Plasma Exchange And Glucocorticoids In ANCA Associated Vasculitis: A Randomised Controlled Trial (PEXIVAS Australia)
Funder
National Health and Medical Research Council
Funding Amount
$635,243.00
Summary
Vasculitis is a life-threatening disease, and the current treatment for this condition is not satisfactory. This clinical trial aims to determine 1) if plasma exchange can lower mortality and the development of severe kidney failure due to this disease, and 2) if the use of lower doses of corticosteroids can lessen the infectious complications of treatment. This trial is part of a major international effort which will involve a total of 500 patients from Australia, UK, Europe, USA and NZ.
VITATOPS - A Randomised Controlled Trial Of Vitamins To Prevent Stroke
Funder
National Health and Medical Research Council
Funding Amount
$391,364.00
Summary
A high level of a normal protein component in the blood (homocysteine) is fast becoming recognised as a new risk factor for premature stroke and heart disease, although it remains uncertain whether treatment with vitamins can prevent these diseases from occurring. VITATOPS is a multi-centre, double-blind, placebo-controlled trial designed to examine the efficacy and safety of multi-vitamin therapy (folate, B6 and B12) in the prevention of stroke and other types of vascular disease. The VITATOPS ....A high level of a normal protein component in the blood (homocysteine) is fast becoming recognised as a new risk factor for premature stroke and heart disease, although it remains uncertain whether treatment with vitamins can prevent these diseases from occurring. VITATOPS is a multi-centre, double-blind, placebo-controlled trial designed to examine the efficacy and safety of multi-vitamin therapy (folate, B6 and B12) in the prevention of stroke and other types of vascular disease. The VITATOPS study arises from a large body of consistent, biologically plausible evidence linking homocysteine in a dose-dependent fashion to stroke and other types of vascular disease. A simple, non-toxic, and inexpensive intervention in the form of multivitamins (folate, B6 and B12) has been shown to be highly effective at reducing homocysteine levels, irrespective of the underlying cause. All patients who are referred to a neurologist or general physician in one of the collaborating centres within six months of a stroke or transient ischaemic attack are eligible for the trial. In total, treatment will continue for a period of between 1 and 5 years. During this time, patients will be closely monitored in order to record the occurrence of any vascular events (particularly strokes and heart attacks). Neither the study investigator nor the patient will know which treatment they are receiving (i.e. it is 'double blind'). The number of vascular events in the treatment groups will be compared at the end of the study in order to determine whether vitamin treatment is beneficial. This application is for five years of support to allow the investigators to move from the pilot phase of VITATOPS in Perth to begin recruitment to the definitive trial in other centres across Australia and New Zealand. This study may have a major impact on patient management. If vitamins prove to be effective, we may recommend vitamin supplementation to all of our stroke patients in the future.Read moreRead less
Enhancing Efficacy Of Cognitive Behavioural Treatment For Children With Anxiety Disorders: Treating Parent Anxiety.
Funder
National Health and Medical Research Council
Funding Amount
$377,961.00
Summary
Much attention is focused on childhood problems such as attention-deficit, depression and substance abuse. However, the most prevalent psychological problem experienced in childhood is anxiety. There is even some evidence to suggest that anxiety may lead to later problems such as depression or substance abuse. We know that anxiety disorders are a widespread problem in our youth. We also know that anxiety, if left untreated, will persist through the child's life and cause significant disruption t ....Much attention is focused on childhood problems such as attention-deficit, depression and substance abuse. However, the most prevalent psychological problem experienced in childhood is anxiety. There is even some evidence to suggest that anxiety may lead to later problems such as depression or substance abuse. We know that anxiety disorders are a widespread problem in our youth. We also know that anxiety, if left untreated, will persist through the child's life and cause significant disruption to their life. The good news is that there has been an increased interest in these disorders and as a result treatments that work have been developed. However, a recent review of the best psychological treatments for anxiety in children showed that on average studies are reporting remission rates of only 56.5%. Clearly we need to develop more effective treatments for anxious children. One possible approach to improve outcomes for children with anxiety is to provide additional treatment for the parents. We know that anxiety runs in families: anxious children are more likely than non-anxious children to have anxious parents. A number of theories have suggested that parental anxiety plays an important role in the development of anxiety in children: An anxious parent may model anxious behaviour, encourage avoidance of anxious situations and reinforce anxious behaviour in their child. The results of this study will determine whether it is possible to improve the efficacy of treatments for anxiety in children by addressing anxiety in their parents. If the data show no additional benefit of the modified treatment, therapists can be more efficient in their treatment of anxious children by ignoring the parent's own anxiety. However, if as expected the modified treatment proves to be more efficacious, then we will have identified an important strategy to increase the efficacy of intervention for this highly prevalent and debilitating childhood problem.Read moreRead less
Randomised Trial To Determine The Safety And Efficacy Of Early Versus Deferred Treatment Of Adult HIV Infection
Funder
National Health and Medical Research Council
Funding Amount
$417,254.00
Summary
The purpose of this randomised study is to determine whether the use of combination antiviral drugs during early stages of HIV disease is superior to later use in adults with HIV infection. Superiority is defined in terms of reducing the number of serious diseases and deaths that are associated with HIV infection.
Neural Changes Associated With Symptom Improvement In Posttraumatic Stress Disorder Following Exposure Treatment
Funder
National Health and Medical Research Council
Funding Amount
$223,855.00
Summary
Posttraumatic stress disorder (PTSD) is a chronic disorder with enormous psychological, social and economic consequences that affects approximately 10-15% of Australians. Recent international research is focused on identifying mechanisms underlying effective treatments of PTSD, in an attempt to understand both the processes that maintain PTSD, and to help target more precise interventions to prevent chronic PTSD, a disabling condition that creates an enormous economic burden on health and compen ....Posttraumatic stress disorder (PTSD) is a chronic disorder with enormous psychological, social and economic consequences that affects approximately 10-15% of Australians. Recent international research is focused on identifying mechanisms underlying effective treatments of PTSD, in an attempt to understand both the processes that maintain PTSD, and to help target more precise interventions to prevent chronic PTSD, a disabling condition that creates an enormous economic burden on health and compensation systems. This project will be the first study to identify the neural mechanisms underlying effective exposure-based treatment of PTSD. Exposure-based treatments are the current treatments of choice for PTSD, with several studies showing them to be highly effective in treating PTSD. Yet, the mechanisms and agents of change underlying this effective treatment remain unknown. Exploring the neural networks associated with effective treatment and symptom change will help identify and elucidate the mechanisms underlying exposure treatment. This has critical clinical implications, enabling insight into biological mechanisms underlying PTSD, more precise identification of populations that are less responsive to standard exposure-based treatments, and eventually will lead to better targeted and more effective treatment of chronic PTSD.Read moreRead less