Abergavenny

This research aims to understand the genetic factors that contribute to the risk of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). GCA is a serious inflammatory disease affecting blood vessels, mainly in people over 50, which can cause severe complications like vision loss or stroke if untreated. PMR causes pain and stiffness in the limbs with signs of inflammation. The study involves both patients recently suspected of having GCA and those with confirmed diagnoses from the past. It seeks to provide new insights into disease causes and improve diagnosis and treatment approaches. Participants are observed in a multi-center study collecting clinical and genetic data. The study includes both prospective patients with suspected GCA and retrospective patients with confirmed GCA or PMR diagnoses. Some retrospective participants receiving tocilizumab for recurring or difficult-to-treat GCA are also included in a safety monitoring registry. Data collected include clinical features, imaging, tissue and blood samples, and advanced genetic testing. The study also follows patients over time to assess disease impact, quality of life, and long-term outcomes. During the study, participants provide medical information, biological samples, and complete questionnaires about their symptoms and quality of life. Researchers monitor disease activity and treatment effects, especially among those starting certain immune-modifying drugs. The main measurements focus on genetic susceptibility at the study start, with ongoing evaluation of diagnosis, prognosis, and disease progression. The study is designed to improve understanding and management of GCA and PMR over time.

Researchers are evaluating a range of treatments to improve outcomes for adults admitted to intensive care units (ICUs) with severe community-acquired pneumonia (CAP), including cases caused by influenza and COVID-19. This Phase 3 adaptive platform trial, REMAP-CAP, is designed to test multiple treatment strategies simultaneously and adapt over time, allowing new treatments to be added as questions are answered. The trial also serves as a platform to quickly evaluate treatments during respiratory pandemics, such as COVID-19, through a sub-study called REMAP-COVID in the United States. Participants receive various interventions including antibiotics like ceftriaxone, moxifloxacin, or piperacillin-tazobactam, as well as macrolide therapies given for different durations. Other treatments assessed include corticosteroids such as hydrocortisone and dexamethasone, antiviral agents like oseltamivir and remdesivir, immune modulators including tocilizumab and baricitinib, and supportive care strategies such as mechanical ventilation methods. Dosing and duration vary for each treatment, with some interventions now closed. Treatments are administered according to local guidelines and clinical decisions, with some requiring intravenous or enteral routes. Participants are closely monitored with assessments focusing on survival and organ support status in the ICU up to 90 days after enrollment. The main outcomes measured include all-cause mortality by day 90 and the number of days alive without needing organ support in the ICU by day 21. The study collects data continuously to adapt treatment assignments for new participants, aiming to identify the most effective therapies. Follow-up and safety monitoring continue throughout hospitalization and up to 90 days after admission.

Researchers are evaluating diagnostic methods at Rapid Diagnostic Centres (RDCs) in England to improve cancer detection in patients presenting with common but unclear symptoms such as weight loss, fatigue, cough, or general practitioner suspicion. These centres aim to provide faster and more personalized cancer diagnosis, especially for patients with non-specific symptoms that are often harder to interpret. The study focuses on developing new blood or non-blood tests to identify which patients have cancer and which are at higher risk for future cancer, enhancing current diagnostic pathways. The study will collect breath, blood, and saliva samples from approximately 1000 patients attending RDCs. Breath samples will be collected from around 300 patients, while blood and saliva samples will be collected from about 1000 patients. Samples will be taken at the first appointment and potentially at up to three follow-up visits if needed. The study will use these samples alongside routine clinical data, imaging scans for some patients, and patient questionnaires to develop tests that can distinguish cancer from non-cancer cases and identify cancer types. Each participant will be assigned a unique Study ID to protect their personal information. Participants will provide clinical data, biological samples, and health questionnaires at multiple appointments. Researchers will analyze the accuracy of clinical data review, polygenic risk scores, imaging radiomics, and multiparametric machine learning analyses over a 5-year period. Patients will be followed for 12 months after recruitment to confirm diagnoses or monitor stability. The study aims to develop tests that can correctly classify patients and support earlier cancer detection while protecting patient privacy and maintaining confidentiality throughout the study.