$5.5M NHMRC grant will power trial of precision medicine in sepsis care

A project to investigate how a person’s genes influence their response to different treatments for sepsis has secured $5.5M in funding through the National Health and Medical Research Council (NHMRC) Clinical Trials & Cohort Studies program.

The CoRticostEroids in SepTic Shock (CREST) study will be led by Professor Bala Venkatesh, Program Director of Critical Care at The George Institute for Global Health, Professor of Intensive Care Medicine at UNSW Sydney, and an intensive care specialist.

CREST is a two-arm trial to address the current clinical uncertainty around the efficacy of a single corticosteroid (hydrocortisone) vs a combination of two agents (hydrocortisone plus fludrocortisone) in the treatment of septic shock, the most severe form of sepsis.

Researchers will track outcomes including the period of survival (free of organ support) and functional recovery up to 28 days after admission.

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Sepsis is a major global public health problem and, while corticosteroids are a commonly used drug, their evaluation in people suffering septic shock is inconsistent.

CREST will allow us not only to answer that question but by also testing patient’s genes prior to treatment, we will see how the underlying biological response to the disease affects their response to the drugs. We can then tailor their treatment to ensure they’re getting the combination that is most effective, which will be the first time precision medicine based on genetic information has been used to treat septic shock.

By:

Professor Bala Venkatesh

Program Director - Critical Care, The George Institute

Sepsis describes the life-threatening organ dysfunction that happens when the body ‘over-reacts’ to infection. The George Institute’s team has led the world’s largest clinical trials and epidemiological studies of sepsis. In Australia alone, there are an estimated 55,000 cases of sepsis per year, of whom 18,000 are admitted to Intensive Care Units (ICUs) and 8,700 will die. The mortality of septic shock has remained unacceptably high at 30% for the last 10 years, indicating an urgent unmet need for effective treatments. Of survivors, 30% suffer significant functional limitations including physical, cognitive and psychological disability.