The PANORAMIC trial (short for Platform Adaptive Trial of Novel Antivirals for Early Treatment of COVID-19 in the Community) is a

clinical trial Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...

in the United Kingdom testing the effectiveness of new

antiviral drugs Antiviral drugs are a class of medication used for treating viral infections. Most antivirals target specific viruses, while a broad-spectrum antiviral is effective against a wide range of viruses. Antiviral drugs are a class of antimicrobials ...

at the early stages of COVID-19 infections. The study aims to find out if antivirals can prevent death and hospitalisation and help faster recovery for people aged over 50 and those at higher risk due to underlying health conditions. The trial was launched in December 2021, and had nearly 30,000 people enrolled as

participants Participation or participant may refer to: Politics *Participation (decision making), mechanisms for people to participate in social decisions *Civic engagement, Civic participation, engagement by the citizens in government *e-participation, citi ...

Overview

PANORAMIC is a

platform trial A platform trial is a type of prospective, disease-focused, adaptive, randomized clinical trial (RCT) that compares multiple, simultaneous and possibly differently-timed interventions against a single, constant control group. As a disease-focused ...

that compares groups who are having symptoms of COVID: one receives standard care (same as best care in the

NHS The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...

) and others receive standard care plus antiviral treatment. Participants take part from home online or via phone and the antivirals are delivered to them.

Participants

People could enroll in the study if they had symptoms of COVID (confirmed by a

test Test(s), testing, or TEST may refer to: * Test (assessment), an educational assessment intended to measure the respondents' knowledge or other abilities Arts and entertainment * ''Test'' (2013 film), an American film * ''Test'' (2014 film) ...

) less than 5 days prior to enrolling. They had to be either aged 50 or over, or have a preexisting health condition.

Treatments

The antivirals tested in the study were

molnupiravir Molnupiravir, sold under the brand name Lagevrio, is an antiviral medication that inhibits the replication of certain RNA viruses. It is used to treat COVID19 in those infected by SARS-CoV-2. It is taken by mouth. Molnupiravir is a prodrug o ...

(Lagevrio) and

nirmatrelvir/ritonavir Nirmatrelvir/ritonavir, sold under the brand name Paxlovid, is a co-packaged medication used as a treatment for COVID19. It contains the antiviral medications nirmatrelvir and ritonavir and was developed by Pfizer. Nirmatrelvir inhibits ...

(Paxlovid).

Results

Molnupiravir

Results from the trial showed that for higher risk, vaccinated adults molnupiravir does not reduce the chances of hospitalisation and death. However molnupiravir was found to help people recover four days sooner and reduces the amount of virus in the body (

viral load Viral load, also known as viral burden, is a numerical expression of the quantity of virus in a given volume of fluid, including biological and environmental specimens. It is not to be confused with viral titre or viral titer, which depends on the ...

). Participants receiving molnupiravir reported feeling better in comparison to those who received usual care. Even though molnupiravir reduced the amount of virus after a 5-day treatment, the virus was still present and infectious in some of the participants. Furthermore those taking the medicine had fewer

antibodies An antibody (Ab) or immunoglobulin (Ig) is a large, Y-shaped protein belonging to the immunoglobulin superfamily which is used by the immune system to identify and neutralize antigens such as bacteria and viruses, including those that caus ...

compared to those who did not which is a potential issue for boosting

immunity Immunity may refer to: Medicine * Immunity (medical), resistance of an organism to infection or disease * ''Immunity'' (journal), a scientific journal published by Cell Press Biology * Immune system Engineering * Radiofrequence immunity ...

. After a 6-month follow-up, the PANORAMIC study showed that people who took the antiviral molnupiravir felt better, had fewer and less severe COVID-19 symptoms, took less time off and needed healthcare services less compared to those who received standard care. However, differences between the two groups were small and were evident only if a large number of people received molnupiravir.

Nirmatrelvir/ritonavir

As of March 2025, the results of PANORAMIC regarding nirmatrelvir/ritonavir are still being analysed.

Significance

According to a paper reviewing how the PANORAMIC trial was delivered, learnings from the trial could be useful in preparing for future pandemics and for

health research Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...

in general. The main recommendation of the review was that research conducted in

primary care Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive, and coordinated person-focused care. It aims to optimise population health and reduce disparities across the groups by ensuring equitable ...

settings (as opposed to hospitals) should play a central role in future pandemics to help prevent the worsening of symptoms and hospitalisation. Further recommendations included the use of the platform study format, focusing on recruiting participants in care homes, and working on ways to rapidly deliver medicine to participants. The review also stressed the importance of building trust with diverse communities so that participation and involvement in research can be inclusive.

Leadership and funding

The trial is led by Chris Butler and Richard Hobbs (

University of Oxford The University of Oxford is a collegiate university, collegiate research university in Oxford, England. There is evidence of teaching as early as 1096, making it the oldest university in the English-speaking world and the List of oldest un ...

) and Paul Little (

University of Southampton The University of Southampton (abbreviated as ''Soton'' in post-nominal letters) is a public university, public research university in Southampton, England. Southampton is a founding member of the Russell Group of research-intensive universit ...

). PANORAMIC is sponsored by the University of Oxford and funded and delivered by the

National Institute for Health and Care Research The National Institute for Health and Care Research (NIHR) is the British government's major funder of clinical, public health, social care and translational research. With a budget of over £1.2 billion in 2020–21, its mission is to "impr ...

(NIHR).

Awards

The PANORAMIC trial received the

Prix Galien Prix was an American power pop band formed in Memphis, Tennessee, in 1975 by Tommy Hoehn and Jon Tiven. The group ended up primarily as a studio project. Its recordings were produced by Tiven along with former Big Star member Chris Bell, who ...

Best Public Sector Innovation Award in 2024.

References

External links

* {{Portal bar , Medicine , Viruses , COVID-19 Clinical trials related to COVID-19 COVID-19 pandemic in the United Kingdom Medical responses to the COVID-19 pandemic United Kingdom responses to the COVID-19 pandemic