The Medical Research Institute of New Zealand (MRINZ) has received extraordinary recognition at the Australian Clinical
Trials Alliance (ACTA) 2021 Trial of the Year Awards, announced in Melbourne last night. MRINZ played a senior role in three clinical trials which won five of the seven ACTA Awards, which celebrate the vital
place trials have in advancing clinical practice and saving or improving patients' lives every year.
Professor Richard Beasley, director of the MRINZ, says “We are grateful for the opportunity to contribute in a
meaningful way to improve the healthcare systems both here in Aotearoa New Zealand and internationally, collaboratively
creating tangible change to patient care worldwide.
“As well as addressing the needs of New Zealand’s diverse population, MRINZ research is helping to explore global issues
of concern and interest in collaboration with scientists internationally. MRINZ research is hugely respected worldwide,
and the Trustees congratulate our team at the MRINZ for these well-deserved ACTA accolades that continue to showcase
MRINZ researchers as world-leaders in their field,” says, David Chamberlain, MRINZ Trustee Board Chair.
The ACTA statistics award and runner up for the ACTA Trial of the Year award were won by the MRINZ-Led PEPTIC STUDY. The Health Research Council of New Zealand (HRC) funded the New Zealand arm of the study, led by Professor Paul Young,
and based at the MRINZ Wellington.
The PEPTIC Study is the largest clinical trial ever completed in the field of intensive care medicine. This trial
explored the effect on in-hospital mortality using proton pump inhibitors (PPIs) vs histamine-2 receptor blockers
(H2RBs) for stress ulcer prophylaxis among adults requiring invasive mechanical ventilation in the intensive care unit
(ICU). The findings of the study, which was conceived and run out of the MRINZ, were consistent with a treatment effect
estimate that ranged from no effect to a 10% relative increase in mortality using the PPI strategy. The trial used an
innovative cluster crossover registry embedded methodology which Professor Young was instrumental in developing. This
methodology, recognised with the ACTA award, allowed the 26,982-participant trial to be completed across five countries
with a study budget of under $500,000.
Co-winner of the Trial of the Year was won by PNEUMOTHORAX STUDY. The HRC funded the New Zealand arm of the study, which was run by Dr Kyle Perrin, based at the MRINZ.
This clinical trial explored the optimal way to treat a collapsed lung, pneumothorax. The trial which was undertaken in
39 hospitals across Australia and New Zealand, challenged current practice that an invasive surgical approach was the
best treatment of this serious condition. It investigated whether a ‘first do no harm’ approach in which a surgical
intervention was only undertaken if the patient became unstable, might be as effective and safer. This randomized
controlled trial showed that a ‘watchful waiting’ approach to the treatment of a collapsed lung led to better outcomes
and was considerably safer than the traditional invasive surgical approach, leading to fewer days in hospital or off
work, lower rates of surgery, and markedly lower risk of serious side effects and pneumothorax recurrence. This study
has led to paradigm change in management globally, a change that has both prevented harm and saved money.
The 2021 ACTA Trial of the Year Commendation, and the Excellence in Statistics Commendation was won by REMAP-CAP STUDY. The MRINZ has played a crucial senior role in the establishment and running of the study through the leadership of Dr
Colin McArthur, with funding from the HRC.
The REMAP-CAP [Randomised, Embedded, Multifactorial Adaptive Platform trial for Community-Acquired Pneumonia] trial
investigates the effect of potential treatments for critically ill patients with COVID-19. This study showed that both
corticosteroids and arthritis drugs tocilizumab and sarilumab reduce the risk of death due to COVID-19 in critically ill
patients. REMAP-CAP uses a novel and innovative adaptive trial design to evaluate multiple treatment options
simultaneously and efficiently. This design was able to quickly adapt during the COVID-19 pandemic, and increases the
likelihood that patients will receive the treatment that is most likely to be effective for them.
"We’re enormously grateful for the continued support of the Health Research Council of New Zealand. Their commitment to
our mission-led research has underpinned all of the trials celebrated with these awards,” says Professor Beasley. “Much
of our success can be attributed to strong long-lasting partnerships with our clinical colleagues, both across the
country and around the world; the dedication of frontline medical and nursing staff; and our remarkable volunteers,
without whom, none of these research findings could be possible.”
“The HRC is proud to support these high-impact, high-calibre trials run by the Medical Research Institute of New
Zealand,” says Professor Sunny Collings, chief executive of the Health Research Council of New Zealand. “These trials
have led to significant improvements in clinical practice and made a difference at the frontline of healthcare.”