Research is essential in developing health care and improving patient outcomes.
Since enrolling at Monash University, I have been involved in all aspects of research from small hospital audits to large international clinical trials. At the core of my practice is a belief that research and academic endeavor will advance the treatment options available to patients and help evolve modern day medicine.
Below are a selection of my recent publications from peer reviewed journals.
For a full list of publications click here:
Gut - 2020
There is increasing evidence that faecal microbiota transplantation (FMT) is effective in inducing remission in ulcerative colitis (i.e. treating a flare). However, it remains unclear how durable any response is following FMT cessation. Furthermore, very little is known about the long term safety and health impacts following FMT, especially in patients with inflammatory bowel disease.
Our research team conducted the largest randomised control trial of FMT to date (published in the Lancet 2017) and in this particular project we followed up all patients who received FMT during the initial study (up to 6 years later). We found that most people had a disease flare around 6 months following therapy and only a small proportion of patients have remained well. These patients either had repeated FMT or had a self imposed dietary intervention.
These results are extremely important and will help design future studies trying to push the boundaries of microbial manipulation therapy.
****Hot off the Press****
The Lancet - Gastroenterology and Hepatology- 2021
Gut - 2020
We brought together 27 experts from around Australia to create guidelines on the use of FMT. These guidelines define standards for screening, indications for therapy and provided a regulatory framework for the TGA.
Medical Journal of Australia - 2020
Biosimilars are a "generic" version of a biologic medications such is infliximab or Humira. It is like referring to paracetamol as opposed to panadol (although a little more complicated). It is extremely important to assess whether using these medications are safe and effective in those patients who are stable on the original medication.
This study was the largest Australian experience using biosimilar infliximab in patients with IBD and the results show that it is safe, effective and emphasises the cost savings to the PBS (and tax payer) on having market competition.
Current Opinions in Pharmacology - 2020
This was a recent review article on the the current evidence for FMT in the management of patients with IBD.
Hepatobiliary Surgery and Nutrition - 2020
This was an editorial written in response to a fascinating paper which suggested elements of your microbiome were associated with aging. The paper also used FMT (poo) gathered from people over 100yrs of age and gave to mice which subsequently seem to halt the aging process.
Therapeutic Advances in Gastroenterology - 2019
Vitamin D deficiency is common in patients with Crohn's disease. It is unclear whether this can worsen Crohn's disease or whether the Crohn's disease will cause the Vitamin D deficiency (i.e. chicken or the egg). We used new techniques to look for Vitamin D breakdown products and found that when you have active Crohn's disease, your body will change how you break vitmain D down to maintain the active products in your body.