Ongoing Trials of Plasma-Based Therapies for the Treatment of COVID-19

This report provides information on ongoing randomized controlled trials of intravenous immune globulin and hyperimmune globulin that are being investigated for the management of COVID-19. It will be updated every month. Ongoing trials of convalescent plasma are addressed in separate CADTH reports Link to Report Ongoing Trials of Plasma-Based Therapies for the Treatment of COVID-19 […]

What You Should Know About Drug Treatments for COVID-19

CADTH created this handout, intended for the general public, explaining the risks of using unproven drug treatments for COVID-19. The handout also provides information on what to do if someone is experiencing COVID-19 symptoms, tips on how to assess the reliability of health information found on the internet, and a list of reliable websites that […]

Ongoing Trials for Drugs in the Prevention and Treatment of COVID-19

This report provides information on ongoing randomized controlled trials of drugs being investigated to treat or prevent COVID-19. It will be updated every two weeks. Ongoing trials of vaccines and plasma-based therapies are addressed in separate CADTH reports. Link to Report Ongoing Trials for Drugs in the Prevention and Treatment of COVID-19 (Updated September 16, […]

Remdesivir Implementation Panel

Remdesivir (Veklury) is authorized by Health Canada to treat patients with severe COVID-19 symptoms who have pneumonia and need extra oxygen to help them breathe. The drug is administered intravenously and is only to be used in health care facilities where patients can be closely monitored. CADTH is convening an implementation panel of clinical specialists […]

Tocilizumab for the Treatment and Prevention of COVID-19: A Review of Clinical Effectiveness

Tocilizumab (TCZ), a recombinant humanized monoclonal antibody, used for severe rheumatoid arthritis and life-threatening cytochrome release syndrome, may be a potential treatment option for COVID-19 infection. Patients with severe COVID-19 infection showed an increase in pro-inflammatory cytokines; hence, it was thought that blocking the receptor of these agents may reduce the inflammatory response to COVID-19. […]

CADTH Emerging Health Technology for COVID-19: Sarilumab

Sarilumab is an interleukin-6 receptor antagonist indicated, in Canada, for rheumatoid arthritis and has been identified as a potential option for treating COVID-19. Two published studies were identified in the CADTH Horizon Scan that evaluated the efficacy and safety of sarilumab for the treatment of COVID-19. Link to Report CADTH Emerging Health Technology for COVID-19: […]

Remdesivir: Evidence Review and Appraisal

CADTH conducted a Health Technology Review on remdesivir — an antiviral drug currently being used to treat COVID-19. Remdesivir was approved in Canada on July 27, 2020 to treat adults and adolescents with severe symptoms of COVID-19 who have pneumonia and require extra oxygen. Four randomized controlled trials were identified and included in the review. […]

Convalescent Plasma Therapy for the Treatment of COVID-19 : A Review of Clinical Effectiveness

Convalescent plasma (CP) therapy is an intervention where plasma is collected from recovered COVID-19 patients in the hope that the disease-specific antibodies could help the recipient recover from COVID-19. Evidence on the effectiveness of CP therapy for the treatment of COVID-19 is still in the early stages. This report summarizes the current evidence and it […]

What You Should Know About Dexamethasone for Treating COVID-19

This tool provides general information about the drug dexamethasone, its past uses, and new evidence for dexamethasone as a potential treatment for COVID-19. The results from the dexamethasone arm of the RECOVERY trial are provided, together with the current Canadian recommendations for its use in treating COVID-19. Link to Tool What You Should Know About […]

Lopinavir-Ritonavir for the Treatment and Prevention of COVID-19: A Review of Clinical Effectiveness

HIV medications lopinavir and ritonavir (LPVR), in combination, are currently being investigated as a proposed COVID-19 treatment. The potential mechanism of action of LPVR is that it may disrupt the replication and spread of the severe acute respiratory syndrome coronavirus 2 — or SARS-CoV-2 — within the body. However, there is uncertainty around the clinical […]

CADTH Emerging Health Technology for COVID-19: Favipiravir

Favipiravir is an oral antiviral drug that has emerged as a potential treatment or prevention option for COVID-19. An international expert panel issued a weak recommendation for not using favipiravir in patients with non-severe or severe COVID-19 because of low-quality evidence. Favipiravir is not approved in Canada and is not currently accessible outside of clinical […]

Chloroquine or Hydroxychloroquine to Prevent or Treat COVID-19

This report reviews the current scientific evidence on the potential benefits and harms of chloroquine and hydroxychloroquine for the prevention or treatment of COVID-19. A total of four trials were identified — three treatment trials and one prevention trial. The evidence available at this time is limited in both quantity and quality, with some of […]

Dexamethasone in the Treatment of Hospitalized Patients With COVID-19: A Critical Appraisal of the RECOVERY Study

The RECOVERY trial is a large, ongoing, multi-centre, open-label, randomized controlled trial investigating several treatments for patients hospitalized with COVID-19. In July 2020, the preliminary results were published comparing dexamethasone plus usual standard of care with usual standard of care alone. Dexamethasone reduced the 28-day mortality rate in patients hospitalized with COVID-19. The purpose of […]

Gabapentin, Phenobarbital, Diazepam, and Lorazepam for the Treatment of Alcohol Withdrawal: Clinical Effectiveness and Guidelines

During pandemics, such as the COVID-19 pandemic, it can be challenging to offer care to vulnerable populations, especially those experiencing alcohol withdrawal. CADTH conducted a Rapid Response on the clinical effectiveness of using gabapentin, phenobarbital, diazepam, or lorazepam to treat alcohol withdrawal. This report also searched for evidence-based guidelines for treating alcohol withdrawal in the […]

Virtual Pulmonary Rehabilitation for Respirator Disease or Post-Intensive Care Syndrome: Clinical Effectiveness and Guidelines

As a result of the COVID-19 pandemic, many people are interested in whether health care interventions can be done virtually or remotely. CADTH conducted a Rapid Response regarding virtual pulmonary rehabilitation (programs to improve lung function) for patients with respiratory disease or post-intensive care syndrome (health problems individuals may experience after being in intensive care). […]

Venous Thromboembolism Prophylaxis in Patients Hospitalized With COVID-19

Patients hospitalized with COVID-19, particularly those in intensive care units, are at an increased risk for venous thromboembolism (VTE). CADTH’s Horizon Scan identified seventeen studies reporting on the frequency of VTE in patients hospitalized with COVID-19. The Horizon Scan also summarized Canadian and International guidance regarding the dose and duration of pharmacologic thromboprophylaxis for VTE […]

Methoxyflurane for Acute Pain: Clinical Effectiveness

CADTH conducted a Rapid Response report to search for evidence on the comparative clinical effectiveness of methoxyflurane versus inhaled nitrous oxide for acute pain, as well as the clinical effectiveness of methoxyflurane for acute pain in pre-hospital or emergency department settings. One systematic review was identified; however, it has not been critically appraised by CADTH. […]

Reusing Metered Dose Inhalers in a Health Care Setting: Clinical Effectiveness, Cost-Effectiveness, and Guidelines

CADTH searched for evidence on the safety and cost-effectiveness of re-using the canister portion of metered dose inhalers (MDIs) across multiple patients in a health care setting. CADTH also searched for any evidence-based guidelines on the topic. Three non-randomized studies were identified regarding the safety of reusing the canister portion of MDIs and they are […]

Convalescent Plasma Therapy for the Treatment of COVID-19: Clinical Effectiveness

CADTH performed a literature search to find evidence on the clinical effectiveness of convalescent plasma therapy for the treatment of COVID-19. Two non-randomized studies were identified and their abstracts (as well as the links to the full publications) are included in this report; however, CADTH has not critically appraised these studies. Additional information of potential […]

Dialysis Modalities for the Treatment of End-Stage Kidney Disease

This summary tool provides an overview of the key findings of a CADTH review of dialysis modalities for the treatment of end-stage kidney disease. The review found that home-based dialysis modalities appear to offer clinical benefits similar to those offered by in-centre hemodialysis. Based on this review, self-care home-based dialysis is recommended for eligible patients. […]

Disposable Continuous Positive Airway Pressure Devices for Respiratory Distress: Clinical Effectiveness and Guidelines

CADTH conducted a Rapid Response search for evidence on the effectiveness of disposable continuous positive airway pressure (CPAP) devices compared with mechanical CPAP devices for patients in respiratory distress. One non-randomized study was found. This information might be of interest to health care decision-makers when considering the use of CPAP in the treatment of COVID-19. […]

Impact of substituting Coumadin lab test results

INESSS’s Position (07-05-2020) Based on the scientific literature available when preparing the report and on the various consultations carried out, and despite a very quick review process, INESSS finds that: There should not be any particular clinical issues in substituting Coumadin® with a generic version of warfarin. Section 21 of the Pharmacy Act shall apply. […]

Medication Administration via Multi-Dose Inhalers and Aerochambers Versus Nebulizers: Clinical Effectiveness

CADTH conducted a Rapid Response report to search for evidence regarding the clinical effectiveness of medication administration via multi-dose inhalers compared to nebulizers. This report may be of interest to health care professionals treating patients with asthma or chronic obstructive pulmonary disease, as the CADTH report found studies with patients experiencing these conditions. Link to […]

Resumption of elective health services amid COVID-19

CADTH has prepared a briefing note that describes the challenges health systems face in making decisions about resuming elective procedures during the COVID-19 pandemic, summarizes some recent guidance on service resumption, and discusses potential implications and long-term considerations for these choices. Link to Report Resumption of elective health services amid COVID-19

Plastic or Reusable Aerochambers in Multi-Dose Inhalers: Clinical Effectiveness and Guidelines

CADTH created a Rapid Response report that included a search for evidence regarding the clinical effectiveness of plastic or reusable aerochambers in multi-dose inhalers for patients requiring medication administration, as well as any evidence-based guidelines on the topic. However, no relevant literature or evidence-based guidelines were identified; therefore, no conclusions could be drawn. Link to […]

Pre-Treatment Mouth Rinses for Dental Patients With Suspected SARS or COVID-19: Clinical Effectiveness and Guidelines

In response to the COVID-19 pandemic, CADTH looked for studies on the clinical effectiveness of using pre-dental treatment mouth rinses for patients with suspected SARS or COVID-19 in order to prevent virus transmission from patients to oral health care providers. The report also looked for evidence-based guidelines for the use of pre-treatment mouth rinses in […]

An Overview of Clinical Applications of 3-D Printing and Bioprinting

This bulletin describes 3-D printing and bioprinting technologies in use, or being studied for use, in health care. No evidence on 3-D-printed personal protective equipment was found, but the bulletin might still be of interest to decision-makers considering 3-D printing as a solution to equipment shortages. There is currently a lack of high-quality evidence on […]

Initiatives to Optimize the Utilization of Laboratory Tests

This environmental scan provides information from across Canada and internationally on initiatives to improve patient care and reduce costs through test utilization management. This information may be useful to decision-makers looking at ways to optimize the use of COVID-19 tests. The report notes a lack of publicly available information on such initiatives. Link to Report […]

Transitioning Long-Term Ventilator-Dependent Patients Out of the Intensive Care Unit

This environmental scan reports on survey responses from nine Canadian long-term ventilator programs. It describes the varied ways the programs assess and address medical and non-medical factors before moving patients out of ICU. It might be of interest to those making decisions regarding the transition of stable COVID-19 patients from ICU ventilators to alternate levels […]