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

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September 2022

Are you interested in using your lived experience and voice to help us shape the future pulmonary fibrosis research?

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, alongside many other patient organsiations, will be raising awareness of the project and helping to involve people affected by pulmonary fibrosis. 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?

Traditional clinical trials have led to the discovery of many new treatments for patients around the world. But we know there is a desperate need for patients living with pulmonary fibrosis to have access to new and better treatments now! In many traditional clinical trials, only one drug is tested at a time against a placebo (dummy drug). If you want to test lots of different drugs, you need to run lots of different trials. It often takes many years to discover a safe and effective new treatment.

In a REMAP trial, many different treatments and combinations of treatments can be tested at the same time, and the results can be understood sooner. Information gathered during the trial is used adapt the trial design so that it is as effective and efficient as possible. REMAP trials are very flexible and can help test potential new treatments at different stages of development within the same platform trial. This could include brand new drugs in their earlier stages of development, right through to 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!

Importantly for patients, REMAP trials are more inclusive, which means more people affected by the disease will have the opportunity to take part. And if you do take part, you will have more chance of trying a potential new drug because of the way patients are allocated to test different treatments.

What does REMAP stand for?

Each letter of REMAP stands for something special about how the trial is designed and run.

Learn more about what each of these important elements means by watching our introductory webinar about REMAP-ILD.

One of the most important features of a REMAP design is that information gathered while the trial is live is used to change and adapt what happens next. This constant learning means that effective treatments can be identified more quickly and patients are more likely to be allocated to a treatment that might be beneficial. The ability to make sense of such a huge amount of data so quickly is, in part, been made possible through advances in technology and computing power that can perform complicated mathematical modelling and help guide decision making.

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. Within the next 12 months, researchers will apply for further funding in the hope of carrying out the clinical trial in different countries around the world.

How can I get involved?

Check out the REMAP-ILD webpage and follow us 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. Within the next 12 months, researchers will apply for further funding with the hope of making REMAP-ILD a reality!