COVID-19 antivirals to be tested in high-risk patients in the community

The PANORAMIC trial will evaluate new antiviral treatments in people in the community who are at a higher risk of complications from COVID-19.
Mahendra Patel

A new national COVID-19 trial is being set up to investigate the use of novel antivirals as an early treatment for people in the community.

The Platform Adaptive trial of NOvel antiviRals for eArly treatMent of COVID-19 In the Community (PANORAMIC), which is being led by the University of Oxford’s Primary Care Clinical Trials Unit and funded by the National Institute for Health Research, will be open to participants from across the UK.

Eligible participants will include people in the community with COVID-19 who are at a higher risk of complications.

It has been designed as a ‘platform clinical trial’, which means it will evaluate the efficacy of several antiviral treatments that could help people at high risk of COVID-19 recover sooner, with the aim of preventing hospital admissions.

On 20 October 2021, health secretary Sajid Javid announced two “landmark deals” to secure hundreds of thousands of doses of two antiviral treatments for the UK, saying he was aiming to deploy these treatments “as quickly as possible” to protect the most vulnerable during the winter months.

However, full trial results of the two antivirals ordered by the government — molnupiravir and PF-07321332/ritonavir — have not yet been published and the Medicines and Healthcare products Regulatory Agency is still evaluating whether to approve their use.

Chris Butler, professor of primary care in the Nuffield Department of Primary Care Health Sciences and chief investigator of the study, highlighted that antivirals for COVID-19 were likely to have the “greatest benefit” early on in the illness, when people were still being cared for in the community.

“So far, a lot of the research has focused on finding out if well-known drugs can be repurposed to treat COVID-19. This new trial will test whether exciting, new antiviral treatments, which are more specific to COVID-19, help people in the community recover faster and reduce the need for treatment in hospital.”

Mahendra Patel, pharmacy research lead for inclusion and diversity for the Platform Randomised Trial for Treatments in the Community for Epidemic and Pandemic Illnesses (PRINCIPLE), a role that has now extended into the new PANORAMIC trial, said the trial was “significant” in assessing the importance of novel antivirals in combating COVID-19. 

“Pharmacists have played an important role UK-wide in supporting recruitment [to the PRINCIPLE trial] and increasing the visibility of the trial in different communities — this has shown the value pharmacists can have in terms of supporting recruitment and engaging with clinical primary care research,” he said. “[We] hope that pharmacy will again be able to help us [with the PANORAMIC trial]; to come forward and join in with supporting recruitment.

“Further announcements are coming — we are hoping to start recruitment as soon as possible.”

The PANORAMIC trial will also have two sub-studies, one to test if antiviral agents are able to prevent transmission to people living with someone who gets COVID-19; and another to find out if the new treatments reduce viral shedding and cause the virus to become resistant to treatment.

Last updated
The Pharmaceutical Journal, PJ, October 2021, Vol 307, No 7954;307(7954)::DOI:10.1211/PJ.2021.1.112531

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