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Welcome to the Research department

Derby Teaching Hospitals NHS Foundation Trust provides a diverse and vibrant research environment and we are proud of the ground breaking research carried out by our investigators and researchers.
Our experienced team works alongside clinicians and healthcare professionals to promote, design and deliver studies and we are dedicated to helping departments achieve research excellence. We are also delighted to support small and medium enterprises to design and deliver their clinical trial within a clinical setting.
You will find more information about the research we are currently undertaking and the services we are providing within the R&D Webpages

In this page you will find a short summary report of completed studies and the impact on clinical practice.  

Derby was one of the participating centres for the landmark WAIT (Wheeze and Intermittent Therapy) multicentre research study. Paediatric consultants, Dr Will Carroll and Dr Helen Sammons were the local investigators on this study. The WAIT trial  assessed the effectiveness of intermittent montelukast for treatment of wheezing episodes in 1358 children aged 10 months to 5 years who had had two or more wheeze episodes, with at least one episode in the preceding 3 months. This is a very common problem in childhood. One third of preschool children have one or more wheezy episodes.

The study - Children were randomly allocated to receive montelukast or placebo. There was no difference in unscheduled medical attendances for wheezing episodes between children in the montelukast  and placebo groups. However, the subgroup of patients who carried the wild type (common) genotype of the 5-lipoxygenase (ALOX5) gene promoter, which encodes a key enzyme in the leukotriene synthesis pathway, had significantly reduced unscheduled severe medical attendances for wheezing episodes.

 Additional support for a salutory effect of montelukast in the present study was provided by results of the secondary outcomes. In the entire study group, need for rescue oral corticosteroids was decreased with 0·26 uses per child in the montelukast group versus 0·33 in the placebo group. This difference was statistically significant and clinically relevant, irrespective of the genotype. Additionally, time to first hospital admission was longer in children in the montelukast group than in those in the placebo group.

Impact on Practice  In the absence of more effective therapies we have a safe and steroid-sparing medication available. In clinical practice it is the more severe group of patients that see paediatricians and this group seem to have 'most to gain' from a rescue therapy.

 You can access the full study publication at: www.ncbi.nlm.nih.gov/pubmed/25212745

The results of the Complete versus Lesion-only Primary Percutaneous Coronary Intervention Trial (CvLPRIT), to which Derby made a significant contribution (26 patients randomised) was presented at the European Society of Cardiology (ESC) Congress in Barcelona. 

Dr Damian Kelly, who was the Principal Investigator at this Trust, paid tribute to his colleagues who worked on the trial with him, “A very big personal thank you to everyone including Fiona Robertson, Marie Appleby and the catheter lab staff (who worked very hard and who I think enjoyed it!).”  He concluded, “We have undoubtedly helped our national profile and I'm keen we maintain involvement with multi-centre trials in interventional (and general) cardiology.” 

The study - CVLPRIT (Complete Versus culprit-Lesion only PRimary PCI Trial) is an open-label, prospective, randomised, multicentre trial. STEMI patients undergo verbal "assent" on presentation. Patients are included when angiographic MVD has been detected, and randomised to culprit (IRA)-only PCI (n=150) or in-patient complete multivessel PCI (n=150).

Impact on Practice  - Dr Kelly has said “you can see a clear result favouring complete multi-vessel revascularization following ST-segment-elevation myocardial infarction (STEMI) (consistent with the recent PRAMI trial) which may influence the 2015 ESC update guidance on STEMI management.” 

You can access the full study publication at: www.ncbi.nlm.nih.gov/pubmed/23425543

On June 17th at the 31st Annual Meeting of the European Society for Human Reproduction and Embryology (ESHRE) in Portugal, Mr Saad Amer, Consultant in Obstetrics & Gynaecology, presented the results of a study entitled Clomiphene Citrate vs Letrozole (CLET).  The trial was designed to determine whether treatment with letrozole improved pregnancy rates in women with Polycystic Ovarian Syndrome (PCOS) compared to clomiphene citrate treatment.

 Lead Investigator, Mr Amer and his research team at Derby Teaching Hospitals NHS Foundation Trust, randomised 159 anovulatory women with PCOS according to the Rotterdam criteria. Baseline clinical characteristics across the treatment groups were similar. 

Summary of study

Treatments were initiated as 1 tablet of letrozole 2.5 mg (n = 80) or clomiphene citrate 50 mg (n = 79), with response measured according to ovulation by follicle tracking and midluteal phase progesterone. Treatment was continued for responders until pregnancy or up to 6 cycles, followed by crossover to the other treatment after a 6-week treatment-free break.

 For nonresponders, the dose was doubled, and if these women continued as nonresponders, they were crossed over to the other treatment after a 6-week break. The study terminated at pregnancy or after the second treatment.

Impact on Practice - The results showed that letrozole as the primary treatment promoted significant increase in pregnancy rates and higher ovulation compared to clomiphene, although pregnancy outcomes were not significantly different across the treatment groups.  The benefit of letrozole remained even when it was a secondary treatment following crossover.

Mr Amer said “We now have compelling evidence that letrozole is superior to clomiphene citrate, and should be seriously considered as first choice for ovulation induction.”   Mr Amer has also commended the research team at Derby and thanked them for their valuable contribution.

✸✸ Based on this study, Derby Teaching Hospitals NHS Foundation Trust now uses letrozole as first choice for ovulation induction instead of clomiphene citrate  ✸✸

 

CLET Protocol

For full article go to www.firstwordpharma.com/node/1293069?tsid=28&region_id=5#axzz3dyOVUKDw

In this page you will find the current and previous issues of the R&D Newsletter.  

If you would like your research story or experience to be included in the R&D Newsletter please email it to dhft.RandDadmin@nhs.net.

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