Platform Trials to Assess Therapeutics in Patients Hospitalized With Influenza
Alicia Waite, Leon Peto, Anthony Gordon, Peter Horby
Abstract
Evidence-based effective treatments for hospitalized patients with influenza have yet to be identified. Traditional randomized controlled trials have struggled to provide definitive guidance due in part to small sample sizes and logistical challenges. Adaptive platform trials, such as REMAP-CAP (Randomised Embedded Multifactorial Adaptive Platform for Community-Acquired Pneumonia) and RECOVERY (Randomised Evaluation of COVID-19 Therapy), offer a transformative approach to evaluating influenza therapeutics. REMAP-CAP and RECOVERY utilize flexible, efficient designs that enable the simultaneous assessment of multiple interventions, adaptation to emerging data, and large-scale recruitment. Both platforms are currently evaluating antiviral and immunomodulatory therapies for severe influenza, building on their success in identifying effective treatments for COVID-19. Establishing global platform trials for influenza will facilitate the generation of high-quality evidence to guide seasonal influenza treatment and enhance pandemic preparedness. A coordinated international effort to sustain platform trials beyond pandemic periods is essential for improving clinical outcomes, optimizing resource utilization, and ensuring readiness for future pandemics.