Lessons of the pandemic being used to help those hospitalized with flu

By Danny Halpin via SWNS

The lessons of the COVID-19 pandemic are to be used to find the best treatment for those hospitalized with flu, in a bid to save lives.

With a bad flu season predicted UK scientists have begun a new clinical trial applying the same approach that helped COVID-19 patients recover during the pandemic.

At present, there is no clear evidence about which treatments are best for severe cases.

Most people recover on their own without needing a hospital but it can make others seriously ill and even become life-threatening.

The new £2.9 million ($3.5 million USD) trial, a type known as REMAP-CAP, is looking to recruit children and adults hospitalized with flu from 150 hospitals across the UK over the next two years.

Run by researchers and clinicians from Imperial College London and other collaborators, it is the first time a trial of this kind will be used for flu.

The REMAP-CAP trial was originally set up to tackle pandemics. Two years ago this type of trial showed that the drug tocilizumab can save the lives of severely ill COVID-19 patients by reducing inflammation.

The current trial will test multiple treatments at the same time in thousands of people, which will allow the team to learn quickly from results and get treatments out to patients as soon as possible.

Chief Investigator Professor Anthony Gordon of Imperial College London 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 new trial will test the anti-viral treatments oseltamivir (also known as Tamiflu) and baloxavir, as well as steroids and anti-inflammatory drugs that were found to be effective against COVID-19. More treatments may be added in the future.

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

Dr. Elizabeth Whittaker of Imperial College Healthcare NHS Trust 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 hospitalization and problems like bronchitis and pneumonia.

“Getting the free spray flu vaccine is our first line of defense 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.

“Working with a range of experts across the country, we hope to determine the best treatments for flu and ultimately save lives.”

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

They will also monitor whether the treatments reduce severe symptoms, stop people needing breathing support, shorten the amount of time people stay in hospital or intensive care, and measure quality of life and disability after recovery.

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

It will also involve experts in infectious diseases and virology who will carefully monitor to see if the flu virus becomes resistant to any of the anti-viral drugs tested.

Unlike other trials, which usually test individual treatments for a set amount of time, the new trial – known as an adaptive platform trial – continues as new treatments are added.

Any treatments which are found not to work will be removed. It will also involve trialing the treatments alone, in combination, and for different durations to find the best way to treat the flu.

Professor Gordon said: “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.”

Patient groups have helped design this trial platform through workshops and interviews.

Professor Paul Dark of the National Institute for Health and Care Research said: "The scale of this study, requiring us to co-ordinate 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."