The Tommy’s National Centre for Miscarriage Research team, led by Professor Arri Coomarasamy and Associate Professor Adam Devall, has been given the University of Birmingham’s award for Outstanding Contribution to Research Impact in Policy Change for the PRISM trial – an investigation into progesterone treatment for people experiencing early pregnancy bleeding.
More than 4,000 women in the first 12 weeks of pregnancy took part in the trial, making it the largest ever study on this area. The results, published in the New England Journal of Medicine, showed that use of progesterone pessaries increases the rate of successful live births for those who have early pregnancy bleeding and a history of previous miscarriage.
The trial found a small reduction in miscarriage for people who had previously had 1 or 2 previous miscarriages, and a big reduction in miscarriage for those with 3 or more previous miscarriages.
Following publication, our research and an analysis of how much it would cost the NHS to introduce was used by NICE to inform their review of national guidelines. In a change of practice endorsed by the Royal College of Obstetricians and Gynaecologists, NICE’s guidelines were updated in November 2021 to make progesterone more readily available as a treatment for miscarriage.
Our UK-wide survey carried out before the publication of the PRISM trial showed that only 13% of doctors prescribed progesterone to those who could benefit. A second survey, carried out after publication of the PRISM trial, showed that 75% were now prescribing progesterone for women and pregnant people.
A third survey in March 2022 following the NICE guideline change and additional work by Tommy’s to raise public awareness of the treatment, found that 86% of clinicians now use progesterone.
It’s estimated that this change will now prevent 8,450 miscarriages a year in the UK, saving babies’ lives.
Following the receipt of the team’s impact award from the University of Birmingham, Tommy’s Chief Executive Kath Abrahams said:
“Congratulations to the team on this recognition. The incredible success of this research gives us hope that we can firmly relegate to the past a belief that miscarriage is ‘just one of those things’. Treatments can be developed, and lives can be saved.
“The PRISM trial confirmed that a simple, relatively low-cost, treatment, when given to the right women at the right time can have an incredible impact, preventing more than 8,000 babies’ lives being lost a year, and changing thousands of families forever. When parents show us photographs of their babies and tell us ‘they wouldn’t be here if it wasn’t for progesterone’ – we see the enormous difference our researchers have made.”
The PRISM trial was funded by the National Institute for Health Research (NIHR) and co-ordinated by the University of Birmingham in collaboration with Tommy’s National Centre for Miscarriage Research.
Image: Professor Adam Duvall (centre) receives an Impact Award from the University of Birmingham's Professor Heather Widdows (left) and Professor Alice Roberts (right)