The AustralaSian COVID-19 Trial (ASCOT) has identified the most effective level of anticoagulant treatment needed for patients hospitalized with COVID-19, in a study published in the New England Journal of Medicine Evidence and presented today at the American Society for Hematology conference.
The global COVID-19 pandemic remains a major public health challenge. ASCOT researchers aim to find out which treatments are most effective in patients hospitalized with COVID-19.
Patients hospitalized with COVID-19 are at increased risk of blood clots (or thromboses), which in turn can contribute to the development of organ failure. Almost all of these patients will receive some degree of anticoagulant medication.
In an international study, the ASCOT team conducted a randomized clinical trial to test different levels of anticoagulation (or blood thinning) in over 1,500 patients in Australia, New Zealand, India and Nepal.
They found that an intermediate level of anticoagulation had an 86% chance of being better than low-dose anticoagulation. A higher therapeutic dose showed no benefit.
ASCOT lead researcher Professor Steven Tong, an infectious disease clinician at the Royal Melbourne Hospital and co-head of clinical research at the Doherty Institute, said the findings will inform WHO-sponsored guidelines.
“Current practice in Australia is for low dose anticoagulation, while international guidelines recommend the therapeutic high dose of anticoagulation. Therefore, our results provide evidence that middle ground may be most beneficial” , said Professor Tong.
Associate Professor Zoe McQuilten, Deputy Director of Monash University’s Transfusion Research Unit and Consultant Hematologist at Monash University and Monash Health, said: “We are delighted that our study has been selected for presentation. at the American Society of Hematology Annual Meeting & Exposition, which is the premier international hematology conference.
“Importantly, we found no evidence that the mid-dose of anticoagulation resulted in an increased risk of bleeding. Although we did not find evidence of benefit from the high therapeutic dose of anticoagulation, we enrolled fewer patients in this arm of the trial.”
Professor Bala Venkatesh, Full Professor at the George Institute for Global Health, said: “This study highlights the importance of conducting clinical trials across different healthcare systems. Low and middle income countries (LMICs) have been underrepresented in Covid-19. and ASCOT is one of the few studies with major involvement in LMIC regions. The results of the ASCOT trial are expected to have a significant influence on clinical guidelines.
New England Journal of Medicine EvidenceDOI: 10.1056/EVIDoa22009293
Provided by the Peter Doherty Institute for Infection and Immunity
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