Vipul Jairath 

Graduate Research Prize Winners Spring 2014

Vipul Jairath

As an undergraduate at Leeds University, I obtained a first class honours degree in Pharmacology and then graduated in Medicine with honours and distinction in 2003. Following junior doctor training in Oxford and London, I commenced specialty training in Gastroenterology in 2006 in North East Thames. I returned to Oxford in 2009 as a clinical research fellow funded by NHS Blood and Transplant under the supervision of Professors Mike Murphy and Simon Travis and was awarded a DPhil in Clinical Medicine.

During my 4 years as a research fellow I was co-chief investigator of the TRIGGER trial, a pragmatic cluster randomised feasibility trial comparing restrictive versus liberal blood transfusion for gastrointestinal bleeding, published in the Lancet in 2015. The trial was run in partnership with the MRC Clinical Trials Unit and was a collaborative effort with emergency medicine, acute medicine, gastroenterology, critical care and blood transfusion services.

I am also co-investigator for the HALT-IT trial (Tranexamic acid for gastrointestinal bleeding), a trial funded by the NIHR HTA aiming to recruit 8000 patients internationally with acute severe gastrointestinal bleeding. I was involved in the trial design, successful grant application, set-up and championing of the study within UK gastroenterology.

In 2015, I was awarded a National Institute for Health Research Clinical Trials Fellowship which was spent at the Oxford Clinical Trials Unit and Centre for Statistics in Medicine in Oxford, headed by Professors Doug Altman and Sally Lamb. I have formalised training in clinical trials through a combination of “hands on” exposure as well as a diploma in Clinical Trials at the London School of Hygiene and Tropical Medicine and collaborate with clinical trial statisticians on a broad range of methodological projects focusing on design and analytical issues in clinical trials.

My research focuses on the design and conduct of multi-centre clinical trials with a particular interest in cluster randomisation as an efficient method of evaluating treatment strategies. I am involved in the development of range of new indices to be used as endpoints in clinical trials for inflammatory bowel disease as well as several investigator initiated clinical trials.

Between 2010-2015 I have been a direct or co-applicant to over £4.5 million of peer reviewed grant funding.

In 2016, I moved to the University of Western Ontario in Canada as Associate Professor of Medicine and recipient of the John and Susan Macdonald Endowed Chair in Inflammatory Bowel Disease Clinical Research. My clinical inflammatory bowel disease practice is based at University Hospital, London Ontario. I retain a cross appointment at the Nuffield Department of Experimental Medicine, University of Oxford.

Selected publications:

Khanna R, Jairath V (joint 1st), Vande Casteele N et al.  Efficient early drug development in ulcerative colitis. Gastroenterology 2016 Mar 23. pii: S0016-5085(16)00366-8. doi: 0.1053/j.gastro.2016.03.013

Morgan K, Forbes A, Keogh R, Jairath V, Kahan BC. Choosing appropriate analysis methods for clusterrandomized cross over trials with a binary outcome. Statistics in Medicine, In press.

Jairath V, Zou GY, Parker C et al. Systematic review and meta-analysis: Placebo rates in induction and maintenance trial of Ulcerative Colitis. Journal of Crohn’s and Colitis. 2016

Jairath V, Khanna R, Zhou GY,Stitt L, Mosli M, Vandervoot MK, D’Haens G , Sandborn WJ, Feagan BG, Levesque BG. Development of Interim Patient Reported Outcome Measures for the Assessment of Ulcerative Colitis Disease Activity in Clinical Trials. Aliment Pharmacol Ther. 2015 Sep 21. doi: 10.1111/apt.13408

Jairath V, Kahan BC, Gray A et al. Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): pragmatic, cluster randomised feasibility trial. Lancet 2015 Jul 11;386(9989):137-44.

Cro S, Kahan BC, Dore CJ, Bratton DJ, Rehal S, Maskell N, Rahman N,  Jairath V. Reducing bias in open label trials where blinded outcome assessment is not feasible: strategies from two randomised trials Trials 2014 DOI: 10.1186/1745-6215-15-456

Jairath V, Thompson J, Kahan BC et al. Poor outcomes in hospitalised patients with gastrointestinal bleeding. Impact of baseline risk, bleeding severity and process of care. American Journal of Gastroenterology 2014, in press.

Kahan BC, Jairath V, Dore C, Morris T. The risks and rewards of covariate adjustment
in randomised trials: an assessment of 12 outcomes from 8 studies. Trials
2014 Apr 23;15(1):139.

Roberts I, Coats T, Edwards P, Gilmore I, Jairath V et al. The HALT-IT Trial: Tranexamic acid for treatment of gastrointestinal bleeding: an international, randomised, double blind placebo controlled trial. Trials 2014, in press.

Jairath V, Rehal S, Logan RFA, Kahan BC, Stanworth S, Travis SP, Murphy MF, Palmer KR,
Burroughs AK. Acute variceal haemorrhage in the United Kingdom: patient characteristics,
management and outcomes in a nationwide audit. Dig Liv Dis 2014 May; 46(5):419-26 in

Bryant RV, Jairath V, Curry N, Travis SP. Thrombosis in inflammatory bowel disease: are we
tailoring prophylaxis to those most at risk? Journal of Crohn’s and colitis 2014 Feb; 8(2):166-

Jairath V, Kahan BC, Gray A et al. Restrictive versus liberal blood transfusion for
acute upper gastrointestinal bleeding: Rationale and protocol for a cluster randomized
feasibility trial. Transfus Med Rev 2013 Jul;27(3):146-53

Kahan BC, Jairath V, Murphy MF, Dore CJ. Update on the Transfusion in Gastrointestinal
Bleeding (TRIGGER) trial: statistical analysis plan for a cluster-randomised feasibility trial.
Trials 2013 Jul; 14: 206

Gecse KB, Khanna R, van den Brink GR, Ponsioen CY, Löwenberg M, Jairath V, Travis SP, WJ,
Feagan BG, D'Haens GR. Biosimilars in IBD: hope or expectation? Gut (leading article) 2013
Jun: 62)6); 803-7.

Restellini S, Kherad O, Jairath V, Martel M, Barkun AN. Red blood cell transfusion is
associated with increased rebleeding in patients with non-variceal upper gastrointestinal
bleeding. Aliment Pharmacol Ther. 2013 Apr;37(8):839-40.

Jairath V, Kahan BC, Stanworth SJ, Logan RFA, Hearnshaw SA, Travis SPLT , Palmer KR,
Murphy MF. Prevalence, management and outcomes of patients with coagulopathy
following acute non-variceal upper gastrointestinal bleeding in the UK. Transfusion
2013 May; 53 (5):1069-76.

Jairath V, Burroughs AK. Anti-coagulation in liver cirrhosis – complication or therapeutic
opportunity? Gut (leading article) 2013 Apr;62(4):479-82.

Jairath V and Barkun AN. Improving outcomes from acute upper gastrointestinal bleeding.
Gut (leading article) 2012 Sep;61(9):1246-9

Jairath V. Acute Upper Gastrointestinal Bleeding – time for some new triggers? Transfus
Med 2013 Jun: 23(3); 139-41.

Jairath V, Kahan BC, Logan RFA, Hearnshaw SA, Dore C, Travis SPLT, Murphy MF, Palmer
KR. Outcomes following acute nonvariceal gastrointestinal bleeding in relation to time to
endoscopy: results from a nationwide study. Endoscopy 2012 Aug; 44(8):723-30

Jairath V, Martel M, Logan RF, Barkun AN. Why do outcomes for Acute Upper
Gastrointestinal Bleeding differ around the world?- A systematic review of cohort studies.
Canadian Journal of Gastroenterology 2012 Aug; 26(8); 537-43

Roberts I, Ker, K, Jairath V, Shakur H. The case for universal access to Tranexamic Acid. Vox
Sanguinis, ISBT Science Series (2012) 7, 173-6

Jairath V, Stanworth SJ. Gastrointestinal Bleeding. Vox Sanguinis, ISBT Science
Series (2012) 7, 34-36.

Jairath V and Barkun AN. The Overall Approach to the Management of UGIB. GI Endoscopy
Clinics of North America. 2011 Oct;21(4):657-70.

Jairath V, Kahan BC, Logan RFA, Hearnshaw SA, Travis SPLT, Murphy MF, Palmer KR.
Mortality from Acute Upper Gastrointestinal Bleeding in the UK- does it display a weekend
effect? American Journal of Gastroenterology. 2011 Sep;106(9):1621-8.

Jairath V, Kahan BC, Logan RFA, Travis SPLT, Palmer KR, Murphy MF. Red Cell Transfusion
Practice in patients presenting with Acute Upper Gastrointestinal Bleeding- A survey of 815
UK Clinicians. Transfusion. 2011 Sep;51(9):1940-8.

Jairath V, Hearnshaw S, Brunskill S, Doree C, Hopewell S, Hyde C, Travis S, Murphy MF. Red
Cell transfusion for the management of upper gastrointestinal haemorrhage. Cochrane
database of systematic reviews. 2010 Sep 8;(9):CD006613. Review.