$5.7m for clinical trials

Three UNSW Sydney projects have been awarded funding under the government’s Medical Research Future Fund’s clinical trials activity initiative.

UNSW Sydney researchers have been awarded more than $5.7 million under the Australian government’s Medical Research Future Fund (MRFF) clinical trials activity initiative, with projects spanning spinal cord injury, stroke, and diabetic ketoacidosis.

Interim Dean of UNSW Medicine & Health Professor Adrienne Torda congratulated the UNSW researchers who received funding. 

“These grants will help UNSW researchers and our partners improve the quality of life and health outcomes for many. I am so proud the teams who were successful in this round of funding and look forward to supporting their studies,” Prof. Torda said. 

Reducing spinal cord injury pain 

UNSW Professor Sylvia Gustin from UNSW Science and NeuRA was awarded $2.22 million for a randomised placebo-controlled trial to investigate the efficacy of an interactive brain-computer interface neuromodulation treatment combined with transcranial direct current stimulation for people with spinal cord injury neuropathic pain. 

The team of Prof. Gustin will conduct a randomised clinical trial to examine the efficacy and mechanisms of an advanced interactive Brain-Computer Interface Neuromodulation (BCI-N) treatment combined with transcranial direct current stimulation (tDCS). The study has the potential to inform patient care across the spectrum of initial hospitalisation to home-based self-management.

“Given the deleterious impact of spinal cord injury neuropathic pain on the quality of life and the easy translation of our novel brain-technology intervention into accessible home use, the results of this clinical trial are expected to provide a sustainable advance in spinal cord injury pain management,” Prof. Gustin said.  

Improving outcomes for people with a debilitating form of stroke

Professor Jeremy Cohen from The George Institute for Global Health and UNSW Medicine & Health has received $1.9 million for a project that aims to improve the outcomes for younger people with a debilitating form of stroke, subarachnoid haemorrhage.

“A subarachnoid haemorrhage is a devastating type of stroke affecting around 2000 Australians a year, a third of whom will die from the condition with the remainder at risk of permanent disability. Up to 40 per cent of this often young and previously fit population are unable to return to their previous occupation,” Prof. Cohen said.

A common complication in this type of stroke is low blood levels of sodium (or hyponatremia) which occurs in up to two thirds of hospitalised patients. Hyponatremia is associated with a twofold increase in duration of hospital and ICU stay in these patients.

Previous work by Dr Jeremy Cohen, Director of the Wesley Hospital Intensive Care Unit and Honorary Professorial Fellow at The George Institute, confirmed that hyponatraemia during ICU admission is also significantly associated with worse levels of disability six months later.

This study will investigate if fludrocortisone, a low cost and well-established corticosteroid that regulates salt and water balance in the body, can prevent this fall in sodium and therefore improve outcomes in these patients.

Fluid therapy for diabetic ketoacidosis

Professor Mahesh Ramanan from The George Institute for Global Health and UNSW Medicine & Health has received $1.6 million for a fluid therapy trial for patients presenting with diabetic ketoacidosis.

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes in which the body produces excess blood acids known as ketones. It occurs when there isn't enough insulin in the body and can be triggered by infection or other illness.

Fluid therapy is a vital component of the treatment of DKA, but which fluid provides the best outcomes is unknown. Saline is widely recommended in national and international guidelines despite a lack of high-quality evidence to support its use. It can lead to complications associated with worse outcomes in critically ill patients.

An alternative fluid, Plasma-Lyte 148 – a balanced salt solution that more closely matches the biochemistry of human blood – has theoretical advantages over saline and is recommended in some DKA guidelines.

“It is hoped that the results will provide definitive guidance on the best choice of fluid therapy in DKA and reduce healthcare costs by reducing the time patients need to spend in ICU and hospital,” Prof. Ramanan said.