The Corticosteroid Early and Extended (CORT-E2) Randomized Controlled Trial

  • Funded by Canadian Institutes of Health Research (CIHR)
  • Total publications:0 publications

Grant number: 466232

Grant search

Key facts

  • Disease

    COVID-19
  • start year

    2022
  • Known Financial Commitments (USD)

    $2,645,389.73
  • Funder

    Canadian Institutes of Health Research (CIHR)
  • Principal Investigator

    Rochwerg Bram N, Del Sorbo Lorenzo, Fan Eddy, Ferguson Niall D, Goligher Ewan C
  • Research Location

    Canada
  • Lead Research Institution

    McMaster University
  • Research Priority Alignment

    N/A
  • Research Category

    Clinical characterisation and management

  • Research Subcategory

    Clinical trials for disease management

  • Special Interest Tags

    N/A

  • Study Type

    Clinical

  • Clinical Trial Details

    Randomized Controlled Trial

  • Broad Policy Alignment

    Pending

  • Age Group

    Unspecified

  • Vulnerable Population

    Unspecified

  • Occupations of Interest

    Unspecified

Abstract

Acute hypoxemic respiratory failure (AHRF), or acute breathing problems, are one of the most common reasons to require hospital admission, or in the most severe cases, admission to the intensive care unit (ICU) for advanced oxygen support. AHRF has multiple causes including pneumonia (COVID or bacterial), aspiration, or even illness in other organs of the body (such as sepsis or pancreatitis) which lead to lung inflammation. Corticosteroids, a group of immune suppressing drugs, have been investigated as a potential therapy for AHRF. Smaller studies have shown benefit of corticosteroids in hospitalized patients with severe pneumonia and in those with a form of severe ARF called ARDS (acute respiratory distress syndrome). Despite this, clinical practice remains varied. Dexamethasone, a type of corticosteroid, was one of the first therapies to show benefit in hospitalized patients with COVID-19 and has now become the standard of therapy in this population. Whether this is also helpful for other causes of ARF remains unclear. Another really important question is how long to treat with corticosteroids in patients with ARF. The largest of the COVID studies used a short course of 10 days, but uncertainty remains, especially if a patient is not improving after 10 days of treatment. We propose to answer two questions within the same research platform. The platform (called PRACTICAL) aims to study many different interventions for treating ICU patients with AHRF. Within this platform, we propose to study corticosteroids: 1) in patients with non-COVID AHRF requiring advanced oxygen support, 2) in patients with AHRF from COVID or non-COVID who have already been treated with a short course of corticosteroids and are still requiring advanced oxygen support, examining the role of extending the duration corticosteroids. The main outcome to be studied will be mortality at 60 days but we will also study a number of other outcomes that are important to patients.