ThePANORAMIC trial (short forPlatform Adaptive Trial of Novel Antivirals for Early Treatment of COVID-19 in the Community) is aclinical trial in the United Kingdom testing the effectiveness of newantiviral drugs at the early stages ofCOVID-19 infections.[1][2][3] The study aims to find out if antivirals can prevent death and hospitalisation and help faster recovery for people aged over 50 and those at higher risk due to underlying health conditions.[4] The trial was launched in December 2021,[5] and had nearly 30,000 people enrolled asparticipants.[6]
PANORAMIC is aplatform trial[7] that compares groups who are havingsymptoms of COVID: one receives standard care (same as best care in theNHS) and others receive standard care plus antiviral treatment. Participants take part from home online or via phone and the antivirals are delivered to them.[8]
People could enroll in the study if they had symptoms of COVID (confirmed by atest) less than 5 days prior to enrolling. They had to be either aged 50 or over, or have a preexisting health condition.[8][2]
Results from the trial showed that for higher risk, vaccinated adults molnupiravir does not reduce the chances of hospitalisation and death. However molnupiravir was found to help people recover four days sooner and reduces the amount of virus in the body (viral load). Participants receiving molnupiravir reported feeling better in comparison to those who received usual care.[10][11]
Even though molnupiravir reduced the amount of virus after a 5-day treatment, the virus was still present and infectious in some of the participants. Furthermore those taking the medicine had fewerantibodies compared to those who did not which is a potential issue for boostingimmunity.[12]
After a 6-month follow-up, the PANORAMIC study showed that people who took the antiviral molnupiravir felt better, had fewer and less severe COVID-19 symptoms, took less time off and needed healthcare services less compared to those who received standard care. However, differences between the two groups were small and were evident only if alarge number of people received molnupiravir.[13]
According to a paper reviewing how the PANORAMIC trial was delivered, learnings from the trial could be useful in preparing for future pandemics and forhealth research in general. The main recommendation of the review was that research conducted inprimary care settings (as opposed to hospitals) should play a central role in future pandemics to help prevent the worsening of symptoms and hospitalisation. Further recommendations included the use of the platform study format, focusing on recruiting participants incare homes, and working on ways to rapidly deliver medicine to participants. The review also stressed the importance of building trust with diverse communities so that participation andinvolvement in research can be inclusive.[15][16]
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