Undertaking Clinical Research to Improve Patient Outcomes
Professor Tak-Mao Chan, Chair Professor and Chief of Nephrology at the Department of Medicine, The University of Hong Kong (HKU), has been conducting clinical research in kidney diseases for over two decades, and is an internationally recognized leader in the field of lupus nephritis management and research. The care and concern of healthcare professionals lend great support to patients with chronic kidney diseases in overcoming the numerous challenges and hardships. It is against this background that Professor Chan has dedicated his efforts in the pursuit of new and improved treatments through clinical research in collaboration with other investigators and his many supportive patients.
Clinical Research is Patient-Focused and for Patients’ Benefit
Chronic kidney diseases and kidney failure cause not only physical suffering to the patients but also often result in detrimental psychosocial consequences for them and their families. Patients with endstage kidney failure rely on long-term peritoneal dialysis or haemodialysis to sustain life, and few are lucky enough to undergo kidney transplantation. Treatments for kidney diseases, in particular long-term dialysis, are costly and often do not allow full rehabilitation. Patients with chronic kidney diseases also suffer from complications affecting different body systems. Professor Chan stated: “As it is presently impossible to revive damaged kidney tissue, rapid and effective reversal of kidney injury and preservation of kidney reserve assume pivotal importance in preventing adverse consequences. Also, while clinical research projects sponsored by pharmaceutical industry are mostly new drug development programmes aiming for registration purposes, clinician scientists play an important role in embarking on investigator-initiated clinical studies to address knowledge gaps that are important in patient management but might not present sufficient commercial interest to pharmaceutical companies.”
Lupus nephritis is an important cause of acute kidney injury, and its incidence is higher in Asian populations compared with the West. In the past, a considerable proportion of patients with lupus nephritis continue to develop chronic kidney disease and progress to endstage kidney failure. In view of its clinical importance, Professor Chan’s team has been conducting research on lupus nephritis for over two decades, aiming to increase the understanding of the mechanisms in this complex disease, and to improve the clinical management and the outcome of patients, in particular to reduce the risk of patients progressing to kidney failure. His team pioneered the novel treatment of severe lupus nephritis with mycophenolate, and published a landmark clinical study in the year 2000 showing that this new treatment had high efficacy and reduced adverse effects compared with conventional therapy. This paradigm-changing clinical study was followed by a series of subsequent clinical studies, which demonstrated the feasibility of reducing the dose of corticosteroids, and thus its related side-effects, and also the ability to reduce disease relapses with new treatment regimens. The resultant benefit to patients is evidenced by the low disease flare rate and the low incidence of kidney failure in his patients, data that he has reported in the literature and presented at many international conferences, thereby spreading the clinical benefits to patients in different parts of the world.
Teamwork in Clinical Research and Support from the Clinical Trial Centre
Professor Chan has continued to explore new and improved treatments, and since 2017 is leading an investigator-initiated Asian multi-centre study on lupus nephritis in collaboration with investigators in China, Thailand, Japan, Singapore, Malaysia, Philippines, and other countries. With extremely limited financial backing, an investigator-initiated clinical study of this scale faces numerous challenges. The joint efforts and contributions of all the collaborating investigators and the professional support from HKU Clinical Trial Centre, in various aspects ranging from contractual and legal matters to data management and regulatory compliance issues, have been crucial to the smooth running of this research project.