Zollikon

Researchers are evaluating the effectiveness and safety of Xeomin injections in preventing chronic migraine. This Phase 3 clinical trial compares Xeomin to placebo injections given into muscles of the head and neck. Participants have chronic migraine diagnosed for at least 12 months and meet specific headache and migraine day criteria. The study aims to measure changes in monthly migraine days over time with Xeomin treatment. Participants will receive four treatments spaced about 12 weeks apart over a total study duration of 52 to 55 weeks. The treatments involve injections of either Xeomin or placebo solution prepared with sodium chloride. Visits occur approximately every 4 weeks, totaling 14 visits: the first, last, and four treatment visits are on-site, while the other eight visits are remote via phone or video call. During the study, participants will keep headache diaries to track migraine and headache days. Researchers will focus on the change in monthly migraine days from baseline to six months after the first injection. Safety and effectiveness are monitored throughout, with frequent assessments during both on-site and remote visits to ensure accurate tracking of migraine symptoms and any side effects.

Researchers are evaluating the effect of Xeomin injections compared to placebo injections for preventing episodic migraine. This phase 3 clinical trial focuses on adults who experience episodic migraine, aiming to measure changes in the number of migraine days per month. Participants must have a diagnosis of episodic migraine for at least 12 months and meet specific headache frequency criteria. Participants will receive four treatments of either Xeomin or placebo injections into muscles of the head and neck, with treatments spaced about 12 weeks apart. The entire trial lasts approximately 52 to 55 weeks, beginning with a screening period of 4 to 5 weeks. There are about 14 visits in total, with the first, last, and four treatment visits conducted on-site, while the other visits are held remotely via phone or video. Throughout the study, participants will track their migraine days using a headache diary, and researchers will assess changes in monthly migraine frequency from baseline to six months after the first injection. Regular monitoring includes both in-person and remote assessments. The primary outcome focuses on the change in monthly migraine days between baseline and month six after treatment initiation.

Researchers are evaluating treatments for patients with clinically node positive breast cancer who undergo upfront surgery. The study aims to compare tailored axillary surgery (TAS) combined with axillary radiotherapy (ART) against the standard axillary lymph node dissection (ALND) to see which approach results in better arm-related quality of life and fewer cases of lymphedema two years after treatment. This trial addresses the concern that ALND, while standard, can cause significant harm and morbidity, and seeks to determine if TAS plus ART can reduce this burden. Participants are randomly assigned to receive either ALND, which involves surgical removal of lymphatic tissue in the armpit area, or the combination of TAS and ART. TAS targets positive lymph nodes more selectively than ALND and removes fewer nodes, while ART involves radiation treatment to the axillary region. The trial is conducted in the upfront surgery setting, with prior clipping of the most suspicious axillary lymph node to aid in treatment precision. During the study, participants will complete quality of life questionnaires and be closely monitored for the development of lymphedema over two years following randomization. The main outcomes measured are changes in arm-related quality of life and the occurrence of lymphedema. Safety and treatment effects will be tracked through regular follow-up visits, with the overall goal of improving patient well-being and reducing treatment-related side effects.

Researchers are investigating the Hospital at Home (HaH) approach, which provides hospital-level care for acutely ill patients in their own homes. This includes daily visits from doctors and nurses, infusions, physiotherapy, and diagnostic tests. HaH bridges the gap between inpatient and outpatient care by working closely with hospitals, doctors, home care services, and therapy providers. The study focuses on two pathways: admission avoidance, where stable patients are admitted directly to HaH instead of the hospital, and early supported discharge, where hospitalized patients are discharged early and continue care at home. International studies suggest HaH is safe, effective, and may reduce costs and rehospitalization rates compared to hospital care. In this study, patients will receive hospital-equivalent treatment at home including daily medical and nursing visits, infusion therapies, home physiotherapy, and diagnostic procedures like blood tests, ultrasound, and ECG. Care is coordinated with hospitals and other health providers to ensure comprehensive treatment. The study compares HaH care to regular hospital care, assessing costs and a range of outcomes such as mortality, rehospitalization, complications, patient satisfaction, length of stay, and post-discharge care including referrals and emergency visits. Participants will be monitored throughout their treatment period with evaluations of costs, clinical outcomes, and patient experiences. Researchers will collect data on therapy types, monitoring, diagnostics, complications, and follow-up care. The main measure is the cost comparison between HaH and inpatient care over one year or until 200 participants are included. Secondary outcomes include safety, satisfaction, rehospitalization, and long-term care needs. This comprehensive evaluation aims to determine if HaH is a cost-efficient, safe, and patient-centered alternative to traditional hospitalization.

Migraine is a neurological condition causing moderate to severe headaches often accompanied by nausea, vomiting, and sensitivity to light and sound. This research aims to assess how well atogepant works in adults with migraine when used in everyday medical practice. Atogepant is an approved preventive treatment for migraines, and the study will include about 1000 adult participants prescribed this medication by their doctors worldwide. Participants will take atogepant tablets orally as prescribed by their healthcare providers following usual medical care. The study will observe participants over a two-year period without requiring extra treatments or procedures beyond their regular clinical visits. These visits will occur at hospitals or clinics according to each participant's routine care schedule. During the study, participants will attend regular check-ups where researchers will monitor their health and migraine symptoms. The main outcome measured will be the percentage of participants who report feeling "much better" or "very much better" by week 12, based on their own impression of change. There are no additional burdens expected for participants beyond their normal treatment and follow-up appointments.

Researchers are evaluating the effects of different virtual landscape environments on gait therapy for older adults with gait instability. The study focuses on how urban, rural, and forest virtual landscapes may help reduce stress, restore attention, and improve walking performance. This pilot randomized controlled trial aims to identify which types of landscapes best support restoration and contribute to improved gait stability in older people receiving gait therapy as inpatients. Participants will be randomly assigned to either a control group receiving standard gait therapy or intervention groups that receive five additional virtual reality (VR) training sessions over 10 days. During each 25-minute session, participants will wear a head-mounted display (HMD) and first view the assigned landscape (urban, rural, or forest) while seated for 5 minutes, followed by 20 minutes of independent walking exploration within the virtual environment. Walking aids may be used based on individual gait stability. The study uses a commercially available VR system with eye-tracking to provide immersive, safe, and motivating training environments. Throughout the study, participants will undergo various assessments including heart rate variability, electrodermal activity, gait measurements, eye-tracking, and interviews to evaluate stress levels, attention restoration, landscape perception, and balance confidence. The primary outcome is gait stability measured at the start and end of the intervention. This research aims to understand how virtual landscapes influence physical and psychological factors linked to gait improvement, with the goal of enhancing rehabilitation approaches for older adults with gait insecurity.

Researchers are investigating whether early replacement of coagulation factor XIII (FXIII) can reduce postpartum blood loss and complications in women experiencing postpartum hemorrhage (PPH). PPH is a leading cause of maternal death and illness worldwide, defined as blood loss of 500 mL or more within 24 hours after delivery. Current treatments focus on fibrinogen replenishment, but evidence is inconclusive. Previous studies showed a strong link between FXIII levels before birth and postpartum bleeding, motivating this nationwide, multi-center, randomized controlled trial across Switzerland. Women who experience PPH with measured blood loss of 500 mL or more receive 1g tranexamic acid intravenously as standard care. If bleeding continues and exceeds 700 mL, participants are randomized to either receive FXIII (Fibrogammin4) according to approved dosing plus standard obstetric care or to receive only standard care. The study is open-label and conducted at multiple perinatal centers, aiming to assess whether FXIII can reduce blood loss and related complications. During the trial, blood loss is closely monitored within 24 hours after delivery. Researchers will evaluate the amount of blood lost and the incidence of PPH-related complications. Participants are assessed through clinical monitoring and treatment response after randomization. This Phase 4 study contributes to understanding coagulation disorders and improving management of PPH. Participation includes adherence to standard care protocols and treatment administration as per study guidelines.

Gastroentero-pancreatic neuroendocrine tumors (GEP-NETs) are rare tumors that arise from the neuroendocrine system in the gastrointestinal tract and pancreas. This registry study aims to better understand these tumors by collecting detailed clinical information from patients diagnosed with GEP-NETs in Switzerland. Since limited knowledge exists about the biology and treatment of these tumors, the study focuses on gathering data to improve understanding and management strategies. Patients with a confirmed diagnosis of neuroendocrine tumors from any location who agree to participate will have their information entered prospectively into a secure, anonymized database. Data collection involves visits from study nurses to healthcare centers, where patient files are reviewed and information is recorded. There are no specific treatments assigned by this registry; instead, it tracks various treatment approaches used in Switzerland. Participants contribute data that includes tumor types, treatments received, and outcomes such as mortality and hospitalization rates. The study reviews and evaluates this information regularly to identify patterns and assess patient outcomes over time. The main outcome measured is tumor-related mortality every five years, helping to monitor long-term effects. This registry allows for improved knowledge sharing across hospitals and practitioners in Switzerland to enhance care for patients with neuroendocrine tumors.