Denmark’s life science strategy calls for EU focus on platform trials

Using platform trials, five Nordic hospitals hope to facilitate the introduction of new treatments while eliminating so-called ‘low-value care’.

“We want to find more effective treatments, work in smarter ways and encourage innovation,” Rasmus Møgelvang, cardiologist and Chief Executive Officer of Rigshospitalet in Denmark, told Euractiv.

Platform trials made their breakthrough during the COVID pandemic as a clinical method for simultaneously testing several interventions’ benefit or lack of benefit. They have also found use in oncology, Alzheimer’s disease, and pneumonia research.

Five major hospitals collaborating in the Nordic University Hospital Alliance (NUHA) are now using them. One participant is Rigshospitalet in Copenhagen, also known as Riget (the Realm), with around 1,000 beds and 12,000 employees.

“Our overall desire is for Rigshospitalet to benefit the entire Danish healthcare system, Rasmus Møgelvang commented in an interview with Euractiv.

The Danish life sciences way

As a member of the Danish Life Science Council, he stresses that the country has been successful in life sciences because of the Danish approach of involving public and private competencies and strongly focusing on implementation.

The council has recently submitted a report with life sciences recommendations to the EU Commission, as input to the Union’s forthcoming life sciences strategy, proposing a European life science council.

“My sincere hope is that there soon will be such a European Life Science council, also consisting of multiple competencies and working in the same constructive way as our Danish Council,” Møgelvang said.

Cross-border trials

Another measure the Danish Council recommends to the EU is to facilitate and fund platform trials across member states, for example, through the Union’s current and future research programmes, Horizon and FP10.

“This is something that we think could be very useful and meaningful for patients, for health care workers and for introducing new treatments and technologies in a strategic way to build and improve our healthcare,” he continued.

Rigshospitalet is already conducting platform trials, such as those on blood cancer and dialysis, and has also built a hub, a competence centre, to help doctors and academic researchers use the platform model.

Unlike traditional clinical trials, platform trials are open-ended, allowing new treatments to be added, evaluated, or dropped over time without having to define them all upfront, as Oxford University explains.

While conventional trials typically ask whether a specific drug outperforms standard care or a placebo, platform trials take a broader, disease-centred approach. They aim to identify the most effective treatment for a given condition through continuous assessment.

Researching ICU care

After the NUHA started its collaboration in May last year, Rigshopitalet has also started embedding a new platform trial in its intensive care unit (ICU).

“The main focus of the platform is to reexamine the value of the given care and treatments given, as well-founded evidence can often be lacking,” Rasmus Møgelvang. “How do treatments work, and which ones actually don’t?,” he added.

There is, for example, a need to study how to combine a patient’s current medication with one or more new treatments, which is not always thoroughly researched by pharmaceutical companies.

“A trial such as this could point out which drugs do not work or have low value or actually no health benefit for patients, so that we could implement more effective treatments,” he explained.

The trials also have a bottom-up profile: when the ICU platform trial starts, the doctors in the ICU will carry out clinical evaluations themselves.

Looking deeper

However, the ICU trial at Rigshospitalet will also examine staff resources, smarter ways of working, patient/user involvement, and how to introduce and effectively use new innovations.

The validated knowledge gathered could be shared with other intensive care physicians in Danish and Nordic hospitals. According to Rigshospitalet’s Chief Executive Officer, there is an increasing need for knowledge sharing across the Nordic region to benefit patients with rare diseases, for example.

In May, Rasmus Møgelvang will also meet representatives from the other participating hospitals in the alliance, including the Karolinska University Hospital in Stockholm, Oslo University Hospital, Helsinki University Hospital, and Landspítali in Reykjavik, to discuss the implementation of other platform studies.

The Swedish hospital Karolinska also has ongoing platform trials in oncology. However, as Olof Akre, Director of Research, Education, and Development at Karolinska University Hospital, explained to Euractiv, the hospital is now interested in connecting with the Danish platform studies hub at Rigshospitalet.

“These studies have become very popular, but they are also complex to conduct, so we want to learn how to network to strengthen our knowledge and include patients in studies in other Nordic countries. The Danish hub at the Rigshospitalet will be very important in a Nordic innovation perspective.”

However, Rigshospitalet’s work to modernise its health care does not stop here; it is also expanding its use of telemedicine.

“We are, for example, training surgeons here in Copenhagen who will work in Greenland and be able to treat strokes, cerebral haemorrhages and other brain injuries. These surgeons will work closely with neurosurgeons in Denmark via telemedicine. There is also a growing internal telemedicine consultation between Rigshospitalet and other, smaller hospitals in Denmark, Møgelvang told Euractiv.

[Edited by Vasiliki Angouridi, Brian Maguire]