Dr Ahmad leads a research team at the University of Exeter Medical School delivering translational research and also heads up a clinical trial group investigating new therapies for patients with Inflammatory Bowel Disease (IBD).
IBD Pharmacogenetic Group
The University of Exeter Inflammatory Bowel Disease (IBD) Pharmacogenetics Group was established in 2012. The group’s research activity is focused on the development & implementation of diagnostic tests that facilitate a) early diagnosis, b) individualised treatment strategies and c) smarter monitoring & cost effective use of current therapies.
The team has established a UK-wide network of clinicians and NIHR supported research nurses to identify and recruit large prospective, recallable, cohorts of IBD patients rigorously characterised by disease phenotype, drug exposure and genotype with longitudinal follow-up involving sampling at multiple time points. This process has been supported by the national patient group, CCUK and its 40,000 UK members.
PRED4 is an international collaborative pharmacogenetics project investigating the genetic mechanisms behind serious adverse drug reactions to medications commonly used in the treatment of IBD. It is an NIHR portfolio study, run with the backing of the UK IBD genetics consortium with funding from the BSG and the International Serious Adverse Events Consortium. There are multiple arms to this study that are investigating several different drug side effects.
The first study was completed in April 2014 and the research findings published in the journal Nature Genetics. This study investigated pancreatitis, a serious unpredictable side effect experienced by approximately 4-7% of patients treated with Azathioprine or Mercaptopurine. The team recruited more than 400 patients with inflammatory bowel disease who had developed pancreatitis within three months of starting these drugs from 168 sites around the world. The DNA from these individuals was compared with the DNA from more than 2000 Exeter inflammatory bowel disease patients without a history of pancreatitis revealing specific genetic variants on chromosome 6 associated with this serious drug side effect. It is hoped these initial genetic findings will be used to develop a test to be used in the NHS to help doctors and patients choose the safest treatment option.
The PANTS study is a prospective uncontrolled cohort study investigating primary non-response, loss of response and adverse drug reactions to Infliximab and Adalimumab in patients with severe active luminal Crohn’s disease. The study has recruited more than 1600 patients from 130 UK hospitals since March 2013. The study is due to close to new recruits in June 2016. The collection of clinical data is shared with the Royal College of Physicians UK IBD Biologics Audit (and in due course with the UK IBD registry), and individual patient laboratory data is released on the web portal. Preliminary clinical data relating to primary non-response will be presented at the British Society of Gastroenterology meeting in Liverpool in June 2016.
The Exeter IBD Clinical Trials team
Dr Ahmad leads a clinical trials team offering new therapies to patients with treatment refractory inflammatory bowel disease. The clinical trials team has consistently been one of the top 5 recruiting UK sites to NIHR gastroenterology portfolio studies since 2011.
The team are currently recruiting inflammatory bowel disease patients to the following clinical trials of new therapies:
Ulcerative colitis
A Study of the Efficacy and Safety of Etrolizumab in Ulcerative Colitis Patients Who Are Refractory to or Intolerant of TNF Inhibitors
A Study Comparing the Efficacy and Safety of Etrolizumab to Infliximab in Patients with Moderate to Severe Ulcerative Colitis Who Are Naive to TNF Inhibitors
A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled Trial of Oral RPC1063 as Induction and Maintenance Therapy for Moderate to Severe Ulcerative Colitis – For further information visit http://www.hra.nhs.uk/news/research-summaries/rpc01-3101-true-north-study/#sthash.q5FTgFSK.dpuf
Crohn’s disease
A Study of the Safety and Efficacy of Etrolizumab in Patients With Moderately to Severely Active Crohn’s Disease