Monday 7 October 2024
MAHSC Honorary Clinical Chairs are celebrated as we invite the audience to hear their professional and personal journeys, clinical and research areas, and plans for the future. This MAHSC Inaugural Lecture welcomed MAHSC Honorary Clinical Chairs Professor Raja Padidela and Professor Benjamin Parker.
The MAHSC Honorary Clinical Chairs are awarded on an annual basis by The University of Manchester’s Faculty of Biology, Medicine and Health Promotions Committee. They are awarded to individuals from across Greater Manchester who have made a major contribution to their clinical specialty, including excellence in research and education. There are now 86 MAHSC Honorary Clinical Chairs.
Prof Raja Padidela is a Consultant Paediatric Endocrinologist at Manchester University NHS Foundation Trust (MFT) and Deputy Medical Director for the National Institute for Health and Care Research (NIHR) Manchester Clinical Research Facility (CRF) at Royal Manchester Children’s Hospital, part of MFT. Prof. Padidela, a leading expert in paediatric metabolic bone disorders, provided an in-depth overview of the pioneering work undertaken in the field of rare bone diseases, particularly hypophosphatasia.
The lecture traced the evolution of clinical trials, the formation of a multidisciplinary team (MDT), and the subsequent establishment of Manchester as an international centre for research and treatment in this specialised area.
The Journey Begins: Clinical Trials and Formation of an MDT
In 2012, the first clinical trial for hypophosphatasia was initiated, which Prof. Padidela was integral to. This rare genetic disorder, caused by a deficiency of serum alkaline phosphatase, can lead to severe respiratory failure and high mortality rates, especially in infants. Prof. Padidela found that the early trials highlighted the need for a robust MDT, including specialist nurses, therapists, and administrators, to manage the complexities of the condition and provide comprehensive patient care.
Despite initial challenges, including funding difficulties and the logistics of patient transfer from international locations, the team’s perseverance paid off. The successful treatment of the first patient, who was transferred from Prague, set a precedent and established Manchester as a leader in this field.
National Recognition and Expansion
The success of these early efforts from Prof. Padidela and the team, led to national commissioning for a quaternary service for hypophosphatasia, which brought significant annual funding. This allowed further expansion of the MDT and solidified the team’s position as a national leader. 2020 marked a turning point, as the team became one of the leading international centres for clinical trials in paediatric metabolic bone disorders.
The team’s work has been instrumental in securing approval from the National Institute for Health and Care Excellence (NICE) for new medications, using real-world data collected from multiple centres. This approval process not only enhanced the understanding of NHS financial structures but also facilitated the expansion of the MDT and the appointment of additional research staff.
Broader Impact on Rare Bone Disorders
The lecture also highlighted Prof. Padidela’s involvement in clinical trials for other rare bone disorders, such as X-linked hypophosphatemic rickets (XLH). The efforts in this area have led to significant advancements in treatment, including the development of clinical guidelines and participation in international registries. The team’s success in these trials has further established Manchester as a key player in the global research community.
He spoke of the impact of research and said: “The lessons we have learned from rare disorders like hypophosphatasia have allowed us to manage more common conditions, early diagnosis and treatment are always beneficial, no matter the disorder.”
Innovating Clinical Practice and International Collaboration
Prof. Padidela focused a portion of the lecture on his team’s work in innovating clinical practice, particularly in the management of Metabolic Bone Disease of Prematurity. By challenging established treatment protocols and advocating for new approaches based on pathophysiological insights, his team has contributed to changes in clinical practice both nationally and internationally.
The lecture concluded with a discussion of the team’s international collaborations, particularly with partners in India, which have led to large-scale epidemiological studies and significant publications. These collaborations have not only advanced research but also brought substantial grant funding, further supporting the team’s ongoing work.
Providing advice to researchers who may be early on in their careers, Prof. Padidela said: “Grab every opportunity that comes your way, because you never know where it will lead. Our perseverance with a single patient from Prague allowed us to become a centre recognised internationally.”
The second half of this MAHSC Inaugural Lecture welcomed Professor Ben. Parker, Consultant Rheumatologist at MFT. Prof Parker, is also Medical Director for the NIHR Manchester CRF at Manchester Royal Infirmary and Co-Director of the NIHR Manchester CRF.
In his lecture, Professor Ben Parker delivered an insightful and comprehensive overview of his journey and contributions to the field of rheumatology, particularly his work on lupus and complex connective tissue diseases.
A Diverse Career in Rheumatology and Research
Prof. Parker described his career as a “portfolio career,” characterised by diverse roles and a broad range of research interests. He leads specialised rheumatology services and manages the award winning biologics service for high-cost drug therapies. His career is deeply embedded in clinical research, particularly in lupus, where he has led numerous trials and studies aimed at improving patient outcomes.
Clinical and Research Contributions
Throughout his career, Prof. Parker has focused on improving patient care through both clinical practice and research. He has been instrumental in establishing and leading several initiatives, including the Greater Manchester Biologics Optimisation Network and a young adult rheumatology service that supports patients transitioning from paediatric to adult care. His research has been a cornerstone of his work, with a significant focus on lupus, cardiovascular risk, and comorbidities associated with connective tissue diseases.
Lupus Research: Addressing Unmet Needs
Prof. Parker’s research has been driven by the ongoing challenges in treating lupus, a complex and relapsing autoimmune disease. He highlighted the multifaceted nature of lupus, its severe impact on patients, and the limitations of current therapies. His PhD work, which focused on the cardiovascular risks associated with lupus, laid the foundation for much of his subsequent research. Prof Parker’s studies have explored the interactions between inflammation, treatment, and cardiovascular health, providing crucial insights into how to better manage these risks in lupus patients.
Innovative Approaches and Future Directions
A recurring theme in Prof. Parker’s lecture was the need for innovation in clinical trials for connective tissue diseases. He discussed the limitations of current trial designs, which often exclude a significant portion of patients with complex conditions like lupus.
Speaking on innovation and collaboration, Prof Parker said: “Innovation doesn’t happen in isolation—it’s the product of collaboration across disciplines and between researchers, clinicians, and patients.”
Prof Parker advocated for a more inclusive approach to clinical trials, one that considers shared biomarkers and disease manifestations across different connective tissue diseases. This, he argued, could lead to more effective and personalised treatments, benefiting a broader range of patients.
Leadership in Clinical Research
In addition to his research, Prof. Parker has taken on several leadership roles. He is co-director of the NIHR Manchester Clinical Research Facility, where he oversees early-phase clinical trials. His experience during the COVID-19 pandemic, particularly in supporting urgent public health studies, highlighted his ability to adapt and lead in times of crisis.
Prof. Parker’s lecture was a testament to his dedication to improving the lives of patients with lupus and other connective tissue diseases. His work spans the spectrum from direct patient care to cutting-edge research, with a clear focus on addressing unmet clinical needs. He spoke of this and said: “My research has always been driven by the needs of patients. It’s about finding solutions that make a real difference in their lives.”
As he continues to lead and innovate, his contributions are likely to shape the future of rheumatology for years to come.
The MAHSC Inaugural Lecture Series provides a platform for MAHSC Honorary to showcase their cutting-edge research. Their lectures highlighted the importance of innovation, collaboration, and technology in advancing medical science.
For those interested in a deeper dive into their research, the full lectures are available to watch here. These pioneering efforts in health science not only enhance our understanding but also pave the way for improved patient care and outcomes.
MAHSC is a collaborative partnership between The University of Manchester, Manchester University NHS Foundation Trust, The Christie NHS Foundation Trust, Salford Royal NHS Foundation Trust (part of the Northern Care Alliance), and Greater Manchester Mental Health NHS Foundation Trust. This alliance unites leading healthcare providers with world-class academics and researchers to foster innovation and advancements in healthcare.