The NIHR is the nation's largest funder of health and care research and provides the people, facilities and technology that enable research to thrive. We work in partnership with the NHS, universities, local government, other research funders (including industry and charities), patients and the public to improve the health and wealth of the nation.
In 2017/18, the NIHR spent £9.6 million on research studies into metabolic and endocrine disorders through our research programmes. Last year (2018/2019), the NIHR Clinical Research Network (CRN) supported 144 studies in this specialty, 58 of which were new studies, and recruited 7,618 patients to metabolic and endocrine disorders studies.
The Neurokinin 3 study tested the effectiveness of oral NK3R antagonist in reducing the frequency of menopausal hot flushes, without the need for oestrogen, as used in hormone replacement therapy (HRT). The study revealed that post-menopausal women experiencing seven or more hot flushes within a 24-hour period, had an overall 73 per cent reduction in the frequency of hot flushes while receiving the antagonist over a four week period.
The study paves the way for further research into the use of NK3R antagonists as a potential novel and effective treatment for menopausal hot flushes, and as a viable alternative to HRT. The potential benefit to patients is significant, especially given the prevalence of hot flush symptoms and the symptomatic burden for post-menopausal women.
Alkaptonuria (AKU), also known as black bone disease, is so rare that currently there are only around 65 patients in the UK that are known to have it. It is a genetic disease caused when both parents pass the AKU gene to their children.
SONIA 1 has improved the knowledge of AKU for patients and clinicians through a short four week study. The international clinical trial, across multiple centres has provided evidence to support the treatment of AKU with Nitisinone. The study also identifed the correct dosage required to effectively reduce the build up of HGA (10mg daily).
The clinical phase of SONIA 2 is due to finish by March 2019 and the full data analysis and study report will be complete by end of December 2019. This will provide further understanding of the effectiveness of Nitisinone in treating people with AKU.
The SCALE study (Liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes) showed how a daily injection of the drug liraglutide, alongside diet and exercise, led to weight loss in overweight or obese patients, reducing risk factors for heart disease and the chances of developing diabetes for those at high risk of the condition.
The liraglutide injection works by helping people feel fuller after meals, thus reducing their food intake and helping them to lose weight.
Identifying metabolic diseases at birth is crucial to early treatment and the ability to save lives. Using non-invasive prenatal testing for detecting trisomy disorders is safer, more accurate and will reduce the risk of test-related miscarriage.
The Expanded Newborn Screening project, funded by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber, involved screening 430,000 infants with non-invasive prenatal testing for five metabolic disorders, in addition to the five conditions that was usual practice. During the project, 12 patients were detected as having an inherited metabolic disease, thus allowing for treatment to start sooner than otherwise would have been possible.
Clinical and health economic evidence was submitted to the National Screening Committee and as a consequence, children born since January 2015 are now screened for a further four conditions.
You can find out more about research 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. This support covers every stage of research, from set up to delivery.
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 Metabolic and Endocrine Disorders Specialty is one of 31 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.
Each of our 15 Local Clinical Research Networks has at least one nominated local Clinical Specialty Research Lead for Metabolic and Endocrine studies. These clinicians lead research groups to promote and support Metabolic and Endocrine research within the NHS trusts in their area.
At a national level the local leads come together to manage the national Metabolic & Endocrine 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.
Our Metabolic and Endocrine Specialty profile gives an overview of our offer to the Life Sciences industry.
We work with stakeholders, including Society for Endocrinology, funders of research, and patient support organisations, to promote the successful delivery of research studies in the NHS and to help plan new studies that will address patients' needs.
We have key stakeholder representatives on our national specialty group to help define the metabolic and endocrine disorders research agenda, identify and support new clinical researchers and promote patient involvement in study design, delivery and recruitment.
Clinical research is being undertaken across the United Kingdom. We continue to work closely with the Scottish, Welsh and Northern Irish clinical research networks to support the design and delivery of high quality research.
Society for Endocrinology support scientists, clinicians and nurses who work with hormones throughout their careers. They also engage policy-makers, journalists, patients and the public with hormone science to encourage informed health decisions, and to demonstrate the value of endocrinology to the wider world.
British Inherited Metabolic Disease Group’s aim is to improve the provision of services for patients with inherited metabolic disorders.
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 undertake research in metabolic and endocrine disorders:
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 MIC undertakes research in metabolic and endocrine disorders:
The MRC-NIHR National Phenome Centre brings together leading academics in the field of metabolic phenotyping. The Centre delivers its world-class molecular-phenotyping service using a complimentary mix of analytical platforms, that work in concert to provide the greatest coverage.
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 Leads) can give advice on delivering your metabolic & endocrine disorders study in the NHS.
Prof John Wilding leads Clinical Research into Obesity, Diabetes and Endocrinology at the University of Liverpool. He trained at Southampton and the Hammersmith Hospital, London where he also undertook three years laboratory-based research into the neurobiology of obesity and diabetes. He has worked at University Hospital Aintree, Liverpool since 1996 and as Professor of Medicine since 2005.
He leads specialist services for severe obesity at University Hospital Aintree – designated a Centre for Obesity Management by the European Association for the Study of Obesity.
Prof Wilding is a Council member of the Royal College of Physicians and is currently the NIHR Clinical Research Network National Lead for Metabolic and Endocrine Disorders.
He has published over 250 research papers, chapters and review articles related to his clinical and laboratory research interests in the pathophysiology of obesity and type 2 diabetes and evaluation of new treatments.
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