First global standard published to measure outcomes in dengue treatment trials

The first global standard which harmonizes what outcomes to measure in dengue treatment trials has been published this week in The Lancet Infectious Diseases. Co-led by researchers at King's and the University of Oxford, this solves a longstanding discrepancy in terms of what is measured in these trials.

The project was undertaken as a part of The International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) program.

About half the world's population is at risk of dengue infection. In-country transmission of dengue has doubled in Europe over the past year, with the ECDC reporting a historic peak of 304 locally acquired cases in 2024. There has also been a rise in dengue cases globally driven by the acceleration of the climate crisis.

Dengue is a viral infection and is the most rapidly spreading mosquito-borne viral disease worldwide. Its increase globally is driven by climate change, urbanisation, human mobility and the expanding range of Aedes mosquitoes. There are currently no specific treatments for patients with dengue.

Despite growing research interest, outcomes and measurements have been assessed differently across a variety of trials, which limits how the evidence from these can be compared and synthesised.

A new global standard enables faster, more comparable evaluations for regulators and guidelines and could help accelerate a path to finding a treatment to dengue fever, as well as improve future clinical guidelines development.

The paper published in The Lancet Infectious Diseases had contributors from 36 countries and actively included people with lived experience of dengue fever. This means the outcome scale is reflective of their experiences and need, while also balancing these with clinical needs.

With dengue spreading rapidly across continents, we urgently need new treatments. This global standard provides the clarity regulators and researchers require to evaluate therapies faster and make them more widely accessible."

Daniel Munblit, corresponding author on the paper, reader in pediatrics, King's College London

Sophie Yacoub, corresponding author on the paper, associate professor, University of Oxford, said: "Bringing together a global consensus on clinically relevant outcomes to be measured in all future dengue clinical trials, is a major step forward for the dengue therapeutics field."

Laura Merson, Head of Data, International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) and Head of Clinical Research, Institut Pasteur de Dakar, said: "Harmonising outcomes across dengue trials strengthens both the quality of each study and the scientific value of the data generated. Initiatives like this support the World Health Organization's efforts to advance clinical trials globally, ensuring robust evidence for health interventions."