Precision Medicine and Warfarin Dosing

Precision Medicine and Warfarin Dosing

Lead: Professor Munir Pirmohamed (LHP Clinical Academic Programme Lead for LHP's Therapeutics Theme)

Warfarin is an essential drug used by 1% of the population.  However, it is difficult to use because of the inability to predict the doses needed to achieve adequate anticoagulation.  The variability in daily dose requirements is caused by both genetic and environmental factors.  In an international randomized controlled trial led from Liverpool, and published in the New England Journal of Medicine (2013; 369(24):2294-303), we have able to show that personalized dosing based on determining the patient’s age and body size, together variation in two genes (CYP2C9 and VKORC1), led to a significant improvement in anticoagulation control.  The study highlights the potential value of a personalised approach to medicine.

 
Behcet

Behcet's Syndrome Study

Lead: Professor Robert Moots (Clinical Academic Programme Lead for LHP Musculoskeletal CAP Theme)

Aims to investigate the potential for novel genetic and metabolomic biomarkers to target biologic therapy in  the treatment of severe organ threatening involvement in  this multi system autoinflammatory disease.

    This 3-year international research project, led by the University of Liverpool and involving sites in London, Birmingham, Leeds and Paris as well as Liverpool, will recruit 100 patients who have failed to respond to initial treatment and split them into two groups, one of whom will be given infliximab and the other interferon alpha.  Genetic information from blood and metabolites from urine will be collected and analysed to identify factors that predict  efficacy. This study is the first of its kind and  will for the first time allow doctors to prescribe medication for Behcet's based on the likelihood of it being effective, rather than by guesswork.   This precision medicine study is supported by the Efficacy and Mechanism Evaluation (EME) Programme of the MRC and NIHR and will save the NHS a minimum of £500K in the cost of prescribing medicine to sufferers
     

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    The Story of James Duncan as told by Helen Nichol

    The Story of James Duncan as told by Helen Nichol

    My story begins on 29 December 2012 when Andrew and I discovered that we were expecting our first child. We were delighted, we hadn’t been trying for very long and felt very blessed. However, there was something about the pregnancy that didn’t feel quite right, I couldn’t put my finger on it but I could never seem to imagine a happy ending. As time progressed and I passed the 12 week mark I felt much more settled but even then would still worry a bit. Andrew tried to reassure me and put it down to first time pregnancy worries.

     

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    Healthy Liverpool Day - July 2014

    Healthy Liverpool Day - July 2014

    NHS Liverpool Clinical Commissioning Group, the City Council and Liverpool Health Partners organised the firstHealthy Liverpool event on 27 June 2014.  Held at the World Museum, the event was of a new citywide initiative to help the people of Liverpool take better control of their wellbeing and lead longer, healthier lives.   This free, fun event involved local schools, a wide range of healthcare and wellbeing service providers as well local NHS trusts.

     

     
    Cancer - Research Workshops

    Cancer - Research Workshops

    A key issue in addressing the Cancer problem in, and around, Liverpool has been identified, as the diverse nature of the region’s resources ranging from charities and community support to the nine NHS trusts each with different specialties, and the University of Liverpool. Following a series of workshops that LHP has facilitated to bring together all stakeholders, within a common area of interest, a number of regional alliances have been formed. Such alliances are now in place for Lung, Breast and Head and Neck cancer and are already driving coherent anti-cancer strategies across the region.

     
     
     
     

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