The concept of creating an inter-pandemic platform trial to both understand the challenges of broad collaboration and create a framework for a rapid response to future emergency needs arose through discussions amongst InFACT and ISARIC members over the past few years.
PREPARE – Platform for European Preparedness Against (Re-)Emerging Epidemics - is a platform trial whose objective is to create the infrastructure for a collaborative global trial that could be rapidly activated in response to the research needs of a large scale pandemic or other acute disaster. The trial uses an adaptive design that can evaluate multiple interventions simultaneously, and that can incorporate new interventions as study arms are completed.
PREPARE-EU has been funded by an FP7 grant, and evaluates four separate interventions in pa-tients with severe acute respiratory infection (SARI) – antibiotics (ceftriaxone and azithromycin versus moxifloxacin), steroids (hydrocortisone versus placebo), and ventilation (ARDSNet versus a strategy to minimize driving pressure/optimize PEEP versus ultra-protective lung ventilation with extra-corporeal CO2 removal). Jean-Daniel Chiche leads the trial for the Trials Group of the ESICM.
An Australian PREPARE application has just received successful funding in the amount of $5 million AUD over 5 years, under the leadership of InFACT Vice-Chair, Professor Steve Webb from Perth Australia. Plans are in progress for funding applications from Canada (Rob Fowler and John Marshall) and Africa (Kath Maitland).
PREPARE as a platform trial represents a powerful new model of international research collaboration. We hope to see other groups and regions embrace and enhance it.