10 out of 10 - ten of the greatest health-changing research studies, to have taken place in North Thames over ten years of the CRN

The NIHR Clinical Research Network was formed 10 years ago, in April 2014. To reflect on its mission to support clinical research, we are taking this opportunity to look back on the 10 years of its existence, and revisit some of the incredible research to emerge in the region that has had an impact on treatments and on the health and wellbeing of patients across the UK.

Which aspect of health did this research focus on? 

Infectious diseases - Respiratory.

What was the study investigating?

The study aimed to rapidly identify a range of potential therapies and assess if they can improve health outcomes for patients hospitalised with COVID-19.

There were many aspects (‘arms’) to this trial; one of these tested the effectiveness of a drug called dexamethasone.

Why does it matter?

During the pandemic, thousands of patients became seriously ill and were hospitalised with COVID-19.  

When the pandemic began, there were no treatments that had been proven to improve outcomes in hospitalised patients and many thousands of them died. 

What did the study do?

Founded by UK Research and Innovation (UKRI)’s Medical Research Council (MRC) and NIHR, the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial launched in the early stages of the coronavirus outbreak. 

The controlled trial compared a range of possible treatments in patients who were hospitalised with COVID-19. In this arm, some were given dexamethasone for up to 10 days, whilst others received the standard care only. 

In just two years, a staggering 47,000 participants took part in the wider study in the UK.  

What did we learn?

In patients hospitalised with COVID-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving oxygen or mechanical ventilation. 

How has it benefited patient healthcare and treatments? 

Thanks to this discovery, the NHS and clinicians across the world were able to change the way hospitalised patients were treated for COVID-19. 

It was estimated that dexamethasone saved the lives of around 22,000 COVID-19 patients in the UK and over one million lives globally.

Within the wider trial, four life-saving COVID-19 treatments were identified and reported in The New England Journal of Medicine. 

Dr Koshy Thomas, Principal Investigator for the study at Basildon University Hospital, part of Mid and South Essex NHS Foundation Trust, which recruited 482 participants to the study, said: “We are proud to have been a part of the RECOVERY trial which discovered four life saving treatments for COVID 19. 

“These treatments improved patient outcomes and saved thousands of lives worldwide.”

Anne Nicholson, research nurse on RECOVERY at the same trust, added:

"Working on the RECOVERY study during the height of the pandemic was unlike working on any other study previously or since. Due to the challenging and ever changing situation, the demands for recruitment were greater than anything we'd experienced before. We developed strong working relationships with clinicians and nursing staff to offer patients the opportunity to try potential treatments. 

“We quickly organised ourselves to cover weekends and evenings as we felt very strongly that we should be available to screen and offer every eligible patient the opportunity to participate in this groundbreaking study. We worked extremely hard to ensure that the study ran as smoothly as possible, keeping up to date with continual changes to the protocol and additional training as new treatments were regularly added to the platform. 

“Despite the many challenges of working in a stressful and ever-developing situation, it was a privilege to be part of the Recovery study as we supported clinicians to look after patients at their most vulnerable."

The patient view

Alan Mitchell, who took part in the study at the same trust, said:

“I feel very lucky to still be here, having survived a world-changing illness and I received great care from all the staff at the hospital. An extraordinary thing has happened to me, so I’m very happy to be able to talk about it. It was also my first encounter with a clinical trial, which is something I had never considered before. But now I want to help in any way I can.”

What next?

As many as 25,000 people still die each year from influenza in the UK. Using the RECOVERY trial as a model, the study is being expanded to investigate treatments for influenza in the same way.

The RECOVERY trial is now running at 187 sites across Europe, Asia and Africa.