A nationwide clinical trial, PANORAMIC (Platform Adaptive trial of NOvel antiviRals for eArly treatMent of COVID-19 In the Community), has commenced in the UK to investigate the effectiveness of new oral antiviral treatments for COVID-19. The trial focuses on individuals in the community who are at higher risk of complications from the disease and aims to assess treatments that can be safely administered at home during the early stages of infection.
Trial Design and Eligibility
The PANORAMIC trial is enrolling 10,600 volunteers across the UK who have tested positive for COVID-19 via a lateral flow (LFT) or PCR test within the past seven days and are within five days of symptom onset. Eligible participants include those aged 50 and over, or those between 18 and 49 years with underlying health conditions that increase their clinical vulnerability. Participants will be randomly assigned to receive either the antiviral treatment plus standard care or standard care alone, allowing researchers to compare the benefits of the antiviral against the current standard of care.
Objectives and Scope
Led by the University of Oxford and funded by the National Institute for Health and Care Research (NIHR), PANORAMIC is designed as a platform trial to rapidly evaluate multiple antiviral treatments. The primary goal is to determine if these new treatments can help individuals recover more quickly, reduce the need for hospital admission, and alleviate pressure on the National Health Service (NHS). The trial brings together various healthcare providers, including GP practices, NHS 111, Test and Trace, care homes, and pharmacies, to identify and support potential participants.
Molnupiravir as Initial Treatment
The first antiviral being investigated in the PANORAMIC trial is molnupiravir (Lagevrio), a COVID-19 antiviral pill already licensed by the Medicines and Healthcare products Regulatory Agency (MHRA). As new antiviral treatments become available, they will be added to different arms of the trial platform. Participants randomized to receive molnupiravir will have the medication delivered to their homes by courier. They will then be required to keep a daily diary for 28 days via the PANORAMIC website or participate in phone calls with the trial team on days 7, 14, and 28 to discuss their symptoms and any NHS care they have required.
Expert Perspectives
Professor Nick Lemoine, Medical Director of the NIHR Clinical Research Network (CRN), emphasized the potential of these antiviral treatments to improve outcomes for high-risk patients when taken early in the infection. He noted that while earlier trials have demonstrated the safety and efficacy of these antivirals, more data is needed to understand their effectiveness in a highly vaccinated population like the UK. Professor Chris Butler, Chief Investigator of the trial and Professor of Primary Care at the University of Oxford, highlighted the importance of community-based treatments for COVID-19 and the need to determine if these new antivirals can help people recover faster and reduce hospitalizations.
Broader Implications
Deputy Chief Medical Officer for England Professor Jonathan Van-Tam underscored the significance of antivirals as a vital intervention for protecting those who cannot mount a strong antibody response to vaccines. The PANORAMIC trial is expected to provide crucial evidence for the NHS to effectively roll out these new COVID-19 treatments to those who would benefit the most, contributing to the ongoing efforts to manage the pandemic and protect vulnerable populations.
