Thank you to Northside Living News for profiling an exciting clinical trial to prevent knee osteoarthritis.
Our researchers at the Kolling Institute are now recruiting to the large-scale trial which will offer long-term support to lose weight and avoid knee osteoarthritis all together.
If you would like to know more about the trial and to sign up, click here:
To read about the details in Northside Living News:
A federal government funding boost will pave the way for a much-needed, tailored program for culturally diverse communities experiencing musculoskeletal pain.
Dr Saurab Sharma, the Chief Clinical Scientist from the Pain Management and Research Centre at Royal North Shore Hospital, has received a National Health and Medical Research Council investigator grant to progress his research and develop an innovative treatment plan.
Investigator grants are awarded to only a small number of leading scientists in Australia each year to advance health research.
As a researcher within the Kolling Institute, Dr Sharma said a specific, co-designed program is needed as culturally and linguistically diverse Australians often miss out on high quality care due to cultural, language, and health literacy barriers.
“These communities are often excluded from research including clinical trials, which means evidence-based treatments are designed without their input or experiences,” he said.
“Ultimately, this means Australians from diverse backgrounds receive poor care and experience poorer outcomes compared to other Australians.”
The $700,000 grant will support the development of a digital, pain-management treatment program for communities from Arabic, Chinese, Indian, Nepali, and Vietnamese backgrounds with musculoskeletal pain.
“Importantly, the program will be co-designed with individuals with lived experiences of musculoskeletal pain, healthcare professionals from respective cultural backgrounds, and world-leading musculoskeletal pain experts,” he said.
“Our initiative aims to empower marginalised and disadvantaged communities, build research capacity within these communities, and foster a greater understanding of pain among community members and healthcare professionals to transform pain management for these vulnerable communities.
“Encouragingly, our program could be adopted on a global scale as it will be tailored for Arabic, Cantonese, Hindi, Mandarin, Nepali, and Vietnamese languages, which are spoken by over 2.2 billion people globally.
“A cultural and linguistic adaptation of the educational resources could benefit approximately a quarter of the world’s population.
“We hope the pain management program will enhance health equity, reduce costs and inform national and international guidelines on musculoskeletal pain.”
An innovative tool which could revolutionise the detection and treatment of musculoskeletal and neurological conditions will be further developed following a $230,000 gift.
The donation was made following a campaign by the University of Sydney’s Advancement team and the NORTH Foundation to support the world’s first open-source dataset of whole-body muscle composition.
The Kolling Institute’s Academic Director Professor James Elliott said there is a critical need for the diagnostic tool with musculoskeletal and neurological conditions among the leading causes of illness and disability worldwide.
“With these conditions affecting more than four billion people, they are expected to cost around $21 billion in healthcare expenditure by 2033 in Australia alone,” he said.
“Early identification and intervention are crucial if we are to offer long-term health benefits and minimise the disease burden.
“We know that these conditions often lead to a steady decline in muscle health, and this decline is evident by an increase in fat deposits in the muscles and the loss of muscle fibres.
“CT and MRI scans can be used to identify these changes, but the time it currently takes is prohibitive.
The MuscleMap tool however, will automatically identify any changes, potentially revolutionising the detection of muscle health in any part of the body. It could inform treatment for everyone from elite athletes to astronauts and older people with complex conditions.
Astronauts for instance, experience significant muscle loss due to the effects of prolonged exposure to zero gravity.
Using existing MRI and CT scans, the landmark global study has applied an artificial intelligence model to produce a dataset of muscle health of any part of the body. This will enable a patient’s muscle deterioration to be compared with a healthy person’s.
Professor Elliott said this will mean a clinician will be able to upload a scan into the MuscleMap program, and within minutes, will have access to detailed information measuring muscle composition compared to a reference dataset.
“For athletes and the general population, the tool will accurately inform the journey from injury to repair, recovery and return to physical activity.
“For patients with osteoporosis, the program will provide a detailed analysis of overall health and muscle deterioration, which will then inform personalised strategies to develop healthier muscle mass and improve general health and wellbeing.
“We are very appreciative of this generous donation to the MuscleMap project. It will enable the broader team to continue developing the digital infrastructure needed to launch the open-source portal.
“It will be a pioneering resource, accessible to clinicians and researchers globally, and supporting the long-term health of communities.”
To donate to the innovative MuscleMap project visit the NORTH Foundation.
If you’re looking for the best advice for osteoarthritis care, have a listen to one of our leading clinicians and Kolling Institute researchers Professor David Hunter as he highlights the most effective treatment approaches and the low-value ones to avoid.
The burble of high-powered motorcycles was heard across the Kolling Institute forecourt as part of a 2000 kilometre ride from Melbourne to Armidale to raise awareness and funds for life-changing research.
The ride is an initiative of Robert Hunt from the Ulysses Club which has been supporting rheumatoid arthritis research for nearly three decades.
The late Stephen Dearnley established the club in 1983. His wife Jo had lived with the debilitating disease for more than 20 years. Today, the club has more than 120 branches.
The Ulysses Club has donated funds to the Kolling Institute for over 15 years, consistently investing in our discovery and translational research into rheumatoid arthritis.
Leading rheumatologist Professor Lyn March said the club has been a long-time supporter of the Sutton Arthritis Lab and we’re tremendously grateful that this ride is drawing attention to the condition and raising funds.
“Rheumatoid arthritis is a chronic condition that affects over 500,000 Australians,” she said.
“It causes pain, swelling, and inflammation in the joints as the immune system mistakenly attacks the tissues lining the joints.
“It can be a life limiting illness, causing pain, reducing function and mobility.”
As a leading clinician and internationally respected researcher, Professor March said while many people manage well on current medications, improved options are needed.
“Game changing steps take significant investment and expertise, and we’re indebted to the Ulysses Club members for embarking on this ride and fostering large-scale community support.”
The Ride for Rheumatoid journey will wrap up in Armidale, where a national rally will be held.
All funds from the ride will go directly towards rheumatoid arthritis research, including a PhD scholarship at the Kolling Institute.
Professor March encouraged the community to get behind the club.
Head of the Sutton Arthritis Research Lab in the Kolling Associate Professor Meilang Xue expressed her gratitude to the club members.
Donations can be made through: Ride for Rheumatoid to Armidale
For the past 20 years, Professor Sarah Hilmer has dedicated her career to optimising medicine use for older people and has achieved recognition as a national and world leader in geriatric pharmacology.
Not only has the Royal North Shore Hospital clinical pharmacologist and geriatrician set about improving medication practices for older people, but she has long advocated for ‘age-friendly’ clinical trials.
One of Sarah’s notable contributions has been the development of the Drug Burden Index (DBI), a risk assessment tool that measures an older person’s exposure to medications that slow them down physically and mentally.
“Over the past 20 years or so, we have been validating the tool in populations around the world to show that the higher your Drug Burden Index, the worse your physical function and your cognition is, and the more likely you are to fall or wind up in a nursing home,” she says.
Eager to put the initiative into clinical practice, Sarah and her colleagues developed a calculator that could measure a patient’s drug burden. They produced a way to integrate it into a hospital’s electronic medical record so that staff could use it when treating frail, elderly patients.
In 2021 — at the height of the pandemic — Sarah ran a successful pilot study implementing the calculator at Royal North Shore. “We managed to show that we could really improve prescribing,” she says.
For the past 18 months, she and her team have run a clinical trial in three hospitals in Northern Sydney and three on the Central Coast to see if this package of tools can help clinicians to identify patients who are not functioning optimally because of the medication they have been taking and to minimise medication related harm.
The tools are now available for clinical care across the Northern Sydney and Central Coast health districts and are being implemented at other NSW health districts.
Sarah is eager to see the tool as part of routine hospital care.
Nurses regularly have a “huddle” to discuss patient issues, which can include falls or delirium. Her team has been encouraging nurses to look at the Drug Burden Index during a huddle, and if it is high, arrange for a medication review.
“It might be that the medication is causing the falls or confusion,” she says.
Sarah has long advocated for ‘age-friendly’ clinical trials that make it easier for frail, older people to be included.
While the average older person takes up to eight prescription medications, globally, they are often underrepresented in clinical trials.
“We have a situation where we test drugs in healthy, older people or in middle aged people, and then use them in frail, older people with a lot of different complex problems. We wind up with all sorts of interactions and unexpected effects.”
“I think it’s really important that if we’re going to do clinical trials, we need to make sure that they’re inclusive of the people who are going to actually wind up using the drugs in clinical practice,” she says.
Her advocacy in this space extends beyond Australia. The U.S. Food and Drug Administration recently designed a roadmap for drug evaluation for older adults, and Sarah was the only Australian on the project, representing the Geriatric Committee of International Union of Basic and Clinical Pharmacologists, which she chairs.
Sarah’s work through development and implementation of the Drug Burden Index and her advocacy for age-friendly trials has significantly improved the quality of life for older adults. “We need to ensure our ageing population receives the best possible evidence-based care,” she says.
As a clinical trials program lead at the Kolling Institute, Dr Karen Bracken has long been driven to help researchers conduct trials in the best way possible.
“Researchers are passionate about their disease area and their patients, and they have so many unanswered questions,” she says.
Karen comes from a family of clinicians, and while she didn’t want to practise medicine, she was still drawn to working in the health space. She has spent most of her career working on clinical trials.
She says trials are a multidisciplinary activity that require collaboration between clinicians, statisticians, patients and the trial operations team. She sees her role in operations as the engine that makes the trial run.
Recruiting patients for trials is a complex area, and Karen completed a PhD on the topic after struggling to recruit men for a diabetes study she was working on.
“I really wanted to make that trial a success and I was casting around for ideas on how I could recruit,” she says.
“I realised that everyone was running their recruitment in an evidence-free zone. We often use the kitchen sink method where we brainstorm every single possible thing we can do to recruit participants to our trials and, in the process, waste a lot of time and money.”
Karen says she worked in a more intentional way, testing different strategies to understand why they did or did not work. They were eventually able to fully recruit for the trial.
Karen advises colleagues to properly plan their recruitment.
“Be realistic with yourself about how long it’s going to take and how much money it’s going to cost.”
She also says it’s important to look at similar trials and speak to those who ran them.
“There’s a whole world of people conducting trials, and there’s a lot of evidence out there. People just aren’t in the habit of looking for papers written about how to recruit participants.”
Karen is eager to see greater diversity in trials, which includes recruiting more people who do not have English as their first language, as well as members of the LGBTQIA+ community.
She says she wants everyone to be able to easily join a trial.
“It’s important that we lead change in terms of inclusive health care.”
An exciting partnership between AGRF Ltd (Australian Genome Research Facility) and the University of Sydney and the Kolling Institute will help strengthen genomic capabilities.
The partnership will see a specialised team and cutting-edge technology located within the institute to progress research in this increasingly crucial field.
As Australia’s largest provider of genomic services, AGRF supports researchers and organisations to drive discovery across clinical genomics, translational research, agriculture and environmental science.
AGRF partners with medical and scientific communities to provide world class expertise and high quality genomic data from single-gene analysis to whole genome sequencing and biomarker discovery.
Professor Robyn Ward, Executive Dean and Pro-Vice Chancellor of the Faculty of Medicine and Health at the University of Sydney welcomed the announcement saying there is a growing awareness of the need for genomics in healthcare.
“We are proud to partner with AGRF, and we are looking forward to exploring collaborative research and educational opportunities with this leading genomics provider,” she said.
“By establishing a translational genomics facility within the Kolling Institute, we will be well placed to progress innovative research and directly improve health outcomes.”
AGRF Chairman Professor Simon Foote said he was pleased the partnership had been forged, saying genomics will increasingly help address some of society’s biggest challenges.
“As Australia’s premier provider of genomic solutions, AGRF is delighted to partner with the University of Sydney and the Kolling Institute, where our shared strengths and synergies can advance cutting edge translational research,” he said.
“This collaboration reflects our commitment to enable genomic discoveries to drive innovation, improve lives and build awareness of the transformative potential of genomics.”
Northern Sydney Local Health District Chief Executive Adjunct Professor Anthony Schembri said it was an important step to establish the genomics facility within the institute which is located alongside Royal North Shore Hospital.
“This specialised facility will help speed the translation of genomics research with direct input from leading clinicians and health providers,” he said.
“The partnership will foster discovery science and a pathway to incorporate new knowledge and capabilities into clinical care.
“We are excited to see the advancements in care by bringing together our collective strengths.”
Professor James Elliott, the Kolling Institute’s Academic Director said a collection of our researchers are already working with experts from AGRF.
“We are looking forward to strengthening that relationship and the exciting opportunities and innovations to come from this strategic partnership,” he said.
The Kolling Institute’s Professor Sue Kurrle and her team at the Rehabilitation and Aged Care Network at Hornsby Ku-ring-gai Hospital have been running clinical trials for 25 years, looking at dementia, frailty, and falls to name just some areas.
“We do trials as it keeps you cutting edge and they are really important for our patients,” she says.
As a geriatrician on the frontline, Sue is well positioned to identify the critical areas that need attention.
“You want to do the research that helps answer some of the questions that your clinical practice throws up,” she says.
Falls research
Sue says one of the most impactful trials she participated in was during her PhD research on hip protectors for older people.
Her study found that the underwear with built-in plastic “shields” stopped people from breaking or fracturing their hips when they fell.
“I got involved in hip protectors because we were looking after so many hip fracture patients in our rehab ward at Hornsby,” she says.
“It was the same with dementia and with frailty. Everything we’ve done in research has been driven by what you see in clinical practice.”
Dementia
With an ageing population in the area, Sue and the team have had a long interest in dementia.
Since 1999, they have run 56 trials for dementia drugs, some of which are part of global studies. Although most haven’t been especially successful, Sue says a recent tablet is promising, with the results soon to be published.
“The biggest message is that exercise is much more effective than medication in slowing the decline once you have dementia, or in delaying its onset. It’s one of the 12 modifiable risk factors,” she explains.
In 2012, the NHMRC awarded her $25 million for the Cognitive Decline Partnership Centre, which funded 32 projects across the country which looked at care for people with dementia.
“We developed the clinical practice guidelines for management of dementia, which were the first ones ever done in Australia,” she says.
Frailty
The frailty intervention trial (2011 to 2013) involved 241 frail Hornsby residents. One group received exercise and nutrition interventions, while other received normal care. The experimental group saw numerous benefits.
“We turned frailty around,” she says, adding that the research is now being implemented in hospitals throughout Northern Sydney, with another frailty study soon to be published.
Clinical trials can last up to five years, and older patients often bring a relative along. Sue and her colleagues, including clinical trials research coordinator Roseanne Hogarth and clinical nurse specialist Bronwyn Cook have developed close relationships, knowing their families, pets, and even sharing coffee outings.
“They are like family,” says Sue. “The advantage of working in a smaller hospital is we really get to know our patients.”
Our Kolling Institute newsletter brings together a collection of profiles on our impressive researchers. Flip through our flipping book to discover more about our leading research into kidney disease, rare cancers and the use of supplements for osteoarthritis. There’s a focus too on the first steps towards gene therapy for Meniere’s disease, the latest research into treatments for dementia and an innovative program taking musculoskeletal care to the bush.
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