An Open-label Extension Of A Randomised Clinical Trail Of Intravitreal Triamcinolone For Diabetic Macular Oedema
Funder
National Health and Medical Research Council
Funding Amount
$167,733.00
Summary
A 25 fold increase in the risk of going blind on diagnosis of diabetes is one of the most daunting threats that patients face. Most cases of vision impairment in diabetes are due to macular oedema that persists or recurs after laser treatment. There are now a number of uncontrolled, anecdotal reports that intravitreal triamcinolone (IVTA) is highly effective for the treatment of diabetic macular edema which is refractory to conventional laser treatment. We commenced the first placebo-controlled, ....A 25 fold increase in the risk of going blind on diagnosis of diabetes is one of the most daunting threats that patients face. Most cases of vision impairment in diabetes are due to macular oedema that persists or recurs after laser treatment. There are now a number of uncontrolled, anecdotal reports that intravitreal triamcinolone (IVTA) is highly effective for the treatment of diabetic macular edema which is refractory to conventional laser treatment. We commenced the first placebo-controlled, double masked clinical trial of intravitreal triamcinolone for refractory macular oedema in 2002. The 3 month results from this study provide the first scientific proof of principle that intravitreal triamcinolone reduces macular thickness and improves vision. The two year results will be available in March 2005, but confidential interim analysis of efficacy data in September 2004 suggested that the beneficial effect of triamcinolone treatment persisted. Thus it appears that treatment with intravitreal triamcinolone may be the most significant development for the prevention of blindness in people with diabetes since the introduction of laser treatment. It would also be a highly cost-effective intervention that could be administered by general ophthalmologists. The treatment cannot be recommended for routine use, however, until its long term efficacy and safety have been established. Since we already have a well studied group of patients who have received treatment for 2 years, we are in a unique position to extend the study in order to provide the long-term (5-year) safety and efficacy data that does not appear to be forthcoming from any other source. The results of this study will significantly improve knowledge of long-term outcomes of local high dose steroids for diabetic macular oedema, allowing the treatment to be used more rationally. Thus the study is very likely to directly reduce the risk of blindness in people with diabetes.Read moreRead less
Can Self-management Education Programs Improve Outcomes Of People With Osteoarthritis?
Funder
National Health and Medical Research Council
Funding Amount
$343,874.00
Summary
Arthritis is a very common disease associated with pain, disability and poor quality of life. An important way that people with arthritis can deal with the disease is through using a variety of self-management behaviours and coping strategies as well as becoming well informed about the best available treatments. A specific course was developed in he US to help people self-manage. It has been available in Australia for 20 years through Arthritis Foundations and has become their core business. Tre ....Arthritis is a very common disease associated with pain, disability and poor quality of life. An important way that people with arthritis can deal with the disease is through using a variety of self-management behaviours and coping strategies as well as becoming well informed about the best available treatments. A specific course was developed in he US to help people self-manage. It has been available in Australia for 20 years through Arthritis Foundations and has become their core business. Treatment guidelines used by doctors to treat people with arthritis regularly recommend that patients should be referred to such courses. Although the course is widely distributed, the evidence scientific evidence regarding its effectiveness is patchy, and some overviews suggest it is not useful at all. Confusion exists regarding the value of the course. While treatment guidelines advise doctors to refer patients to the program by very few GPs, Rheumatologist or Orthopaedic surgeons do refer. The proposed study is a large controlled trial which will provide essential evidence to inform patients, doctors and policy makers on the benefits of the course. It will involve people with well defined moderate to severe arthritis who have consulted a surgeon or rheumatologist. People will be randomised to receive the intervention (two hours per week, six session course including an 'arthritis self-help' book) will be compared with people in a control group (who only receive the book without instruction). People will be followed for 1 year to see if the course improves quality of life, health behaviours, and whether less health care resources (ie attendance at doctors or less medication use) are used. The results of this study will be influential in determining government policy as the number of people with chronic diseases like arthritis is rapidly growing and the acute healthcare system, including hospitals, are poorly equipped to deal with this growing problem.Read moreRead less