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ACTT-1
About the Trial
The Adaptive COVID 19 Treatment Trial randomized 1,062 hospitalized COVID patients to remdesivir or placebo. Remdesivir shortened median recovery from 15 to 10 days in the final report, most convincingly in patients on supplemental oxygen. Mortality trended lower but was not statistically significant. Preliminary results were released early, and remdesivir received emergency authorization in 2020 before becoming the first FDA approved COVID treatment. ACTT 1 demonstrated that an antiviral could alter established COVID disease and pioneered the adaptive platform infrastructure at NIH that ran subsequent ACTT trials for baricitinib and beyond. WHO later judged mortality impact modest, illustrating how evidence evolves as pandemics and trials mature.
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