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New study will help rapidly find flu treatments this winter

Published: 29 November 2022

A new £2.9 million NIHR-funded and delivered trial aims to use pandemic lessons to find effective treatments for people hospitalised with severe flu.

Record numbers of flu cases are expected this winter. Currently, there is no clear evidence about which treatments are best for severe cases. Many people with the illness get better on their own without needing hospital treatment. But it can make some people seriously ill and even be life-threatening.

Researchers and clinicians from Imperial College London and Imperial College Healthcare NHS Trust are leading the new REMAP-CAP trial. They will recruit several thousand children and adults hospitalised with severe flu from 150 hospitals across the UK over the next two years.

REMAP-CAP was originally set up to tackle pandemics. Now the trial is being redeveloped for flu, with a new trial.

The platform study is designed to provide answers by using a robust yet rapid approach to test multiple treatments at the same time in thousands of people. It is highly adaptive, allowing the team to quickly learn from early results and ensure people receive treatments showing encouraging results as soon as possible.

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 study will test multiple treatments. These include anti-viral treatments oseltamivir (also known as Tamiflu) and baloxavir, plus 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.

Researchers will study how effective the treatments are at reducing deaths from flu and stopping patients needing intensive care.

The trial will be open to adults, children, and babies over the age of one month who are hospitalised with severe flu. Children and babies will receive lower treatment doses than adults.

Professor Paul Dark, Deputy Medical Director, NIHR Clinical Research Network said: "The scale of this study, requiring us to coordinate patient involvement across at least 150 NHS acute hospitals, is a huge undertaking that draws on the UK's world-leading research infrastructure.

"Taking part in research saves lives and benefits us all, both now and in the future. We really encourage everyone to be part of research."

Professor Andy Ustianowski, NIHR Joint National Infection Specialty Lead, said: "This landmark study aims at urgently providing new treatments for thousands of people at risk of becoming seriously ill or dying from flu.

“NIHR played a critical role funding, enabling and delivering trials in the fight against COVID. It’s heartening that we are building on the legacy of high quality research, by funding new adaptive research to tackle other deadly illnesses.

"The benefit of running a platform study like REMAP-CAP is that it is a more efficient way of delivering answers and evidence around new treatments. This could prove invaluable to help ease pressure on the NHS over winter."

Minister for Health and Secondary Care, Will Quince, said: “Clinical research was vital in our fight against COVID and helped to save thousands of lives across the country.

“This innovative trial will use the lessons we learned from COVID and deliver treatments to reduce serious illness in patients with flu, ease pressure on the NHS and ultimately save lives.

“While this trial aims to prevent illnesses for future flu seasons, we are now seeing increased levels of flu this year, and it is vital that all those eligible for a free vaccine come forward as soon as possible.”

The trial brings together leading UK experts including specialists in intensive care, respiratory medicine, and children’s medicine.

NIHR’s Health Technology Assessment (HTA) Programme funded the study. NIHR’s Clinical Research Network (CRN) is delivering the study.

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