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Toronto (May 12, 2020) – A large-scale international clinical trial to test whether the blood thinner heparin can help improve survival for COVID-19 patients launches this week, led by clinician-scientists from the University of Manitoba and the University Health Network in Toronto.
There has been a high incidence of thrombosis, or blood clots, associated with COVID-19 infections worldwide, causing death by pulmonary embolism or stroke.
"It is believed the drug heparin could help COVID-19 patients survive," says Dr. Ryan Zarychanski, Co-Principal Investigator of the clinical trial, and an associate professor of internal medicine and community health sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba.
"As we rapidly learn more and more about COVID-19, it's becoming clear that clotting is a very important feature of the disease," says Co-Principal Investigator Dr. Ewan Goligher, an assistant professor of medicine, Interdepartmental Division of Critical Care Medicine, University of Toronto, and clinician-scientist at the Toronto General Hospital Research Institute, University Health Network.
"High-dose blood thinners have a very high chance of saving many lives and preventing the need for intubation and mechanical ventilation for many patients."
Heparin is an anticoagulant, or blood thinner, that is inexpensive, familiar, and widely available.
"This trial could lead to an immediately deployable clinical therapy in both high and low income settings, given its universal availability," says Co-Principal Investigator Dr. Patrick Lawler, an assistant professor at the University of Toronto and clinician-scientist at the Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network.
The project, entitled "The Antithrombotic Therapy to Ameliorate Complications of COVID-19 (ATTACC)" trial is a collaboration between Drs. Zarychanski, Goligher, and Lawler.
The randomized clinical trial is set to run at more than 30 sites in Canada, the United States, Mexico and Brazil, with more countries and sites preparing to participate.
The plan is to enroll up to 3,000 people with COVID-19 who have been admitted to hospital. In a second, related trial, the team will evaluate the impact of heparin on patients requiring life support and who are in an intensive care unit.
The trial organization is a model of Canadian collaboration in a time when everyone has been called upon to work together toward a common goal. The University of Manitoba and the University Health Network are working together to make this large international trial a reality.
Dr. Zarychanski has been studying heparin for the last eight years and has led a clinical trial for the past year-and-a-half called HALO. The seven-country trial was studying heparin in people with severe infections. As evidence of coaguloapathy in COVID-19 emerged, Dr. Zarychanski brought that experience to bear in working with Drs. Lawler and Goligher to design the ATTACC trial.
"Because of the high incidence of blood clots and high levels of inflammation in COVID-19, blood thinners offer immense potential benefit for patients with COVID-19 disease," says Dr. Zarychanski.
ATTACC was started with funding from a COVID-19 FastGrant from the Thistledown Foundation, and an Innovation Award from the Peter Munk Cardiac Centre Innovation Committee.
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