COVID-19 brings a new challenge to global health, the NHS and the health of vulnerable patients. Current treatment options are limited and the development and distribution of a proven vaccine may take many months. Subsequently there is a pressing need to develop new therapies which can treat patients with COVID-19, preventing their condition from worsening and reducing the risk of admission to critical care and mortality.
This is the challenge that ACCORD and partner platforms has taken on. Potential new drugs which require detailed testing to demonstrate safety and clinical benefit are selected based on expert scientific review of the emerging mechanism driving severe COVID and entered into ACCORD trials which are active in hospitals across the UK working with patients and clinical teams to generate evidence for the next generation of treatments.
Aim of the platform
ACCORD is a platform for multiple drug trials, which aims to assess several potential COVID-19 treatments at the same time. These treatments are for those hospitalised with COVID-19 and will be given on top of standard care, compared with standard care alone.
Possible potential treatments include anti-viral drugs, drugs that affect the immune system and drugs which target inflammatory molecules.
What does it involve?
ACCORD has two stages:
Stage 1: Evaluation/pilot
This initial stage will assess how well potential drugs work when added onto standard care, in small groups (10-60) of patients hospitalised with COVID‑19.
Stage 2: Confirmation
Drugs that show the most potential will be assessed in larger numbers of patients hospitalised with COVID‑19.
At each stage, patients will be assessed for their suitability to be involved either the day before starting the treatment or on the first day of treatment. Treatment and assessments will continue for 29 days or until they are considered well enough to leave the hospital.
They will also be asked to return for an appointment approximately 60 days after starting their treatment, with a final follow-up after approximately 90 days.
Who is leading it?
The Chief Investigator of the ACCORD Platform is Professor Tom Wilkinson, Professor of Respiratory Medicine at the University of Southampton and Honorary NHS Consultant Physician at University Hospital Southampton. Additionally, there are two coordinating investigators, Professor Anthony De Soyza, Professor in Pulmonary medicine, Newcastle University & Honorary Consultant, Freeman Hospital, Freeman Hospital and Professor Dave Singh, Professor of Clinical Pharmacology & Respiratory Medicine Respiratory Research Group at the University of Manchester.
A Scientific Advisory Committee was established to support the relaunch of the programme, and is chaired by Professor Ashley Woodcock, Associate Dean for Clinical Affairs, Professor of Respiratory Medicine, University of Manchester and Consultant Physician, Directorate of Respiratory Medicine, Wythenshawe Hospital, Manchester University Foundation Trust. This committee advises the investigators on the scientific conduct of the study.
The investigators are advised on safety issues by an Independent Data Monitoring Committee, which reviews clinical safety data at regular intervals.