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Medical Research Institute Of New Zealand Wins Big At Australian Clinical Trials Alliance 2021 Trial Of The Year Awards

The Medical Research Institute of New Zealand (MRINZ) has received extraordinary recognition at the Australian Clinical Trials Alliance (ACTA) 2021 Trial of the Year Awards, announced in Melbourne last night. MRINZ played a senior role in three clinical trials which won five of the seven ACTA Awards, which celebrate the vital place trials have in advancing clinical practice and saving or improving patients' lives every year.

Professor Richard Beasley, director of the MRINZ, says “We are grateful for the opportunity to contribute in a meaningful way to improve the healthcare systems both here in Aotearoa New Zealand and internationally, collaboratively creating tangible change to patient care worldwide.

“As well as addressing the needs of New Zealand’s diverse population, MRINZ research is helping to explore global issues of concern and interest in collaboration with scientists internationally. MRINZ research is hugely respected worldwide, and the Trustees congratulate our team at the MRINZ for these well-deserved ACTA accolades that continue to showcase MRINZ researchers as world-leaders in their field,” says, David Chamberlain, MRINZ Trustee Board Chair. 

The ACTA statistics award and runner up for the ACTA Trial of the Year award were won by the MRINZ-Led PEPTIC STUDY. The Health Research Council of New Zealand (HRC) funded the New Zealand arm of the study, led by Professor Paul Young, and based at the MRINZ Wellington. 

The PEPTIC Study is the largest clinical trial ever completed in the field of intensive care medicine. This trial explored the effect on in-hospital mortality using proton pump inhibitors (PPIs) vs histamine-2 receptor blockers (H2RBs) for stress ulcer prophylaxis among adults requiring invasive mechanical ventilation in the intensive care unit (ICU). The findings of the study, which was conceived and run out of the MRINZ, were consistent with a treatment effect estimate that ranged from no effect to a 10% relative increase in mortality using the PPI strategy. The trial used an innovative cluster crossover registry embedded methodology which Professor Young was instrumental in developing. This methodology, recognised with the ACTA award, allowed the 26,982-participant trial to be completed across five countries with a study budget of under $500,000.

Co-winner of the Trial of the Year was won by PNEUMOTHORAX STUDY. The HRC funded the New Zealand arm of the study, which was run by Dr Kyle Perrin, based at the MRINZ.

This clinical trial explored the optimal way to treat a collapsed lung, pneumothorax. The trial which was undertaken in 39 hospitals across Australia and New Zealand, challenged current practice that an invasive surgical approach was the best treatment of this serious condition. It investigated whether a ‘first do no harm’ approach in which a surgical intervention was only undertaken if the patient became unstable, might be as effective and safer. This randomized controlled trial showed that a ‘watchful waiting’ approach to the treatment of a collapsed lung led to better outcomes and was considerably safer than the traditional invasive surgical approach, leading to fewer days in hospital or off work, lower rates of surgery, and markedly lower risk of serious side effects and pneumothorax recurrence. This study has led to paradigm change in management globally, a change that has both prevented harm and saved money. 

The 2021 ACTA Trial of the Year Commendation, and the Excellence in Statistics Commendation was won by REMAP-CAP STUDY. The MRINZ has played a crucial senior role in the establishment and running of the study through the leadership of Dr Colin McArthur, with funding from the HRC.

The REMAP-CAP [Randomised, Embedded, Multifactorial Adaptive Platform trial for Community-Acquired Pneumonia] trial investigates the effect of potential treatments for critically ill patients with COVID-19. This study showed that both corticosteroids and arthritis drugs tocilizumab and sarilumab reduce the risk of death due to COVID-19 in critically ill patients. REMAP-CAP uses a novel and innovative adaptive trial design to evaluate multiple treatment options simultaneously and efficiently. This design was able to quickly adapt during the COVID-19 pandemic, and increases the likelihood that patients will receive the treatment that is most likely to be effective for them.

"We’re enormously grateful for the continued support of the Health Research Council of New Zealand. Their commitment to our mission-led research has underpinned all of the trials celebrated with these awards,” says Professor Beasley. “Much of our success can be attributed to strong long-lasting partnerships with our clinical colleagues, both across the country and around the world; the dedication of frontline medical and nursing staff; and our remarkable volunteers, without whom, none of these research findings could be possible.”

“The HRC is proud to support these high-impact, high-calibre trials run by the Medical Research Institute of New Zealand,” says Professor Sunny Collings, chief executive of the Health Research Council of New Zealand. “These trials have led to significant improvements in clinical practice and made a difference at the frontline of healthcare.”

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