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Flexible Trials

Adaptive clinical trials may help speed the search for COVID-19 treatments, the Los Angeles Times writes.

While double-blind, placebo-controlled randomized clinical trials are considered the gold-standard approach to evaluating a drug's effectiveness, even before the current pandemic, there have been grumblings that the process is too slow and staid, it adds. It notes that some researchers and even regulators have been instead advocating for adaptive clinical trials in which a study's initial results inform how it progresses.

As the LA Times notes, the US National Institutes of Health has now taken this approach with its Adaptive COVID-19 Treatment Trial (ACTT). The trial began by evaluating hydroxychloroquine as a COVID-19 treatment, but then switched to studying remdesivir when hydroxychloroquine faltered, it says. Then as remdesivir exhibited some promise to shorten disease duration, the trial changed to evaluate baricitinib as a treatment, but it is comparing that new drug to remdesivir, rather than to placebo, the LA Times adds.

"ACTT is evidence that in a crisis, at least, flexibility in research will rule the day," the LA Times writes. "As they get an early glimpse of a drug's impact, the people running the trial have the latitude to change many key features of the trial."