Researchers secure £3m NIHR funding for new blood clot prevention trial

The research group Barts Bone & Joint Health, comprising researchers and clinicians from Queen Mary University of London, Barts Health NHS Trust, and other partner institutions has secured £3 million in funding from NIHR (National Institute for Health and Care Research) to deliver the UKs largest trial in thromboprophylaxis.

The trial named Thromboprophylaxis in Lower limb Immobilisation (TiLLI) aims to compare different methods of pharmacological thromboprophylaxis – medications used to prevent blood clots – for patients with temporary lower limb immobilisation after injury to determine their clinical and cost effectiveness.

The bid is being led by Professor Xavier Griffin, Clinical Professor in Orthopaedics at Queen Mary University of London, and Honorary Consultant Orthopaedic Surgeon at Barts Health NHS Trust and Dr Daniel Horner, Consultant in Emergency and Critical Care Medicine at Salford Royal NHS Foundation Trust, in the UK.

Approximately 70,000 people are immobilised after injury every year in the UK. This can lead to venous thromboembolism (VTE), a condition where blood clots form in the veins, and may develop into serious conditions such as deep vein thrombosis (DVT) or pulmonary embolism. Temporary lower limb immobilisation (plaster cast, walking boot or rigid splint) and injury are combined risk factors for someone developing VTE. Many people who survive VTE suffer from longer term physical or psychological complications.

Luckily, VTE in lower limb immobilisation is potentially preventable through early prophylaxis with anticoagulant medication, which helps keep blood flowing smoothly and prevent clot formation. However, the risk of VTE varies widely from person to person, and there are multiple drugs available.

Currently, there is no high-quality evidence comparing different methods of pharmacological thromboprophylaxis for patients at high risk of VTE and limited evidence of the benefits and risks of any prophylaxis for patients at low risk of VTE. This trial will address this evidence gap by comparing the clinical and cost effectiveness of various anticoagulant drugs and therapies.

Chair of Bone and Joint Health Professor Xavier Griffin, Clinical Professor in Orthopaedics at Queen Mary University of London, and Honorary Consultant Orthopaedic Surgeon at Barts Health NHS Trust, said: “We are thrilled to have been awarded this grant to answer this question. It will have a huge impact on clinical care, improving care for patients not just in the UK but worldwide.”