Boxmeer

Researchers are evaluating two diagnostic approaches for patients suspected of having muscle-invasive bladder cancer MIBC. This trial compares the standard care method, Transurethral Resection of the Bladder Tumor TURBT, with a newer approach using multiparametric MRI mpMRI followed by a same-day cystoscopic bladder biopsy. The study aims to assess progression-free survival, time to definitive treatment, and cost-effectiveness over two years. Participants will be randomly assigned to one of two groups one undergoing mpMRI plus same-day cystoscopic bladder biopsy, and the other receiving TURBT with blood samples taken shortly before and after the procedure. Both groups will be monitored and compared for their diagnostic outcomes and related healthcare costs. Throughout the study, participants will have regular evaluations including assessments of progression-free survival, quality of life, healthcare costs, and circulating tumor cells before and after TURBT. The main outcome measure is progression-free survival at two years. The study involves multiple centers and aims to provide detailed information on the effectiveness and cost implications of these diagnostic strategies.

Childhood arthritis is a long-lasting and disabling condition affecting children. New biologic therapies target key molecules causing inflammation and are used for treatment, but these treatments may have serious side effects like infections or cancer, and are costly. Researchers aim to develop tests that understand each childs arthritis biology to better predict when to start or stop biologic therapies for personalized care. This study is an observational research project collecting detailed clinical data, biologic samples, and patient-reported outcomes from children with juvenile idiopathic arthritis JIA. It includes four groups children suspected of JIA untreated except for NSAIDs, those starting or switching biologic therapies, those stopping or tapering biologics after inactive disease, and children with severe or genetically influenced arthritis. Data is securely stored and analyzed in near real-time using advanced cloud technology. Participants will be closely monitored up to 24 months to collect clinical, biologic, and socioeconomic data. The study evaluates disease course, treatment responses, and remission, aiming to create predictive tools for more effective and safe treatment strategies. Outcomes include clinical and biological data collection, assessment of therapy use and discontinuation effects, and socioeconomic impact related to treatment. The study is managed by The Hospital for Sick Children and involves ongoing data integration throughout the trial.