ADVANCE Study
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A randomised trial of blood pressure lowering and glucose control in individuals with type 2 diabetes. |
The Regional Coordinating Centre
The ADVANCE study Regional Coordinating Centre (RCC) for Australasia and SE Asia (Australia New Zealand, Malaysia, Philippines, and India), is located in the Department of Physiology, University of Melbourne.
The Staff
The RCC comprises of a team of four. The Regional Study Chief Investigator is Professor Stephen Harrap Head of the Department of Physiology. Ravathi Subramaniam is the Regional Study Manager, Sonia Noske and Shan Chan are the Regional Associate Study Managers.
Our Responsibilities
Our RCC team is responsible for the coordination of the 43 local clinical centres across the region. Most of these local centres are based in large hospitals where our teams on site consist of Investigators and Coordinators. Most of the 100 Local Investigators are doctors with specialisation in endocrinology and diabetes and most of our 70 or so Local Coordinators are research nurses with expertise in clinical trials. In our region we have over-arching responsibility for ensuring that all stages in this large trial are undertaken strictly in line with the defined protocols and International Good Clinical Practice (ICH-GCP) guidelines. These aspects include recruitment, ethics approvals, data gathering and quality, event reporting, follow-up and eventually close-out in relation to the approximately 2500 patients in our region.
Background to the ADVANCE Study
Diabetes mellitus is a major global health problem, and in 1995 it was estimated to affect about 135 million adults world wide. Type 2 diabetes is the most common form of diabetes.
Individuals with type 2 diabetes have increased risks of macrovascular and microvascular disease. These risks are directly associated with blood pressure levels and blood glucose levels.
Controlling blood pressure levels in hypertensive individuals with diabetes has been shown to reduce the risks of complications. Similarly, intensive glucose control reduces the risk of microvascular disease.
Areas of uncertainty remain as to whether lowering blood pressure further in non-hypertensive individuals further reduces complications; or whether further blood glucose control reduces the risk of macrovascular disease.
ADVANCE study – The Big Picture
The ADVANCE study is a large international study (over 11,000 participants) investigating the unresolved issues relating to blood pressure management and blood glucose control in people with type 2 diabetes. The aim of ADVANCE is to see if treatment to lower blood pressure and control glucose levels more tightly than usual reduces the risk of all complications in adults with type 2 diabetes. Link to ADVANCE website: https://www.ctru.auckland.ac.nz/advance/
Participant recruitment commenced in June 2001 and ended in March 2003. Follow-up is expected to continue until mid 2008.
The international coordination of the study is being undertaken by the George Institute for International Health, Sydney (http://www.thegeorgeinstitute.org/)
The involved countries are divided into 5 regions, which are:
- Australasia and SE Asia;
- Northern Europe;
- Continental Europe;
- Canada and
- China.
Countries involved in the ADVANCE study