REMAP-ILD: The future of clinical trials in pulmonary fibrosis

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September 2022

We are incredibly excited to announce that REMAP-ILD has been awarded funding. This research project has the potential to change the landscape of clinical trials and the lives of patients affected by pulmonary fibrosis.

What is REMAP-ILD?

REMAP-ILD is a bold and ambitious project that aims to find treatments faster for patients affected by pulmonary fibrosis by revolutionising the way clinical trials are carried out in interstitial lung disease (ILD).

It is an international, collaborative project involving ILD experts from around the world, including scientists, clinicians, patients, patient organisations, and industry. The planning project has been awarded funding by NIHR Efficacy and Mechanism Evaluation (EME) Accelerator Award – International platform studies in precision medicine. The award is to turn the idea of a REMAP trial in fibrotic ILD into a reality. Over the next 12 months, there will be an international collaborative effort to design, plan and develop the trial. The REMAP-ILD Team will apply for further funding with the hope of being able to run the trial.

The project is led by APF President Professor Gisli Jenkins, Imperial College London and an international team of ILD experts. Action for Pulmonary Fibrosis will be raising awareness of the project and helping to involve people affected by pulmonary fibrosis and patient organisations. We want as many people as possible to learn about and help shape this exciting project. We will be organising events to keep you up to date and let you know how you can get involved. Watch this space!

How is a REMAP trial different to traditional clinical trials?

In many traditional clinical trials, one drug is tested against a placebo and it often takes well over a year to be able to decide if the treatment is working or not. Once the trial has started, very few changes are made to the trial. In a REMAP trial, multiple treatments and combinations of treatments can be tested at the same time, and the results can be understood sooner. REMAP trials are more inclusive, which means more people affected by the disease can take part. REMAP trials are also good for testing treatments that have already been approved for use in other conditions, but that might help treat pulmonary fibrosis - this is called drug repurposing. Drug repurposing can mean that patients have access to treatments much more quickly than inventing a new medicine from scratch!

Each letter of REMAP stands for something special about how the trial is designed and run: Randomised, Embedded, Multifactorial, Adaptive, Platform Trial. REMAP trials have been made possible, in part, through advances in technology and computing power that can perform complicated mathematical modelling.

Watch this short video to learn more about adaptive trials. For a more detailed, technical explanation of REMAP-ILD watch this video.

REMAP trials are happening right now in other conditions.  REMAP-CAP is a flagship study investigating treatments in community acquired pneumonia. This study was actually designed and running before coronavirus emerged, but has since been hugely important in identifying effective and ineffective treatments for patients with COVID-19. An astounding 20,000 plus patients have been enrolled in the study and over 57 treatments and interventions are or have been tested across 326 trial sites around the world - an awe inspiring global collaboration! Trials like REMAP-CAP have inspired researchers and clinicians to consider whether this type of trial could be applied to their area of expertise.

When will REMAP-ILD be happening?

The planning of REMAP-ILD is happening now and over the next 12 months. At the end of the 12 months, researchers will apply for further funding in the hope of carrying out the clinical trial.

How can I get involved?

Check out the REMAP-ILD webpage and follow on Twitter @REMAP_ILD. Look out for information on our website and social media channels. If you are someone affected by PF or a patient organisation, you can register your interest to be kept up to date about the project or get involved by emailing research@actionpf.org

Can I join the trial?

Not yet! The funding that has been awarded is to PLAN and DESIGN the clinical trial. Over the next 12 months, scientists, clinicians, people affected by pulmonary fibrosis, patient organisations, industry and regulators will be working closely together to agree on how the trial would be run. At the end of the 12 months, researchers will apply for further funding with the hope of making REMAP-ILD a reality!