Academics from the Manchester Institute of Innovation Research (MIoIR) based at AMBS have begun a major three-year study into how personalised treatments can help better tackle cardiovascular diseases.
The project, funded by the Economic and Social Research Council, is a collaboration between The University of Manchester and The University of Liverpool and aims to identify the critical factors affecting the use of genetic and genomic information in such treatments.
Cardiovascular diseases are the most common causes of mortality in the UK, and the study will specifically look at the extent to which such genetic knowledge is being used at present across the NHS. Previous studies have shown that while there has been tremendous investment in early-stage research in this whole area, less investment has been given over to the translation and implementation of new knowledge in clinical and health decision-making across the NHS.
Medical innovation
The principal investigators into the study are Dr Dimitri Gagliardi and Dr Ronald Ramlogan, both Senior Lecturers at MIoIR. Dr Gagliardi said the specific contribution of MIoIR to the study was to understand the institutional, organisational and innovation management issues driving and/or hindering the translation of advanced genetic information into a personalised approach to heart and circulatory diseases.
“We will seek to understand the socio-technical dimensions of how new routines emerge, how organisations innovate, and how this change process (medical innovation) is managed if the respective genetic knowledge is to be introduced on cardiovascular wards of the NHS.”
Personalised medicine
The whole area of personalised medicine based on genetic information has experienced many advances in recent decades and is particularly prominent in oncology.
For instance, Herceptin - a drug used in the treatment of breast and stomach cancers - was first approved by the US Food and Drug Administration in 1998 and together with its companion diagnostics effectively kick-started the era of personalised medicine in oncology.
Since then more than 100 new drugs with genetic indications and diagnostics have been introduced for various medical problems, including cardiovascular diseases. Genetic codes have also been used to adapt therapies such as chemotherapy to reduce adverse reactions and maximise outcomes.
Key questions
Added Dr Ramlogan: “Our central question will be to ask why the use of such informed treatments for cardiovascular disease have so far been absent in the NHS. We are particularly interested in understanding whether, and what, cardiovascular medicine can learn from oncology where genetic knowledge is already at a relatively advanced stage of implementation in clinical practice.”
The project comprises of a strong multi-disciplinary team incorporating medical innovation scholars, pioneers in pharmacogenetic research and its applications in medical practice, as well as oncology and cardiovascular clinicians. Professor Bernard Keavney and Dr Luigi Venetucci from the School of Medical Sciences at The University of Manchester are also co-investigators of the study.
Mapping
The first phase of the project will be to map the knowledge available, after which case studies in oncology and cardiovascular medicines will be developed, followed by a wider comparative analysis. The study will also be conducted within a number of active clinical units in the NHS identified as early adopters in setting up personalised approaches to cardiovascular therapies.
Other individuals central to the project include Professor Sir Munir Pirmohamed, a leading British expert in pharmacogenomics, and Dr Cinzia Dello Russo, both from the Institute of Translational Medicine at the University of Liverpool. Also involved is Dr Anna Olsson-Brown, a consultant medical oncologist at Clatterbridge Cancer Centre NHS Trust, Liverpool.
