Funding prophylaxis research
The value of prophylaxis research
Preventing COVID-19 is the cornerstone to effective control of the ongoing pandemic. Currently prevention relies on reducing person-to-person spread of infection through social distancing, hand washing, face coverings and various degrees of lockdown. Whilst reasonably effective, such measures severely restrict movement of people and their ability to socialise and work.
Vaccines are our best hope in terms of prevention. They work by stimulating the body’s own immune system to recognise the virus. However, not everyone benefits from vaccines in the same way. Some people with weaker immune systems may struggle to mount an adequate immune response - for example, elderly people or those taking immuno-suppressant drugs because they’ve had an organ transplant or as part of treatment for an ongoing chronic disease. It is also not known how long vaccine protection will last or whether they are effective against new mutations of the virus.
In addition to its work on vaccines, NIHR is looking at ways of preventing people in such groups from developing COVID-19 (‘pre-exposure prophylaxis’) or of reducing the severity of disease if they have already been infected (‘post-exposure prophylaxis’). Typically these are medicines, antibody preparations or nutrients that boost the body’s immune system.
Protection for care home residents
The COVID-19 pandemic has been felt particularly acutely in care homes and nursing homes. Preventing infection in residents and reducing transmission of the virus within care homes is currently dependent on infection control measures such as the use of PPE, and restricting freedoms such as movement around the home and the ability to have visitors. These can have a negative effect on the quality of life for residents and their families.
At present there are no medications that have been shown to be effective in the prevention of infection or transmission of COVID-19. The identification of a cost-effective, safe prophylaxis that is easy to administer in a care home setting would be a substantial step forward in controlling this disease in vulnerable populations.
The NIHR is funding a new trial to look at reducing the transmission of Covid-19 and its severity in care homes. Researchers led by the University of Nottingham are now looking for up to 400 care homes to take part in the ground-breaking trial - called PROTECT.
The COVID-19 Prophylaxis Oversight Group (POG) has been established by the Department of Health and Social Care (DHSC) to guide prophylaxis options for COVID-19.
As a first step, it is commissioning a research consortium to deliver a complex, platform design clinical trial of potential drug or antibody candidates in a care home setting in the UK. It is hoped that the study team will be able to help to identify candidates for inclusion into the platform with the final choice of candidates to proceed to trial determined by the POG. This funding call is now closed to applications.