Six projects to receive funding, including trials which will investigate improving outcomes for people suffering severe brain injuries, strokes and knee replacement pain.
UNSW Sydney researchers have received over $20.7 million from the National Health and Medical Research Council (NHMRC) for six clinical trials aimed at addressing significant knowledge gaps in health conditions such as stroke and brain injury.
A total of 25 research projects will receive over $77 million through this round of the NHMRC's Clinical Trials and Cohort Studies Grant scheme.
Interim Dean of UNSW Medicine & Health Professor Adrienne Torda applauded the grant recipients for their success.
"This is an outstanding result and acknowledges the dedication of our researchers in addressing the diverse health problems affecting those in Australia, and around the world. This success also speaks to the University's strength in leading Australian medical research in a range of areas including cardiovascular health, neurology and breast cancer," she said.
Improving treatments for people with severe brain injuries
UNSW Medicine & Health Associate Professor Anthony Delaney, Professorial Fellow in the Critical Care Program at The George Institute for Global Health and Senior Intensive Care Specialist at Royal North Shore Hospital, and his team have received $6.3 million to investigate treatment options for people with a brain injury so severe they need assistance with their breathing.
"These people commonly develop pneumonia and if they do, it increases their chance of dying and can impede the recovery of their brain function," A/Prof. Delaney said.
"Our trial will determine if antibiotics given early in the course of the ICU treatment can prevent these infections, increase the chance of surviving, and improve the recovery of brain function."
Prof. Delaney said one of the most important aspects of the PReVENT-NEURO clinical trial is that researchers are using a new tool to measure how well people with severe brain injury recover. The tool was developed specifically by patients to measure a variety of brain functions not normally measured by traditional tools.
"For patients who survive a severe acute brain injury, preventing infection may avoid the need for decades of care, improve quality of life and allow people to return to the workforce, as well as reducing healthcare costs," he added.
Resolving treatment uncertainty for stroke patients
Director of Global Brain Health at The George Institute and Conjoint Professor at UNSW Medicine & Health, Craig Anderson, and his team were awarded $5.2 million to analyse the effectiveness of a particular clot-busting drug in 4000 patients with presumed acute ischaemic stroke.
Most strokes are ischaemic - occurring when there is a blockage of a blood vessel in the brain. Opening up blocked blood vessels with intravenous thrombolysis is a proven treatment for this type of stroke but little is known of the benefits and risks of the treatment in certain types of patients.
"Our study will solve important outstanding questions to define which patients have the most to gain with the lowest risk of bleeding from using modern clot-busting thrombolysis treatment," Prof. Anderson said.
"This is the first adaptive platform trial in acute stroke that will allow important clinical questions to be addressed for patients in different regions of the world, both low- and middle-income as well as high-income, to improve their chances of recovery from this common and serious illness," he said.
New drug to help treat methamphetamine addiction
Conjoint Professor Nadine Ezard from the National Drug and Alcohol Research Centre and clinician researchers from the National Centre for Clinical Research on Emerging Drugs (NCCRED), have been awarded $2.2 million to trial a new pharmaceutical drug to help in the treatment of methamphetamine use disorder.
Stopping regular methamphetamine use leads to symptoms of withdrawal, which perpetuates drug use and can prevent users seeking help. There is currently no treatment for methamphetamine withdrawal.
Prof. Ezard, Dr Krista Siefried, Dr Brendan Clifford, Mr Liam Acheson and their team, will conduct a clinical trial using a stimulant medication currently used to treat attention deficit or hyperactivity disorder in Australia. Lisdexamfetamine has the potential to reduce withdrawal symptoms and become the first treatment for methamphetamine withdrawal in the world.
"This is an exciting step forward in the treatment of methamphetamine dependence," Prof. Ezard said. "Australia has the highest prevalence of methamphetamine dependence globally and getting through withdrawal is an important step towards recovery."
Testing treatments for a potentially hidden cause of stroke
UNSW Medicine & Health Professor Mark Parsons was awarded $3.7 million to trial treatments aimed at preventing recurrent strokes in patients who have been diagnosed with atrial myopathy.
Atrial myopathy is a recently discovered condition best described as a 'fatty heart'. It causes a clot to form in the left atrium - or heart chamber - which can then dislodge from the heart and go to the brain, causing stroke.
Prof. Parsons said the condition is diagnosed using cardiac echo - a type of ultrasound - using methods that his collaborative team have pioneered worldwide.
"We think atrial myopathy might be a common hidden cause of stroke in the 25 per cent of patients with an uncertain cause for their stroke," he said. "So, we are going to start a trial where we randomise people who have had a recent stroke and evidence of atrial myopathy, to an anticoagulant medicine instead of standard blood thinning treatment to see if that reduces the risk of recurrent stroke."
Improving outcomes for women with a condition detected during breast cancer screening
UNSW Medicine & Health Professor Boon H Chua and her team have received $1.1 million to improve the treatment outcomes of women diagnosed with ductal carcinoma in-situ (DCIS) of the breast.
DCIS of the breast is characterised by abnormal cells in the milk ducts which have not spread into the breast tissue, but some DCIS could progress to become invasive breast cancer. Despite it being a common diagnosis, there has been little research to improve the treatment outcomes of women with DCIS.
"As a result, there are often uncertainties on how women diagnosed with DCIS may best be managed to decrease the risk of their DCIS becoming an invasive breast cancer," Prof. Chua said.
Radiation therapy after surgery decreases the risk of DCIS coming back as another DCIS or importantly, as an invasive breast cancer. The research study will test the long-term efficacy and safety of different radiation doses and number of radiation therapy sessions to reduce the risk of recurrence and improve the safety and convenience of care for women with DCIS.
"The results will be important in tailoring radiation therapy in individual women to avoid over- or under-treatment," Prof. Chua said. The study also aims to better understand the lived experiences of the diagnosis and treatment in women with DCIS.
Managing care for knee replacement patients
Conjoint Associate Professor Sam Adie received $2.2 million to test an innovative model of care for people who get a total knee replacement.
Total knee replacement is an excellent surgery for people with advanced arthritis and provides people with large improvements in pain and function long term, A/Prof. Adie said.
"But about one in five patients continue to have niggling pain and aren't completely satisfied with their surgery even though their surgery is otherwise technically successful," he said.
The Early Pain Intervention in Knee replacement (EPIK) trial will test a new model of care that will identify these patients early and put in place a management plan to improve their long term outcomes.
The trial will be nested in the Australian Orthopaedic Association National Joint Replacement Registry and use telehealth to provide some elements of care. It will also be the first time a comprehensive, multidisciplinary model of care will be used and tested by surgeons and other clinicians to manage these patients.
