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Document 1167502
School of Medicine
at Guy’s,
King’s College and
St Thomas’
Hospital
Professor J N W N Barker
BSc MD FRCP FRCPath
Dr C H Smith
MD FRCP MRCP MB BS
Skin Therapy Research Unit
Division of Genetics and
Molecular Medicine
St John’s Institute of Dermatology
9th Floor, Tower Wing
Guy's Hospital
London SE1 9RT
Tel +44 (0)20 71886277
Fax +44 (0)20 718 86113
Email: [email protected]
Site Recruitment Questionnaire / Expression of Interest
A multi-centre, prospective, cohort study to establish clinically relevant pharmaco-genetic
markers of systemic treatment outcomes in patients with severe psoriasis
Short title - “Bio-marker of Systemic Treatment Outcomes in Psoriasis”, B-STOP
REC Ref: 11/H0802/7
PLEASE RETURN THE COMPLETED FORM TO: [email protected]
Proposed Principal Investigator at Site
Have your PI and nursing staff taken part in other
research studies previously?
Number of staff to be involved in the project?
Is there a specialist severe psoriasis/biologic clinic
in the Dept.
What is your site’s current recruitment to the
BADBIR Study?
Approximately how many new patients do you
recruit to BADBIR per month?
Are there facilities within the dermatology
department for the collection of blood samples?
Will you have access to facilities for the centrifuging
of samples at your site?
(centrifugation of samples at 10 minutes at 1000g
or RPM equivolent)
Do you have facilities available to store frozen
blood and serum samples?
(-20 celcius or colder)
If Yes to above, at what temperature can you store
samples?
The BSTOP study has strong interest in recruiting
patients who are commencing biologic therapies
Adalimumab and Ustekinumab.
Approximately how many patients at your hospital
initiate Adalimumab and Ustekinumab per month?
Are there any other research studies running in
your department that may conflict, either with staff
time or patient recruitment?
Version 2, 25 August 2015
New Adalimumab per month: _____
New Ustekinumab per month: ____
(e.g. iMAP, BioDIP)
Address of Reseach Site
R&D Goverance Contact at your Site
To expedite the R&D process, please provide CVs for your proposed study team
along with your completed form.
Thank you.
Version 2, 25 August 2015
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