PANTHER (Precision medicine Adaptive platform Network Trial in Hypoxaemic acutE respiratory failure) is a Bayesian adaptive platform randomized clinical trial studying novel interventions to improve outcomes for patients with acute hypoxaemic respiratory failure.
The Acute Respiratory Distress Syndrome (ARDS) is a severe lung problem that makes it hard to breathe because there is too much fluid in the lungs.
About 1 out of every 4 people in intensive care who need a machine to help them breathe have ARDS. There are no proven medicines to treat it.
We are trying to find better ways to identify which subgroups of ARDS patients will respond to different treatments.
We have discovered two types of ARDS, called “hyperinflammatory” and “hyopinflammatory”, which have different features and outcomes.
We can identify these types by measuring certain substances in the blood when someone comes to the intensive care unit. These types of ARDS may respond differently to various treatments. We want to match these subgroups of ARDS patients with the appropriate treatments.
We are planning a platform trial to test different treatments for ARDS in the hypoinflammatory and hyperinflammatory groups.
This type of trial can test multiple treatments simultaneously in the same population, saving time and money. We will use a Bayesian Adaptive Trial method, which allows us to learn from new information as the trial goes on.
This method also lets us test additional treatments during the trial. This way of testing treatments will help us find effective treatments for ARDS as quickly as possible while maximising benefit to patients and minimising risk.
To start, we will test simvastatin and baricitinib. Simvastatin is a common cholesterol-lowering medicine that has anti-inflammatory effects on the injured lung.
Baricitinib is another anti-inflammatory medicine that is used to treat COVID-19. Both are safe and may improve outcomes in subgroups of ARDS. We will study more treatments as the trial goes on. These treatments are chosen by a therapeutics prioritisation committee.
