The Health Research Board has announced a €10 million investment in four new clinical trial networks in the areas of stroke, perinatal health, primary care and critical care medicine. UCD Medicine has secured two of the four awards with funding of a stroke clinical trials network led by Prof Peter Kelly and the creation of a national critical care clinical trials network led by Prof Alistair Nichol.
HRB Irish Critical-Care Clinical Trials Group
The HRB Irish Critical-Care Clinical Trials Group (IC-CTG) is a collaboration involving three quarters of the Irish intensive care capacity and is led by Professor Alistair Nichol (UCD Professor of Critical Care Medicine at St Vincent’s University Hospital).
Thousands of critically ill patients pass through our intensive care units (ICU) each year. Sadly the nature of their conditions can often result in death, or mean they survive with a long term disability. The HRB Irish Critical Care Clinical Trials Group will bring together doctors, nurses and researchers to test new treatments that can improve outcomes for these patients.
As Professor Alistair Nichol notes
Our network will offer ICU patients the highest quality care, give them access to the latest innovations in intensive care and ensure future patients benefit from the lessons learned in national and international research. The group includes the academic leadership in our speciality and encompasses more than 75% of all the ICU capacity in Ireland,’
Initial work to be addressed by the IC-CTG:
PHARLAP – will establish whether the way we ‘set’ the breathing machine helps reduce further lung damage in patients with a severe lung disease (Acute Respiratory Distress Syndrome ARDS). A small research study by some of the group members showed that reducing the size of each breath in conjunction with an occasional sustained deep breath, through the ventilator appeared to reduce further damage to the lungs. But the study size was too small to make definitive conclusions. So a larger study, which this network now makes possible, will assess whether patients with ARDS are better off on this PHARLAP breathing strategy.
TRANSFUSE – Does giving ‘fresher’ blood versus “older blood” in transfusions make a difference to patients who are admitted to ICU. This study will result in a worldwide practice change if it finds freshest available blood us best but if there is no difference this will provide great confidence to blood banks that current practice is optimal.
The network will also carry out test studies to determine which of the common treatments to help reduce bleeding from the stomach when people are very unwell is best. The network will also provide extra training for junior doctors and nurses in Ireland, so they can be future world leaders in research within the Irish health system.
Prof Nichol adds,
We will be conducting studies with colleagues from Australia and New Zealand where a similar group to ours have made an enormous impact on improving ICU care. We very much hope to replicate their success in Ireland.
HRB Irish Stroke Clinical Trials Network
Stroke is the second leading cause of death in the world, the leading cause of new disability, and a major cause of dementia and health costs.
This Stroke Clinical Trials Network will give Irish patients access to cutting edge new treatments with the potential to prevent strokes, or to improve emergency treatment and recovery after stroke.
said UCD Clinical Professor at Mater Misericordiae University Hospital. Elaborating further, Professor Kelly said
We recently saw the benefit to Irish patients of participating in clinical trials via Irish involvement in the ESCAPE trial. This trial was one of the first to prove that emergency clot extraction for carefully selected patients after stroke resulted in a 3-fold improvement of disability, and reduced risk of death by half from 20% to 10%. Irish patients were among the first in Europe to benefit from the treatment, which they otherwise would not have accessed.
In the Network, Irish researchers in hospitals will: –
- Join several new international trials of new treatments for emergency care, prevention, and recovery after stroke.
- Lead a new clinical trial to investigate low-dose colchicine (a medicine traditionally used for gout) versus placebo (sugar pill) to improve prevention of heart attacks and second stroke following a first stroke.
- Train new doctors, nurses, and therapists in how to perform safe high-quality clinical trials, and will work with patient groups and the private sector to bring new treatments to patients with stroke.
The Network will initially involve eight Irish hospitals, six leading universities, and all seven Hospital Groups, including colleagues from UCD, RCSI, Trinity College, UCC, NUI Galway, and University of Limerick. It will have strong links with international researchers in the UK, Europe, and North America. In addition to the HRB, other Network partners are the Irish Heart Foundation, who will fund new Stroke Research Nurses, and seven industry partners, who will fund education and training activities.
UCD Clinical Professor, Professor Peter Kelly is a consultant stroke neurologist and Director of the Stroke Service at the Mater Misericordiae University Hospital. Over the past ten years, Prof Kelly has built a strong neurovascular clinical science unit at the Mater to further patient-oriented research on stroke. His academic work is focused on stroke prevention and the development of surrogate biomarkers to allow early stroke intervention. He has lead several major vascular disease research initiatives including the North Dublin Stroke Study, the North Dublin Transient Ischaemic Attack Study and the Dublin Carotid Artery Atherosclerosis Study. Through these research projects, Prof Kelly has established a multi-centred research network which will now be leveraged to build theHRB Irish Stroke Clinical Trials Network.
Our congratulations to both Prof Kelly and Prof Nichol on these grant awards and continued success in developing these important national clinical trials networks. Both awards demonstrate the value of the research infrastructure already established by the School within the UCD Clinical Research Centre and under development across the School.