The Experts and Partnerships Driving the Future of Infectious Disease Research

As the largest international clinical trial ever conducted for this infection, it has brought together more than 150 hospitals across over 14 counties to systematically evaluate treatment strategies at scale. 

The recent publication of results from the SNAP Trial in both the New England Journal of Medicine (NEJM) and The Lancet marks a defining moment for the treatment of SAB bloodstream infections. These two complementary studies provide long-awaited, high-quality evidence to guide clinical treatment for a life-threatening condition.

The design of the SNAP trial enables researchers to address multiple research questions simultaneously. The Adaptive Platform Trial (APT) design builds an infrastructure that generates robust evidence while minimising duplication and inefficiency. More results from this trial are expected, as patient recruitment to address other research questions is still ongoing. 

By combining innovative trial design with a deeply embedded network of experts and partners, SNAP demonstrates how collaborative, cross-border research can deliver answers faster and more efficiently. Ecraid is proud to be the European partner in this landmark effort, rapidly activating clinical sites across Europe and supporting delivery of these critical insights though a highly coordinated international network. 

Building Collaboration Across Borders

For Jeri Nijland (SNAP EU clinical trial project manager), one of the defining challenges of multinational infectious disease trials is operational complexity. 

"Running successful multinational infectious disease trials depends on turning diverse countries, teams, and regulatory environments into a single coordinated research effort. While fragmented regulations, site variability, and differing local practices remain major operational challenges, strong collaboration and teamwork are what makes global adaptive trials possible."

From her experience, coordinated research networks fundamentally change what can be achieved compared to running trials in isolation. Shared infrastructure, operational expertise, and aligned processes help reduce duplication, accelerate recruitment, and ensure that lessons learned in one region can rapidly benefit others.

But collaboration at this scale also requires flexibility and continuous communication behind the scenes. 

"Successful collaboration in a global adaptive platform trial means turning diverse regions, time zones, and regulatory environments into a single coordinated research engine, she says. It depends on constant communication, adaptability, and a shared commitment across all participating teams."

Rethinking Trial Design for Infectious Diseases

For Marjolein Hensgens (Chief Investigator SNAP Europe), adaptive platform trials (APTs) are helping overcome many of the limitations of traditional clinical research models in infectious diseases.

“APTs are transforming infectious disease research by replacing fragmented, single-question studies with flexible trial frameworks that can evaluate multiple treatment strategies simultaneously,” she explains. Rather than running separate trials for every clinical question, adaptive platforms like SNAP allow researchers to evaluate multiple interventions within a single overarching framework. New treatment arms can be added or adapted as evidence evolves, making research more responsive to urgent clinical needs. 

Janneke Verberk (SNAP Europe Operational Lead) is responsible for translating the scientific vision into the operational implementation of SNAP in Europe. She says:

"There are a few teams that are able to translate a clinical study with a complex design into an implementation that is fully inline with European laws and regulations within a short period of time, supported by clear processes and efficient organisation. Ecraid has that capacity." 

SNAP’s design has enabled researchers to study several important unanswered questions in SAB treatment simultaneously - from identifying the most effective first-line antibiotics to evaluating adjunctive therapies and early oral treatment strategies. This approach has significantly reduced duplication of effort while accelerating recruitment and evidence generation. 

The trial has now enrolled more than 7,000 patients globally, demonstrating the scalability and efficiency of the adaptive platform model.

The Strength of a Global Expert Network

A key factor behind SNAP’s success is the international network of experts contributing to the trial.

Researchers, infectious disease specialists, microbiologists, statisticians, trial methodologists, patients, and operational teams work closely together to evaluate each intervention introduced into the platform. This collaborative process helps ensure that trial questions are scientifically rigorous, clinically relevant, and feasible across different healthcare systems and patient populations.

Ecraid plays a critical operational expertise role in supporting this complexity. 

"The collaboration between the (scientific) partners and Ecraid demonstrates how scientific innovation and operational expertise can reinforce one another. The Ecraid team successfully managed to integrate a complex study design, originally developed outside Europe, into the European regulatory framework" says Janneke Verberk.

As collaboration is a key feature of the SNAP trial, we asked Janneke which aspects has the biggest impact on making SNAP globally relevant and she explains:

"Not only from a scientific perspective, but also from an operational standpoint, all partners strengthen one another by sharing expertise, experience, and insights. Researchers continuously develop new research questions that are both suitable for the SNAP infrastructure and highly relevant to clinical practice. As the same time, operational partners such as Ecraid contribute by streamlining workflows, optimising organisational processes, and ensuring compliance with both European and national regulatory requirements. This is achieved in close collaboration with outstanding national coordinating teams, whose local expertise is essential or the successful implementation of the study". 

A New Model for Infectious Disease Research

The SNAP trial demonstrates what becomes possible when innovative methodologies are combined with trusted international networks. Janneke explains that:

One of the major advantages for participating countries in Europe is that they do not need to build the trial infrastructure from the ground up. Within the global SNAP community, Ecraid has created a European framework that countries can join, enabling a much faster start-up and providing a structure that is already aligned with European regulations. Beyond the operational efficiencies, the collaboration fosters the exchange of ideas, expertise, and best practices, creating a truly integrated European research community. The publications you see today would not have been possible without the extraordinary dedication and commitment of all teams involved: within European level, an at site level. Ecraid serves as the European Trial Management Group, acting as the unique link between sites, the global coordinating centre, and European partners."
 

SNAP EU is a collaboration between the University Medical Center Utrecht, Radboudumc Nijmegen, Otto von Guericke University Magdeburg, Centre Hospitalier Universitaire de Rennes and Region Skåne-Helsingborg hospital.