New COVID antiviral treatment investigated in Wessex through PANORAMIC study

The NIHR-supported PANORAMIC trial has begun assessing a new oral COVID-19 antiviral treatment, Paxlovid, among vulnerable groups in Wessex.

PANORAMIC is a nationwide platform trial, set up to rapidly investigate a range of new COVID-19 antiviral treatments that can be taken at home, in the early stages of infection, to help people recover more quickly and reduce the risk of serious illness from the virus.

In just over three months, more than 23,000 patients have enrolled into the study for a chance to access molnupiravir, the first antiviral to be made available.

The Wessex region has made a significant contribution thanks to the generosity of local research participants and the hard work of primary care teams across the region, supported by the NIHR Clinical Research Network Wessex.

The introduction of Paxlovid will allow many more patients to enrol in the study for a chance of accessing this groundbreaking treatment, which has been shown to reduce the risk of death or hospitalisation by 88% in clinical trials of unvaccinated people who have COVID-19.

The study is open to adults over the age of 50 or those aged 18 to 49 with an underlying health condition that can increase the risk of developing severe COVID, who have received a positive COVID test result, and who are experiencing symptoms that started in the previous five days.

The study is UK wide, although initially recruitment into the Paxlovid arm will only be available for patients who are registered with the general practices that are taking part in the PANORAMIC Trial. The Department of Health and Social Care (DHSC) is working with counterparts in the devolved administrations to develop plans for how this arm could be started in all four nations in due course.

About Paxlovid

Paxlovid - an oral COVID-19 antiviral pill - has already received conditional marketing authorisation from the Medicines and Healthcare products Regulatory Agency (MHRA), following an assessment of evidence from earlier studies which showed the drug to be effective in the treatment of COVID-19.

Paxlovid is already being rolled out outside of the PANORAMIC study to those at highest risk who test positive for the virus directly through the NHS – including those who are immunocompromised, cancer patients or those with Down’s syndrome.

Antivirals are treatments used to either treat those who are infected with a virus or protect exposed individuals from becoming infected. Whilst vaccines remain the most important first line of defence, antivirals target the virus at an early stage, with the aim of preventing progression to more severe, or even critical, symptoms.

The PANORAMIC study makes antivirals available to a large number of patients, whilst collecting further data on how the antivirals work where the majority of the adult population is vaccinated.

This will help the NHS to develop plans for rolling out the antivirals to further patients later this year. Those who enrol in the study will be randomly allocated to receive either an antiviral treatment in addition to standard NHS care, or standard NHS care only.

Professor Nick Lemoine CBE, National Institute for Health and Care Research, said:

“The addition of Paxlovid into the NIHR-supported PANORAMIC trial represents an exciting development. While smaller-scale studies have already shown this new antiviral treatment to be highly effective against COVID-19 in the early stages of infection, additional evidence from much larger cohorts is needed to enable clinicians to make best use of these exciting new treatments.

"With over 23,000 participants having taken part in PANORAMIC so far - making it the world’s largest platform trial into new COVID-19 antiviral treatments - collectively the UK is providing vital data which will enable rapid deployment and best use of these new potentially life-saving treatments to patients who will benefit from them the most.”

Professor Chris Butler, Chief Investigator, University of Oxford said:

“It is early on in the illness, when people are still being cared for in the community, that treatments for COVID-19 could have their greatest benefit. The PANORAMIC trial is testing whether novel, promising antiviral treatments help people suffering from COVID in the community recover faster and reduce the need for treatment in hospital.

"It is critically important that new treatments are tested in people and in the situation where they are intended to be used; joining the PANORAMIC Trial will help ensure people with COVID, and indeed the NHS, get the maximum benefit from these precious treatments.”

Health and Social Care Secretary Sajid Javid, said:

“As we learn to live with Covid, the UK continues to lead the way in using cutting-edge treatments which have already saved the lives of many of the country’s most vulnerable patients.

“The addition of Paxlovid to the ground-breaking PANORAMIC study is an important milestone and will help us understand who benefits most from these treatments.

“If you’re aged 50 and over or have an underlying health condition and test positive for Covid, I urge you to participate in this study by signing up as soon as you can.”

The study is run by the University of Oxford's Nuffield Department of Primary Care Health Sciences, and funded and supported by the National Institute for Health and Care Research (NIHR).

Additional information on PANORAMIC Trial:

• Further information on eligibility for the national study can be found on the PANORAMIC website
• If you receive a positive test for COVID and believe you may be eligible for the study, you can self-register via the study website.
• Registration for the trial is pausing over the Easter 2022 period, from the end of 12 April and reopening online late on 19 April.
• The study can currently recruit a maximum of 450 participants per day. This is to ensure that all standard processes involved in enrolling patients are followed thoroughly and each patient is provided with the best possible care. If the daily maximum of participants has already been reached, individuals are encouraged to wait until the following day to register for the study.
• Those in the highest risk group have been informed by the NHS if they have a condition that will make them eligible to receive these treatments directly, should they test positive for COVID-19. Eligible patients who receive a positive test will be assessed over the phone by an expert clinician from an NHS COVID Medicines Delivery Unit (CMDU), who will review and discuss with the patient what the most appropriate treatment would be for them.
• If you have not been contacted within 24 hours of your positive test but you are eligible for COVID-19 treatments, call your GP surgery or specialist, or call 111. Your GP, specialist or NHS 111 will be able to make an urgent referral if needed.
• As announced as part of the Government’s Living with COVID plan, free symptomatic testing will be provided for people who are eligible for community COVID-19 treatments because they are at higher risk of getting seriously ill from COVID-19. People in this group will be contacted directly and sent lateral flow tests to keep at home for use if they have symptoms as well as being told how to reorder tests. The NHS will write to patients with information on how to access treatments and to provide lateral flow tests.