UPMC providing updates on COVID-19 clinical data, adaptive clinical trials
afternoon’s thank you all for participating in today’s media availability. I’m joined by Dr Don Yearly. New PM sees senior medical director and the chair of emergency medicine. Dr Auster. Mary Queen UPMC is chief healthcare data and Analytics officer, and Dr Derek Angus UPMC is chief health care innovation officer and chair critical care medicine at the University of Pittsburgh. They will update you on our clinical data and experience with Cove in 19 and show how and show what has changed over time and how that continues soon. Former actions. And they will also discuss our ongoing adaptive clinical trials and how they’re helping us to, uh, helping to inform us and to take better care of our patients after they offer their remarks will take your questions. Dr. Really, thank you very much, Paul, and thank you all for showing ongoing interests in the pandemic and the UPMC experience with Cove in 19. As we’ve been saying for many months, Kobe, 19 came to all the communities that we serve your UPMC, and it’s not going away. Everyone, that’s all of us in our communities, including the medical professions, is learning how and adapting to living with this virus, something that we will continue to do for many months as you’ll soon hear from Dr Merrick Win and Dr Angus and UPMC. We are learning while we deliver care to you into your loved ones. And we’re learning fast, which is helping to approve our outcomes for all of our patients. Key measures, including the UPMC Cove in 19 test positivity rates, the amount of time our patients spend in the hospital, their need for intensive care or the use of ventilators and those air machines that help you breathe. And the death rates are all far lower now than they were earlier in the pandemic. That’s very good news for all the communities we serve in Pennsylvania, in New York and in Maryland. It isn’t a victory declaration, though. It shows that we can impact this infection with our actions, and that includes not only you in the public, but health care providers. Why are we seeing these better results today compared to what we saw in March and April? Well, first, we have better treatments, including steroids and more effective clinical protocols, and we know better how to use all of the care steps for patient care, including positioning and breathing support we’re seeing from our own data, as well as data from other locations that suggestions exist that the virus is a changing in important ways. People are now experiencing less frequent bouts of severe virus impact. Perhaps that means that the virus is less virulent than we once sought or experience. That doesn’t mean that we can all go back to normal as we knew it before. Cove in 19 wearing a mask as much as possible, keeping distance whenever possible. Staying home when you’re sick and washing your hands frequently remain critical to keeping this virus and check so that we can reopen our businesses and our skins as safely as possible. We thank our dedicated staff and more importantly, all the communities that we live in and we serve for taking these steps. You followed public health guidance and you demonstrated that we can care about ourselves and about each other. We can’t predict what the future holds for this virus in terms of its spread and its severity, and especially as we enter the flu season and we spend more time together indoors. What was key? What is key and what will continue to be key is clear where a masked whenever you’re near ovens and where it correctly cover your nose. Secondly, make sure that we all protect those who are vulnerable. This virus looks for the most vulnerable. Keep them safe and be safe around people who are vulnerable. That includes the elderly and those who have conditions that affect immunity, their heart or their lung function. These actions will help us sustain and improve our collective cove in 19 experience. And if we all do these actions, we can avoid impacts of broader closures, closures of our workplaces, businesses, schools and other activities. A UPMC re remain committed and vigilant to be prepared to care for all of our patients and our sting. Should the virus surge again, we will do all that is necessary to make sure that we can treat you no matter what your healthcare need is, and we can do it safely. We will also create the new knowledge and the new care processes that will help now and will help moving forward. You expect this real world class medical center and will deliver it excellence in care and in innovation. That excellence includes approaches to testing. While many push for expanded use of new rapid tests for the virus, we use an approach that is based on the facts and the science. We need fast and reliable tests to contain this virus, just as we need develop safe and reliable vaccines. And we will fully evaluate any new rapid tests to make sure they meet both of those criteria before adopting them. Now Dr American will explain in more detail. What are clinical data are telling us about what has and hasn’t changed since the pandemic beginning. Thank you, though, really, As Dr Yearly explained, the clinical data we have tracked and analysed closely throughout Covered 19 are showing us some important lessons about how to better manage this illness. Let’s start with testing Well, we all wish that we could do more. We are, in fact, testing 2.5 times more covet patients per day in the last two months compared to the prior period, and the desk positivity rates is Onley slightly higher at 5.28% currently compared to this spring, which was 4.94% suggesting that the people we serve are mostly taking the right precautions to protect themselves. While our testing has grown dramatically, our number off hospitalized patients has not. The average daily number of patients hospitalized with covered 19 since July is approximately 2.8 times higher, done in the spring, but they lead discharges are three times higher. Our discharges are out based out basing our hospitalization rates. Patients are getting better, and they’re getting better faster at least a day faster, as a matter of fact, done before, the best news of all is that in hospital mortality, mortality rates are trending down. Surprisingly, the patients who we admit are not much difference than those we treated earlier in the pandemic, that is, current patients are similar in age and have similar co morbidity ease like diabetes compared to those hospitalized in the past. So why are the outcomes better in the past two months? We think part of the answer lies in the way that we have changed our care for these patients as we’ve learned more about this previously unknown disease. As Dr Yearly noted earlier, for instance, our data show that more than half off patients since the end of June have received X a methadone or other steroids while they use over in Destin, beer has declined, and we are more judiciously using mechanical ventilation. These are just some of the factors at play in this incredibly dynamic disease. We continue to gather data on refine our analysis so that we can continue improving care on outcomes for our patients. Dr. Angus will tell you more about the lessons we have learned, particularly through our little leadership in rigorous and adoptive clinical trials. Thanks very much. Um, so as don’t American just told you, our data show that, um, we’re learning how to do things better over time. And maybe also the disease itself changed. Specifically. What I’d like to talk to you about today is some positive news from our Sorry, Are you having trouble hearing me? Um, I’d like to report some positive news from our global remap trop, a commonly available, inexpensive class of drugs called cortical steroids. Um, we have found considerably reducing the odds of adverse outcome Death on inauguration on life support in critically ill cove in 19 patients. These results, coupled with those of other global cortical steroid trials, were published yesterday in Jianmin or the Journal of the American Medical Association and in fact, also led yesterday to the W. H O to issue new updated guidelines in this regard. Um on and it’s important to know we were delighted not only to be involved in the leadership of the remap trial, but toe have you UPMC actively participating. And we had a significant number of patients from UPMC hospitals participating in this trial. I spoke once before about remap, um, as a reminder. Remap stands were randomised embedded multifactorial adaptive platform, which is a new kind of way of thinking about do randomized trials. The gold standard for testing whether treatment actually works has for a long time being the so called randomized clinical trial, or RCTI. But the way in which we’ve done our sentences traditionally being to look at one treatment at one does at time. Every patient is randomized 50 fifties that sometimes something that someone doesn’t actually want to participate in, and furthermore, it can take months or years to get to an answer. What we want to do is think about trying to generate Justin’s robust information, but do it more quickly and do it in a way where patients have a greater chance of benefit. Remap is designed to simultaneously test multiple combinations of potential therapies at the same time, and this increases the efficiency and speed with which we generate information which is always valuable but particularly valuable during a pendant. And so, for example, within our current remap Cat Corbett program, we’ve actually been testing multiple different treatment regimens, including various doors, ease and combinations of even simple things like vitamin C but also convalescent plasma, blood thinners, anti virals and other drugs. The other thing that I just want to remind you are we were involved in the design of remark leave. We’ve bean very vested in delivering it here, UPMC, but it is actually a global initiative. In the cortical steering domain that I was alluding to, we actually enrolled patients at 121 hospitals at eight countries around, and it’s that is also crucial to get into information quickly. So coming back to the actual corticosteroid, many of you have probably heard about decks of methods on this is one type of corticosteroid, and there was a trial published from the United Kingdom earlier this summer that suggested that there would be benefit with Dex, a method what was going on in remap. We were actually testing another steal and hide the court it up. It was being given in a very similar Does Andi in similar patients, critically ill patients? It turned out that with hydrocortisone within our trial, there was a 93% probability that hydrocortisone superior to not giving her the same time we had colleagues conduct conducting traditional randomized trials in Brazil and friends. And actually, all of these studies came together and they were all published yesterday in JAMA. And so after the initial good news from June on decks of methadone, what we did yesterday was really help provide definitive information. And that’s in part why the W. H. O has now issued this very clear guidelines on giving corticosteroids high recorders on or decks a methadone to critically ill patients. This is only possible because of a global community of position scientists coordinating across different languages, different countries working together and sharing data at a speed and a level that I think has bean unprecedented in order to generate definitive answers. And, uh, I feel incredibly proud that UPMC in the University of Pittsburgh was absolutely center that initiative. Now I do understand as our ability to that randomized trials can often feel slow, and they take too long to generate information. I think it’s we’ve shown with remap that does not need to be the case. We have absolutely been able to generate robust, actionable information at this speed required to respond efficiently in this epidemic. This is part of what we would say is learning while doing it allows us to arrive quickly at clear guidance on how to treat patients. I would also say it’s a way of thinking about how we can have a structure where we’re trying to learn from every patient we’re treating. So that, for example, in this trial, when someone in Amsterdam agrees to be enrolled in the trial, they produce data that can then help our street someone in Altuna. This pandemic has shown more clearly than ever why this approach is necessary to achieve speed and generate effective medicine. Thanks, thanks very much. Dr Marik Win and Dr Angus, What you say supports what I see daily at UPMC and that is our cove in 19 patients are doing far better now than it. This started this pandemic. We have a team of gifted physicians and dedicated nurses and other health care experts that are doing the things that matter. During these trying times. We will use our excellence and will leverage all the knowledge that we have and that we find in other locations and the abilities from around the world to help eradicate Cove in 19 and all the communities that we serve. UPMC remains ready to care for you and your families throughout this endemic and beyond, and we’ll keep you healthy. Thank you doctors. And now we’ll take questions from media, all of whom are joining us remotely.
UPMC providing updates on COVID-19 clinical data, adaptive clinical trials
UPMC doctors provided updates on clinical data and the health system’s experience with COVID-19 Thursday afternoon, showing what has changed over time and how findings continue to inform COVID-19 care. They also discussed UPMC’s ongoing adaptive clinical trials and the impact they have had on the approach to patient treatment of coronavirus.Those speaking at the press conference included the following: Derek Angus, M.D., M.P.H., UPMC chief health care innovation officer and chair of critical care medicine at the University of Pittsburgh. Oscar Marroquin, M.D., F.A.C.C., UPMC chief health care data and analytics officer. Donald Yealy, M.D., UPMC senior medical director and chair of the Department of Emergency Medicine at UPMC and the University of Pittsburgh. A replay of the press conference will be available soon. Click the video player above to watch.
UPMC doctors provided updates on clinical data and the health system’s experience with COVID-19 Thursday afternoon, showing what has changed over time and how findings continue to inform COVID-19 care.
They also discussed UPMC’s ongoing adaptive clinical trials and the impact they have had on the approach to patient treatment of coronavirus.
Those speaking at the press conference included the following:
- Derek Angus, M.D., M.P.H., UPMC chief health care innovation officer and chair of critical care medicine at the University of Pittsburgh.
- Oscar Marroquin, M.D., F.A.C.C., UPMC chief health care data and analytics officer.
- Donald Yealy, M.D., UPMC senior medical director and chair of the Department of Emergency Medicine at UPMC and the University of Pittsburgh.
A replay of the press conference will be available soon. Click the video player above to watch.