实用医学杂志2026，Vol.42Issue(12)：2252-2258,7.DOI:10.3969/j.issn.1006-5725.2026.12.022
适应性平台试验在新型冠状病毒感染大流行中的应用:以RECOVERY为例的方法学反思与未来展望
Application of adaptive platform trials in the COVID-19 pandemic:Methodological reflections and future perspectives using RECOVERY as an example
摘要
Abstract
During the early stage of the COVID-19 pandemic,the decision-making regarding the treatment of hospitalized patients was marked by an urgent clinical requirement but a lack of high-quality evidence.The Ran-domised Evaluation of COVID-19 Therapy(RECOVERY)trial,leveraging its adaptive multi-arm platform design,quickly assessed multiple candidate therapies within a unified framework.It confirmed the clinical efficacy of dexamethasone,tocilizumab,and baricitinib in specific hospitalized patients,while disproving the effectiveness of several interventions such as hydroxychloroquine,azithromycin,and lopinavir/ritonavir with strong randomized evidence.Using RECOVERY as the core framework,this review explores how the trial transformed the treatment of hospitalized COVID-19 patients from widespread empirical use to stratified decision-making based on disease stage,inflammatory phenotype,host immune status,and treatment timing.It also outlines RECOVERY'S methodological,clinical,and evidentiary contributions for future emerging infectious diseases.We contend that the significant contribution of RECOVERY lies not only in identifying effective therapies but also in demonstrating that embedded platform trials can rapidly generate evidence that can change clinical practice and support the development of dynamically updated treatment strategies during public health emergencies.关键词
RECOVERY试验/COVID-19/住院患者/平台试验/分层治疗/循证医学Key words
RECOVERY trial/COVID-19/hospitalized patients/platform trial/stratified treat-ment/evidence-based medicine分类
医药卫生引用本文复制引用
余怀淼,罗磊,杨文龙..适应性平台试验在新型冠状病毒感染大流行中的应用:以RECOVERY为例的方法学反思与未来展望[J].实用医学杂志,2026,42(12):2252-2258,7.基金项目
江西省自然科学基金项目(编号:20192BAB205014) （编号:20192BAB205014）
南昌大学第二附属医院博士启动基金项目(编号:B2273) （编号:B2273）
北京肝胆相照公益基金会临床科研专项资助基金项目(编号:iGandanF-1082024-LG009) （编号:iGandanF-1082024-LG009）
