REMAP-CAP: The Origin

In this episode of "In the Interim…", Dr. Scott Berry explores the origins of REMAP-CAP with Prof. Steve Webb, former chair of the REMAP-CAP International Trial Steering Committee. This episode examines how pandemic preparedness efforts after 2009 H1N1 shaped the design of an international, adaptive platform trial to be able to respond rapidly to new infectious threats. Steve and Scott explain the sequence of strategy meetings, the role of the PREPARE consortium in securing EU funding and subsequent federation across Australia and Canada. The discussion details REMAP-CAP’s technical foundations: a modular master protocol, domain architecture, Bayesian adaptive methods, and frequent interim analyses. When COVID-19 emerged, these core elements permitted immediate platform activation to combat the pandemic infection with assessment of treatments across multiple domains—including steroids, immune modulation, and anticoagulation—generating actionable evidence in weeks. The episode also addresses international data harmonization, multi-platform trial collaboration, and the capacity to adapt trial structure as infectious disease threats evolve.

Key Highlights

• Response to H1N1 and feckless pandemic trials
• International strategy meetings—origins of platform concept
• PREPARE consortium and cross-continental funding
• Modular master protocol, factorial allocation, and domain-specific appendices
• Bayesian triggers and response adaptive randomization
• Pivot to COVID-19 and rapid data generation
• Multi-platform international collaboration

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