ATTEST 2 aims to test tenecteplase in a large clinical trial to establish whether it is a better drug than alteplase for use in thrombolysis. This will involve a large number of hospitals in the UK, and possibly overseas. People who are considered suitable for thrombolysis will be allocated at random to receive either the current standard treatment with alteplase, or tenecteplase, and will be followed up for the first 90 days to measure the effects on recovery.
Even if there are no significant differences between between the two drugs, tenecteplase is less expensive and much easier to give to patients than alteplase, needing a single injection only. Alteplase has to be given as an injection followed by a longer injection over an hour. This advantage of tenecteplase alone would have worthwhile benefits to the patient.
Prospective Randomised Open, Blinded End-point (PROBE) – Phase III
Dr. Will Whitely, Stroke Medicine, University of Edinburgh & NHS Lothian
Director of EMERGE, Consultant, NRS Career Research Fellow & Honorary Reader in Emergency Medicine
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.
Identification and characterization of the clinical toxicology of novel psychoactive substances (NPS) by laboratory analysis of biological samples from recreational drug users.
Identification of Novel Psychoactive Substances (IONA)