Les Abymes

Researchers are evaluating whether adding lidocaine to the standard pain management for adults experiencing severe vaso-occlusive crises in sickle cell disease can reduce the total opioid use during these painful episodes. This phase 3 trial focuses on adults admitted to intensive care with vaso-occlusive crisis or acute chest syndrome, aiming to understand the impact on opioid consumption expressed as morphine milligram equivalents. Participants are randomly assigned to receive either intravenous lidocaine or a placebo, both given as an initial bolus followed by a continuous infusion over 72 hours, alongside standard care for pain management. The lidocaine is administered as a 1.5 mgkg bolus over 30 minutes, then a continuous infusion of 1 mgkg per hour, with maximum doses specified. The placebo group receives a similar volume of sodium chloride solution. The study monitors treatment effects during hospital intensive care and up to 28 days following randomization. Throughout the study, participants undergo regular assessments including pain scales, opioid usage tracking, length of stay in intensive care and hospital, and evaluations of crisis resolution and complications. Quality of life and safety profiles related to lidocaine infusion are also measured at 28 days. The primary outcome is total opioid consumption up to intensive care discharge. Participants remain under close observation, with data collected on readmissions and economic factors related to adding lidocaine to standard care.

Sepsis is a serious condition involving life-threatening organ dysfunction caused by an uncontrolled response to infection, affecting many people worldwide. This research aims to understand how a protein complex called NLRP3 inflammasome activates in blood platelets among different groups of patients with bacterial or viral sepsis, including COVID-19 cases. The study evaluates the role of platelets in the intense inflammation called a cytokine storm seen in sepsis. Participants will be divided into five groups those with leptospirosis, bacterial infections including hospital-acquired infections, viral infections excluding COVID-19, non-infected controls, and patients with COVID-19 previously enrolled in another trial. The study involves one blood sample collection per participant to analyze the activation of the NLRP3 inflammasome. During the study, researchers will measure the activation level of the NLRP3 protein in platelets and use confocal microscopy for detailed analysis. Participants will provide consent, and the study will monitor these markers at the baseline. The overall goal is to better understand platelet involvement in sepsis-related inflammation, with no further treatment or follow-up procedures mentioned. The study is observational and includes adults aged 18 years and older.

Researchers are studying the effects of acetylsalicylic acid and atorvastatin on overall survival in patients with castrate-resistant prostate cancer CRPC who are starting first-line treatment. This international, open, phase III trial uses a 2x2 factorial randomized design to evaluate these drugs in addition to the standard care for CRPC. The study aims to understand whether adding these medications can improve survival outcomes for this patient group. Participants are randomly assigned to one of four groups standard of care alone, standard of care plus acetylsalicylic acid 100 mg daily, standard of care plus atorvastatin 80 mg daily, or standard of care plus both acetylsalicylic acid and atorvastatin. These treatments are taken daily alongside the usual care for their cancer. The trial monitors patients over up to 15 years to assess the long-term impact on survival. During the study, participants will be regularly evaluated for overall survival, which is calculated from the date of randomization until death. Researchers will also monitor patients for safety and adherence to the treatments. The trial includes detailed eligibility screening, performance status assessments, and laboratory tests to ensure patients meet the criteria to participate safely. The long follow-up period allows for comprehensive observation of treatment effects and patient outcomes.