I've been working in clinical trials now for 20 years. I first started with a study called the Second Australian National Blood Pressure Study. The original drugs that were used to treat high blood pressure had been largely displaced by newer agents, and they wanted to make sure that these agents were as good in preventing heart attacks and strokes. So, they decided to do that in primary care and we developed the systems and mechanisms to do these large-scale clinical trials in general practice. Up until that time, people said you can't do clinical trials in general practice, but we need to do clinical trials in general practice because that's where the patients are.
I've always had an interest in knowledge and new knowledge, and that's what clinical trials provide us with. I think it's more curiosity. Passion gets you interested, but curiosity keeps you going. I want to know what I can recommend to my patients, and that's what clinical trials do. They give you very reliable information that you can objectively give to patients or to the general community about whether something works or not.
ASPREE is a randomised controlled trial. Patients are either put on an active drug in this case, which is 100 milligrams of aspirin. It really is testing a strategy and whether there's a difference or no difference between the placebo and the aspirin, it will really inform the population and not only here in Australia, because there’s going to be no barrier to its uptake around the world should it become a standard recommendation. Remember, it started out as a cardiovascular prevention trial, so it was going to be strokes and heart attacks. So, we thought, well, aspirin is a wonder drug. Perhaps we can look at other potential benefits. The first one is dementia. There was some evidence coming around, around the time we were planning this that it may prevent cancer, specifically colorectal cancer. We initially got support to do this from the Heart Foundation and that allowed us to go to the National Health and Medical Research Council to apply for a project grant. And at that time, we got awarded a grant of $3.6 million, which was the largest project grant awarded up until the time. Now, that wasn't enough to do our main study because our main study has 19,114. So, it's 3 times bigger than the previous one we've done. Australia didn't have the resources to do that, but the Americans and the Brits and the Europeans did.
So, we used that NHMRC grant as an imprimatur to say that our peak research body supports this eventually to get a grant of US$50 million, which was I think the largest grant that had ever been given to international investigators. So, we recruited them through their general practice. I moved to Tasmania about 10 or 11 years ago and when I moved down there, we started up the ASPREE study there. Tasmania nearly has the same number in this trial as the whole of the United States. The public buy in to this is is very great because they’re recognising that they're generating knowledge not for their own good but for the generations that follow. Around 10% of the entire GP workforce has become involved. So, there is goodwill towards doing public good research and in general practice. It's discovery and advancement of knowledge and it's the contribution of whatever interventions, things that we do for patients that will benefit them in the long term.
After we got the funding from the United States, more than half of the US$50 million flowed into Australia. They were reassured about our quality collection of data and the fact that we could recruit people in the specified period of time. In fact, the NIH came over and went right through our quality of our data and our systems and said, this is better than what we've got at home. I think there's no doubt that Australia is seen as punching above its weight. We publish. relative to our population probably twice as much as what you'd expect. The Americans are now talking to us about doing further studies. They’re coming back to us because they don't see that anyone else does it better.
I've always had an interest in knowledge and new knowledge, and that's what clinical trials provide us with. I think it is more curiosity driven. Passion gets you interested, however curiosity keeps you going. I want to know what I can recommend to my patients, and that's what clinical trials do. They give you very reliable information that you can objectively give to patients or to the general community about whether something works or not.
I am currently a principal investigator on the ASPirin in Reducing Events in the Elderly (ASPREE) randomised control trial. It is a huge trial of over 19,000 participants worldwide, 16,700 of which are in Australia. Patients are either put on an active drug which is 100 mg of aspirin or a placebo. The trial started out as a cardiovascular prevention trial. However we are also looking at other possible benefits including preventing dementia and cancer, specifically colorectal cancer, and thus it is now more a healthy ageing study.
We received the initial grant from the Heart Foundation which then allowed us to go to the National Health and Medical Research Council to apply for a project grant. We were awarded a grant of $3.6 million, which was the largest project grant awarded at that time. We could then approach the National Institute of Health (NIH) in the USA, leveraging off the NHMRC grant to say that our peak research body supports this, and as a result successfully obtained a grant of $50 million US dollars. I believe this was largest grant that had ever been given to international investigators! NIH were initially a little concerned given the size of the grant so they came over to Australia and went right through the quality of our data and our systems. They were very reassured about our quality collection of data and the fact that we could recruit people in the specified period of time.
I think there's no doubt that Australia is seen as punching above its weight. We publish relative to our population, probably twice as much as what you'd expect. The Americans now are talking to us about doing further clinical trials. They're coming back to us because they don't see that anyone else does it any better.