Randomisation in Platform Trials: New Challenges, New Solutions

Platform trials offer clear advantages through their adaptive and efficient design, but these same features place unprecedented demands on randomisation.

As treatment arms are added, modified, or retired – often alongside unequal or response‑adaptive allocation – randomisation moves from a supporting function to a central operational and statistical challenge.

This article examines the unique randomisation complexities inherent to platform trials and outlines practical approaches to addressing them, with particular emphasis on design foresight, methodological rigor, and the critical role of well‑architected Interactive Response Technology systems.