Cape Town

Researchers are evaluating a quality improvement program called the '5 Rs to Rescue' aimed at reducing preventable deaths after surgery, known as 'failure to rescue,' in hospitals across Africa. This condition occurs when complications after surgery are not identified and treated quickly enough, leading to deterioration and death. The study takes place in 20 centers across Ethiopia, South Africa, Tanzania, and Uganda, focusing on improving patient management after surgery to lower mortality rates compared to high-income countries. The '5 Rs to Rescue' intervention targets five key areas: assessing risk using the ASOS risk score, recognizing patient deterioration through regular vital signs monitoring and Early Warning Score (EWS) systems, responding to deterioration with protocol-based care, reassessing patients after interventions, and reflecting on care during regular meetings. This complex quality improvement approach is implemented as a cluster trial with a baseline assessment to measure its effectiveness in increasing surveillance for patients at risk of failure to rescue after surgery. Participants aged 18 and older who undergo surgery and receive postoperative care on participating wards will be involved. Researchers will collect data on patient monitoring, clinical responses, and outcomes including intervention success within 72 hours after surgery. The study includes a mixed-methods process evaluation to understand how and why the program works or does not, aiming to improve postoperative survival through better identification and management of complications.

Researchers are evaluating remibrutinib (LOU064) in adolescents aged 12 to under 18 years who have chronic spontaneous urticaria (CSU) that is not well controlled by H1-antihistamines. This Phase 3 trial aims to assess the effectiveness, how the drug is processed in the body, and safety of remibrutinib compared to a placebo. The study also intends to gather long-term data on how well remibrutinib works and its safety over several years after treatment ends. The trial includes three periods. First, the core period is a 24-week double-blind phase where about two-thirds of participants receive remibrutinib and one-third receive placebo, with about 10 site visits over approximately 32 weeks. Next is an optional open-label extension lasting from one to three years, where participants who completed the core period may receive remibrutinib or enter an observational treatment-free phase depending on their symptoms. Participants may cycle through treatment and observational periods up to six times. Finally, an optional long-term treatment-free follow-up can last up to three years with one site visit and up to four phone calls. During the study, participants undergo assessments including changes in urticaria activity scores (UAS7), itching severity (ISS7), and hive severity (HSS7) measured from baseline to 12 weeks. Regular visits monitor safety, symptoms, and drug effects. The study tracks these measures to understand remibrutinib's impact on CSU symptoms and overall safety profile during and after treatment, with total participation potentially lasting several years.

Researchers are looking for new medicines to prevent HIV-1 (Human Immunodeficiency Virus Type 1) infection. The goals of this study are to learn: * If taking MK-8527 once a month works to prevent HIV-1 infection as well as or better than a standard (usual) pre-exposure prophylaxis (PrEP) taken once a day * About the safety of MK-8527 and if people tolerate it

Researchers are investigating new treatments for people with high-risk, early-stage breast cancer, specifically targeting triple-negative breast cancer (TNBC) and hormone receptor (HR)-low positive/HER2-negative breast cancer. These types have little or no HER2 protein and involve hormones like estrogen or progesterone. The study aims to evaluate if the addition of sacituzumab tirumotecan (sac-TMT), a targeted therapy, combined with pembrolizumab and chemotherapy can improve outcomes compared to pembrolizumab with chemotherapy alone. Participants receive treatments including sacituzumab tirumotecan, pembrolizumab, and chemotherapy drugs such as carboplatin and paclitaxel, all given by intravenous infusion. Rescue medications like antihistamines, acetaminophen, dexamethasone, or steroid mouthwash may be used as needed. The study is randomized and open-label, comparing sac-TMT followed by chemotherapy plus pembrolizumab to chemotherapy and pembrolizumab without sac-TMT. During the study, researchers will monitor participants up to about 30 weeks to assess the percentage of people with no remaining cancer cells at surgery. They will also follow participants for up to approximately 92 months to track event-free survival, meaning time without cancer growth, spread, or return. Participants will undergo imaging, clinical assessments, and laboratory tests to evaluate treatment effects and safety throughout the study.

Researchers are conducting a global observational study to understand how molecular changes in mature T-cell and NK-cell neoplasms affect patient outcomes such as overall survival and progression-free survival. The study aims to use machine learning to identify genetic factors that influence treatment response and resistance, with the goal of moving towards personalized treatment options for these lymphoma types. The study focuses on patients who are newly diagnosed, have primary refractory disease, or have relapsed. This prospective, longitudinal study enrolls patients at their initial visit and follows them for up to four years during their clinical care. Data collected includes routine demographics, clinical features, pathology, molecular tumor information, radiology, treatment details, and quality of life measures. Molecular analysis uses next generation sequencing techniques on archived tumor samples, mononuclear cells, cell-free DNA, and saliva when feasible. The data is securely shared among participating institutions and analyzed with advanced deep learning to predict treatment responses and survival. Participants will be monitored over the course of four years with regular collection of clinical and molecular data by research teams. The study measures overall survival, progression-free survival, duration of response, time to disease progression, and rates of stem cell transplantation. Researchers also investigate associations between tumor-specific genetic changes and treatment outcomes. The secure, collaborative data sharing supports comprehensive analysis to improve understanding of these lymphomas and guide future therapies.

Researchers are evaluating the safety and effectiveness of combining durvalumab and domvanalimab compared to durvalumab plus placebo in adults with locally advanced (Stage III), unresectable non-small cell lung cancer (NSCLC) whose disease has not worsened after definitive platinum-based concurrent chemoradiation therapy. This Phase III, randomized, double-blind, placebo-controlled, international study involves multiple centers. Participants receive intravenous infusions of durvalumab and domvanalimab or durvalumab and placebo. The treatments are given after patients have completed concurrent platinum-based chemotherapy and radiation therapy with a total radiation dose of approximately 60 Gy. The study monitors patients over time to assess treatment effects and safety. During the study, participants undergo evaluations including tumor tissue analysis for PD-L1 status, performance status assessments, and monitoring of organ and marrow function. The main outcome measured is progression-free survival up to 8 years after randomization. Researchers also monitor for any adverse effects and disease progression throughout the study period.

Researchers are evaluating the efficacy and safety of benralizumab, given as a subcutaneous injection, in children and adolescents aged 6 to under 18 years who have severe eosinophilic asthma. These patients have a history of asthma exacerbations and uncontrolled symptoms despite treatment with high-dose inhaled corticosteroids plus at least one other controller medication. This Phase III study aims to compare benralizumab to placebo in reducing the time to the first asthma exacerbation. The study includes a screening period lasting from 4 to 12 weeks to confirm eligibility. After screening, patients are randomly assigned in a 1:1 ratio to receive either benralizumab or placebo via subcutaneous injections during a double-blind treatment period lasting a minimum of 16 weeks. This period continues until the patient experiences an asthma exacerbation or a set number of events occur. Patients who exacerbate can enter an open-label extension where all receive benralizumab for at least 48 weeks. An end-of-treatment visit occurs 8 weeks after the last dose in the extension phase. Participants will be monitored through visits and assessments including confirmation of severe eosinophilic asthma, asthma control questionnaires, and symptom diaries. Researchers will measure the time to first asthma exacerbation as the primary outcome. Medication adherence is tracked during screening, and safety is monitored throughout both the double-blind and extension periods. Total participation may span over a year, considering screening, treatment, extension, and follow-up visits.

Researchers are evaluating the safety, tolerability, and immune response duration of a second dose of the RSVpreF vaccine given during later pregnancies. The study also examines how long immunity lasts from a single dose given during a previous pregnancy by analyzing blood samples from nonpregnant participants who had the vaccine before. This is a Phase 3 trial focused on pregnant women and their babies as well as nonpregnant women previously vaccinated. Pregnant participants are grouped into Cohort 1, who previously received RSVpreF in a Pfizer trial and will get a second dose, and Cohort 2, who received RSVpreF previously via commercial or trial means and will be randomly given either RSVpreF or placebo. Both groups will be monitored for safety and immune response. Cohort 3 includes nonpregnant women who had RSVpreF before and will provide blood samples to check how long protection lasts, without receiving further vaccination. Participants will undergo safety monitoring during pregnancy and after birth. Infants will be followed for six months to assess safety and antibody levels. Blood tests will measure immune response, including neutralizing antibodies at birth. The study tracks local and systemic reactions, adverse events, serious adverse events, and new medical conditions in both pregnant participants and their infants over various timeframes throughout the study.

Researchers are evaluating the safety and effectiveness of zodasiran injections in adolescents and adults aged 12 years and older who have genetically or clinically diagnosed Homozygous Familial Hypercholesterolemia (HoFH). This phase 3, randomized, placebo-controlled study aims to understand how the treatment affects levels of LDL cholesterol, a harmful type of cholesterol, in the blood over time. Participants receive either zodasiran or a placebo through subcutaneous injections during the double-blind treatment period. After completing this phase, those who wish can enter an optional open-label extension where all placebo participants have the chance to switch to the active drug. The study involves ongoing monitoring to compare the effects of zodasiran versus placebo. Throughout the study, participants will have their LDL cholesterol levels measured at the start and after 12 months to assess changes. Researchers will also monitor safety through regular clinical assessments and laboratory tests. The total duration includes the double-blind period plus the optional extension, providing detailed information on treatment impact and participant health over time.

This research aims to evaluate the effectiveness, safety, and tolerability of two doses of remibrutinib compared to placebo in people aged 12 years and older with moderate to severe hidradenitis suppurativa, a chronic skin condition. The study is a phase 3 clinical trial involving participants with a diagnosis lasting at least six months and active symptoms in multiple body areas. The purpose is to determine how well remibrutinib works and how safe and tolerable it is for this condition. The trial lasts a total of 76 weeks and includes several parts: a screening period of up to 4 weeks, a first treatment period of 16 weeks where participants receive either remibrutinib Dose A, Dose B, or placebo in a double-blind manner, followed by a second treatment period lasting 52 weeks during which all participants receive remibrutinib doses. After treatment, there is a 4-week safety follow-up without treatment. Participants stopping treatment early are encouraged to continue in the study and complete the safety follow-up. During the study, participants will be regularly monitored for their response to treatment, including the proportion who achieve a clinical response measure called HiSCR50 at Week 16. Assessments will include physical exams and safety checks throughout the treatment periods and follow-up. The study seeks to gather detailed information on how remibrutinib affects the severity of hidradenitis suppurativa and participants' overall health during and after treatment.