Dr Frances Hall and a team of clinicians and scientists have established a new clinical trial that will test whether drugs that are already in use to treat other immune-related conditions can prevent the development of severe COVID-19 infection.

As a result of the COVID-19 pandemic, research teams have formed across the world to get to grips with the virus and are fast-tracking the development of clinical trials in the hope of discovering potential therapies.

In March, as the pandemic took hold in the UK, Dr Frances Hall, Sidney Fellow in Medical and Veterinary Science, realised that the national platform trials studying potential therapies for COVID-19-related disease (RECOVERY and REMAP-CAP) were focusing mainly on anti-viral therapies.

Frances noted, "I was concerned by this, since the people who develop severe disease following infection with Covid-19 appear to do so, not because the virus is replicating, per se, but rather because their immune response overreacts and causes serious damage to lungs and other organs. Following discussions with colleagues who also had experience of managing immune-mediated diseases, I drew the conclusion that we needed another platform in which immunomodulatory drugs could be tested for their ability to reduce mortality and the need for ICU-level care in patients with Covid-19-related disease."

Since April, Frances has been collaborating with colleagues in the Cambridge Clinical Trials Unit, and together with Professor David Jayne (a clinician with expertise in management of immune-mediated organ damage and co-Chief Investigator for TACTIC-R), these clinicians have formed the Trial Management Group (TMG). Supported by advice from other colleagues in Cambridge and around the UK, and by tireless efforts on behalf of the Cambridge Clinical Trial Unit staff, the TACTIC team has guided TACTIC-R from concept to launch in just over a month. A project of this size and complexity would typically take several months to set up. A fantastic achievement!

TACTIC-R will explore the re-purposing of certain drugs which target the body’s own immune response. These drugs are routinely used to prevent immune-mediated damage in the conditions for which they are licensed. Baricitinib is used to treat rheumatoid arthritis, whereas Ravulizumab is a treatment to prevent part of the body’s own immune system (complement) from destroying the patient’s own red blood cells; this is used in a condition called paroxysmal nocturnal haemoglobinuria. TACTIC-R tests the hypothesis that these medications, which each inhibit distinct pathways of immune activity, may reduce the severity, and associated mortality, of COVID-19-related disease.

The trial is part of the coordinated national approach to support the development of potential new treatments for COVID-19.

Frances is the Chief Investigator of the trial, alongside Professor David Jayne. TACTIC-R officially launched in the Cambridge University Hospitals on 7 May 2020, and nine patients have so far been recruited with severe COVID-19-related disease. TACTIC-R is now rolling out across other UK sites. 

We give our thanks to Frances and all other researchers who are working tirelessly to help us to combat this disease.

Watch ITV news coverage into the development of the TACTIC-R clinical trial.

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