New results are in for the ASCOT Trial (Australasian Covid-19 Trial), another study in Spiral’s manifest of platform trials. This platform trial was set up to evaluate 3 different treatment approaches for effectiveness against COVID-19. Each of these approaches is called a 'domain'. The findings from the anticoagulation domain have recently been published in NEJM Evidence.

The Australasian Covid-19 Trial (ASCOT) is an investigator-initiated, international, open-label, pragmatic adaptive platform randomized clinical trial of therapeutics for non–critically ill patients hospitalized with Covid-19. 

The purpose of the anticoagulation domain was to determine which level of anticoagulation treatment showed the most benefit to patients admitted to hospital with COVID-19. These patients are at an increased risk of blood clots which can lead to organ failure. As a result, almost all of these patients will receive some form of blood thinning medication (anticoagulation treatment).

Almost 1500 patients were enrolled from across 26 sites in Australia, New Zealand, India and Nepal. The results showed that an intermediate level of anticoagulation had an 86% probability of being better than low-dose anticoagulation. A therapeutic (high) dose did not show any benefit.

By pinpointing the most efficient level of blood-thinning treatment needed for patients hospitalised with COVID-19, this trial will be able to inform WHO-sponsored guidelines on the treatment of COVID-19 across the globe.

“Current practice in Australia is for low dose of anticoagulation, while international guidelines recommend the high therapeutic dose of anticoagulation. Therefore, our findings provide evidence that a middle ground may be most beneficial” - ASCOT Principal Investigator Professor Steven Tong

Practice in this realm is varied therefore these results prove essential for the future treatment of patients with the virus. These results are also important in generating evidence from participants in low and middle-income countries, which have been largely underrepresented in COVID-19 studies.  

Spiral has been involved in the ASCOT trial since 2020, at the height of the pandemic. We have a dedicated team developing the software requirements needed to perform this study within our Spinnaker platform. It is crucial that we remain agile and flexible in this current global environment, ensuring we deliver robust, dependable software that makes trials like ASCOT faster, more adaptable, and highly configurable.

“Platform trials like ASCOT are the future of clinical trials. We find them exciting to work on and love the dynamic nature of projects like this. With the results from the published anticoagulation domain, we are already moving onto a new phase in the project as we adapt our application to match the vision of the ASCOT team's future.” - Audrey Shearer, Spiral CEO and Founder

Thanks to trials like ASCOT, the current pool of evidence on how to treat COVID-19 continues to grow. It is a source of invaluable information that we are proud to be able to contribute to. The fight against this pandemic is an ongoing one, but with global collaboration, the likes of which we see in trials such as ASCOT, we can continue to discover how to make this virus manageable and even prevent death in patients. 

Sources:

ASCOT Trial News

NEJM Evidence

ASCOT Trial Site