More Than a Study: Research Breakthroughs at UH Have Human Impact, Change Patients’ Lives

More than 40 years ago, endocrinologists across the U.S and Canada posed a key question: Could intensive management of type 1 diabetes (T1D) – defined as multiple injections of insulin each day – improve on the standard care and help patients achieve near-normal blood glucose levels, thereby lessening their long-term complications?

In 1983, the NIH-funded Diabetes Control and Complications Trial (DCCT) was launched to explore this question. And the research community looked to University Hospitals to help find answers. Our adult and pediatric endocrinology experts at UH Cleveland Medical Center and UH Rainbow Babies & Children’s were there on the ground floor, serving as study co-chair. Since that time, we’ve served as the clinical coordinating center for the study for decades, even as the research focus has evolved to the Epidemiology of Diabetes Interventions and Complications (EDIC). The study continues to this day.

Its results have been phenomenal. DCCT-EDIC demonstrated that keeping blood glucose levels more balanced with intensive management results in significantly better long-term outcomes and fewer complications, from diabetic eye disease, advanced kidney disease, nerve problems and heart disease and stroke.

This is a research breakthrough with human impact, due in no small part to our efforts at UH.

Our experts here and elsewhere, including the American Diabetes Association, say that these findings – and many others related to it – have proven to be the most impactful research in diabetes history. In the process, this precious new knowledge has ignited a pharmaceutical and technological revolution in diabetes care, from continuous glucose monitors to insulin pumps.

A story like this is amazing, but it’s by no means the only great research story we have to tell here at UH. For example, the triple-threat team of a UH gastroenterologist, oncology researcher and pathologist has also helped advance the standard of care by inventing a device to improve screening for esophageal cancer and specifically Barrett’s esophagus, the precursor to cancer. Given that esophageal cancer has a stark 20%, five-year survival rate, early detection and treatment of Barrett’s esophagus are critical to improving outcomes.

It’s a brilliantly simple design: Clinicians quickly and non-invasively gather surface esophagus cells for analysis without endoscopy by using the EsoCheck capsule, which resembles a gel cap and is connected to a thin catheter and is swallowed by patients. The whole procedure takes less than five minutes. Then following cell retrieval, the EsoGuard DNA test is used to identify abnormal esophageal cells associated with disease risk.

This innovative technology has now received FDA approval and has been licensed commercially to Lucid Technologies. Guidelines from the American College of Gastroenterology state that the swallowable, non-endoscopic capsule device – combined with a biomarker – is an acceptable alternative to endoscopy in screening certain patients for Barrett’s esophagus. UH and Case Western Reserve University collaborated in the NIH-funded research to make this possible.

Our collaboration exemplifies how research partnerships can translate innovation into clinical practice. That’s research with impact.

Another great example is the FDA approval of a new therapy giving hope to thousands of patients at high risk of losing a leg to amputation. UH Harrington Heart & Vascular Institute played a leading role in the pivotal research on the new LimFlow technology, reported in multiple articles in The New England Journal of Medicine and ushering in a new era of hope for patients who’ve run out of options.

Results show that the therapy – which essentially turns a vein into an artery during a minimally invasive procedure – was associated with high limb salvage rates and wound healing. At six months post-procedure, 76% of patients avoided major amputation. Within the same period, 76% of patients had completely healed or healing wounds.

We are proud of our role at UH in generating key clinical evidence that supported FDA review and approval of LimFlow, and for creating the conditions where more patients have access to this life-changing and lifesaving technology, beyond just the hospitals participating in the clinical studies. With greater access, more patients may benefit, improving quality of life for individuals who previously had no revascularization option.

Of course, no discussion of research with human impact would be complete without a mention of AI.

We have many outstanding AI research endeavors across our health system, but one worth noting is in Radiation Oncology among patients with prostate cancer, the most common cancer in men in the world. Prostate cancer still kills more men every year than colorectal cancer, pancreatic cancer, liver tumors or brain tumors. What’s more, androgen deprivation therapy can help some men with prostate cancer live for long periods, but it also can have significant side effects, including metabolic syndrome, diabetes, high blood pressure, fractures and muscle loss.

To tackle this problem, our Radiation Oncology leader and team worked to develop genomic and AI-based biomarkers to get more accurate information about prognosis and predict which men are most likely to benefit from androgen deprivation therapy – and which can avoid it. After years of work, these tests have now been validated in over 12 randomized trials and are now part of the National Comprehensive Cancer Network Guidelines, and the Centers for Medicare & Medicaid (CMS) provides coverage for the tests. These tests can help guide the use of hormone therapy, among other approaches, all over the country.

By harnessing the power of AI, we can unleash the power of something a computer will never be able to provide – our trademark UH compassion.

By sparing men battling prostate cancer across the country of unnecessary side effects, that’s research that changes lives – not tomorrow, but today.

The standard of care for large ischemic strokes is also changing – both here and around the world – thanks to UH research leadership and breakthroughs with impact. As coordinating center for the extremely consequential SELECT2 trial, we at University Hospitals have assumed a global leadership role in helping to better define the best therapy for large strokes caused by a blood clot, known as an ischemic stroke.

Previously, patients with large ischemic strokes were not treated with a mechanical thrombectomy to remove the clot, due to concerns that there was too much tissue damage and patients were less likely to benefit. But SELECT2 results from around the world are now changing that. They show that patients with large strokes had a dramatically better recovery after endovascular thrombectomy plus medical management than patients who only received standard medical management.

UH made a major contribution to the success of this trial. Within less than a year, we enrolled 21 patients. It’s one of the strengths of our system, having many hospitals and people who can identify and enroll patients for consequential research like this. And the results have real impact. Because of this research, many stroke patients around the country and around the world are now being treated and going back to their families and society to live independently. When you can not only survive but also begin the journey to reclaim your life after such a serious event as a large ischemic stroke, research has changed your life for the better.

Of course, these are just a few examples of UH research with human impact. Medical discovery is a full-time endeavor here; breakthroughs are a way of life. In our 160 years, we’ve shown time and time again that when it comes to improving the health of our patients, we’re not interested in the status quo. Instead, we drive what’s next – and that happens every day.

Who knows what the next discovery will be that turns the medical world upside down. But given the drive, ingenuity and compassion of our doctors, scientists and caregivers, we know there’s a great chance that it will happen here at UH.