A Phase 2 Trial Comparing Antiviral Treatments in Early Symptomatic Influenza

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

Inclusion Criteria:Patient understands the procedures and requirements and is willing and able to give informed consent for full participation in the studyAdults, male or female, aged 18 to 50 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 <30Able 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 visitsExclusion 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 activityPresence of any chronic illness/condition requiring long term treatment or other significant comorbidityBMI ≥35 Kg/m2Clinically relevant laboratory abnormalities discovered at screeningHaemaglobin <10g/dLPlatelet count <100,000/uLALT > 2x ULNTotal bilirubin >1.5 x ULNeGFR <70mls/min/1.73m2For 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 therapeuticsCurrently participating in another interventional influenza or COVID-19 therapeutic trialClinical 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