Prior to the Astral 3 study, standard treatment for hepatitis C virus genotype 3 consisted of either interferon based therapies (interferon is an injectable drug with numerous side effects, some of which may be long lasting) or a combination of sofosbuvir and ribavirin for 24 weeks. The treatment time for this combination is lengthy and has significant side effects, such as anaemia due to ribavirin and it also has low cure rates.
A new interferon, side-effect free and effective therapy was required to treat patients with hepatitis C virus genotype 3 and the Astral 3 clinical research study addressed this.
STeroids Or Pentoxifylline for Alcoholic Hepatitis (STOPAH) study, funded by the NIHR Health Technology Assessment (HTA) Programme, is investigating steroids or pentoxifylline for alcoholic hepatitis. The study, which has finished recruiting, is the largest Randomised Controlled trial of treatment in alcoholic liver disease ever performed.
In the UK, the mortality rate from alcoholic liver disease is rising rapidly, and so STOPAH is considered as a vitally important study, being more than ten times larger than any previous study in this patient population. 61 UK hospitals recruited for the study which achieved 1100 recruits and it will provide key answers to vital therapeutic questions and alter clinical practice when analysis is complete.
The UK-wide project (UK-PBC), supported by the NIHR Newcastle Biomedical Research Centre, aims at improving our understanding of primary biliary cholangitis (PBC) and its impacts.
The study has recruited 4500 patients establishing the largest research cohort in the world with well characterised patients and a range of clinical parameters. The collaboration with the Sanger centre has moved forward the genetic basis of the disease with publications in Nature Genetics and has led to the further award of a £6 million grant to expand the cohort and undertake further studies in the disease area. This cohort has already produced links to industry with new therapeutics being trialled extensively in the UK.
A MRF (Medical Research Foundation) funded cohort study of hepatitis C patients in the UK. It aims to provide a biobank of 10,000 well characterised patients with appropriate biological samples available for clinical researchers. It has recruited well to time and target with more than 7000 patients currently enrolled. It has already enhanced research on hepatitis C in the UK with the Medical Research Council and industry funding for linked studies (STOP HCV). The study provided key links with industry, bringing to the UK a major Gilead study of their new HCV drug. The UK recruited more than 65% globally for the study enhancing the UK reputation for delivery in commercial studies.
You can find out more about hepatology studies in your area through the Be Part of Research website.
The NIHR Clinical Research Network (CRN) provides researchers with the practical support they need to make clinical studies happen in the NHS. We provide world-class health service infrastructure - research support staff such as clinical research nurses, and research support services such as pharmacy, pathology and radiology - to support organisations seeking to conduct clinical research in the NHS in England. Some of this research is funded by the NIHR, but most of it is funded by NHS non-commercial partners and industry.
We support the set up and delivery of clinical research in the NHS through our Study Support Service and our Research Design Service helps researchers develop proposals to secure funding from our research programmes.
The Hepatology Specialty is one of 30 specialties which bring together communities of clinical practice to provide national networks of research expertise and clinical leadership. It is made up of research-interested clinicians and practitioners who work at both national and local levels to ensure the studies that are included in our national portfolio of research are delivered successfully in the NHS.
The Hepatology Specialty oversees research that deals with the diagnosis and management of patients with diseases of the liver, biliary tree, and pancreas. This means that we support a wide range of research studies such as those involving acute and chronic liver disease, liver fibrosis and cirrhosis, screening and treating viral hepatitis and genetic studies including pharmacogenetics.
Each of our 15 Local Clinical Research Networks has at least one nominated local Clinical Specialty Research Lead for Hepatology. These clinicians lead research groups to promote and support Hepatology research within the NHS Trusts in their area.
At a national level the local leads come together to manage the national Hepatology clinical research portfolio. This involves regularly reviewing the progress of studies, identifying barriers to recruitment, and coming up with solutions and strategies to help overcome those barriers. Our National Specialty Group of clinical experts offer advice and support to commercial and non-commercial customers looking to conduct research in the NHS.
The Hepatology Specialty supports a wide range of research studies which include hepatology specific studies as studies led by other specialties such as cancer, surgery and gastroenterology
The Hepatology Specialty profile gives an overview of our offer to the Life Science industry.
The NIHR Clinical Research Network Hepatology National Specialty Group membership includes representation from The British Society of Gastroenterology (BSG), who we work closely with. The CRN, BSG and BSAL regularly meet to agree research priorities and have worked to align their training research agenda.
The British Society of Gastroenterology (BSG) is an organisation focused on the promotion of gastroenterology within the United Kingdom. It has over three thousand members drawn from the ranks of physicians, surgeons, pathologists, radiologists, scientists, nurses, dieticians, and others interested in the field.
Find out more about the BSG.
The British Association for the Study of the Liver is the National Association for hepatology. BASL is dedicated to advancing knowledge and understanding of the biology and pathology of the liver for the optimal care of patients.It aims to disseminate research findings and clinical expertise and promote opportunities for collaboration in liver research. BASL is composed of interested individuals from clinical medicine, clinical and basic research and allied professions.
Find out about BASL.
The British Liver Trust is the leading UK liver disease charity for adults – we provide information and support; increase awareness of how liver disease can be prevented and promote early diagnosis; fund and champion research and campaign for better services.
Find out about the British Liver Trust.
The Hepatitis C Trust is a key patient group in the field of liver disease. Historically, hepatitis C has been neglected, partly because there has been no concerted patient voice and because it is often wrongly stigmatised as a drug user’s disease. We strive to impact on both the political process and the NHS to ensure that the UK works towards its international commitment to eliminate hepatitis C as a serious risk to public health.
Find out about the Hepatitis C Trust.
Primary Biliary Cholangitis (PBC) is an autoimmune condition which affects the liver. The PBC Foundation is the only UK based organisation that specifically deals with PBC. We serve members in over 65 countries around the world. Primary Biliary Cholangitis (PBC) is an autoimmune condition which affects the liver.
Find out about the the PBC Foundation.
Since its inception in 2006, the NIHR has significantly increased the scale of clinical research in the NHS, particularly through the NIHR Clinical Research Network. The enthusiastic engagement of NHS physicians and trainees is essential for sustaining and building on this success, particularly given the many competing demands on clinician time and resources.
For a second year, the NIHR Clinical Research Network has ran research awards in partnership with the Royal College of Physicians. The awards recognise outstanding contributions of NHS consultants and trainees who are active in research.
For further information visit the awards webpage.
The James Lind Alliance (JLA) has identified a set of priorities for alcohol related liver diseases. The JLA is a non-profit making initiative established in 2004 that brings patients, carers and clinicians together in Priority Setting Partnerships (PSPs) to identify and prioritise the Top 10 uncertainties, or unanswered questions, about the effects of treatments.The aim of this is to make sure that health research funders are aware of the issues that matter most to patients and clinicians
Find out more about the James Lind Alliance.
The NIHR provides the support and facilities the NHS needs for first-class research by funding a range of infrastructure.
NIHR Biomedical Research Centres (BRCs), partnerships between England’s leading NHS organisations and universities, conduct translational research to transform scientific breakthroughs into life-saving treatments. The following BRCs undertakes research in hepatology:
NIHR Medtech and In vitro diagnostics Co-operatives (MICs) build expertise and capacity in the NHS to develop new medical technologies and provide evidence on commercially-supplied in vitro diagnostic tests. The following MICs undertake research in hepatology:
NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are collaborations between local providers of NHS services and NHS commissioners, universities, other local organisations and the relevant Academic Health Science Network. The primary focus of CLAHRCs is research targeted at chronic disease and public health interventions. The following CLAHRCs undertake research in hepatology:
All of the NIHR facilities and centres are opening to working with the public, charities, industry and other partners. If you are interested in collaborating with the NIHR please contact the NIHR Office for Clinical Research infrastructure: firstname.lastname@example.org
Our experts in the NIHR Clinical Research Network National Specialty Group can advise on delivering your hepatology study in the NHS.
William Rosenberg holds the Peter Scheuer Chair of Liver Diseases at the Institute for Liver and Digestive Health, University College London. He is the Clinical Lead for Viral Hepatitis at Royal Free London and UCLH NHS Foundation Trusts and chairs the North Central London Viral Hepatitis Network. William is the NIHR CRN Hepatology National Specialty Lead.
Professor William Rosenberg is a graduate of the University of Cambridge and qualified in medicine at Guy’s Hospital, London. He trained in London and Oxford and gained his DPhil in molecular medicine in Oxford in 1992. As Clinical Tutor in Medicine he co-founded the Centre for Evidence Based Medicine in Oxford before moving to Southampton in 1997 where he was professor of hepatology, NHS Director of Research and Development, and Director of the Wellcome Trust Clinical Research Facility. He moved to UCL in 2007 to take up the Peter Scheuer Chair in Liver Diseases.
Professor Rosenberg is an active clinical investigator in the field of viral hepatitis. He leads a research program spanning basic, translational, clinical and applied health research. Main areas of interest are vaccines, immune responses in viral hepatitis, the use of non-invasive tests for liver fibrosis, and the clinical epidemiology of chronic liver disease.
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