A landmark step in dengue research
The first global standard for measuring outcomes in dengue treatment trials has been published in The Lancet Infectious Diseases this week. Co-led by researchers from King’s College London and the University of Oxford, the study resolves a long-standing mismatch in how outcomes are defined and reported across trials. By harmonising what is measured, the new standard enables faster, more reliable comparisons of potential therapies and supports regulators and guideline developers as they evaluate emerging treatments for dengue fever.
Why a global standard was needed
Dengue is the fastest-spreading mosquito-borne viral disease globally, driven by climate change, urbanisation, human mobility and expanding Aedes mosquito ranges. With roughly half of the world’s population at risk, variability in trial outcomes has hindered evidence synthesis and delayed progress toward effective therapies. Although research interest in dengue has grown, comparability across trials has often been limited by differences in outcome measures, timing, and definitions. The new standard directly addresses these gaps by providing a common framework that captures clinically meaningful, patient-centered outcomes while remaining applicable to diverse settings.
The ISARIC role and the collaborative effort
The project was undertaken as part of the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) program, emphasising global collaboration. The Lancet Infectious Diseases paper includes contributors from 36 countries and actively involved people with lived experience of dengue fever. This inclusive approach ensures the chosen outcomes reflect what patients and clinicians deem important, balancing lived experiences with clinical relevance for trial design and regulatory review.
How the standard works in practice
The standard outlines a core set of outcomes that should be collected in all dengue treatment trials, along with recommended time points for assessment. By aligning endpoints such as fever duration, clinical severity, resolution of warning signs, viral markers where available, and functional recovery, researchers can generate more directly comparable data. This consistency is expected to improve the quality of evidence, support meta-analyses, and accelerate the evaluation of promising therapies as they move through regulatory pathways.
Implications for regulators, researchers and patients
Global harmonisation of outcomes offers multiple benefits. For regulators, it means clearer, faster decision-making grounded in uniformly reported results. For researchers, the standard clarifies trial design and reduces unnecessary variability. For patients and communities affected by dengue, the ultimate goal is faster access to effective treatments and better-informed clinical guidelines. The paper’s interdisciplinary approach, including patient and caregiver perspectives, strengthens the real-world relevance of the outcome measures.
Statements from leadership
Daniel Munblit, corresponding author and reader in pediatrics at King’s College London, emphasised the importance of global consensus in the dengue therapeutics field. Sophie Yacoub, associate professor at the University of Oxford and a corresponding author, highlighted that harmonising outcomes across trials represents a major advance for future clinical research. Laura Merson, Head of Data at ISARIC, noted that standardised outcomes strengthen study quality and data value, aligning with WHO efforts to advance robust clinical evidence globally.
Looking ahead
As dengue continues to spread, both through climate-driven risk and expanding transmission networks, the need for effective treatments becomes more urgent. The new global standard provides the clarity regulators and researchers require to evaluate therapies efficiently and, ultimately, to improve patient care. While no specific dengue therapies exist yet, harmonised outcomes create a solid foundation for future trials and guideline development, helping to translate scientific advances into real-world health benefits.
