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Ninewells Hospital is UK’s joint top recruiter for trial aimed at treating life-threatening respiratory condition
The University of Dundee and NHS Tayside has been named the UK’s joint top recruiting site for a trial involving 65 hospitals, exploring dexamethasone treatment in patients with acute respiratory distress syndrome (ARDS)
The Glucocorticoids in adults with Acute Respiratory Distress Syndrome (GuARDS) trial being delivered at Ninewells Hospital in Dundee — and led by the local Principal Investigator, Dr Matt Cassey — has recruited 16 participants.
That recruitment drive has matched the Royal Oldham Hospital in Greater Manchester and contributed more than 10% of all patients randomised to date.
ARDS is a life-threatening condition, often requiring critical care support, where the lungs cannot provide the body’s vital organs with enough oxygen. ARDS is common with one in four adults in intensive care units developing the condition.
All age groups can be affected with high mortality rates. Around 40% of patients with ARDS die within 60 days of developing the condition. Patients who survive and leave intensive care are known to be at higher risk for long-term reduction in their quality of life and will often attend their doctor or hospital more often than they did before their stay in critical care with ARDS.
Breathing difficulties in ARDS happen because the lungs fill with fluid due to inflammation — part of the body’s response to the conditions which cause it.
Over the last 30 years, various drug treatments have been tested to reduce the inflammation in ARDS but with limited success, and there remains no cure.
The GuARDS study is testing if dexamethasone treatment – a well-known steroid and cheap anti-inflammatory drug which presented encouraging results following a small research study conducted in Spain five years ago — can save ARDS patients’ lives and reduce long term complications post survival.
In order to understand how effective dexamethasone is, UK researchers decided that testing it with a much bigger group of 1700 patients with ARDS could provide a definitive answer.
It is also hoped that dexamethasone could help to reduce the need for extended ICU care, improve longer-term patient quality of life, and find the best value for the public and health services.
GuARDS now has over 60 sites open to recruitment — with University Hospital Hairmyres/NHS Ayrshire & Arran and the University of Edinburgh/NHS Lothian also active sites in Scotland.
The trial is not limited to traditional ARDS — it will also test if dexamethasone is effective in treating both pneumonia and respiratory failure secondary to pancreatitis, where patients also need respiratory support in critical care.
The trial will also follow patients up for six months post discharge from critical care allowing the study team to report on survival and the longer-term health of patients treated in the study.
Liz Coote, Head of Non-Commercial Research Services at Tayside Medical Science Centre (TASC), said: “We’re delighted with this recognition of Tayside's ongoing success in the GuARDS study.
“It means that a lot of hard work and team effort is paying off, and that hopefully, an important breakthrough in the treatment of life-threatening ARDS might be made with the help of a strong contribution from our colleagues in NHS Tayside amid a collective UK-wide endeavour — but of course we must keep pushing and enable opportunities for other patients to take part if they wish to do so.”
Steve McSwiggan, Senior Research and Development Manager at NHS Tayside, added: “With the GuARDS trial being conducted across more than 60 sites it’s great to see the Ninewells site recruiting so well and making such an important contribution to the study recruitment.
“It is down to the efforts of Dr Matt Cassey and the research team from our Clinical Research Centre, supported by their clinical colleagues in the Critical Care Unit who have provided the opportunity to participate in this important research study to their patients. With Ninewells aiming to recruit 36 patients into the study by July 2027, the team are on track to achieve that comfortably.
“This would also not be possible without the immense support from all involved, culminating in a well-coordinated study co-led by Professor Manu Shankar-Hari of the University of Edinburgh, and underpinned by a strong foundation of patient and public involvement which has really helped to shape the study and reflecting the strong support for clinical research in NHS Scotland.”
The GuARDS study is funded by the National Institute for Health and Care Research (NIHR). For further information visit GuARDS | GLUcocorticoids for ARDS.
Publication date: 4th April 2025
