The PRINCIPLE Trial has led the way in evaluating treatments for COVID-19 in the community over the past two years. It has tested five potential treatments so far, with a further two, favipiravir and ivermectin, still being studied in the trial.
PRINCIPLE was designed to rapidly identify treatments that showed promise and rule out treatments that did not work. Early on in the pandemic, the antibiotics azithromycin and doxycycline were being widely used around the world to treat acute COVID-19; PRINCIPLE was the first major trial in the community to show that, in the absence of other indications, these antibiotics did not benefit COVID patients and so merely put them at unnecessary risk of side effects and added to the problem of antibiotic resistance.
PRINCIPLE also found that the anti-inflammatory drug, colchicine, did not help people get better any quicker.
A key finding from the Trial announced in April 2021 was that the commonly used asthma drug, inhaled Budesonide, a steroid, was effective in reducing recovery time by around three days and that there was a high probability that it also reduced hospital admission.
The Platform Randomised trIal of treatmeNts in the Community for epIdemic and Pandemic iLlnEsses (PRINCIPLE) Trial is led by the University of Oxford and funded by UK Research and Innovation (UKRI) and National Institute for Health Research (NIHR).