Salisbury

Researchers are evaluating the safety and performance of the Polymer Free Sirolimus Eluting Coronary Stent Vivo ISAR in patients with coronary artery disease CAD. This observational registry focuses on individuals treated with this specific stent and planned for a short dual antiplatelet therapy DAPT of up to 3 months. The study aims to collect real-world data on clinical outcomes including safety and effectiveness over a 12-month period. Participants in this single-arm registry have undergone percutaneous coronary intervention PCI using the Vivo ISAR stent and will receive standard care short DAPT treatment for no more than 3 months. The study does not affect treatment choices or standard care procedures. After the PCI, eligible patients will be invited to join the registry and followed up at 1 month, 3 months, and 12 months. During the study, researchers will collect baseline medical data and conduct telephonic follow-ups at 30 days, 3 months, and 12 months. These follow-ups will check on medication use, laboratory assessments, adverse events, and any further interventions. The main outcomes measured include ischemic and bleeding events at 12 months, along with secondary outcomes such as mortality, heart attacks, strokes, stent thrombosis, and need for additional vessel treatments. The total participation duration is one year from the PCI procedure.

Researchers are evaluating the safety and effectiveness of BGB-16673 compared to pirtobrutinib in adults with relapsed or refractory chronic lymphocytic leukemia CLL or small lymphocytic lymphoma SLL who have previously been treated with a covalent Bruton tyrosine kinase inhibitor cBTKi. The study is a phase 3, open-label, randomized trial sponsored by BeOne Medicines, aiming to assess treatment options for these patients. Participants are randomly assigned to receive either BGB-16673 or pirtobrutinib, both taken orally. This parallel assignment design compares these two drugs directly. The treatments continue with monitoring up to approximately three years to observe progression-free survival and other outcomes. The study began in September 2025 and is expected to complete in April 2028. During the trial, participants will undergo regular assessments including imaging scans to measure disease status, quality of life questionnaires, and monitoring for adverse events. Outcomes such as overall survival, response rates, duration of response, and time to next treatment are tracked. Safety and quality of life will be evaluated throughout the study period, which may last up to about three years for each participant.

Researchers are evaluating an experimental drug called odronextamab combined with lenalidomide in adults who have relapsed or refractory follicular lymphoma FL or marginal zone lymphoma MZL, which are subtypes of Non-Hodgkins lymphoma. The study aims to assess the safety, tolerability, and proper dosing of this new combination and compare its effectiveness to the current standard treatment of rituximab combined with lenalidomide. The research also explores side effects, drug levels in the blood, immune responses to the drug, and impacts on quality of life and daily functioning. The study has two parts Part 1 is a safety phase where all participants receive odronextamab plus lenalidomide to determine the appropriate dose. Part 2 is randomized and compares two groupsone receiving odronextamab with lenalidomide, and the other receiving rituximab with lenalidomide followed by lenalidomide alone. Participants receive these treatments according to the study protocol during these phases. Throughout the study, participants will undergo various assessments including safety monitoring for side effects, measurement of drug concentrations and immune responses, imaging scans to evaluate disease status, and quality-of-life questionnaires. The primary outcomes include tracking dose-limiting toxicities up to 35 days and treatment-emergent adverse events up to 2 years. Longer-term outcomes such as progression-free survival and overall survival will be followed for up to 5 years, with ongoing evaluations to understand the treatments impact over time.

Researchers are evaluating whether using MRI imaging for staging sigmoid colon adenocarcinoma can change treatment plans by detecting more high-risk tumors compared to standard CT imaging. This randomized phase II multicenter trial aims to improve radical treatment decisions and provide better prognostic information to patients. The study involves patients eligible for curative treatment whose MRI can be reviewed before surgery without a prior treatment decision. Participants are assigned randomly to one of three groups standard preoperative CT imaging with multidisciplinary team discussion, standard CT plus an additional preoperative MRI scan with team discussion, or observation only. The MRI provides supplementary diagnostic information that may alter treatment strategies based on local protocols. During the study, patients are followed up at 1 and 3 years with quality of life questionnaires. Researchers assess differences in cancer staging between CT and MRI, treatment changes, recurrence rates, disease-free survival, surgery quality, pathology outcomes, morbidity and mortality, and permanent stoma rates. The total follow-up extends up to 5 years after treatment, with outcomes measured at multiple time points to understand the impact of MRI staging on patient care.

Researchers are studying the use of magnetic resonance tumour regression grade mrTRG as a new imaging biomarker to guide treatment decisions for patients with locally advanced rectal cancer. This phase III trial is unique in the UK as it offers a watch and wait approach for patients showing a good response to preoperative treatment, potentially avoiding surgery. The trial aims to validate mrTRGs ability to identify patients who can safely defer surgery and those who may need intensified treatment, thus tailoring care based on MRI findings. Participants are randomly assigned to one of two groups. The control group receives management according to national guidelines with post-treatment MRI scans interpreted without mrTRG assessment. The intervention group has their post-treatment MRI scans evaluated by specially trained radiologists to assign an mrTRG grade. Patients with a good response mrTRG 1 & 2 are offered a watch and wait approach to avoid surgery, while those with a poor response mrTRG 3-5 have their cases reviewed by a local colorectal multidisciplinary team for further treatment planning and surveillance. Treatment decisions, including chemotherapy use, follow routine clinical practice and are documented but not dictated by the trial. Participants undergo regular monitoring for up to five years, including routine post-treatment MRI scans following the MERCURY protocol and quality of life questionnaires at registration, 3 years, and 5 years. The study assesses if surgery can be safely avoided after a good MRI response and tracks surgical outcomes, survival, quality of life, and economic impact. Additional evaluations include reproducibility of mrTRG readings, molecular and immunological markers, and circulating tumor DNA to predict relapse. This long-term follow-up aims to improve personalized treatment for rectal cancer patients.

This research aims to improve the accuracy of MRI scans in detecting early-stage rectal cancer and significant rectal polyps. Many patients with early rectal cancer currently undergo major surgery or unnecessary treatments due to inaccurate staging. The study evaluates a new MRI reading method called PRESERVE, which has been shown to identify early rectal cancers more accurately and may allow more patients to have less invasive local excision surgery that preserves the rectum and quality of life. The study compares two phases a control phase where patients receive standard care, and an intervention phase following training of radiologists in the PRESERVE MRI staging method. During the intervention phase, MRI scans are recommended for rectal polyps 20mm or larger or with suspicious features before removal, alongside radiologist training. Each hospital transitions from control to intervention at a randomized time, with no crossover of patients between phases. Participants will be monitored through clinical investigations before, during, and after treatment as per standard care. Researchers will assess the accuracy of tumor staging on MRI, the number of patients identified for rectal preservation surgery, and quality of life outcomes over up to 5 years. Additional measures include scan quality, tumor characteristics, treatment costs, and histopathological biomarkers. The primary outcome is the impact of radiologist training on staging accuracy measured after one year.

Researchers are evaluating the impact of implantable cardioverter-defibrillators ICDs on patients who have survived a myocardial infarction heart attack and have a severely reduced left ventricular ejection fraction LVEF of 35% or less. This group is at increased risk of sudden cardiac death caused by dangerous heart rhythms. Past landmark trials showed ICDs improved survival, but advances in medical therapy have changed patient outcomes, prompting the need to reassess the benefits and risks of ICDs alongside current optimal treatments. In this randomized trial, participants receive optimal medical therapy OMT based on European Society of Cardiology guidelines for managing heart failure and chronic coronary syndromes. One group will also receive an ICD device, while the other group will not. The study compares outcomes between these two groups to determine if OMT without ICD is not worse than OMT with ICD in preventing death. The trial includes patients with symptomatic heart failure and reduced LVEF after a myocardial infarction. Participants will be followed over time with regular evaluations to monitor health and outcomes. Researchers will measure the time from randomization to death from any cause as the primary outcome, with additional assessments including cardiovascular death, sudden cardiac death, hospital readmissions, length of hospital stays, and quality of life over a year. The study is event-driven and expects to observe outcomes about 15 months after the last participant is enrolled. Safety and effectiveness of treatments will be carefully monitored throughout.

Researchers are exploring whether trained volunteers can help older adults in hospitals stay active to prevent loss of strength and mobility, a common issue that can lower quality of life and increase healthcare costs. This study is a feasibility trial conducted in three hospitals of varying sizes, aiming to see if volunteer-led physical activity is practical and accepted by patients, volunteers, and staff. The study will compare outcomes in patients who receive usual care with those who receive the volunteer-led intervention. Trained volunteers will deliver tailored physical activities twice daily to hospitalised older adults starting from recruitment until discharge. Patients who can walk independently will perform walking exercises progressing over time, while those with mobility impairments will do bedside or chair exercises, advancing as they improve. Volunteers receive training and are monitored by hospital therapists to ensure safety and correct exercise delivery. Control patients receive usual care without the volunteer-led activities. Participants will be assessed at baseline and discharge for physical function, muscle strength, quality of life, and physical activity levels using various tests and monitors. Data on hospital stay length and readmissions will also be collected. Researchers will track the number of trainers and volunteers recruited, trained, and retained, as well as adherence to the intervention. Interviews and observations will explore how well the program is accepted and identify any barriers or facilitators to its implementation. The study runs for about three years and aims to inform wider use of volunteer-led activity programs in hospitals.

Researchers are evaluating treatments for community-acquired pneumonia CAP, especially in patients admitted to intensive care units ICUs. This trial also adapts to study treatments for respiratory pandemics like COVID-19. The goal is to determine which treatment strategies improve outcomes for patients with severe pneumonia, using a flexible, ongoing approach that can test multiple therapies simultaneously and update as new information becomes available. Participants receive different treatment strategies based on random assignment to study groups. Treatments include various antibiotics, steroids, antivirals, immune modulators, anticoagulation methods, and ventilation strategies. Some treatment options have been closed to recruitment, reflecting the trials adaptive nature. The trial includes several domains targeting specific infections such as influenza and COVID-19, with dosing and duration guided by clinical practice and local guidelines. During the study, participants are monitored closely with assessments including survival up to 90 days, days alive without organ support in ICU, ICU and hospital length of stay, ventilator-free days, organ failure-free days, and quality of life up to 6 months. Researchers collect detailed data on patient outcomes, organ support needs, and hospital discharge status. The study runs until February 2028, with ongoing evaluation to improve pneumonia treatment strategies in ICU settings and during respiratory pandemics.

Researchers are studying advanced pelvic cancers, which are rare and often require complex treatment involving radiotherapy, chemotherapy, and surgery. Surgery typically involves removing multiple pelvic organs and surrounding tissues, which can lead to complications affecting recovery and quality of life. This study aims to investigate the frequency of these complications, quality of life, and related costs following different reconstruction techniques to help improve decision-making for patients and doctors. This observational study has three parts maintaining a database of patients undergoing colorectal surgery, conducting a national prospective cohort study to assess morbidity, quality of life, and healthcare resource use, and a qualitative study using interviews to explore patient experiences after surgery. Patients undergoing surgeries like abdominoperineal excision or pelvic exenteration will be followed, with reconstruction methods chosen by the surgeon. Data such as surgery details, complications, and resource use will be collected and analyzed. Participants will complete quality of life and financial impact questionnaires at baseline, 3, 6, and 12 months after surgery, either by telephone or email. Clinical data, imaging, and hospital resource use will also be recorded. The qualitative study will involve interviews with selected patients at 3 and 12 months post-surgery to deepen understanding of recovery and long-term outcomes. The study will analyze these data to evaluate the impact of different reconstruction methods on patient health and healthcare costs over time.