Adaptive trial launched to find flu treatment quickly

Adaptive trial launched to find flu treatment quickly
©iStock/Hiraman

Imperial College London are launching a new nationwide trial to find effective flu treatment for hospitalised patients. 

Record numbers of flu cases are expected this winter, yet there is still no clear evidence about which flu treatment is best for severe cases. Most people with flu will get better over time without hospital treatment, however, it can cause some people to become seriously ill.

The researchers intend on using lessons learned during the pandemic to help them find treatment quickly for people who have been hospitalised with severe flu. 

Using new trial methods to research flu treatment

The trial will be completed by researchers and clinicians from Imperial College London and Imperial College Healthcare NHS Trust in collaboration with theNational Institute for Health and Care Research (NIHR). Children and adults who have been hospitalised with severe flu will be recruited from 150 hospitals across the UK over the next two years.  

This is the first time a trial of this kind will be used to find flu treatment. The trial has been designed to find solutions quickly by using a rapid approach to testing multiple treatments simultaneously in thousands of people.  

“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,” said Professor Anthony Gordon, chief investigator of the new trial.  

“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,” added Gordon. 

The anti-viral treatments oseltamivir and baloxavir will be tested in the trial, as well as steroids and anti-inflammatory drugs that were found to be effective against COVID-19 in previous trials.  

Flu can lead to serious illnesses

“Flu can be a very serious illness for some children, in some cases leading to hospitalisation and problems like bronchitis and pneumonia,” said Dr Elizabeth Whittaker, a consultant in paediatric infectious diseases at the Imperial College Healthcare NHS Trust.  

“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,” she added.  

The researchers will examine whether the treatments reduce severe symptoms, stop people needing breathing support, and shorten the amount of time people spend in hospital or intensive care. They will also measure the patient’s quality of life and disability after recovery.  

Unlike many previous trials, which test individual treatments for a set amount of time, the new trial will be continuous and new treatments will be added constantly. Any potential flu treatment which is found to be ineffective will be removed from the trial immediately. 

“Using this approach, we can bring in new treatments and test them thoroughly against one another without having to stop and start trials. Typically, you’d need a new trial for every treatment, which takes time. Instead, this type of trial keeps research rolling,” explained Gordon. 

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