A £2.9 million national trial, launched today to help find effective treatments for people hospitalised with severe flu, will replicate lessons learnt in the pandemic.
The latest phase of the REMAP-CAP trial will work with the National Institute for Health and Care Research (NIHR) to recruit adults, children and babies over one month hospitalised with severe flu at 150 hospitals across the UK over the next two years.
Led by researchers and clinicians from Imperial College London and Imperial College Healthcare NHS Trust, the adaptive platform trial – the first of its kind for flu – is being funded by the NIHR and delivered by the NIHR’s Clinical Research Network.
The REMAP-CAP trial was originally set up to tackle pandemics and it is two years since it identified how the drug tocilizumab can save lives in severely ill COVID-19 patients.
The trial is designed to provide answers quickly by using a rapid, yet robust, approach to test multiple treatments at the same time in thousands of people.
The trial’s chief investigator, Professor Anthony Gordon from Imperial College London’s Department of Surgery and Cancer and consultant in intensive care medicine at Imperial College Healthcare NHS Trust, said: “During the pandemic, our trial was able to rapidly respond to a new virus and our approach helped save lives. We’re now redeploying it against a known threat. Flu is very infectious and can make children, the elderly and vulnerable people seriously unwell in some cases.
“This winter, we might see more flu cases than usual as the virus potentially resurges after pandemic measures have kept levels low. We hope that our trial will help to find urgently needed flu treatments rapidly. Our COVID-19 trial changed clinical practice globally, and we hope we can impact flu treatment and reduce winter pressures on the NHS in the same way.”
The trial aims to recruit several thousand people, and it will test multiple treatments, including oseltamivir (also known as Tamiflu) and baloxavir, as well as steroids and anti-inflammatory drugs that were found to be effective against COVID-19 in the original REMAP-CAP trial. More treatments may be added in the future.
Dr Elizabeth Whittaker, a consultant in paediatric infectious diseases at Imperial College Healthcare NHS Trust and a senior clinical lecturer in the Department of Infectious Diseases at Imperial College London, is leading the children’s part of the trial.
She said: “Flu can be a very serious illness for some children, in some cases leading to hospitalisation and problems like bronchitis and pneumonia.
“Getting the free spray flu vaccine is our first line of defence and drastically reduces the risks for children. But we also need more treatments to help those children who do become very ill, which is why this trial is so important.”
To help the researchers to determine which treatments provide the best use of NHS resources, they will also monitor whether the treatments reduce severe symptoms, stop people needing breathing support, and shorten the amount of time people stay in hospital or intensive care.
Quality of life and disability after recovery will also be measured.
Prof Gordon said using an adaptive platform trial approach means they can bring in new treatments and test them against one another without having to stop and start trials.
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