Research

Action Medical Research awards £100k for IBD research

Dr Matthias Zilbauer, of the University of Cambridge, has been awarded £100k for a project aiming to find a way to predict how a child’s condition is likely to progress if they are diagnosed with IBD – whether the child’s symptoms are likely to be mild and require minimal treatment, or more severe, needing more intensive treatment. Studies in adults suggest it might be possible to identify people who are at highest risk of having severe symptoms by analysing certain blood cells. Dr Zilbauer has been investigating whether this approach might also work for children and early results are promising. In this project, the team is finding out more about the potential benefits of the new test in children and simplifying the techniques used, so they are suitable for routine use. More information is available from the Action Medical Research website.

Three new clinical trials - personalising treatment in pancreatic cancer

PRECISION-Panc is an ambitious programme of research that seeks to uncover the molecular profile of individual patients with pancreatic cancer, to learn more about the disease and to pave the way for patients entering clinical trials in a way that matches their tumour biology to the type of treatment. Professor Andrew Biankin at the University of Glasgow is leading the PRECISION-Panc project. His team will set up three clinical trials, across two waves of research, with the scope to add more trials in the future. They will be focusing on defects in the DNA damage response (DDR) pathway, which are seen in approximately 20% of patients with pancreatic ductal adenocarcinoma (PDAC). In the first wave they will establish the best way to collect and analyse the molecular profile of tumour samples from patients with pancreatic cancer. Each patient will have five samples taken from their tumour for analysis at diagnosis. In the second wave of research, the team will apply this understanding to allocate patients to trials with different treatments, depending on the molecular nature of their tumour. Further information is available from the PRECISION-Panc website.

IASO trial of anakinra for acute severe ulcerative colitis

Despite huge progress in the outpatient management of ulcerative colitis, there are still around 2,500 admissions for acute severe UC in the UK every year. Our current standard initial therapy (intravenous corticosteroids) is based upon the landmark trial of Truelove and Witt in the 1950s; advances since have been restricted to rescue therapy for those failing this initial care. Led by Tim Raine and Arthur Kaser in Cambridge, with a team of researchers from across the UK, the IASO trial will be a multicentre, randomised, double-blind, placebo-controlled trial to test the hypothesis that IL-1 blockade using anakinra, a safe and affordable antagonist of the IL-1 receptor, can improve outcomes when given as initial therapy in acute severe UC alongside corticosteroids. Funding for IASO has been provided by the NIHR and MRC through the EME programme, with additional funding from the Wellcome Trust and Swedish Orphan Biovitrum, totalling in all in excess of £1.6m. IASO will set this major clinical trial in the context of a detailed scientific study of the largest cohort of patients with acute severe UC ever assembled. Patient recruitment will begin in 2017, with final trial reporting expected in 2021/22.

METRIC Study closed for recruitment - add-on study funded

The NIHR HTA funded Metric study (MR Enterography or ulTRasound In Crohn’s disease; “Diagnostic accuracy for the extent and activity of newly diagnosed and relapsed Crohn’s disease: a multicentre prospective comparison of magnetic resonance enterography and small bowel ultrasound compared to a reference standard in those aged 16 and over”) has closed to recruitment; data collection and analysis are underway. The research team led by Prof Stuart Taylor and Dr Andrew Plumb were successful in securing £358,183 funding from the HTA for an add on study (MRI enterography as a predictor of disabling disease in newly diagnosed Crohn's disease) to develop a prognostic model for future disabling disease in those newly diagnosed with Crohn's disease. In particular, the group will investigate whether findings on MR enterography at diagnosis are predictive of a worse long-term outcome, over and above existing prognostic markers. Co-investigators: Ailsa Hart, Andrew Plumb, Gauraang Bhatnagar, Nicola Muirhead, John Hamlin, Stuart Bloom, Susan Mallett, Ilan Jacobs, Susan Tebbs, Simon Travis, Stephen Morris, Steve Halligan.

Crohn's Disease trial funding success: cine MRI

Joint collaborations between members of the British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and the BSG have led to recent grant success from the NIHR. Led by Prof Stuart Taylor and Dr Andrew Plumb, the team has been awarded £895,292 by NIHR EME to investigate “Small bowel motility quantified by cine MRI as a predictor of long term response in patients with Crohn's disease commencing biological therapy”. The trial will recruit from 10 centers and perform dynamic cine MRI imaging of the small bowel in those commencing biological therapies for active disease. Small bowel motility is reduced by active inflammation and this can be quantified using MRI and specialist analysis software. The study will test if early improvement in small bowel motility after commencing therapy is better predictive of 1 year response or remission than CRP or calprotectin. An embedded mechanistic study led by Dr Gordon Moran will explore the relationship between gut peptides, inflammatory cytokines, aberrant small bowel motility on MRI, and patient abdominal symptoms. A team led by Prof Ailsa Hart will investigate the effect of body composition on patient response. Co-investigators: Gordon Moran, Ailsa Hart, Alex Menys, Andrew Plumb, Stuart Bloom, Tariq Ahmad, Ilan Jacobs, Susan Tebbs, Caroline Dore, Simon Travis, Steve Halligan.

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