg bid. COVID MED Trial - Comparison Of Therapeutics for Hospitalized Patients Infected With SARS-CoV-2 (COVIDMED). Intervention: Losartan, 25 mg po QD X 5-14 days "depending on availability." Study of Open Label Losartan in COVID-19. Intervention: Losartan 25mg qd, escalated to 50mg od. Losartan for Patients With COVID-19 Requiring Hospitalization. Intervention: Losartan 50mg od. Losartan for Patients With COVID-19 Not Requiring Hospitalization. Intervention: Losartan 25mg od. Telmisartan for Treatment of COVID-19 Patients. Intervention: Telmisartan 80mg bid. Results: Preliminary results Treatments to Decrease the Risk of Hospitalization or Death in Elderly Outpatients With Symptomatic SARS-CoV-2 Infection (COVID-19) (COVERAGE). Intervention: Telmisartan 20mg od. Trial description paper. Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY Disease (CLARITY). Intervention: ARB, dose/medication not specified. CLARITY 2.0. Intervention: ARB, dose/medication unknown, plus CCR2-inhibitor, DMX-200. Chloroquine + Losartan Compared to Chloroquine Alone for the Treatment of COVID-19 Pneumonia. Intervention: Losartan 25mg bid. Early Treatment With Ivermectin and LosarTAN for Cancer Patients With COVID-19 Infection (TITAN). Intervention: Losartan 50mg od. Austrian CoronaVirus Adaptive Clinical Trial (COVID-19) (ACOVACT). Intervention: Candesartan 4mg od, titrated up based on BP. Pilot Clinical Trial of the Safety and Efficacy of Telmisartan for the Mitigation of Pulmonary and Cardiac Complications in COVID-19 Patients. Intervention: Telmisartan 40mg od. Host Response Mediators in Coronavirus (COVID-19) Infection (ARBS CORONA I). Intervention: observational study of existing ACEi/ARB users. Host response mediators in Coronavirus (COVID-19) infection - Is there a protective effect of ARBs on outcomes of Coronavirus infection? (ARBs CORONA II). Intervention: Losartan 25mg, then 24 hours later 50mg, then 24 hours later 100mg. News article on trial. The McGill RAAS-COVID-19 Randomized Controlled Trial (RAAS-COVID). Intervention: observational study of existing ACEi/ARB users. Will suspend or hold ACEi/ARB. Telmisartan in Respiratory Failure Due to COVID-19 (STAR-COVID). Intervention: Telmisartan 40mg od. Evaluation of the effects of Losartan in patients with corona virus disease 2019. Intervention: Losartan 25mg bid. The COVID-RASi Trial (COVID-19). Intervention: ACEi or ARB of choice (unspecified). Losartan and Spironolactone Treatment for ICU Patients With COVID-19 Suffering From ARDS (COVIDANCE). Intervention: Losartan 50mg od, Spironolactone 25mg od. Combination Therapies to Reduce Carriage of SARS-Cov-2 and Improve Outcome of COVID-19 in Ivory Coast: a Phase Randomized IIb Trial (INTENSE-COV). Intervention: Lopinavir/ritonavir + telmisartan. Telmisartan 40mg od for 10 days. ACE inhibitor trials: Ramipril for the Treatment of COVID-19 (RAMIC). Intervention: Ramipril 2.5 od. Efficacy of Captopril in Covid-19 Patients With Severe Acute Respiratory Syndrome (SARS) CoV-2 Pneumonia (CAPTOCOVID) (CAPTOCOVID). Intervention: captopril 25mg od. Efficacy of Aerosol Combination Therapy of 13 Cis Retinoic Acid and Captopril for Treating Covid-19 Patients Via Indirect Inhibition of Transmembrane Protease, Serine 2 (TMPRSS2). Intervention: captopril 25mg alongside "aerosolized 13 cis retinoic acid plus Inhalation administration by nebulization." Other trials of renin-angiotensin modulation for COVID-19: Treatment of Angiotensin Peptide (1-7) for COVID-19 Angiotensin-(1,7) Treatment in COVID-19: the ATCO Trial (ATCO) Angiotensin 1-7 in the Therapy of Covid19 TXA COVID-19 Clinical Trial RAS and Coagulopathy in COVID19 Angiotensin (1-7) for the Treatment of COVID-19 in Hospitalized Patients Safety and Efficacy of C21 in Subjects With COVID-19. Intervention: AT2R agonist C21, 100mg bid. Results: "14 of 51 patients (27%) on a twice-daily dose of the drug (n=51) plus standard of care required oxygen therapy at the end of the treatment period vs. 22 of 55 patients (45%) in the control arm. That corresponds to a 40% relative risk reduction, an effect, the company said, that was “statistically significant (p=0.057) at the 10% level as predefined in the statistical analysis plan.". Press release on C21 results. See also Dosing ARBs for COVID-19 COVID-19 therapeutics

~~Deletions are marked like this~~

Additions are marked like this

While not a trial of ARBs as therapy, BRACE CORONA was a randomized controlled trial exploring stopping-versus-continuing ACE inhibitors/ARBs in patients with hypertension. It showed no harm in continuation of ACE inhibitors and ARBs with COVID-19. There was a non-statistically significant hint of a benefit in the ACEi/ARB group but the trial was not powered to detect this.

The first randomized controlled trial of an ARB for treatment of COVID-19 returned preliminary results showing possible improvements in time to discharge, need for supplementary oxygen and CRP. See "Telmisartan for treatment of Covid-19 patients: an open randomized clinical trial. Preliminary report." See independent critical appraisal of trial.

List of Angiotensin-receptor blocker (ARB) trials for COVID-19:

Do Angiotensin Receptor Blockers Mitigate Progression to Acute Respiratory Distress Syndrome With SARS-CoV-2 Infection. Intervention: Losartan 12.5mg bid, can be increased based on SBP.
Valsartan for Prevention of Acute Respiratory Distress Syndrome in Hospitalized Patients With SARS-COV-2 (COVID-19) Infection Disease. Intervention: Valsartan titrated based on BP, maximum of 160mg bid.
COVID MED Trial - Comparison Of Therapeutics for Hospitalized Patients Infected With SARS-CoV-2 (COVIDMED). Intervention: Losartan, 25 mg po QD X 5-14 days "depending on availability."
Study of Open Label Losartan in COVID-19. Intervention: Losartan 25mg qd, escalated to 50mg od.
Losartan for Patients With COVID-19 Requiring Hospitalization. Intervention: Losartan 50mg od.
Losartan for Patients With COVID-19 Not Requiring Hospitalization. Intervention: Losartan 25mg od.
Telmisartan for Treatment of COVID-19 Patients. Intervention: Telmisartan 80mg bid.
- Results: Preliminary results
Treatments to Decrease the Risk of Hospitalization or Death in Elderly Outpatients With Symptomatic SARS-CoV-2 Infection (COVID-19) (COVERAGE). Intervention: Telmisartan 20mg od.
- Trial description paper.
Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY Disease (CLARITY). Intervention: ARB, dose/medication not specified.
CLARITY 2.0. Intervention: ARB, dose/medication unknown, plus CCR2-inhibitor, DMX-200.
Chloroquine + Losartan Compared to Chloroquine Alone for the Treatment of COVID-19 Pneumonia. Intervention: Losartan 25mg bid.
Early Treatment With Ivermectin and LosarTAN for Cancer Patients With COVID-19 Infection (TITAN). Intervention: Losartan 50mg od.
Austrian CoronaVirus Adaptive Clinical Trial (COVID-19) (ACOVACT). Intervention: Candesartan 4mg od, titrated up based on BP.
Pilot Clinical Trial of the Safety and Efficacy of Telmisartan for the Mitigation of Pulmonary and Cardiac Complications in COVID-19 Patients. Intervention: Telmisartan 40mg od.
Host Response Mediators in Coronavirus (COVID-19) Infection (ARBS CORONA I). Intervention: observational study of existing ACEi/ARB users.
Host response mediators in Coronavirus (COVID-19) infection - Is there a protective effect of ARBs on outcomes of Coronavirus infection? (ARBs CORONA II). Intervention: Losartan 25mg, then 24 hours later 50mg, then 24 hours later 100mg.
- News article on trial.
The McGill RAAS-COVID-19 Randomized Controlled Trial (RAAS-COVID). Intervention: observational study of existing ACEi/ARB users. Will suspend or hold ACEi/ARB.
Telmisartan in Respiratory Failure Due to COVID-19 (STAR-COVID). Intervention: Telmisartan 40mg od.
Evaluation of the effects of Losartan in patients with corona virus disease 2019. Intervention: Losartan 25mg bid.
The COVID-RASi Trial (COVID-19). Intervention: ACEi or ARB of choice (unspecified).
Losartan and Spironolactone Treatment for ICU Patients With COVID-19 Suffering From ARDS (COVIDANCE). Intervention: Losartan 50mg od, Spironolactone 25mg od.
Combination Therapies to Reduce Carriage of SARS-Cov-2 and Improve Outcome of COVID-19 in Ivory Coast: a Phase Randomized IIb Trial (INTENSE-COV). Intervention: Lopinavir/ritonavir + telmisartan. Telmisartan 40mg od for 10 days.

Other trials of renin-angiotensin modulation for COVID-19:

Treatment of Angiotensin Peptide (1-7) for COVID-19
Angiotensin-(1,7) Treatment in COVID-19: the ATCO Trial (ATCO)
Angiotensin 1-7 in the Therapy of Covid19
TXA COVID-19 Clinical Trial
RAS and Coagulopathy in COVID19
Angiotensin (1-7) for the Treatment of COVID-19 in Hospitalized Patients
Safety and Efficacy of C21 in Subjects With COVID-19. Intervention: AT2R agonist C21, 100mg bid.
- Results: "14 of 51 patients (27%) on a twice-daily dose of the drug (n=51) plus standard of care required oxygen therapy at the end of the treatment period vs. 22 of 55 patients (45%) in the control arm. That corresponds to a 40% relative risk reduction, an effect, the company said, that was “statistically significant (p=0.057) at the 10% level as predefined in the statistical analysis plan.".
- Press release on C21 results.

philipn / List of COVID-19 ARB trials 71b77ca4abc89ec85bcddb049301d413becb9d2a

ACE inhibitor trials:

Other trials of renin-angiotensin modulation for COVID-19:

See also

ACE inhibitor trials:

Other trials of renin-angiotensin modulation for COVID-19:

See also