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Findings from ground-breaking COVID-19 treatment trial released

Researchers from the University of Oxford have today released findings from an NIHR-funded clinical trial investigating the effectiveness of the antiviral treatment molnupiravir against COVID-19 – the first treatment tested in the ongoing PANORAMIC trial.

In their paper published in The Lancet, they reported that molnupiravir did not reduce hospitalisations or deaths among higher risk, vaccinated adults with COVID-19 in the community. The treatment was, however, associated with a faster recovery time and reduced viral detection and load – participants who received molnupiravir reported feeling better compared to those who received usual care.

More than 250 people in the West Midlands were among the 25,000 participants in the trial, across three sites in Warwick, Stourport and Rocester, including Sonia - read her story here.

Molnupiravir (brand name Lagevrio) was the first treatment to be studied by the Platform Adaptive trial of NOvel antiviRals for eArly treatMent of COVID-19 In the Community (PANORAMIC), set up to identify which groups of higher risk people were most likely to benefit from new antiviral treatments for COVID-19. The study allows multiple antiviral drugs to be tested in parallel.

Dr David Shukla,   Clinical Research Lead for Primary Care at the NIHR CRN West Midlands said:  “Patients who have supported this trial have played an invaluable part in helping us gather the vital information we need in the fight against the virus. We are incredibly grateful to them.”

Chris Butler, Professor of Primary Care in the Nuffield Department of Primary Care Health Sciences and co-Chief Investigator of PANORAMIC, said: “Finding effective, safe and scalable early treatments for COVID-19 in the community is the next major frontier in our research response to the ongoing worldwide pandemic. It is in the community where treatments could have a massive reach and impact. But decisions about who to treat should always be based on evidence from rigorous clinical trials that involve people who would most likely be prescribed the drugs.

“The evidence PANORAMIC has produced about molnupiravir will guide treatment decisions for COVID-19 world-wide. It is rapidly generating critically important clinical evidence from within the pandemic to guide care during the pandemic itself, in this case determining effects of molnupiravir among people who are almost all vaccinated.

``We must not forget the other ongoing pandemic of antibiotic resistance, which in part stems from using antimicrobial drugs at scale before we did rigorous clinical trials to find out who really benefits from treatment, and who does not. The PANORAMIC team is also doing the necessary trials and gathering evidence about these treatments before we go straight to widespread use.”

Study participants were within five days of symptoms onset and either aged over 50 years in good health or between 18-50 with underlying health conditions that made them clinically more vulnerable. A total of 25,786 study participants were randomly assigned to receive either molnupiravir or the usual standard of NHS care.

Recruitment of people from ethnically and culturally diverse backgrounds into clinical trials has been important in ensuring audiences likely to benefit from treatment are represented.

Professor Mahendra G Patel OBE, PANORAMIC’s Pharmacy, and Diversity, and Inclusivity Lead, said: ‘We are determined to ensure that we are as inclusive as possible in our recruitment. To this effect, we have been working closely with national and local communities and religious organisations, alongside national and regional pharmacy networks to help make the PANORAMIC trial more visible and easily accessible to as many people as possible, including from ethnically diverse communities.

‘I’m delighted to see how our recruitment strategy has been hugely successful across all ethnicities and areas of high deprivation. This is an incredible testament to all those involved for their efforts in supporting the fastest and largest recruiting randomised interventional clinical trial in the world.’

Prof Nick Lemoine, Medical Director of the NIHR Clinical Research Network, said:

“PANORAMIC is an important NIHR-funded trial that enabled the rapid production of evidence and information about how well this new antiviral works. The commendable pace and scale at which this study recruited in at-risk groups shows how we can adapt to make future trials more accessible to a more diverse group of people. It is also testament to the GPs and researchers involved in this trial that we were able to recruit so fast in such record numbers.”

PANORAMIC is led by the University of Oxford and funded by UK Research and Innovation(UKRI) and National Institute for Health and Care Research (NIHR).

The study will now continue to investigate new antiviral medications such as Paxlovid. For more information or to enrol, please visit www.panoramictrial.org

ENDS

Notes for Editors

Link to paper

For further information, a copy of the paper or to request an interview with the researchers, please contact: news.office@admin.ox.ac.uk or call 01865 280528.