A Phase 2 Trial Comparing Antiviral Treatments in Early Symptomatic Influenza

NCT ID: NCT05648448

Last Updated: 2026-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

3000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-22

Study Completion Date

2027-01-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This trial will use a previously validated platform, to quantitatively assess antiviral effects in low-risk patients with high viral burdens and uncomplicated influenza, to determine in-vivo antiviral activity. In this randomised, open-label, controlled, group sequential, adaptive, platform trial, we will compare the performance of available influenza antivirals, and those with potential activity, relative to the control (no treatment) and each other.

AD ASTRA study is supported by the Wellcome Trust Grant ref: 223195/Z/21/Z through the COVID-19 Therapeutics Accelerator

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Several influenza antivirals are licensed, differing in availability and routes of administration. Direct comparisons of antiviral and clinical efficacy between the multiple available antivirals are lacking. This comparative information is important for guideline development and for aiding purchasing and prioritisation decisions with several options available.

The platform trial will assess the following interventions:

* Licensed influenza antiviral interventions: oseltamivir (TAMIFLU®), peramivir (RAPIVAB®), zanamivir (RELENZA®), laninamivir (INAVIR®), baloxavir (XOFLUZA®) and favipiravir alone and in combination. The interventions will be chosen in order of priority as well as local feasibility at sites (availability of drugs, local ethics committee and regulatory approvals)
* Interventions with antiviral activity against influenza demonstrated in pre-clinical studies: molnupiravir

Randomisation to the no antiviral treatment control arm (no intervention) will be fixed at a minimum of 20% throughout the study. The randomisation ratios will be uniform for all available interventions.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Influenza Influenza, Human

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Oseltamivir (TAMIFLU®)

Group Type EXPERIMENTAL

Oseltamivir

Intervention Type DRUG

Oral oseltamivir 75mg BD for 5/7

Favipiravir

Group Type EXPERIMENTAL

Favipiravir

Intervention Type DRUG

Oral favipiravir 1800mg BD D0 and 800mg BD for a further 4/7

Zanamivir (RELENZA®) [Pending addition]

Group Type EXPERIMENTAL

Zanamivir

Intervention Type DRUG

Inhaled zanamivir 10mg BD for 5/7

Baloxavir (XOFLUZA®)

Group Type EXPERIMENTAL

Baloxavir

Intervention Type DRUG

Oral baloxavir:

* \<80kg- single dose of 40mg on D0
* ≥80kg- single dose of 80mg on D0

Molnupiravir [Pending addition]

Group Type EXPERIMENTAL

Molnupiravir

Intervention Type DRUG

Oral molnupiravir 800mg BD for 5/7

Peramivir (RAPIVAB®) [Pending addition]

Group Type EXPERIMENTAL

Peramivir

Intervention Type DRUG

Intravenous peramivir 600mg once only

Laninamivir (INAVIR®) [Pending addition]

Group Type EXPERIMENTAL

Laninamivir

Intervention Type DRUG

Inhaled laninamivir 40mg once only

Oseltamivir and Baloxavir [Pending addition]

Group Type EXPERIMENTAL

Oseltamivir and Baloxavir

Intervention Type DRUG

Oseltamivir 75mg BD for 5/7 and

Baloxavir:

* \<80kg- single dose of 40mg on D0
* ≥80kg- single dose of 80mg on D0

Oseltamivir and Favipiravir [Pending addition]

Group Type EXPERIMENTAL

Oseltamivir and Favipiravir

Intervention Type DRUG

Oseltamivir 75mg BD for 5/7 and

favipiravir 1800mg BD D0 and 800mg BD for a further 4/7

Favipiravir and Baloxavir [Pending addition]

Group Type EXPERIMENTAL

Favipiravir and Baloxavir

Intervention Type DRUG

favipiravir 1800mg BD D0 and 800mg BD for a further 4/7

Baloxavir:

* \<80kg- single dose of 40mg on D0
* ≥80kg- single dose of 80mg on D0

Negative control group

No treatment (except antipyretics- paracetamol)

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Oseltamivir

Oral oseltamivir 75mg BD for 5/7

Intervention Type DRUG

Favipiravir

Oral favipiravir 1800mg BD D0 and 800mg BD for a further 4/7

Intervention Type DRUG

Zanamivir

Inhaled zanamivir 10mg BD for 5/7

Intervention Type DRUG

Baloxavir

Oral baloxavir:

* \<80kg- single dose of 40mg on D0
* ≥80kg- single dose of 80mg on D0

Intervention Type DRUG

Molnupiravir

Oral molnupiravir 800mg BD for 5/7

Intervention Type DRUG

Peramivir

Intravenous peramivir 600mg once only

Intervention Type DRUG

Laninamivir

Inhaled laninamivir 40mg once only

Intervention Type DRUG

Oseltamivir and Baloxavir

Oseltamivir 75mg BD for 5/7 and

Baloxavir:

* \<80kg- single dose of 40mg on D0
* ≥80kg- single dose of 80mg on D0

Intervention Type DRUG

Oseltamivir and Favipiravir

Oseltamivir 75mg BD for 5/7 and

favipiravir 1800mg BD D0 and 800mg BD for a further 4/7

Intervention Type DRUG

Favipiravir and Baloxavir

favipiravir 1800mg BD D0 and 800mg BD for a further 4/7

Baloxavir:

* \<80kg- single dose of 40mg on D0
* ≥80kg- single dose of 80mg on D0

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patient understands the procedures and requirements and is willing and able to give informed consent for full participation in the study
* Adults, male or female, aged 18 to 60 years at time of consent.
* Early symptomatic Influenza (A or B); at least one reported symptom of influenza (including fever, history of fever, myalgias, headache, cough, fatigue, nasal congestion, rhinorrhoea and sore throat) within 4 days (96 hours)
* Influenza positive by rapid antigen test OR a positive RT-PCR test for influenza viruses within the last 24hrs with a Ct value of \<30
* Able to walk unaided and unimpeded in activities of daily living (ADLs)
* Agrees and is able to adhere to all study procedures, including availability and contact information for follow-up visits

Exclusion Criteria

The patient may not enter the study if ANY of the following apply:

* Taking any concomitant medications or drugs which could interact with the study medications or have antiviral activity
* Presence of any chronic illness/condition requiring long term treatment or other significant comorbidity
* BMI ≥35 Kg/m2
* Clinically relevant laboratory abnormalities discovered at screening

* Haemoglobin \<10g/dL
* Platelet count \<100,000/uL
* ALT \> 2x ULN
* Total bilirubin \>1.5 x ULN
* eGFR \<70mls/min/1.73m2
* For females: pregnancy, actively trying to become pregnant or lactation (healthy women on OCP are eligible to join)
* Contraindication to taking, or known hypersensitivity reaction to any of the proposed therapeutics
* Currently participating in another interventional influenza or COVID-19 therapeutic trial
* Clinical evidence of pneumonia- e.g. shortness of breath, hypoxaemia, crepitations (imaging not required)
* Known to be currently co-infected with SARS-CoV-2 (i.e. confirmed with positive ATK or RT-PCR)
* Received live attenuated influenza virus vaccine within 3 weeks prior to study entry
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Oxford

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Universidade Federal de Minas Gerais

Minas Gerais, , Brazil

Site Status RECRUITING

Laos-Oxford-Mahosot Wellcome Trust Research unit

Vientiane, , Laos

Site Status RECRUITING

Sukraraj Tropical & Infectious Disease Hospital

Kathmandu, , Nepal

Site Status RECRUITING

Faculty of Tropical Medicine, Mahidol University

Bangkok, , Thailand

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Brazil Laos Nepal Thailand

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

William Schilling, MD

Role: CONTACT

+662 203 6333

Nicholas J White, Prof

Role: CONTACT

+662 203 6333

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Mauro Martins Teixeira

Role: primary

Elizabeth Ashley, Professor

Role: primary

Abhilasha Karkey, Dr

Role: primary

Weerapong Phumratanaprapin, MD

Role: primary

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

VIR22003

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Treatment of Severe Influenza A Infection
NCT02108366 COMPLETED PHASE3
Phase 1 Study of ATR-002
NCT04385420 COMPLETED PHASE1
Study of VIR-2482 in Healthy Volunteers
NCT04033406 COMPLETED PHASE1