Health
Niagara thrombosis clinic launches research studies
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After eight years of preparation, Niagara Health’s thrombosis service clinic can now offer cutting-edge treatments to thousands of patients in the region suffering from the potentially deadly disease.
For the first time since the hospital system’s Niagara Thrombosis Service began in 2015, the clinic’s director, Dr. Blair Leonard, said his team and patients are participating in four clinical research studies, offering cutting-edge medications and treatments they would have previously had to leave the region to access.
“For thrombosis, which is my area, this is obviously a first,” said Leonard, Niagara Health’s regional physician lead for benign hematology and thrombosis.
Although he said the clinic has been involved in smaller clinical trials in conjunction with Hamilton Health Sciences while other hospital programs have been involved in clinical trials for several years, this is the first time the local clinic is doing so on its own.
And it’s starting out with four clinical trials running concurrently, with funding from Ottawa Hospital Research Institute.
The research includes two studies called ANTHOS trials, investigating promising “and very new” blood thinner medications that are not yet available “to anyone” other than patients participating in the trial.
“The fact that we have those trials here means our patients will have access to those medications,” Leonard said.
The clinic is also participating in the SAVER trial, to determine if cholesterol-lowering medications called statins can help prevent the development of potential deadly blood clots in veins, and a study called the TRIM-line trial looking at the viability of strategies to prevent blood clots in patients using peripherally inserted central catheters.
While those studies will be conducted concurrently in the next up to three years, he said a fifth study is expected to begin in the fall looking at treatments for patients with post-thrombotic syndrome — the ongoing symptoms of blood clots.
“We’ll have more trials that will come in the interim,” he said. “As new trial group, we are very interested in bringing whatever cutting edge research we can to Niagara.”
He said as many as about 15 people will be recruited for each of the studies from among patients who are being treated at the clinic, in addition to thousands of other patients participating at other clinics across the country.
Although typically half the patients in clinical trials are given a placebo, Leonard said that can change depending on early results of the study.
He said researchers “periodically review the data as it comes in, and if it’s quite clear that this (the medication) is a game-changer, they basically stop the trial” and provide the medication to all participants.
“We’ve tried to refine the way we do trials to be as ethical as possible, so periodically they’ll review the data as it comes in and if it’s clear that something is far superior then it’s not ethically right to take the trial to the end and deny people potentially life-saving or life-altering medication.”
Leonard said the Niagara Thrombosis Service clinic was launched primarily to allow Niagara residents to receive the care they needed within the region, while offering “the level of expertise you could get at any top institution.”
“The whole idea of creating the service was so these people wouldn’t have to leave the region for that level of specialty care, and we can take care of our own as best as possible,” he said. “We brought our standard up to the leading edge, at least cross Canada if not the world.”
However, being involved in research programs “was all part of the grand plan, since we launched many years ago,” Leonard added.
By recruiting additional specialists and increasing capacity at the clinic that currently has about 5,000 patients, he said it also made the clinic a viable location for research studies.
“Once you build that capacity, the research starts coming because people realize that there are a lot of patients here, and experts here that have an interest in research,” he said.
“That wouldn’t have happened if we didn’t build the service to allow us to see all those patients to begin with.”
Leonard said he reached contacted research institutions in Hamilton and Ottawa, offering to participate in any upcoming research projects “to offer our patients the newest potential therapeutics.”
“They were quite happy to have us involved, since we have so many patients,” he said.
Leonard said about 50,000 people each year experience a blood clot, while Statistics Canada listed cerebrovascular diseases that includes thrombosis as the sixth leading cause of death in the country, with 13,695 deaths reported in Canada in 2020 from the condition.
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Grande Prairie RCMP issued a warning Friday after it was revealed fentanyl linked to a deadly overdose was mixed with a chemical that doesn’t respond to naloxone treatment.
The drugs were initially seized on Feb. 28 after a fatal overdose, and this week, Health Canada reported back to Mounties that the fentanyl had been mixed with Bromazolam, which is a benzodiazepine.
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Mounties say this is the first recorded instance of Bromazolam in Alberta. The drug has previously been linked to nine fatal overdoses in New Brunswick in 2022.
The pills seized in Alberta were oval-shaped and stamped with “20” and “SS,” though Mounties say it can come in other forms.
Naloxone treatment, given in many cases of opioid toxicity, is not effective in reversing the effects of Bromazalam, Mounties said, and therefore, any fentanyl mixed with the benzodiazepine “would see a reduced effectiveness of naloxone, requiring the use of additional doses and may still result in a fatality.”
From January to November of last year, there were 1,706 opioid-related deaths in Alberta, and 57 linked to benzodiazepine, up from 1,375 and 43, respectively, in 2022.
Mounties say officers responded to about 1,100 opioid-related calls for service, last year with a third of those proving fatal. RCMP officers also used naloxone 67 times while in the field, a jump of nearly a third over the previous year.
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Health
CFIA continues surveillance for HPAI in cattle, while sticking with original name for disease – RealAgriculture
The Canada Food Inspection Agency will continue to refer to highly pathogenic avian influenza in cattle as HPAI in cattle, and not refer to it as bovine influenza A virus (BIAV), as suggested by the American Association of Bovine Practitioners earlier this month.
Dr. Martin Appelt, senior director for the Canadian Food Inspection Agency, in the interview below, says at this time Canada will stick with “HPAI in cattle” when referencing the disease that’s been confirmed in dairy cattle in multiple states in the U.S.
The CFIA’s naming policy is consistent with the agency’s U.S. counterparts’, as the U.S. Animal and Plant Health Inspection Service has also said it will continue referring to it as HPAI or H5N1.
Appelt explains how the CFIA is learning from the U.S. experience to-date, and how it is working with veterinarians across Canada to stay vigilant for signs of the disease in dairy and beef cattle.
As of April 19, there has not been a confirmed case of HPAI in cattle in Canada. Appelt says it’s too soon to say if an eventual positive case will significantly restrict animal movement, as is the case with positive poultry cases.
This is a major concern for the cattle industry, as beef cattle especially move north and south across the U.S. border by the thousands. Appelt says that CFIA will address an infection in each species differently in conjunction with how the disease is spread and the threat to neighbouring farms or livestock.
Currently, provincial dairy organizations have advised producers to postpone any non-essential tours of dairy barns, as a precaution, in addition to other biosecurity measures to reduce the risk of cattle contracting HPAI.
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Health
Toronto reports 2 more measles cases. Use our tool to check the spread in Canada – Toronto Star
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Canada has seen a concerning rise in measles cases in the first months of 2024.
By the third week of March, the country had already recorded more than three times the number of cases as all of last year. Canada had just 12 cases of measles in 2023, up from three in 2022.
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