Sao Jose

Researchers are studying finerenone to evaluate its safety and effectiveness in patients hospitalized with acute decompensated heart failure who have mildly reduced or preserved left ventricular ejection fraction. This international trial is randomized, double-blind, and placebo-controlled, focusing on how finerenone compares to placebo in reducing heart failure events and cardiovascular death. Participants receive either oral finerenone or a matching placebo while hospitalized or recently discharged for heart failure. The study monitors patients over approximately 30 months to assess the total heart failure events, cardiovascular death, and adverse events related to the treatment. Throughout the study, participants undergo regular assessments including symptom scoring using the Kansas City Cardiomyopathy Questionnaire, monitoring for serious adverse events, and evaluation of heart failure outcomes. The study tracks safety and efficacy data over the long term, with follow-up visits scheduled to measure the impact of treatment on morbidity and mortality in heart failure patients.

Researchers are evaluating the effects of therapeutic-dose heparin compared to usual care pharmacological thromboprophylaxis in patients hospitalized with community-acquired pneumonia CAP. This international, open-label, randomized controlled trial aims to understand if higher doses of heparin can improve outcomes by addressing inflammatory and thrombotic processes that contribute to respiratory, cardiac, and organ complications in CAP. The study builds on findings from COVID-19 patients, where therapeutic-dose heparin showed benefits in non-critically ill patients. Participants are randomly assigned to one of two groups. One group receives a daily therapeutic dose of low molecular-weight heparin LMWH or unfractionated heparin UFH for up to 14 days or until hospital discharge. The other group receives usual care with thromboprophylactic dose anticoagulation following local protocols, with doses not exceeding half the therapeutic level. The investigational arm prefers LMWH but may use UFH, especially in cases of renal compromise, with dosing tailored to patient weight and local standards. During the study, participants will be monitored for survival over 30 days as the primary outcome. Secondary outcomes include bleeding events, heparin-induced thrombocytopenia HIT, thrombotic events, invasive mechanical ventilation, mortality at multiple time points, hospital-free days, and health-related quality of life. The study involves hospital assessments, close monitoring of safety and clinical status, and tracking of various health measures up to 180 days, ensuring comprehensive evaluation of the treatments under study.

Researchers are investigating the impact of adding inclisiran to usual care compared to usual care alone on lowering LDL cholesterol LDL-C in patients hospitalized after an acute cardiovascular event such as a heart attack, ischemic stroke, or urgent coronary revascularization. This multi-country, open-label, randomized clinical trial focuses on patients stabilized and ready for discharge following such events. The study explores the real-world effects on LDL-C levels, patient-reported outcomes, and healthcare resource use. Participants are divided into two groups one receives usual care, which includes physical activity, diet changes, and standard cholesterol-lowering medications like statins and others the other group receives the same usual care plus inclisiran injections at baseline, 90 days, and 270 days. Usual care treatments vary by country but commonly involve statins and other cholesterol-lowering drugs. This phase 4 study measures the effectiveness of inclisiran added to usual care over approximately 11 months. During the study, participants will have assessments at baseline and at day 330 to measure changes in LDL-C and other outcomes such as the proportion of patients achieving specific LDL-C reduction goals. Researchers also track the timing of statin initiation during the study period. Patient health, adherence to treatment, and safety will be monitored throughout. The study concludes for each participant after the last visit and related assessments at day 330.

Researchers are investigating the effects of pre-operative mouthwash and varying oxygen levels during surgery on the rates of pneumonia and surgical site infections in patients undergoing major abdominal surgery. This trial focuses on patients in low and middle-income countries, where postoperative complications are more common and often more severe. The study aims to find ways to reduce these serious complications, which can cause pain, disability, and increased healthcare costs. Participants will be randomly assigned to one of four groups pre-operative chlorhexidine mouthwash combined with high oxygen levels 80-100% FiO2, no mouthwash with high oxygen levels, mouthwash with low oxygen levels 21-30% FiO2, or no mouthwash with low oxygen levels. Treatments are given around the time of surgery, with oxygen delivered during the operation and mouthwash used before surgery. The study includes an internal pilot phase lasting six months to check recruitment and compliance, followed by a larger trial aiming to enroll nearly 13,000 participants. During the study, researchers will monitor participants for up to 30 days after surgery, assessing rates of pneumonia and surgical site infections using CDC definitions. They will also track other outcomes like mortality, repeat surgeries, hospital stay length, return to normal activities, critical care admissions, and healthcare resource use. Follow-up includes evaluating patient recovery and safety, with all data collected to understand how these interventions impact surgical outcomes in these settings.

Researchers are evaluating two experimental drugs, REGN7508 and REGN9933, in adults with atrial fibrillation, a condition where the heart beats too fast and unevenly. The study aims to compare how well these drugs prevent blood clots and their bleeding effects against apixaban, a commonly used medicine for preventing blood clots in atrial fibrillation. The research also explores side effects, drug levels in the blood, and whether the body develops antibodies that might affect the drugs action or cause side effects. Participants will be randomly assigned to receive REGN7508, REGN9933, or apixaban according to the study protocol. The treatments are given as monoclonal antibodies targeting FXI for the experimental drugs, while apixaban is an active comparator. The study is conducted with a parallel design in multiple centers, focusing on safety and prevention over a 12-week period primarily. During the study, participants will have regular monitoring to assess bleeding events, side effects, blood levels of the study drugs, and antibody responses over approximately 25 weeks. Researchers will measure various bleeding outcomes, stroke or embolism incidence, and changes in blood clotting times. Safety and treatment effects will be tracked closely throughout the trial period, which continues until study completion in 2027.

Researchers are evaluating whether adding zilebesiran to standard antihypertensive treatment can reduce major cardiovascular events in adults with hypertension that is not well controlled and who either have established cardiovascular disease or are at high risk for it. This phase 3, randomized, double-blind study aims to determine if zilebesiran lowers the risk of cardiovascular death, heart attacks, strokes, or heart failure events compared to placebo. The study will continue until a targeted number of these events have occurred, which may take up to about 5 years. Participants will be randomly assigned to receive either 300 mg of zilebesiran or a placebo, both given as subcutaneous injections every 6 months, alongside their usual blood pressure medications. The study uses a parallel design and includes careful monitoring of blood pressure and cardiovascular events over time. Both groups will continue their standard antihypertensive therapies, including at least two medications where one must be a diuretic. During the study, participants will be regularly assessed for cardiovascular events such as heart attacks, strokes, heart failure hospitalizations, and cardiovascular death. Blood pressure measurements will be taken at baseline and at 6 months, among other times. The primary outcome is the time until the first occurrence of a major cardiovascular event, with secondary outcomes including changes in blood pressure and other cardiovascular events. Participants will be followed for up to approximately 5 years to monitor these outcomes and overall survival.