Translation in Action: Prof Ed Wild
Professor Ed Wild talks us through his lab’s recent work with Roche on developing smartphone tests that could accelerate drug development for Huntington's disease
What does translation mean to you in your work?
Translation is turning ideas into solutions that work for the people who need them.
What’s the motivation behind your research?
We are centrally involved in many clinical trials for Huntington’s disease (HD) – a fatal neurogenerative disorder. Because HD is rare and slowly progressive, running such trials is challenging and anything we can do to get answers sooner or more accurately will help us develop meaningful treatments as soon as possible. My work since 2005 has focused on biomarkers - things we can measure that tell us how severe a person’s symptoms are or give an indication of whether a treatment is working.
What did your research involve?
In partnership with Roche, we developed a “digital biomarker” platform for assessing the symptoms of HD including overall wellbeing and movement symptoms. These were assessed via a smartphone in the daily lives of over a thousand volunteers.
Participants were invited to complete several movement tasks each day – such as walking and turning with the phone in their pocket; holding the phone flat to assess involuntary movements (chorea); and drawing shapes on the screen.
From the dozens of tests and hundreds of measurements collected, we were able to develop the HD Digital Motor Score (HDDMS) which assesses the effect of HD on a person’s movement control – and turns out to be about twice as sensitive as the best in-clinic measure for detecting progression in HD. That could lead to smaller, shorter trials – getting us where we need to be more efficiently.
How long did your research take, from ideation to application?
The idea began in 2016 with focus groups to figure out what were the most relevant things we needed to capture. It took eight years (and a pandemic, and a failed phase 3 drug trial) to generate the data we needed and derive the HDDMS.
How many people were involved in the project?
The core team included two UCL researchers and a team of about a dozen at Roche. But the digital platform relied on data collected from just over a thousand patient and control volunteers, largely via a phase 3 trial that enrolled 900 people at 99 sites in 20 countries – pretty big for a rare disease.
How will your research impact people living with Huntingdon’s disease?
If the HDDMS lives up to its initial performance, sponsors of future clinical trials will want to include it in their studies, to give an earlier idea of success or failure. We may even see it used to support regulatory applications for accelerated approval alongside traditional clinical and biomarker measures. For the people living with HD, I hope this will translate into meaningful disease-slowing treatments becoming available for prescribing months or years sooner than they otherwise would.
What will happen now? And are you conducting further research as a result of this?
Now the HDDMS has been published it’s up to the global HD community to put it to the test. Anyone who wants to can use it in their studies just like any other commercially available measurement like a biosample or MRI analysis. My team will continue to work with Roche to refine the platform and see what other meaningful tools we can generate from the mountain of data we’ve collected.