Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

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. The AVID-CC trial, which will be conducted by Oxford Clinical Trials Research Unit (OCTRU), will enrol up to 750 patients from community care settings throughout the UK.

COVID-19 treatments in care homes

It 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.

Residents of care homes were particularly hard hit by the first wave of COVID-19 in the UK and other countries. Research has identified limited treatments that are effective for patients in hospital with COVID-19, but no effective treatments have yet been identified for those in the community care settings, many of whom may have severe symptoms.

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 Prof Duncan Richards, Professor of Clinical Therapeutics, University of Oxford. "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. I would also like to thank Sandoz Ltd for provision of adalimumab. We are also looking forward to working with Sensyne Health to collect additional information on patients' clinical status through their app. Subject to the necessary approvals we hope to start recruiting patients in late October."

The study will be delivered by 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 study sits therefore in a unique niche between the existing national platform therapeutic studies PRINCIPLE (primary care) and RECOVERY (hospitals).

Prof Dan Lasserson, Professor of Acute Ambulatory Care, University of Warwick who also works as a clinician in a Hospital at Home service for Oxford University Hospitals NHS Foundation Trust, said: "This is the first drug trial designed for Acute Hospital at Home services and it could not come at a more important time. 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. This grant from the COVID-19 Therapeutics Accelerator not only helps us determine whether anti-TNF drugs could improve outcomes, but the trial itself will help the development nationally of acute hospital at home services."

Professor Adam Gordon, Professor of Care of Older People at the University of Nottingham, and Consultant Geriatrician, said, "We have seen lots of examples, earlier in the COVID pandemic, of older people in care homes being disadvantaged regarding access to treatments simply because of where they live. This study is an exciting opportunity to open up promising treatments to this most vulnerable, and underserved, group of people. It is an important step forward as we investigate how to manage COVID, and more generally in terms of bringing research to the frailest older people."

Oxford Hospital at Home Service receives support from the Oxford NIHR Biomedical Research Centre.

Similar stories

Yoshi Itoh wins the International Dupuytren Award 2022

Yoshi Itoh, Associate Professor and Principal Investigator Cell Migration Group at the Kennedy Institute has been awarded the International Dupuytren Award 2022.

Taking a break from immune-suppressing medicines doubles the antibody response to COVID-19 booster vaccination

The Oxford Clinical Trials Research Unit (OCTRU) at NDORMS played a key role in the VROOM study which found that pausing immune-suppressing medicines such as methotrexate can increase the response to COVID-19 booster jabs.

Ten Years of Athena Swan in the Medical Sciences Division

2022 marks ten years since the first Athena Swan Bronze applications from the Medical Sciences Division. Ten years later, and all 16 departments in the Division have achieved a Silver Award. We look at NDORMS’ Athena Swan journey.

NDORMS researchers awarded Associate Professor title

The University of Oxford has awarded the title of Associate Professor to Adam Cribbs and Luke Jostins.

Oxford's largest ever study into varicose veins shows need for surgery is linked to genetics

A new international study by Oxford researchers published in Nature Communications, establishes for the first time a critical genetic risk score to predict the likelihood of patients suffering with varicose veins to require surgery, as well as pointing the way towards potential new therapies.

Reflecting on the role of Clinical Director of Trauma and Orthopaedics

In 2021 Professor Andrew Price was appointed Clinical Director of Trauma and Orthopaedics at the Oxford University Hospitals NHS Foundation Trust. After 9 months in post, we find out what the challenges are and what he’s been able to bring to the role.