What research are we doing into Inflammatory Bowel Disease?
Crohn’s Disease (CD) and Ulcerative Colitis (UC), are two main forms of Inflammatory Bowel Disease (IBD). The UK has a prevalence of 1 in 200, affecting more than 300,000 people.
IBD is an autoimmune chronic, disabling, relapsing, systemic inflammatory disease of the digestive tract which greatly impacts on day to day quality of life.
Here is some of the research currently underway in this area:
At Manchester Royal Infirmary (MRI) Consultant Gastroenterologist, Dr Scott Levison, and his team are working in collaboration with Dr Mark Travis Principal Investigator at Manchester Collaborative Centre for Inflammation Research at The University of Manchester, to understand the cellular and molecular pathogenesis of inflammatory bowel disease. This is critical in assessing which patients are at risk, how the disease behaves, and for developing future therapies.
With patient consent, extra biopsy samples are collected whilst undergoing intestinal endoscopy for Dr Travis’ university team to complete this work.
Gastroenterologists Dr Levison and Dr Willert continue to run commercial phase 2 and 3 drug trials in IBD giving patients another treatment choice.
One trial currently running is a phase 2 study using a novel Jak1 inhibitor, which is really benefiting our patients. Patients who had exhausted the current licenced medications and were really struggling with their condition, with surgery being their next option, are now improving and able to complete their normal daily activities. The drug is an oral treatment where many of the current treatments are either intravenous or injections so much easier for patients.
Another study is the Mongersen (an antisense oligodeoxynucleotide) drug, formulated as a gastro-resistant delayed release pH-dependent tablet designed to deliver the active substance in the distal area of the GI tract. This treatment is not intended to achieve systemic absorption, but rather to obtain a local release and therapeutic benefit directly on the intestinal inflammatory lesions. Again thankfully this trail too is helping patients gain disease remission and helping to improve patients’ day to day lives.
We are also involved in observational and registry studies. Some of these are looking at personalising anti-TNF therapy in Crohn’s disease, long term safety of Vedolizumab versus other biological treatments for both Crohn’s and Ulcerative colitis, plus a study reviewing safety and effectiveness of current immunomodulators.
My role as an IBD Clinical Research Nurse
I have worked as a Senior Clinical Research Nurse for the IBD team within Gastroenterology now since Jan 2012. Initially as the only member of the team supporting the PIs, meant I also took on the role of study coordinator. Having been a research nurse at that point for six years, it was good to expand my experience in research gaining a greater understanding and knowledge base of study set-up from feasibility to close.
With the support of a great Research Support Officer in R&D we managed to set-up and recruit to 7 randomized control trials in the space of 6 months, along with managing twelve other studies in our portfolio. Thankfully the NIHR Manchester Clinical Research Facility (CRF) was there to support me with some of the many patient visits.
Being involved with study set-up at the feasibility stage is really beneficial for clinical staff; from required protocol activities we can assess any training needs, help review whether the study is achievable with our patient population and plan recruitment strategies etc. at an early stage.
Since January 2012 to present the IBD research team has run mainly commercial studies, approx. 19 phase 2 and 3 trials and at least 14 observational studies.