Dr Zenas Yiu

Researcher awarded £1.4 million to find better ways to use treatments for skin, joint, and gut conditions

A dermatology researcher from Northern Care Alliance and the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC) has been awarded £1.4 million to look for better ways of using current treatments for people with chronic, long-term skin, joint and gut conditions, which could potentially improve patient outcomes.

Dr Zenas Yiu, who is an Honorary Consultant Dermatologist at Salford Royal and part of the Dermatology Theme of the NIHR Manchester BRC, has been awarded the funding through a highly prestigious Clinician Scientist Fellowship from the UK Research and Innovation (UKRI) Medical Research Council (MRC).  His research project, entitled; ‘Making Effectiveness Research better by meta-analysing Trial and Real World Evidence in Immune-Mediated inflammatory Diseases (MERMAID)’, starts in August 2024 and will take place over 5 years.

The focus of the project will be immune-mediated inflammatory diseases (IMIDs), which include conditions affecting the skin (psoriasis, eczema, cutaneous lupus), joints (rheumatoid arthritis, lupus), and the gut (inflammatory bowel disease) and are estimated to impact almost 7% of the global population. These diseases are among the most common chronic conditions in the UK.

Underserved populations

Dr Yiu, who is also a Clinical Senior Lecturer in Dermatology and Pharmacoepidemiology at The University of Manchester, said: “Randomised controlled trials (RCTs) are where two or more different medicines, one of which may be a dummy medicine, are given randomly to groups of participants who are followed in a strict and regimented way. RCTs are generally reliable but people from underserved populations, examples of which include women of child-bearing age and people of diverse ethnic background, are often excluded or under-represented due to strict trial inclusion and exclusion criteria or differences in access to research. This could lead to an over-estimation of benefits and under-estimation of the risks of medicines overall.

“Observational studies are where large groups of people are observed in routine settings, such as patients being treated in the NHS, without being allocated medicines as part of a trial. Observational studies can better reflect the safety and effect of medicines in a more representative population of people, are relatively cheap, and can be quicker to run. However, they can be affected by many biases and so are often less reliable.

Patient factors

“I am delighted to have been awarded this fellowship which aims to use data from RCTs and observational studies together to take advantage of the strengths of both type of studies, while looking to minimise their limitations. It will allow me to compare and contrast outcomes across the two types of studies; assess the effect of medicines on people not eligible to be included in trials across different conditions; and uncover any patient factors that might lead to different treatment responses to help personalise treatment.

“This means that people with IMIDs could then have a better understanding of how likely high-cost medicines would work for them, leading to more efficient and appropriate treatment decisions. This work may also then help scientists, clinicians, and policy makers conduct better observational studies in the future to improve care for people suffering from chronic inflammatory diseases.”

A Clinician Scientist Fellowship supports clinically active healthcare professionals to lead their own research plans, establish their own research team and make the transition to independent researcher over a 5-year period.

Professor Anne Barton, NIHR Manchester BRC Director, said; “Huge congratulations to Dr Yiu. The Clinician Scientist Fellowship that he has been awarded is highly competitive and so his success is testament to the quality of work and research he is undertaking to help drive health improvements.”

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