Research

BSG members win substantial funding for clinical trial

Several BSG members were co-applicants on a recent successful application for substantial funding of a clinical trial in hepatology. Prof Mark Thursz, Dr Steve Ryder, Prof Matthew Cramp, Dr Paul Richardson and Dr Stuart McPherson are among a group represented by Dr Alastair O’Brien. The group received £1.6 million from the Health Innovation Challenge Fund (joint Wellcome Trust and Department of Health) for ATTIRE (Albumin To prevenT Infection in chronic liveR failure).

The money will fund a multi-centre, clinical, phase II and phase III trial at 15 sites that will examine whether administration of albumin to patients admitted with decompensated liver failure, in order to increase plasma levels to near normal, will prevent hospital acquired infection. Dr O'Brien's local clinical research network (LCRN) will fund the research nurse costs (>£1million).

Over 100,000 patients are admitted to hospital every year with advanced liver cirrhosis; infection is their most common problem. Dr O’Brien and his team have shown that, in these patients, leukocyte function is markedly impaired by an up-regulation of the hormone Prostaglandin E2; infusion of albumin can reverse this process by binding and neutralising its effects. Albumin is widely considered by hepatologists to be beneficial in liver disease but no putative mechanism had been identified, so no consensus had developed for how to prescribe it. Dr O’Brien and colleagues aim to repurpose albumin as an immunity-restoring drug to improve leukocyte function in patients with advanced cirrhosis and therefore improve their ability to fight off infection. They hope to demonstrate that its use will lead to reduced rates of nosocomial infection and mortality and shorter hospital stays, thereby reducing health care costs.