Knee osteoarthritis (OA) affects about 30% of Australians over the age of 65, but also at younger ages. It causes joint pain and stiffness, especially on exercise. The cause is unknown but it results in loss of joint cartilage. There are few treatments available to stop the progression, which can finally result in need for an artificial joint. Most treatments such as paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) reduce pain but have no effect on cartilage. NSAIDs can have serious ....Knee osteoarthritis (OA) affects about 30% of Australians over the age of 65, but also at younger ages. It causes joint pain and stiffness, especially on exercise. The cause is unknown but it results in loss of joint cartilage. There are few treatments available to stop the progression, which can finally result in need for an artificial joint. Most treatments such as paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) reduce pain but have no effect on cartilage. NSAIDs can have serious side effects such as stomach ulcers and increased cardiovascular events (such as heart attacks). Fish oil has possible benefits in OA as it decreases pain and inflammation in rheumatoid arthritis (RA, another type of arthritis with joint inflammation and swelling), less use of NSAID in patients with RA, and in laboratory experiments may reduce cartilage breakdown in OA. It is likely that fish oil will have few side effects and decrease blood cholesterol. Many people with OA are already taking fish oil, however, there is no studies to know if it is effective in OA. The aim of this proposal is to study the effect of fish oil on pain and progression of knee OA, by doing a randomised clinical trial. Participants with knee OA will be given either high dose fish oil or similar oil with low levels of fish oil. The study will run for 2 years and during that time, we will measure pain and blood levels of fatty acids (part of the fish oil) and cholesterol. At the beginning and end of the study, magnetic resonance imaging (MRI) of the knee, a knee xray, and bone density testing will be done. The outcomes of the study will be to determine if fish oil affects pain and function (measured by questionnaires) and progression of OA (measured by cartilage changes on MRI). If fish oil is shown to reduce pain and disability and cartilage loss in OA, it will provide Australians with OA an alternative treatment that is low in side effects with positive effects on cardiovascular disease.Read moreRead less
Strategies To Improve Vascular Access Outcomes In Haemodialysis Patients
Funder
National Health and Medical Research Council
Funding Amount
$102,345.00
Summary
This project explores strategies to improve vascular access outcomes in haemodialysis patients. It involves analysis of the FAVOURED (Fish oil and Aspirin in Vascular access OUtcomes in REnal Disease) trial, the largest randomized controlled trial investigating whether fish oil will reduce failure rates of newly created arteriovenous fistulae (a surgically created connection between artery and vein) and a systematic review and meta-analysis on fish oil to prevent vascular access failure.
The Impact Of Polyunsaturated Fatty Acids On Cardiovascular Events In The Endstage Kidney Disease Dialysis Population
Funder
National Health and Medical Research Council
Funding Amount
$1,076,284.00
Summary
Patients with kidney failure who require dialysis are at high risk for cardiovascular (CV) disease. Small studies suggest fish oil supplementation may protect dialysis patients against CV events such as heart attacks and strokes. We will study the impact of fish oil supplementation on reducing CV events in dialysis patients. If proven beneficial, it represents an easily accessible and inexpensive novel therapy to improve the lifespan of dialysis patients.
Postprandial Lipid Metabolism In Familial Hypercholersterolaemia: Mechanisms And Effects Of Omega-3 Fatty Acid Ethyl Esters
Funder
National Health and Medical Research Council
Funding Amount
$616,344.00
Summary
Familial hypercholesterolaemia (FH) is the most common genetic condition known to cause premature coronary heart diseaseis (CHD). The increasd CHD risk in FH may be in part due to accumulation of fat in blood. Fish oil supplementation may be a new target, additional to standard best therapy, for reducing CHD risk in FH. Our results will add value to the science behind and clinical therapy for lipid disorders in FH, and will establish a key role for fish oils.
RCT Of Aspirin And Fish Oil For The Prevention Of Thrombosis In Arterio-venous Fistulae For Dialysis Access
Funder
National Health and Medical Research Council
Funding Amount
$1,869,190.00
Summary
This randomised, placebo-controlled clinical trial aims to determine whether the anti-platelet agents aspirin and fish oil, either alone or in combination, will effectively reduce the risk of early thrombosis (blood clots) in arterio-venous fistulae (AVF) that are used for accessing the circulatory system in dialysis. The trial is to be conducted by the Australasian Kidney Trials Network (AKTN). 1200 patients requiring haemodialysis who are scheduled to undergo creation of an AVF and are not cur ....This randomised, placebo-controlled clinical trial aims to determine whether the anti-platelet agents aspirin and fish oil, either alone or in combination, will effectively reduce the risk of early thrombosis (blood clots) in arterio-venous fistulae (AVF) that are used for accessing the circulatory system in dialysis. The trial is to be conducted by the Australasian Kidney Trials Network (AKTN). 1200 patients requiring haemodialysis who are scheduled to undergo creation of an AVF and are not currently taking anti-platelet agents will be recruited over 3 years. AVF is the accepted standard for haemodialysis patients because it utilises the patient's own artery and vein to allow repeated access to the vascular system with a minimal risk of complications. Failure of the AVF means the use of inferior permanent venous catheters or arterio-venous artificial grafts. These devices are more costly to insert, and have an increased risk of failure due to infection and thrombosis. Reducing this rate of failure by simple, cheap and readily available interventions has the potential to reduce these problems. Aspirin has been chosen because of its well-established anti-thrombosis effects. Fish oil has a number of biological effects which make it an attractive agent for the prevention of vascular access thrombosis. Study treatment will be aspirin 100 mg per day or matching placebo, and fish oil 4 gm daily or matching placebo, both commencing on the day prior to surgery and continued for 3 months. If the trial demonstrates a positive effect of either or both agents, this will lead to a reduction in thromboses, quicker time to working dialysis access, and less need for surgery.Read moreRead less