Mission Viejo

Researchers are evaluating the effect of a triple therapy inhaler called BGF MDI containing budesonide, glycopyrronium, and formoterol fumarate compared with a dual therapy inhaler called GFF MDI containing glycopyrronium and formoterol fumarate in people with Chronic Obstructive Pulmonary Disease (COPD) who have a higher risk of heart and lung problems. This Phase III randomized, double-blind, parallel group study takes place at multiple centers and focuses on cardiopulmonary outcomes in these patients. Participants receive either the BGF MDI 320/14.4/9.6 micrograms twice daily or the GFF MDI 14.4/9.6 micrograms twice daily. The treatments are inhaled using metered dose inhalers. The study compares these two therapies over time to see how they affect the time until the first severe heart or lung event occurs. The study design ensures that neither participants nor researchers know which treatment is given to reduce bias. During the study, participants will have regular visits to the study site or virtual visits to complete assessments. Researchers will monitor lung function, symptoms, and blood tests, including blood eosinophil counts and COPD assessment test scores. The main outcome measured is the time to the first severe cardiac or COPD event, with follow-up lasting up to three years. Safety and adherence to treatment will also be closely observed throughout the study period.

Researchers are evaluating the effectiveness and safety of upadacitinib at different doses in adults with moderate to severe atopic dermatitis (AD) who have not responded adequately to dupilumab treatment. AD is a skin condition causing rash and itching due to inflammation, and some people require systemic treatments beyond topical therapies. This phase 3b/4 study aims to provide data on upadacitinib's impact on AD symptoms in this specific population. The study is conducted in two open-label periods. In Period 1, participants are randomly assigned to receive either upadacitinib 15mg orally once daily or dupilumab 300mg by subcutaneous injection every two weeks. After two weeks, those on upadacitinib 15mg may have their dose increased to 30mg based on their response. Period 2 lasts 24 weeks, during which participants either continue their assigned dose or switch doses depending on their eczema severity scores. The entire treatment duration is 32 weeks with follow-up for 30 days after treatment ends. Participants will undergo regular visits at hospitals or clinics for medical assessments, blood tests, side effect monitoring, and questionnaires to evaluate treatment effects. The main outcome measured is the number of participants achieving at least a 90% improvement in their eczema severity index by week 8. The study includes a 35-day screening period before treatment begins and monitors safety and efficacy throughout the study duration.

Researchers are evaluating the effects of a combination treatment of Fluticasone Furoate (FF), Umeclidinium (UMEC), and Vilanterol (VI) on lung function in adolescents aged 12 to 17 years with asthma that is not well controlled by current treatments. This Phase 3 study compares this three-drug combination with a two-drug combination of FF and VI over a 24-week period to assess their impact on breathing ability and safety. Participants will receive either the FF/UMEC/VI combination or the FF/VI combination, both delivered using the ELLIPTA inhaler device. The treatment will be administered consistently over 24 weeks, with the study designed as a randomized, double-blind, parallel-group trial to fairly compare the two therapies. The goal is to observe differences in lung function and other health effects during this treatment period. During the study, participants will undergo evaluations including lung function tests measuring forced expiratory volume in 1 second (FEV1) at the start and after 24 weeks of treatment. Researchers will monitor safety, tolerability, and how well participants respond to the therapies. The total participation time spans these 24 weeks of treatment, with assessments to track changes and effects throughout the study.

Researchers are evaluating the effects of two inhalers, budesonide/albuterol metered-dose inhaler (BDA MDI) and albuterol sulfate metered-dose inhaler (AS MDI), both taken as needed, on reducing severe asthma attacks in adolescents aged 12 to under 18 years who have a clinical diagnosis of asthma and have experienced at least one severe asthma exacerbation in the past year. This is a Phase IIIb randomized, double-blind, multicenter study lasting 52 weeks with a safety follow-up period after treatment. Participants will be randomly assigned to receive either BDA MDI 160/180 micrograms (two puffs of 80/90 micrograms) or AS MDI 180 micrograms (two puffs of 90 micrograms) as needed, alongside their usual asthma maintenance therapy, for 52 weeks. The study includes a 7 to 28-day screening period before treatment and a safety follow-up visit 7 to 14 days after the end of treatment. Additionally, a pharmacokinetic sub-study involves a single dose of open-label BDA MDI administered after the safety follow-up. During the study, participants will be monitored for the annual rate of severe asthma exacerbations from randomization to week 52. Assessments include evaluating inhaler technique, peak expiratory flow measurements, and adherence to contraception methods for participants of childbearing potential. Safety will be monitored throughout the treatment and follow-up periods. The total study duration includes screening, 52 weeks of treatment, and safety follow-up.

Central Line-Associated Bloodstream Infections (CLABSIs) are a serious problem in U.S. hospitals, leading to more deaths, longer hospital stays, and higher costs. This trial evaluates whether giving hospital Infection Preventionists access to a machine learning (ML) model that predicts possible CLABSI risk can reduce infection rates compared to standard care. The study is a prospective, multi-center, cluster-randomized trial conducted at 20 Providence hospitals with the highest CLABSI rates, aiming to assess the clinical impact of deploying the ML model in real-world hospital settings. In the trial, Infection Preventionists at intervention hospitals use a daily dashboard showing patients at risk for CLABSI based on the ML model's predictions. They review flagged cases and provide targeted education and recommendations focused on central line care best practices, including line necessity evaluation, alternative IV access suggestions, and ensuring proper line maintenance such as clean dressings and daily chlorhexidine baths. The intervention group receives this support for four to five months, while the control group continues routine clinical practice. Participants are adult inpatients with central lines in place for more than 48 hours. Researchers measure the rate of CLABSI events per 1,000 central line-days from hospital admission through discharge. Additional outcomes include the proportion of central lines removed within 48 hours of alerts, positive blood culture rates, frequency of Infection Preventionist interventions, and safety monitoring for complications like pneumothorax and hemorrhage. The study plans interim and final analyses to evaluate the effectiveness of the ML-guided intervention over a five-month period.

Researchers are evaluating surgical and minimally invasive treatments for lumbar spinal stenosis (LSS) by comparing Medicare patients who received the MILD procedure against those who had interspinous process decompression (IPD). The study focuses on outcomes such as the rate of harms related to the initial procedure and the frequency of additional surgical or minimally invasive interventions within 24 months after treatment. Enrollment includes patients treated from January 1, 2017, onward, with continuation until the sponsor decides to stop. The MILD procedure involves percutaneous image-guided lumbar decompression, performed under fluoroscopy through a dorsal approach to partially remove tissue and bone at the affected spinal level. The control group receives the IPD procedure for LSS. Both groups are monitored for a 24-month period post-index procedure using Medicare claims data to track reoperations and any harms. Participants contribute data through Medicare claims without needing prior enrollment or consent, as the study is exempt from IRB oversight. Researchers collect and analyze information on procedure-related harms and subsequent interventions over two years. This approach allows evaluation of long-term safety and effectiveness outcomes for patients treated with either MILD or IPD.

Researchers are evaluating the safety and effectiveness of up to two injections of REACT/rilparencel in adults with type 2 diabetes mellitus and chronic kidney disease. This phase 3 randomized controlled study divides participants into two groups to compare the effects of the actual treatment versus sham procedures mimicking kidney biopsy and injections. The goal is to monitor kidney function and clinical outcomes over time to understand the impact of this therapy on disease progression. Participants are randomly assigned before a kidney biopsy to either receive sham procedures or the real treatment involving a kidney biopsy followed by two rilparencel injections about 12 weeks apart, each into different kidneys. Those receiving sham procedures will undergo similar-sounding and looking activities without actual tissue removal or injection. All participants will be followed until the study's global end date, ensuring consistent long-term observation. During the study, participants will undergo kidney biopsies or sham procedures, followed by injections or sham injections. Researchers will assess kidney function by measuring the slope of estimated glomerular filtration rate (eGFR) over 18 months after the 135th participant's first injection or sham procedure. They will also track clinical events such as significant kidney function decline, need for dialysis or transplant, or renal and cardiovascular deaths for up to 94 months. Safety and efficacy will be monitored throughout the study to evaluate treatment impact.

Researchers are evaluating the use of the HistoSonics Edison System, a device for histotripsy treatment of liver tumors, in a real-world, observational study called the BOOMBOX: Master Study. The study aims to collect information on how patient and procedural characteristics affect the success of histotripsy treatment at 36 hours after the procedure. This study includes patients with various types of liver tumors and allows enrollment in additional sub-studies focused on specific populations or clinical questions with more detailed criteria and follow-up. Participants receive histotripsy treatment using the HistoSonics Edison System, which targets full or partial destruction of liver tumors. After the treatment, imaging is performed within 36 hours to assess histotripsy success. The study does not dictate specific treatment plans but collects data based on how physicians use the device in standard care. Participants may join sub-studies if eligible, which have additional enrollment and follow-up requirements. Throughout the study, participants will be followed according to each site's usual clinical practice, with regular monitoring of adverse events for up to five years after the initial histotripsy treatment or until completion of any sub-study follow-up. The study collects information before, during, and after treatment, including imaging and clinical assessments, to understand treatment outcomes and long-term safety.

Researchers are evaluating the safety of DBV712 250 micrograms (mcg) epicutaneous immunotherapy in children aged 1 to 3 years with peanut allergy. This Phase 3, randomized, double-blind, placebo-controlled study aims to observe adverse events over a 6-month treatment period. The study includes participants diagnosed by a physician with peanut allergy, confirmed by specific tests and a strict peanut-free diet. Participants will be randomly assigned in a 3:1 ratio to receive either the DBV712 250 mcg active treatment or a matching placebo patch applied to the skin. The study consists of a 6-week screening period, a 26-week double-blind treatment period, followed by an optional 18-month open-label extension where all participants can receive the active treatment. During the study, participants will be monitored for adverse events, treatment-emergent adverse events, and serious adverse events throughout the 6-month double-blind treatment period. The total study duration for each child is about 112 weeks, including follow-up assessments. Researchers will carefully evaluate safety outcomes and adherence to the treatment regimen to ensure participant well-being.

Researchers are evaluating the effectiveness of ALTO-300 compared to a placebo when added to an antidepressant treatment in adults with moderate to severe major depressive disorder (MDD). This Phase 2 study aims to identify differences in how well ALTO-300 works based on patient characteristics. The main goal is to measure changes in depression symptoms over six weeks using the Montgomery-Åsberg Depression Rating Scale (MADRS). Participants will receive either ALTO-300 capsules or placebo capsules once daily while continuing their current antidepressant, which must be a single SSRI, SNRI, or bupropion taken for at least six weeks without recent dose changes. The study includes a randomized, double-blind phase where neither participants nor researchers know who receives the active drug or placebo. There is also an open-label extension phase after the initial treatment period. During the study, participants will undergo regular assessments to monitor their depression symptoms and overall health. Researchers will track changes in MADRS scores up to week 6 to evaluate treatment effects. Participants must comply with all study procedures, and safety will be closely monitored throughout the trial. The study includes adults aged 18 to 70 years who meet the specific inclusion criteria and do not have any exclusion conditions.