Evidence mapPaperPMID 42101205Full record

Trial reportCritical care medicine2026

Ivermectin for Critically and Noncritically Ill Hospitalized Patients With COVID-19: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP).

Madiha Hashmi, Rashan Haniffa, Deva Jayakumar, Abigail Beane, Elizabeth Lorenzi, Lindsay R Berry, Muhammad Nasir Khoso, Quratul Ain Khan, Ashok Kumar, Aneela Altaf Kidwai and 73 more

Abstract readRandomized Controlled TrialAdaptive Clinical Trial
In one paragraph

Trial report in Critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

83 authors.

Madiha HashmiDepartment of Critical Care Medicine, Ziauddin University-Karachi, Sindh, Pakistan.
Rashan HaniffaMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
Deva JayakumarDepartment of Critical Care, Dr Kamakshi Memorial Hospital, Chennai, Tamil Nadu, India.
Abigail BeaneMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
Elizabeth LorenziBerry Consultants, Austin, TX.
Lindsay R BerryBerry Consultants, Austin, TX.
Muhammad Nasir KhosoSouth City Hospital, Karachi, Pakistan.
Quratul Ain KhanCritical Care, North Nazimabad Campus, Dr Ziauddin Group of Hospitals, Karachi, Pakistan.
Ashok KumarDepartment of Chest Medicine and Critical Care, Ziauddin University, Karachi, Sindh, Pakistan.
Aneela Altaf KidwaiDepartment of Medicine, Abbasi Shaheed Hospital, Nazimabad, Karachi, Pakistan.
Thomas E HillsMedical Research Institute, Wellington, New Zealand.
Djillali AnnaneService de Réanimation médicale et unité de ventilation à domicile, centre de référence neuromusculaire GNHM, CHU Raymond Poincaré, APHP, Université de Versailles Saint Quentin en Yvelines, Garches, France.
Diptesh AryalNepal Intensive Care Research Foundation, Kathmandu, Nepal.
Carly AuClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Kenneth BaillieCentre for Inflammation Research, Deanery of Clinical Sciences, University of Edinburgh, Midlothian, United Kingdom.
Richard BeasleyMedical Research Institute, Wellington, New Zealand.
Janis Best-LaneDivision of Anaesthetics, Pain Medicine, and Intensive Care, Imperial College London, London, United Kingdom.
Marc BontenDepartment of Medical Microbiology, University Medical Center, Utrecht, The Netherlands.
Charlotte A BradburyUniversity of Bristol, Bristol, United Kingdom.
Frank M BrunkhorstJena University Hospital, Jena, Germany.
Aidan BurrellAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Meredith BuxtonGlobal Coalition for Adaptive Research, Larkspur, CA.
Maurizio CecconiDepartment of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Milan, Italy.
Allen C ChengDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Matthew E CoveNational University of Singapore, Singapore.
Menno de JongDepartment of Medical Microbiology, University Medical Center, Utrecht, The Netherlands.
Michelle A DetryBerry Consultants, Austin, TX.
Eamon DuffyAuckland City Hospital, Auckland, New Zealand.
Lise J EstcourtUniversity of Oxford, Oxford, United Kingdom.
Mark FitzgeraldBerry Consultants, Austin, TX.
Rob FowlerSunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Herman GoossensMedical Microbiology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
Cameron GreenMonash University, Melbourne, VIC, Australia.
Leanne M C HaysUniversity College Dublin Clinical Research Centre, St Vincent's University Hospital, Dublin, Ireland.
Alisa M HigginsAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
David T HuangUniversity of Pittsburgh, Pittsburgh, PA.
Nao IchiharaThe University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Sabin KoiralaDepartment of Pulmonary, Critical Care and Sleep Medicine, Hospital for Advanced Medicine and Surgery, Kathmandu, Nepal.
François LamontagneUniversite de Sherbrooke, Sherbrooke, QC, Canada.
Patrick R LawlerMcGill University Faculty of Medicine, Montreal, QC, Canada.
Roger J LewisBerry Consultants, Austin, TX.
Edward LittonThe University of Western Australia, Perth, WA, Australia.
Niamh MahonUniversity College Dublin Clinical Research Centre, St Vincent's University Hospital, Dublin, Ireland.
John C MarshallUniversity of Toronto, Toronto, ON, Canada.
Daniel F McAuleyICU, QUB, Belfast, United Kingdom.
Anna McGlothlinBerry Consultants, Austin, TX.
Shay McGuinnessAuckland City Hospital, Auckland, New Zealand.
Zoe K McQuiltenMonash University, Melbourne, VIC, Australia.
Bryan J McVerryPulmonary Allergy and Critical Care Medicine, University of Pittsburgh Medical Center Health System, Pittsburgh, PA.
Paul R MounceyClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Susan MorpethMiddlemore Hospital, Auckland, New Zealand.
Mihai NeteaRadboud Universitair Medisch Centrum, Nijmegen, The Netherlands.
Katrina OrrFiona Stanley Hospital, Murdoch, WA, Australia.
Rachael L ParkeThe University of Auckland, Auckland, New Zealand.
Jane C ParkerMonash University, Melbourne, VIC, Australia.
Asad PatanwalaAuckland City Hospital, Auckland, New Zealand.
Svenja PetersEuropean Clinical Research Alliance on Infectious Diseases (Ecraid), Utrecht, The Netherlands.
Luis Felipe ReyesUniversidad de La Sabana, Chia, Colombia.
Kathryn M RowanClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Hiroki SaitoSt Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Christina T SaundersBerry Consultants, Austin, TX.
Marlene SantosUnity Health Toronto, Toronto, ON, Canada.
Christopher W SeymourUniversity of Pittsburgh, Pittsburgh, PA.
Manu Shankar-HariCentre for Inflammation Research, The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, United Kingdom.
Vanessa SinghAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Matthew SlaterFaculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
Paul A TambyahDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Steven Y C TongThe Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
Alexis F TurgeonUniversite Laval, Quebec, QC, Canada.
Anne M TurnerMedical Research Institute, Wellington, New Zealand.
Frank van de VeerdonkDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Sebastian WeisInstitute for Infectious Disease and Infection Control, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
Ryan ZarychanskiUniversity of Manitoba, Winnipeg, MB, Canada.
Colin J McArthurAuckland City Hospital, Auckland, New Zealand.
Derek C AngusUniversity of Pittsburgh, Pittsburgh, PA.
Scott M BerryBerry Consultants, Austin, TX.
Anthony C GordonImperial College London, London, United Kingdom.
Lennie P G DerdeIntensive Care Center, University Medical Centre, Utrecht, The Netherlands.
Steve A WebbMonash University, Clayton, VIC, Australia.
Srinivas MurthyThe University of British Columbia, Vancouver, BC, Canada.
Yaseen ArabiCritical Care, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Alistair D NicholAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
and the Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine whether ivermectin improves outcomes for critically and noncritically ill hospitalized patients with COVID-19.

designAn ongoing international, multifactorial, adaptive platform, randomized, controlled trial.

settingHospitals in Pakistan, India, and Ireland between June 11, 2021, and September 9, 2022. PATIENTS: Critically and noncritically ill patients.

interventionsRandomized to ivermectin or no ivermectin (control). MEASUREMENTS AND MAIN

resultsThe primary outcome was respiratory and cardiovascular organ support-free days, assessed on an ordinal scale combining in-hospital death (assigned a value of -1) and days free of organ support through day 21 in survivors. Analyses used a Bayesian cumulative logistic model. Enrollment was closed for operational futility, following external evidence suggesting no benefit with ivermectin in nonhospitalized patients with COVID-19. Among 61 critically ill patients, the median number of organ support-free days was -1, indicating death was the most common vital outcome (interquartile range [IQR], -1 to 17), for the ivermectin group and -1 (IQR, -1 to 17.25) for the control group (adjusted proportional odds ratio [OR], 0.94; 95% credible interval [CrI], 0.40-2.07) and the posterior probability of superiority to control was 44.2%. Among 89 noncritically ill patients, the median number of organ support-free days was 22 (IQR, 18.5-22) for ivermectin and 22 (IQR, 16-22) for control (adjusted proportional OR, 1.04; 95% CrI, 0.48-2.34) and the posterior probability of superiority was 53.7%. Among critically ill patients, hospital survival was 35.1% (13/37) for ivermectin and 37.5% (9/24) for control (adjusted OR, 1.00; 95% CrI, 0.39-2.32), posterior probability of superiority was 50.0%. Among noncritically ill patients, hospital survival was 84.1% (37/44) for ivermectin and 77.8% (35/45) for control (adjusted OR, 1.16; 95% CrI, 0.5-3.07), posterior probability of superiority was 63.3%.

conclusionsFor critically and noncritically ill hospitalized patients with COVID-19, ivermectin was unlikely to improve the primary composite outcome of organ support-free days and hospital survival.

Indexed as

COVID-19COVID-19 Drug TreatmentIvermectinAdultCommunity-Acquired PneumoniaCritical IllnessFemaleHospitalizationHospital MortalityHumansMaleMiddle AgedIvermectinadaptive platform trialantiviralCOVID-19intensive careivermectinpneumonia

Identifiers

PMID42101205
PMCPMC13322157

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.