A multi-million-pound national trial using research lessons learned during the pandemic has been launched to rapidly identify effective treatments for severe flu.

The £2.9m REMAP-CAP trial will test multiple treatments on thousands of children and adults hospitalised with severe flu across 150 UK hospitals over the next two years.

REMAP-CAP, known as an adaptive platform trial, originally ran during the pandemic and found that tocilizumab could reduce mortality in people severely ill with Covid-19.

Clinical trials usually test individual treatments for a set amount of time, but in this model, treatments can be added, removed, and tested against each other, without having to stop and start trials.

Chief investigator Professor Anthony Gordon, an intensive care consultant at Imperial College Healthcare NHS Trust, said the UK might see more flu cases than usual this winter as the virus potentially resurged after the pandemic.

'We hope that our trial will help to find urgently needed flu treatments rapidly,” he said.

'Typically, you’d need a new trial for every treatment, which takes time. Instead, this type of trial keeps research rolling.'

Treatments tested will include the anti-viral drugs oseltamivir (Tamiflu) and baloxavir, as well as steroids and anti-inflammatory drugs found to be effective against Covid-19 in the original REMAP-CAP trial.

Treatments will be trialled alone, in combination and for different durations, with researchers examining outcomes including reduction in mortality and need for intensive care, as well as the effect on severe symptoms and length of hospital stay.

The trial is headed by researchers and clinicians from Imperial College London and Imperial College Healthcare NHS Trust, funded by the National Institute for Health and Care Research (NIHR) and delivered by the NIHR’s Clinical Research Network.

The study’s launch came as the UK Health and Security Agency (UKHSA) urged parents to ensure young children were vaccinated against the flu.

Latest data showed low vaccine uptake among two- to three-year-olds and high rates of under-fives hospitalised with the virus.

Between 14 and 20 November, it was estimated that more 200 children under five were hospitalised suffering from serious complications caused by flu.

Dr Conall Watson, UKHSA consultant epidemiologist at UKHSA, said for the third week running hospitalisation rates among children under five have jumped up, with a 70% increase in just the last week [since 30 November].

'Flu is now circulating at higher levels than recent years and because of the pandemic restrictions most young children will not have encountered flu before. This means they will have no natural immunity and are therefore at even greater risk this year,' he said.

In September, the UK Health Security Agency (UKHSA) warned that the UK could face a ‘twindemic’ of Covid-19 and flu infections this winter, with both infections expected to circle widely.