Boxmeer

Researchers are comparing two diagnostic approaches for patients suspected of having muscle-invasive bladder cancer. The study evaluates progression-free survival over two years, the time to definitive treatment, and cost-effectiveness between the standard care method of transurethral resection of the bladder tumor (TURBT) and a newer approach using multi-parametric MRI (mpMRI) followed by a same-day cystoscopic bladder biopsy. This is a two-arm multicenter randomized controlled trial aiming to improve local staging methods for this condition. Participants will be randomly assigned to one of two groups. One group will receive the standard of care involving TURBT along with blood samples taken shortly before and after the procedure. The other group will undergo mpMRI followed by a cystoscopic bladder biopsy on the same day. These procedures are designed to assess and diagnose the suspected muscle-invasive bladder cancer more precisely. During the study, participants will be monitored for progression-free survival for up to two years. Researchers will collect data on how long patients remain free from disease progression, the timing of definitive treatments, and overall cost-effectiveness. The trial involves multiple centers, and participants will provide written informed consent before enrollment. This study focuses on adults suspected of muscle-invasive bladder cancer without evidence of lymph node or distant metastases.

Childhood arthritis, specifically Juvenile Idiopathic Arthritis (JIA), is a chronic disabling disease. Researchers are studying new biologic therapies that target key molecules causing inflammation. These therapies can be effective but may have serious side effects like infections or cancers and are costly. This research aims to develop tests to understand each child's arthritis biology better and predict the best times to start or stop biologic treatments. The study is an observational cohort across multiple centers collecting data from children with arthritis. It includes collecting biological samples, clinical data, and patient-reported outcomes. The research also examines the economic impact of arthritis treatments by assessing personal and societal costs and benefits, including the value of biomarker testing. Data is managed securely through a cloud-computing service to integrate and analyze information in near real-time, supporting personalized treatment decisions. Participants will be followed for up to 24 months to gather clinical, biological, and socioeconomic data. Researchers will evaluate outcomes related to starting, using, or stopping therapeutic agents. The study also looks at extreme disease forms over 12 months. Data collected includes medical assessments, biological samples, and patient questionnaires, aiming to develop tools to predict disease course, treatment response, and remission to guide safer and more effective care for children with arthritis.