COX-2 Inhibitors And The Development Of Unstable Angina And Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$171,450.00
Summary
Anti-inflammatory drugs (sometimes called NSAIDs) are widely used in the treatment of arthritis and also as general purpose pain killers. Up to 10 million prescriptions are written each year for these drugs in Australia. Some of the older versions of these drugs like ibuprofen (eg Brufen) and naproxen (trade name Naproxen) cause side effects which can be serious. Damage to the stomach is a particular problem and this can lead to serious bleeding or perforation of ulcers. Less well recognized are ....Anti-inflammatory drugs (sometimes called NSAIDs) are widely used in the treatment of arthritis and also as general purpose pain killers. Up to 10 million prescriptions are written each year for these drugs in Australia. Some of the older versions of these drugs like ibuprofen (eg Brufen) and naproxen (trade name Naproxen) cause side effects which can be serious. Damage to the stomach is a particular problem and this can lead to serious bleeding or perforation of ulcers. Less well recognized are the adverse effects of these drugs on the heart and the kidneys. The older fashioned members of this class of drug are rapidly being replaced by newer agents known as COX-2 inhibitors. Popular examples in Australia are celecoxib (trade name Celebrex) and rofecoxib (trade name Vioxx). These drugs are heavily promoted as being safer than the older NSAIDs. In the case of the stomach, this claim seems to be correct. However, the effects of the new COX-2 inhibitors on the circulation have not been fully assessed. Recently, claims have been made that these drugs may increase the risk of heart attacks. If this were true, it would be an effect that was unique to COX-2 inhibitors as it has not been reported with the older NSAIDs. We plan to carry out a 3 year study in Newcastle hospitals in which we compare the use of COX-2 inhibitors in a group of patients admitted to hospital with a heart attack or unstable angina with that of a control group of patients who were admitted to hospital around the same time, but not for heart problems. We are interested in whether COX-2 inhibitors are associated with an increased risk of heart attacks and whether use of small doses of aspirin protects against this effect. Depending on the results we may be able to improve the safety of these drugs in patients at risk of heart attacks.Read moreRead less
Pathophysiology And Alternative Preventative Strategy For Breast Cancer Chemotherapy-induced Bone Loss
Funder
National Health and Medical Research Council
Funding Amount
$540,356.00
Summary
Combination cytotoxic chemotherapy is the current optimal approach for treating breast cancer in premenopausal women. However, long-term skeletal defects (osteoporosis and fractures) caused by the chemotherapy have become an increasingly serious problem due to its intensified use and improved patient survival rate. This project seeks to elucidate the mechanisms for chemotherapy-induced bone defects and to initiate development of a preventative treatment using natural bioactive micronutrients.
Five Year Outcomes Of Care For Prostate Cancer In New South Wales
Funder
National Health and Medical Research Council
Funding Amount
$388,773.00
Summary
Prostate cancer is the most common cancer in Australian males after non-melanocytic skin cancer. Each year more than 10,000 men are diagnosed with prostate cancer, and over 2,500 die from it. While the issue of early detection of prostate cancer through the use of Prostate Specific Antigen test continues to raise debate, the longer term quality of life outcomes after treatment for this disease remain of great interest to patients, clinicians and health planners. The Prostate Cancer Outcomes Stud ....Prostate cancer is the most common cancer in Australian males after non-melanocytic skin cancer. Each year more than 10,000 men are diagnosed with prostate cancer, and over 2,500 die from it. While the issue of early detection of prostate cancer through the use of Prostate Specific Antigen test continues to raise debate, the longer term quality of life outcomes after treatment for this disease remain of great interest to patients, clinicians and health planners. The Prostate Cancer Outcomes Study is an already established research project that was established in 2000 with the aim of documenting the quality of life outcomes of 2000 men with prostate cancer to five years after diagnosis. The Department of Veterans Affairs funded the study between 2000 and 2005, to establish the cohort, collect patterns of care information from clinicians and quality of life information from participants to 3 years post diagnosis. We are now seeking funds to complete the quality of life follow up for each surviving participant at five years after diagnosis. We also will assess rate of recurrence of prostate cancer to five years and seek support to be able to undertake linkage with death certificate information to determine the vital status of each study subject and begin analysis of five-year survival rates. Five-year quality of life information will be the main endpoint for this part of the study. Initial analysis of the three-year data showed a continued improvement in outcomes related to urinary and sexual function. We wish to determine whether these improvements continue to five years and the extent of the difference, at that time, between men with prostate cancer and men without prostate cancer (controls), whom we are also studying. This information will be uniquely useful in helping men make decisions about treatment options when diagnosed with prostate cancer.Read moreRead less
Measuring Adverse Events: Development Of A Patient-Centred Adverse Event Reporting Tool (PAET)
Funder
National Health and Medical Research Council
Funding Amount
$454,721.00
Summary
The decision to treat a patient depends on knowing whether the treatment does more good than harm. If it is likely that the treatment will work as well as or better than other treatments and will have minimal associated risks, then that treatment would be recommended unless unavailable or prohibited by cost. Given two equally effective treatments the one with fewer side effects and greater tolerability would be preferred by all. In the process of acquiring knowledge on treatment benefit and trea ....The decision to treat a patient depends on knowing whether the treatment does more good than harm. If it is likely that the treatment will work as well as or better than other treatments and will have minimal associated risks, then that treatment would be recommended unless unavailable or prohibited by cost. Given two equally effective treatments the one with fewer side effects and greater tolerability would be preferred by all. In the process of acquiring knowledge on treatment benefit and treatment harm we rely on evidence from clinical trials. However, the evaluation of benefit versus harm is not symmetric in this setting. Much more effort (e.g. study design, study power, standardisation of efficacy outcome measures) goes into the assessment of whether a treatment works and rather than its potential harm, as measured by adverse events. Adverse event ascertainment and reporting is poorly standardised . There is no standardised measurement process that elicits adverse event information. There is no standardised method for quantifying adverse event information into an index or profile scores equivalent to instruments developed to measure health status, quality of life and other benefits of treatment. Developing astandardised Patient-centred Adverse Event Questionnaire will benefit multiple stakeholders. For Patients: An easy to understand summary measure of treatment harm aids patient understanding of the benefit versus risk. For Doctors, allied health professionals: The Questionnaire includes drug profiles, to align a drug profile with an individual patient's clinical profile. This leads to better patient care. In health policy: All of the above has flow-on effects for policy. Better adverse event data will facilitate information and understanding generally of risks of treatments, risk-benefits of treatments, and cost-effectiveness of management strategies.Read moreRead less
TIR Signalling Pathway Pharmacogenomics And Opioid Response: Beyond The Mu Opioid Receptor
Funder
National Health and Medical Research Council
Funding Amount
$246,396.00
Summary
This project will identify why some people respond poorly and others have toxic side effects to the major group of pain relieving medications, the opioids. The basis will be the genetics of the immune system and both acute postoperative and chronic cancer pain patients will be studied in this international pharmacogenetics project.
Pharmacodynamics In Liver Disease And In Liver Surgery
Funder
National Health and Medical Research Council
Funding Amount
$899,646.00
Summary
The liver is the main organ in the body for drug metabolism and detoxification. This work seeks to address the poorly understood question: what is the in vivo disposition and response in liver of the drugs for treatment of liver diseases? The results of this work will help us better design new drugs and choose the most effective drugs for liver disease. The research may also help us find a better strategy for liver transplantation and thus improve success rates.
Treatment Of Bacterial Vaginosis: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$265,757.00
Summary
The objective of this research project is to determine if the treatment of Bacterial Vaginosis (BV) can be improved. Bacterial vaginosis is one of the most common causes of vaginal discharge in women. It can also have serious consequences, such as premature labour and can also increase the risk of HIV transmission. These complication cost communities many millions of dollars; for example in the US it is estimated that premature labour caused by BV alone costs about 1 billion dollars a year. The ....The objective of this research project is to determine if the treatment of Bacterial Vaginosis (BV) can be improved. Bacterial vaginosis is one of the most common causes of vaginal discharge in women. It can also have serious consequences, such as premature labour and can also increase the risk of HIV transmission. These complication cost communities many millions of dollars; for example in the US it is estimated that premature labour caused by BV alone costs about 1 billion dollars a year. The currently recommended treatment for BV works well initially (first month about 80% respond) but by 12 months most (60%) have relapsed. This randomised clinical study is investigating new ways to treat BV. The currently recommended arm of treatment (antibiotic metronidazole) is being compared to two other treatments. The second arm of the study involves the use of two antibiotics at once (metronidazole and clindamycin) and the third arm involves the use of a bacterial (lactobacilli) and oestrogen. Lactobacilli are bacteria that may help maintain the normal bacterial (and there by prevent relapse of BV) and oestrogen may have a similar effect. If either of these treatments improved the longer term treatment of BV, very significant benefits would flow to affected women and the community as a whole.Read moreRead less
Clinical Pharmacology Of Methadone During Induction Onto Maintenance Treatment.
Funder
National Health and Medical Research Council
Funding Amount
$422,310.00
Summary
Heroin addiction can be very successfully treated by substituting heroin with methadone. The transition of stopping heroin and starting methadone is risky and can be associated with death. This application seeks to explore the mechanisms of the increased risk during this transition period so that appropriate management strategies might be instituted.