Trial reportBMJ (Clinical research ed.)2022
Angiotensin receptor blockers for the treatment of covid-19: pragmatic, adaptive, multicentre, phase 3, randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04394117 (Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY Disease), which is not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY Disease
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Drug treatments for mild or moderate covid-19: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Effects of renin-angiotensin system blockers on outcomes from COVID-19: a systematic review and meta-analysis of randomized controlled trials.European heart journal. Cardiovascular pharmacotherapy · 2024Pooled it
- Telmisartan reduces systemic inflammation and alters the renin-angiotensin system in mild COVID-19.Scientific reports · 2025Trial
- Atorvastatin and telmisartan do not reduce nasopharyngeal carriage of SARS-CoV-2 in mild or moderate COVID-19 in a phase IIb randomized controlled trial.Scientific reports · 2024Trial
- Combination of the chemokine receptor type 2 (CCR2) antagonist DMX-200 and candesartan for COVID-19: a randomised controlled trial.BMJ open · 2024Trial
- Trial
- Adipose Tissue in SARS-CoV-2 Viral Tropism, Viral Replication, and the Concept of a Viral Reservoir: An Update.Obesity (Silver Spring, Md.) · 2026Review
- Combined ACEI and ARB therapy and ICU mortality in critically ill COVID-19 patients: a retrospective cohort study.Frontiers in pharmacology · 2026Article
- The use of angiotensin-converting enzyme inhibitors in hospitalized patients with COVID-19 is associated with a lower risk of mortality.Scientific reports · 2025Article
- Unlocking Novel Therapeutic Potential of Angiotensin II Receptor Blockers.International journal of molecular sciences · 2025Review
- Anti-Infective Screening of Selected Nine Cannabinoids AgainstCurrent issues in molecular biology · 2025Article
- Angiotensin-(1-7) infusion in COVID-19 patients admitted to the ICU: a seamless phase 1-2 randomized clinical trial.Annals of intensive care · 2024Article
- Rethinking the pros and cons of randomized controlled trials and observational studies in the era of big data and advanced methods: a panel discussion.BMC proceedings · 2024Article
- The KINETIC phase 2 randomized controlled trial of oral pamapimod-pioglitazone in non-critically ill COVID-19 inpatients.iScience · 2023Article
- Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19.Scientific reports · 2023Article
- Review
- Update Alert 10: Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults.Annals of internal medicine · 2023Article
- Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID-19.Pharmacology research & perspectives · 2023Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 13 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether disrupting the renin angiotensin system with angiotensin receptor blockers will improve clinical outcomes in people with covid-19.
designCLARITY was a pragmatic, adaptive, multicentre, phase 3, randomised controlled trial.
setting17 hospital sites in India and Australia.
participantsParticipants were at least 18 years old, previously untreated with angiotensin receptor blockers, with a laboratory confirmed diagnosis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection who had been admitted to hospital for management of covid-19.
interventionOral angiotensin receptor blockers (telmisartan in India) or placebo (1:1) for 28 days.
main outcome measuresThe primary endpoint was covid-19 disease severity using a modified World Health Organization Clinical Progression Scale (WHO scale) at day 14. Secondary outcomes were WHO scale scores at day 28, mortality, intensive care unit admission, and respiratory failure. Analyses were evaluated on an ordinal scale in the intention-to-treat population.
resultsBetween 3 May 2020 and 13 November 2021, 2930 people were screened for eligibility, with 393 randomly assigned to angiotensin receptor blockers (of which 388 (98.7%) to telmisartan 40 mg/day) and 394 to the control group. 787 participants were randomised: 778 (98.9%) from India and nine (1.1%) from Australia. The median WHO scale score at day 14 was 1 (interquartile range 1-1) in 384 participants assigned angiotensin receptor blockers and 1 (1-1) in 382 participants assigned placebo (adjusted odds ratio 1.51 (95% credible interval 1.02 to 2.23), probability of an odds ratio of >1 (Pr(OR>1)=0.98). WHO scale scores at day 28 showed little evidence of difference between groups (1.02 (0.55 to 1.87), Pr(OR>1)=0.53). The trial was stopped when a prespecified futility rule was met.
conclusionsIn patients admitted to hospital for covid-19, mostly with mild disease, not requiring oxygen, no evidence of benefit, based on disease severity score, was found for treatment with angiotensin receptor blockers, using predominantly 40 mg/day of telmisartan.
trial registrationClinicalTrials.gov NCT04394117.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.