The first study to receive funding is an international study in orthopaedics led by Professor Jƶrg Schilcher. Thanks to the grant, Jƶrg Schilcher and the PRIO (Pragmatic Research in Orthopedics) research group can now conduct ABOGRAFT, an extensive clinical study aimed at halving the risk of infection in severe hip replacement surgery. For orthopedic surgeons, infection is a major concern.
āWe, as orthopedic surgeons, see this as the worst thing that can happen to our patients. So everyone wants to do something to reduce the risk,ā says Jƶrg Schilcher.
Local antibiotics to stop the bacteria
In first-time surgery, bone cement mixed with antibiotics is already routinely used, successfully reducing the risk of infection. However, for larger repeat operations where bone cement is not used, a systematic way to supply antibiotics locally has been lacking.
In revision surgeries for loose hip prostheses, it is often necessary to restore lost bone tissue. This is currently done by using ground bone from donors, known as ābone chipsā, to fill the cavities before a new prosthesis is fixed. The risk of infection in these procedures is considerably higher than in the initial operation, as patients are often older and the tissue has already been affected by previous interventions.
The project will now test the effect of mixing antibiotics directly with the bone chips used. The hypothesis is that this will drastically improve outcomes.
āFrom the bone chips, high concentrations of antibiotics are released locally that make it impossible for bacteria to remain on implants or in the joint,ā Jƶrg Schilcher explains.
The goal is to reduce the relative risk of infection by half.
Safety and interdisciplinary collaboration
The road to receiving this grant has been long. The idea has followed Schilcher since he began his academic career.
āThatās what Iām most happy about, that Iāve really worked on this for so long and finally someone is listening,ā he says.
Previous laboratory tests have shown that the antibiotic effectively attaches to bone transplants and kills even resistant bacteria. The project is now taking a full step into clinical reality with the goal of establishing a new standard therapy.
āThis is clinical therapy research that we use in repeat operations on patients suffering from loose hip implants,ā Jƶrg Schilcher concludes.
Improved treatment of opioid addiction
The second study receiving funding is led by Markus Heiligās and Andrea Capusanās research group at the Center for Social and Affective Neuroscience, CSAN. It concerns improving the treatment of addiction to heroin and other opioids.
āOpioids account for 90 per cent of Swedish drug-related mortality, but fewer than half of patients receive evidence-based treatment,ā says Markus Heilig, professor of psychiatry and director of CSAN.
The study has two purposes. Firstly, the goal is to broadly introduce treatment with a depot injection of the drug buprenorphine, which is already supported in research and is one of the two drugs given as maintenance treatment today. All patients in the study will receive buprenorphine treatment in the form of monthly injections, allowing more patients to be treated using the existing resources.
Jenny WIdƩn
Is it possible to reduce drug cravings?
The study will also examine whether it is possible to further improve the treatment by adding a new medication, affecting how the brain reacts to a neurotransmitter called orexine. The question that the researchers hope to answer is whether it can improve sleep and reduce patients' drug cravings.
āWe hope that this will make it easier for patients to remain in treatment and refrain from using illegal drugs,ā says Markus Heilig.
The study will run for three to four years and involve around 200 patients. It is led from Linkƶping University and will be carried out in SkƄne, Jƶnkƶping, Linkƶping, Stockholm, Uppsala and VƤsternorrland. Markus Heilig highlights the importance of the nearly SEK 20 million grant from the Swedish Research Council:
āLarge clinical studies are very expensive, and itās rare for academic researchers to be able to carry out such studies. This contribution enables a study of a patient group that is rarely of interest to pharmaceutical companies.ā
