Researchers at the University of Oxford are starting a new study to explore the effectiveness of the anti-tumour necrosis factor (anti-TNF) drug adalimumab as a treatment for patients with COVID-19 in the community, especially care homes.

For our comprehensive coverage and latest updates on COVID-19 click here.

The AVID-CC trial, which will be conducted by the Oxford Clinical Trials Research Unit (OCTRU), will enrol up to 750 patients from community care settings throughout the UK. Anti-tumour necrosis factor (anti-TNF) drugs have been in widespread use for over 20 years for a range of inflammatory conditions. Recent studies of patients with COVID-19 have shown that patients already taking anti-TNF drugs for inflammatory bowel disease and inflammatory arthritis are less likely to be admitted to hospital. The same was not observed for patients taking other anti-inflammatory drugs.

The availability of biosimilar versions of biological treatments has been an important step forward in driving down costs, making the anti-TNF treatment affordable and accessible if the trial is successful. "The observed potential of anti-TNF drugs has prompted us to conduct a study in patients in community care to see whether treatment with the anti-TNF drug adalimumab reduces the progression to severe or critical disease or death in COVID-19 patients," said study author Duncan Richards from the University of Oxford.

The study is funded by the COVID-19 Therapeutics Accelerator, an initiative set up by Wellcome, the Bill and Melinda Gates Foundation and Mastercard, with support from an array of public and philanthropic donors. "We think anti-TNF drugs could be an important treatment for COVID-19 and are very grateful for the support of the COVID-19 Therapeutics Accelerator, which will allow us to find out," Richards added. The study will be delivered by the Hospital at Home teams around the UK.

Hospital at Home is a relatively new service in which hospital-based teams reach out into the community to deliver more complex treatment interventions while avoiding the need for admission to hospital. "This is the first drug trial designed for Acute Hospital at Home services and it could not come at a more important time," said Dan Lasserson, who works as a clinician in a Hospital at Home service for Oxford University Hospitals NHS Foundation Trust. "We need to determine the best treatments for COVID-19 that can be given to older people with frailty who are in care homes or living in their own homes," Lasserson added.