Impact: Health and welfare and public healthcare policy;
demonstrating that community-directed treatment of onchocerciasis with
doxycycline is effective where ivermectin is contra-indicated.
Significance: 12,936 onchocerciasis patients were treated safely
and protected for at least 4 years. The treatment regime has been adopted
by the US Centers for Disease Control and Prevention, the World Health
Organization and governments.
Beneficiaries: Patients with onchocerciasis; governments and
Attribution: Studies performed by a long-standing African-European
partnership formed and led by Taylor (UoE).
Reach: International; up to 8 million people in the Congo basin;
onchocerciasis patients in Africa where ivermectin is not appropriate plus
those in South America participating in focal eradication campaigns.
Sustained research by the University of Oxford's Mahidol Oxford Tropical
Medicine Research Unit in Thailand (MORU) has been the driving force
behind the current World Health Organization recommendations for the
management of acute and chronic infection in patients with melioidosis.
This research has motivated improvements in treatments and provided new
strategies to identify at-risk populations, enabling clinicians to make
early diagnoses. Melioidosis is a major cause of severe illness in parts
of Southeast Asia and there are increasing numbers of cases in India,
China, and Brazil.
Trachoma, caused by ocular infection with Chlamydia trachomatis,
is the leading infectious cause of blindness. Research by Professors David
Mabey and Robin Bailey, LSHTM, has shown that a single oral dose of
azithromycin is an effective, feasible mass treatment and could eliminate
trachoma from affected communities. As a result, the manufacturer Pfizer
agreed to donate azithromycin to trachoma control programmes for as long
as necessary and WHO established an Alliance for the Global Elimination of
Blinding Trachoma by 2020. Since 2008, 205m azithromycin doses have been
donated, and WHO elimination targets have been achieved in nine countries.
COPD affects up to 3.5 million people in the UK and costs the NHS £700m
pa. Over the last 15 years, research by Professor Calverley and colleagues
at the University of Liverpool (UoL) has impacted significantly on the
care of COPD patients. Specifically, this group showed that routine
testing of COPD patients for the presence of bronchodilator reversibility
was unreliable and did not predict clinical outcomes. This changed
international guideline recommendations in 2007 and the Quality Outcomes
Framework payments to GPs in 2009. They showed that oral corticosteroids
accelerated recovery from exacerbations and that anti-inflammatory drugs,
whether inhaled corticosteroids or PDEIV inhibitors, reduced exacerbations
by 25% with a subsequent fall in the number and length of
hospitalisations. This led to changed NICE guidance for corticosteroids in
2010 and drug registration with EMA and FDA for the PDEIV inhibitor
treatment in 2011. Treatment in UK and Western Europe has changed as a
result of this research.
A research collaboration between LSE and Brunel University has
demonstrated that large-scale programmes to control Neglected Tropical
Diseases (NTDs) through Mass Drug Administration (MDA) can be ineffective,
primarily because of flawed assumptions about local realities in
developing countries. The research findings have helped shift the terms of
debate and consolidate pressure for existing strategies to be revised.
They have been discussed in the UK Parliament, the biomedical literature,
and the news media. In addition, detailed fieldwork has facilitated
treatment for specific groups of people in Tanzania and Uganda who would
otherwise have been overlooked.
Research led by University of Oxford scientists has resulted in
widespread use of the humanised therapeutic antibody, Campath
(alemtuzumab), in patients with chronic lymphocytic leukaemia (CLL).
Licensed by both the European and American regulatory authorities in 2004
for the treatment of CLL, Campath is used as first-line treatment for
patients with aggressive forms of the disease and following relapse. It
can induce long-term clinical remission even in cases resistant to other
drugs. Campath has now been used in approximately 15,000 patients, and has
generated revenues of approximately £750 million from the licensed
treatment of CLL.
Psoriatic arthritis (PsA) is a chronic inflammatory disease of joints,
skin and tendons that affects 0.5-0.8% of the population worldwide. PsA
can cause substantial psychological and social problems and also causes
increased risk of death from cardiovascular disease. Research conducted by
Prof Iain McInnes at the University of Glasgow in partnership with leading
pharmaceutical company, Janssen, has provided robust evidence of the
clinical benefits and safety of the cytokine blocker ustekinumab, leading
to its approval for use for PsA by the European Medicines Agency in July
2013. This was the first approval of a PsA drug with a new mode of action
in a decade, providing a novel treatment for approximately 1.25 million
PsA patients across Europe.
A research collaboration between Brunel University and LSE has demonstrated that large-scale
programmes to control Neglected Tropical Diseases (NTDs) through Mass Drug Administration
(MDA) can be ineffective, primarily because of flawed assumptions about local realities in
developing countries. The research findings have helped shift the terms of debate and consolidate
pressure for existing strategies to be revised. They have been discussed in the UK Parliament, the
biomedical literature, and the news media. In addition, detailed fieldwork has facilitated treatment
for specific groups of people in Tanzania and Uganda who would otherwise have been overlooked.
The epilepsy research group at the University of Liverpool (UoL) has
undertaken a programme of work assessing treatment outcomes associated
with antiepileptic drug treatment in patients with epilepsy. This includes
two large pragmatic trials in patients with first seizures and newly
diagnosed epilepsy, and cohort studies assessing malformations and
cognitive development in children exposed to antiepileptic drugs in utero,
and the work of the Cochrane Epilepsy Group.
This work has influenced prescribing in the UK and worldwide through the
Thyrotoxicosis (over-activity of the thyroid) affects up to 5% of the UK
population and causes excess mortality, especially from vascular diseases,
even in its mildest form. Thyroid cancer is the commonest endocrine
cancer, its treatment being associated with adverse consequences which
need to be minimised. A large programme of thyroid research in Birmingham
led by Prof Jayne Franklyn has made major contributions to improving the
management of thyrotoxicosis, specifically through optimal use of
radioiodine treatment. Her group has developed and delivered a national
training scheme to allow endocrinologists (hormone specialists) to give
this treatment safely and effectively. Radioiodine is also a crucial part
of treatment of thyroid cancer; Franklyn helped deliver a major trial
showing that lower doses are as effective as higher doses in most cases
but with fewer days in hospital and side effects. This research has
changed clinical practice regarding more effective and safe use of
radioiodine in thyrotoxicosis and thyroid cancer. It has been incorporated
in national and international clinical guidance, patient information
sources, and has directly affected clinician training and patient care