Gloucester

Researchers are conducting an observational study to understand the short-term progression of geographic atrophy GA caused by age-related macular degeneration AMD in adults aged 55 years and older. The study aims to identify participants with progressive GA to measure structural and functional changes and explore whether these changes relate to genetic or lifestyle factors. This multi-center research provides insights into disease progression without introducing any treatment interventions. Participants with bilateral GA secondary to AMD will be observed over time. The study involves assessments at baseline, month 3, and month 6 to measure the progression of GA using imaging techniques such as fundus autofluorescence FAF and optical coherence tomography OCT. Researchers will quantify GA lesion size and evaluate visual function parameters, including best-corrected visual acuity BCVA and retinal sensitivity using microperimetry. During the study, participants will attend visits for eye examinations and imaging at specified time points to monitor GA progression. The research team will use these assessments to analyze short-term changes in GA and explore correlations with genetic and lifestyle factors. The total participation duration is approximately six months, during which safety and vision measures will be carefully monitored.

Researchers are evaluating a port delivery system PDS with ranibizumab for adults aged 50 and older who have neovascular age-related macular degeneration nAMD. This Phase IIIb study aims to assess the effectiveness, safety, and patient-reported outcomes of refilling the PDS implant every 36 weeks. The study focuses on maintaining vision and reducing the treatment burden for people with nAMD who have already received prior anti-VEGF injections. Participants will have a PDS implant surgically inserted in their study eye on Day 1, pre-filled with ranibizumab at a concentration of 100 mgmL. Those who show disease activity or receive supplemental ranibizumab injections before Week 24 will have refill exchanges every 24 weeks, while others will receive refill exchanges every 36 weeks. Supplemental intravitreal ranibizumab injections may be given as needed during the study. Throughout the trial, participants will undergo assessments including vision tests using the Early Treatment Diabetic Retinopathy Study chart, eye imaging, and monitoring of eye thickness. Researchers will track changes in vision, need for supplemental treatments, implant safety, and patient preferences. The study lasts until Week 72, with safety and adverse event monitoring continuing for approximately 19 months after implantation.

Researchers are evaluating Dostarlimab compared to a placebo in adults with locally advanced unresected Head and Neck Squamous Cell Carcinoma HNSCC. This phase 3 trial aims to assess the safety and effectiveness of Dostarlimab as a sequential therapy following chemoradiation treatment in participants with this type of cancer. Participants are randomly assigned to receive either Dostarlimab or a placebo, both given as intravenous infusions. The study is double-blind, meaning neither the participants nor the researchers know which treatment is being given. The treatments follow completion of chemoradiation with cisplatin and radiotherapy intended to cure the cancer. During the study, participants will be monitored for up to approximately 5 years. Researchers will evaluate event-free survival and overall survival, with safety assessments including treatment-emergent adverse events and laboratory tests. Blood samples will be taken to measure drug levels and immune responses. This long-term follow-up will help understand the effects and safety of Dostarlimab after chemoradiation therapy.

Multiple myeloma is a cancer of the plasma cells in the bone marrow. This phase 3 study is investigating how well Immune Globulin Infusion IGI, 10% helps prevent infections in adults with multiple myeloma who are receiving B-cell maturation antigen BCMA x cluster of differentiation 3 CD3 directed bispecific antibody therapy. The trial compares primary infection prevention using IGI, 10% with secondary prevention given only after a serious infection occurs. Participants are randomly assigned to one of two groups. The primary infection prevention group receives 400 mgkg IGI, 10% intravenously every 3 or 4 weeks for 12 months. The secondary infection prevention group receives the same dose and schedule only after they develop a serious infection during the 12-month study period. The dosing is given within 3 days after randomization and continues throughout the observation period. Participants will visit the study clinic 15 times if dosed every 4 weeks or 19 times if dosed every 3 weeks, for up to 14 months including an approximately 8-week screening. Assessments include monitoring time to first serious infection and rates of infections, antibiotic use, hospitalizations, and adverse events. Serum immunoglobulin levels and antibody responses are also measured. Safety and tolerability of IGI, 10% are evaluated during the 12-month treatment and follow-up.

Alopecia areata AA is a condition where the immune system attacks hair follicles, causing hair loss mainly on the head and face but possibly on other body parts. This research evaluates the safety, effectiveness, and tolerance of upadacitinib, an approved drug, in adolescents and adults with severe AA. The study is a Phase 3 randomized, placebo-controlled, double-blind trial enrolling about 1500 participants worldwide. Participants are randomly assigned to one of three groups receiving different treatments two doses of upadacitinib or placebo. In initial periods, some may switch from placebo to upadacitinib based on their Severity of Alopecia Tool SALT score. Those completing early parts may enter an extension phase receiving upadacitinib for up to 108 weeks. Treatment involves taking oral tablets once daily for up to 160 weeks, with possible re-randomization at Weeks 24 and 52. Throughout the study, participants attend regular clinic visits for medical assessments, blood tests, side effect monitoring, and questionnaires to track treatment effects. Researchers measure hair loss improvement using SALT scores and record adverse events over approximately 164 weeks. Participants are followed for up to 30 days after their last dose for safety monitoring.

Researchers are evaluating the effects of a medicine called BI 1815368 in adults aged 18 and older who have a specific eye condition known as centre-involved diabetic macular edema CI-DME. This condition affects vision, and the study aims to find out if BI 1815368 can improve sight and to determine the best dose. The trial is a phase 2, randomized, double-masked, placebo-controlled study designed to assess efficacy, safety, and tolerability. The study has two parts. In the first part, participants are randomly assigned to one of two groups one receiving BI 1815368 tablets and the other receiving placebo tablets that look identical but contain no medicine. In the second part, participants are randomly assigned to one of four groups three groups receive different daily doses of BI 1815368, and one group receives placebo. All participants take the tablets twice daily for about 11 months. Participants stay in the study for about one year, during which they visit the study site 16 times. At these visits, doctors check vision, document any health problems, and take detailed eye pictures. Researchers compare changes over time between the groups to evaluate if the treatment affects vision. The main outcome measured is whether participants gain at least 10 Early Treatment Diabetic Retinopathy Study ETDRS letters in vision at Week 48 compared to baseline.

Severe diabetic macular oedema DMO affects the central part of the retina called the macula, leading to sight loss due to fluid buildup from leaking blood vessels. This condition mainly occurs in adults with type 1 or type 2 diabetes and is measured by how thick the macula becomes in microns. This trial evaluates and compares the current standard treatment of anti-vascular endothelial growth factor anti-VEGF injections alone with a new approach where patients start with anti-VEGF injections and then switch to subthreshold micropulse laser SML treatment once the macula thickness decreases below 400 microns. Participants are randomly assigned to receive either continued anti-VEGF monotherapy or a combination where anti-VEGF treatment is followed by SML applied every 2-3 months after the macula thickness drops below 400 microns. Anti-VEGFs used include ranibizumab, aflibercept, faricimab, and brolucizumab, administered monthly initially and then spaced out as needed. SML is applied according to the study guidelines once the macula thins, aiming to reduce the number of injections required. During their participation, individuals will undergo regular optical coherence tomography OCT scans to measure macular thickness and visual acuity tests up to 104 weeks after randomization. Researchers will assess vision changes, macular thickness, quality of life, safety, treatment use, and participant experience. The study also includes follow-up questionnaires and qualitative interviews to understand patient preferences and the potential for wider implementation of the laser treatment strategy.

Alopecia areata AA is a chronic autoimmune condition causing hair loss on the scalp and other body areas, affecting children, adolescents, and adults of all backgrounds. This study focuses on patients aged 12 years and older who are prescribed ritlecitinib, a medication approved for severe AA. Researchers aim to understand patient and disease characteristics, treatment patterns, and outcomes with ritlecitinib in everyday clinical practice. Participants receive ritlecitinib according to approved guidelines and their doctors judgment, reflecting real-world treatment rather than a controlled trial setting. The study observes patients over time, assessing how the medication is used and its impact on AA symptoms. No placebo or control group is involved, as the study is observational. Throughout the study, patients attend regular clinic visits to monitor their condition, complete questionnaires about their experience and quality of life, and undergo assessments like the Severity of Alopecia Tool SALT score. The main measurement is the percentage change in SALT score after 24 weeks, with additional follow-ups at later weeks to evaluate ongoing effectiveness and patient satisfaction. The total study period extends to April 2028.

Researchers are evaluating the effects of a medicine called BI 690517 combined with empagliflozin in adults with chronic kidney disease CKD who are at risk of their kidney condition getting worse. The study includes people with or without type 2 diabetes and those who may already be taking medicines like angiotensin converting enzyme inhibitors ACEi, angiotensin receptor blockers ARB, or sodium-glucose cotransporter-2 inhibitors SGLT2i. The goal is to understand if adding BI 690517 can help delay worsening kidney function, hospitalizations due to heart failure, or cardiovascular death. After a run-in period where all participants take empagliflozin and other standard medications, participants are randomly assigned to receive either BI 690517 tablets or placebo tablets once daily alongside empagliflozin. The run-in period confirms that participants are stabilized on empagliflozin before randomization. The treatment phase continues for about three to four years until enough kidney or heart-related events have occurred to compare outcomes between the two groups. During the study, participants visit the study site about five times in the first six months and then every six months thereafter. At these visits, health is regularly checked through blood and urine tests, blood pressure and weight measurements, kidney function monitoring, and collection of any side effect information. The main outcome measured is the time until the first occurrence of kidney disease progression, hospitalization for heart failure, or cardiovascular death.

This research aims to evaluate the impact and value of immersion training practices for endoscopy trainees. It addresses the current pressures on endoscopy services and the need to review training methods at a national level. The study will investigate whether immersion training is effective and cost-efficient in improving trainee skills and service outcomes. The study involves both retrospective and prospective analyses of endoscopy trainees who have either completed or will soon undergo immersion training in gastroscopy or colonoscopy. The evaluation will compare immersion training with standard base hospital training by examining various performance measures over a six-month period from the start of data collection. Participants will be assessed on improvements in procedural skills scores, intubation rates, time and number of procedures required for certification, post-certification independent endoscopy numbers, and confidence levels. These outcomes will help determine the trainings impact, with data collected and analyzed throughout the study period. The research is sponsored by Gloucestershire Hospitals NHS Foundation Trust and is scheduled to run until February 2026.