Ljungby

Researchers are evaluating the effects of vicadrostat combined with empagliflozin in adults who have type 2 diabetes, high blood pressure, and cardiovascular disease but no history of heart failure. The study aims to assess whether this combination can help reduce cardiovascular risks compared to a placebo with empagliflozin. This Phase III trial involves adults with these conditions who are already receiving treatment for them. Participants are randomly assigned to one of two groups. One group takes vicadrostat and empagliflozin tablets daily, while the other group takes placebo tablets that look like vicadrostat but have no active medicine, alongside empagliflozin. Treatment lasts from two and a half years up to four years and three months. All participants continue their usual medications for diabetes, blood pressure, and heart disease during the study. Throughout the study, lasting up to four years and three months, participants visit the study site regularly for health checks and blood samples. Doctors monitor cardiovascular events and any side effects experienced. The main outcome measured is the time until the first cardiovascular death or heart failure event. Other health indicators like blood pressure and kidney function are also tracked to understand the effects of the treatment combination.

Spontaneous intracerebral hemorrhage ICH is a serious type of stroke with high death and disability rates. Researchers are investigating whether a structured treatment package called a Care Bundle can improve the 3-month outcomes for patients with acute ICH compared to standard care. The study is an international, multicenter, parallel, cluster-randomized clinical trial focusing on implementing this Care Bundle in high-income countries, building on results from previous trials mostly done in low- and middle-income countries. The Care Bundle includes early intensive blood pressure lowering, treatment of fever and high blood sugar, rapid reversal of oral anticoagulation, and timely referrals to intensive care or neurosurgery when needed. Hospitals are randomized in batches through three phases usual care, randomized evaluation of the Care Bundle versus usual care, and a post-implementation follow-up where all hospitals apply the Care Bundle. Each batch lasts 18 months, with 6 months per phase, and the overall study rollout spans 2.5 years. Participants are adults aged 18 or older diagnosed with spontaneous ICH confirmed by imaging within 24 hours of symptom onset. During the study, patient management details and outcomes will be closely monitored, including brain imaging, blood pressure, glucose levels, and functional status. The primary outcome is functional recovery measured by a utility-weighted modified Rankin Scale score at 180 days. Secondary outcomes include disability, death, and health-related quality of life. The study also collects data on treatments and care decisions to evaluate the Care Bundles effectiveness and sustainability.

Researchers are evaluating a Scandinavian decision support tool designed to help manage children with mild and moderate head injuries who seek care in emergency departments. The study focuses on whether these guidelines can reliably identify children with important complications, such as bleeding in or around the brain, following head trauma. This is a prospective, multicenter observational study including hospitals in Sweden and Norway that routinely treat children with traumatic brain injuries. The study involves no changes to usual care all children receive standard management regardless of participation. Data is collected on patient history, symptoms, and treatment during the emergency visit and entered into electronic case report forms. Follow-up is conducted through medical records and electronic questionnaires sent to guardians at 1, 3, and 4 months after injury, with long-term outcomes assessed beyond 6 months. A sub-study will also explore blood and saliva biomarkers to predict brain injury in certain cases. Participants will be monitored through clinical examinations, CT scan results, and questionnaires about recovery. The study measures outcomes like clinically important brain injury within one week, need for neurosurgery, CT findings, hospital admission, and time to full recovery. Safety and long-term effects are followed for up to four years. Data is analyzed to assess how well the Scandinavian and other international guidelines predict outcomes for children with head trauma.