Canadian Adaptive Platform Trial of Treatments for COVID-19 in Community Settings
Summary
CanTreatCOVID is an open-label, individually randomized, multi-centre, national trial. CanTreatCOVID aims to establish an adaptive platform trial aimed at evaluating the clinical- and cost-effectiveness, practical challenges, and outcomes of therapeutics for SARS-CoV-2 for non-hospitalized patients in Canada. Participants will be randomized to receive usual care (i.e. supportive care and symptom relief) or a study therapeutic, which will be determined by the Canadian COVID-19 Out-Patient Therapeutics Committee. The primary outcomes being evaluated is hospitalization and/or death at 28 days, as well as time to recovery.
Timeline
- Start
- 2023-01-16
- Primary completion
- 2025-04-28
- Completion
- 2025-06-28
Outcome
Missed primary endpoint
paper (adjusted odds ratio, 0.48; 95% Bayesian credible interval, 0.08 to 2.23; probability of superiority, 0.830). PMID 42019019 ↗
paper nirmatrelvir-ritonavir did not reduce the incidence of hospitalization or death among vaccinated higher-risk participants with SARS-CoV-2 infection. PMID 42019019 ↗
Publications
- Butler CC, Pinto AD, Harris V, Holmes J, Rahman NM, Cureton L, Hayward G, Richards DB, Lowe DM, Standing JF, Breuer J, Hood K, Png ME, Petrou S, Dorward J, Patel MG, Thomas NPB, Evans P, Hart ND, Jani BD, Hosseini B, Murthy S, McBrien K, Condon A, McDonald EG, Daley P, Greiver M, da Costa BR, Selby P, Juni P, Lee TC, Shi H, Detry MA, Saunders CT, Fitzgerald M, Berry NS, Saville BR, Khoo SH, Nguyen-Van-Tam JS, Hobbs FDR, Yu LM, Little P; PANORAMIC Trial and CanTreatCOVID Trial Collaborative Groups. Oral Nirmatrelvir-Ritonavir for Covid-19 in Higher-Risk Outpatients. N Engl J Med. 2026 Apr 23;394(16):1583-1594. doi: 10.1056/NEJMoa2502457.
- Hosseini B, Condon A, da Costa BR, Daley P, Greiver M, Juni P, Lee TC, McBrien K, McDonald EG, Murthy S, Selby P, Pinto AD. Lessons learned and recommendations from the Canadian adaptive platform trial of treatments for COVID in community settings (CanTreatCOVID). Contemp Clin Trials. 2026 Jun;165:108303. doi: 10.1016/j.cct.2026.108303. Epub 2026 Apr 13.
- Astorga GH, Pinto AD, Sivayoganathan K, Maruthananth K, Hosseini B. Canadian adaptive platform trial of treatments for COVID in community settings (CanTreatCOVID): recruitment strategies of a decentralized, national randomized controlled trial for acute SARS-CoV-2. Front Public Health. 2026 Feb 11;14:1698604. doi: 10.3389/fpubh.2026.1698604. eCollection 2026.
- Hosseini B, Condon A, da Costa BR, Daley P, Greiver M, Juni P, Lee TC, McBrien K, McDonald EG, Murthy S, Selby P, Andrew M, Aubrey-Bassler K, Barber D, Barrett B, Butler CC, Crampton N, Dahrouge S, Damji A, Fowler R, Garies S, Hudon C, Hulme J, Isenor J, Jenkins DJA, Lall R, LeBlanc A, Leong C, Little P, Lofters A, Logsetty S, Lother S, Lussier MT, Maclaren L, Mangin D, Marshall EG, Marshall JC, McCracken R, Moineddin R, Orava B, Paquette JS, Park JJH, Persaud N, Rac VE, Ramsden VR, Rayner J, Sanchez-Ramirez DC, Saxinger L, Shi H, Singer A, Spiwak R, Srivastava A, Sud A, Tarride JE, Telner D, Upshur REG, Walji S, Walsh R, Wilchesky M, Wong ST, Wood B, Zarychanski R, Zelek B, Keynan Y, Piszczek J, Warshafsky D, Pinto AD. Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID): protocol for a randomised controlled adaptive platform trial of treatments for acute SARS-CoV-2 infection in community settings. BMJ Open. 2025 Aug 3;15(8):e097134. doi: 10.1136/bmjopen-2024-097134.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Lycopene | Other / unclassified | 45 mg | — |
| Subject | Nirmatrelvir | Small molecule | 300 mg | Oral |
| Subject | Ritonavir | Other / unclassified | 100 mg | Oral |
| Subject | Selenium | Other / unclassified | 300 ug | — |
| Subject | Vitamin C | Other / unclassified | 1.5 g | — |
| Subject | Zinc Sulfate | Unknown | 40 mg | — |