Gatineau

Researchers are evaluating the effectiveness and safety of empasiprubart compared to intravenous immunoglobulin (IVIg) in adults diagnosed with Multifocal Motor Neuropathy (MMN). This Phase 3 study includes a double-blinded phase where participants receive either empasiprubart or IVIg, followed by an open-label phase where all receive empasiprubart. The study aims to assess treatment impact over a maximum duration of up to 49 months. Participants receive intravenous infusions of either empasiprubart or IVIg during the double-blinded phase, with matching placebo infusions given to maintain blinding. In the open-label phase, all participants are given empasiprubart infusions. The study carefully monitors treatments and their effects throughout these periods. Participants undergo assessments including measuring changes in grip strength of their most affected hand, using a 3-day moving average at week 24 as the primary outcome. Safety and efficacy are tracked throughout the study duration, with detailed follow-up visits and evaluations to monitor participant response and well-being during the study period.

Atrial Fibrillation (AF) affects about 200,000 Canadians and raises the risk of stroke, illness, and death. A stroke can severely impact a person's ability to speak, eat, walk, work, care for themselves, and interact with others, and it can be fatal. AF causes slow blood flow in the heart's upper chambers, which can lead to blood clots that may travel to the brain and cause a stroke. Blood thinners, or anticoagulants, help reduce the chance of these clots forming and lower stroke risk by up to 95%. However, there has been no direct comparison between two newer blood thinners, rivaroxaban and apixaban, which are approved for stroke prevention in AF by Health Canada. This research compares the safety of taking apixaban twice daily versus rivaroxaban once daily in patients with non-valvular AF. Both drugs are taken by mouth and are direct oral anticoagulants (DOACs) that do not require regular blood tests or dietary restrictions like warfarin. The study is a phase 4 randomized controlled trial designed to assess the rate of bleeding events in patients using these medications over 12 months. Participants will be followed for one year, during which researchers will monitor for clinically relevant bleeding events, including major bleeding and other significant bleeding episodes. The study will collect information on safety and side effects to help guide the best choice of anticoagulant for patients with AF. This trial aims to provide important data to improve clinical decisions and patient care regarding stroke prevention in AF.

This research aims to evaluate whether efgartigimod is as effective or not inferior to intravenous immunoglobulin (IVIG) in treating stable myasthenia gravis patients who test positive for acetylcholine receptor antibodies and depend on IVIG. The study also seeks to understand patient treatment preferences between IVIG and efgartigimod, as well as assess the safety and tolerability of efgartigimod administered regularly over six months. Participants include adults aged 18 to 80 years with stable disease and chronic IVIG treatment history. Participants will stop IVIG one week before starting the study. Efgartigimod will be given as an intravenous infusion at a dose of 10 mg/kg (up to 1200 mg) once a week for four weeks, followed by a four-week break. This cycle will repeat four times until week 24. Afterward, there will be a two-week observation period ending at week 26. Throughout the study, other myasthenia treatments like non-steroidal immunosuppressive therapies, acetylcholinesterase inhibitors, or corticosteroids will remain unchanged. During the 26-week study, researchers will perform weekly evaluations using the Myasthenia Gravis Activities of Daily Living (MG-ADL) scale and the Myasthenia Gravis Quality of Life (MGQOL) assessments. They will monitor any sustained decrease in MG-ADL scores over at least four consecutive weeks. Safety and tolerability will also be closely observed. This open-label, single-center study involves descriptive analysis to track participants' responses and preferences between the two treatments.

Researchers are evaluating the immediate effects of a wearable robotic exoskeleton on mobility, balance, and walking in healthy older adults and individuals with Parkinson's disease, groups at high risk for falls and mobility challenges. The study aims to identify which participants benefit most from the exoskeleton, compare different levels of assistance, and explore how users perceive and accept this technology in daily life. This mixed-methods study takes place in a laboratory setting and includes both clinical assessments and user interviews to better understand the potential benefits and concerns of exoskeleton use. Participants will attend two sessions spaced two to four days apart. The first session involves fitting and familiarization with the exoskeleton, baseline health and mobility assessments, and interviews before and after using the device to capture expectations and experiences. In the second session, participants perform various mobility tasks such as walking, standing, and turning with and without the exoskeleton under different assistance levels. The exoskeleton assistance will be adjusted across conditions, including a preferred level determined in the first session, increased and decreased assistance levels, and a free mode with no assistance but no motor resistance. During the study, researchers will measure mobility using functional tests like the Timed Up and Go, 10-meter walk test, and sit-to-stand test, while also collecting movement data with wearable sensors. Participants with Parkinson's disease will be tested during the optimal effect of their usual medication. The study includes clinical, cognitive, and physical assessments, alongside interviews to gather user feedback. Results will inform the development of assistive devices to support safer and more independent mobility in older adults and people with Parkinson's disease.

Researchers are evaluating the impact of repetitive transcranial magnetic stimulation (rTMS) on walking ability, overall disability, walking endurance, and quality of life in people with Multiple Sclerosis (MS) who have spastic paraparesis and moderate walking disability. The study also aims to assess neural synchrony using EEG parameters in these patients. This research focuses on adults aged 18 to 70 years with MS diagnosed according to the 2017 McDonald Criteria and specific disability levels. Participants will receive treatment with either active rTMS or sham rTMS daily, five times per week, for six consecutive weeks. After a six-week break, all participants will undergo another six-week treatment period with active rTMS. The intervention is delivered using a device designed to provide non-invasive neuromodulation targeting the neurological symptoms associated with MS-induced spastic paraparesis. During the study, participants will complete assessments including the Timed 25-Foot Walk Test to measure walking speed, along with evaluations of overall disability and quality of life. Researchers will monitor neurological stability and medication use throughout the study. The primary outcome is improvement in walking ability measured at 18 weeks. Participants' adherence and safety will be observed over the entire treatment and follow-up periods.

Researchers are studying how an online training and peer support platform called Support-t can help youth aged 14 to 16 with Type 1 Diabetes (T1D) prepare to transition from pediatric to adult diabetes care. This transition period often leads to worsening blood sugar control, lower adherence to diabetes management, and higher risk of complications. The trial compares Support-t plus usual diabetes care to usual care alone, aiming to see if Support-t improves blood sugar levels, reduces adverse events, and enhances psychosocial outcomes during this transition phase. Participants will be randomly assigned to one of two groups: one group will receive access to the Support-t platform in addition to their standard pediatric diabetes care, while the other group will continue with usual care only. The intervention lasts 18 months, with participants recruited over a 20-month period from four pediatric diabetes clinics in Quebec. The study is designed to be blinded for outcome assessors and data analysts, and includes ongoing monitoring throughout the intervention. During the study, participants will be assessed at the start and at 6, 12, and 18 months for blood sugar control measured by Hemoglobin A1c (HbA1c), self-efficacy, diabetes distress, quality of life, readiness to transfer to adult care, glucose management, severe hypoglycemic episodes, diabetic ketoacidosis, emergency visits, and hospitalizations related to T1D. Researchers will also evaluate cost-effectiveness and gather feedback on the platform's use, satisfaction, and barriers. The total participation time is 18 months from enrollment.