Okemos

Researchers are reviewing anonymous medical records from multiple centers to understand the outcomes of different treatments for chronic pain. This study includes several groups to assess how various approaches work in distinct patient subgroups. The focus is on patients who have had or may have spinal cord stimulation systems or other treatments like radiofrequency RF or intradiscal therapies IDS. The study looks at patients who have previously received spinal cord stimulation or other therapies and those who have switched to different treatments afterward. Treatments under review include Boston Scientific devices and non-Boston Scientific systems such as spinal cord stimulation, RF, and IDS. The data is retrospective, meaning it examines past patient experiences without introducing new treatments. Participants involvement consists of the analysis of their de-identified medical charts, with no active treatment or visits required. Researchers will measure responder rates approximately two years from the start of data collection to evaluate treatment outcomes. The study spans from April 2012 to December 2030, focusing on long-term clinical results in chronic pain management.

Researchers are comparing treatments for people with active rheumatoid arthritis RA who have not responded well to tumor necrosis factor inhibitor TNFi biologics. This study evaluates switching to either a non-TNFi biologic drug including rituximab, abatacept, tocilizumab, or sarilumab or a targeted synthetic DMARD tsDMARD such as tofacitinib, baricitinib, or upadacitinib. The study aims to provide important real-world data on patient-reported outcomes PROs to help guide treatment decisions, as current guidelines are based on limited evidence and often influenced by insurance or physician preference. Participants will be randomized to one of two groups switching to a targeted synthetic DMARD or switching to a non-TNFi biologic drug. Both treatment options are widely used in clinical practice, but have not been directly compared in a pragmatic trial focusing on PROs. The study will allow patients to continue stable doses of conventional synthetic DMARDs like methotrexate if used for at least three months. The trial will assess changes over 12 months, focusing on functional limitation and quality of life. During the trial, participants will be monitored regularly to assess their function and symptoms using patient-reported tools such as the Health Assessment Questionnaire HAQ. Researchers will collect information on treatment effectiveness, side effects, and safety in a real-world population, including those with other health conditions. The study is designed to reflect routine clinical care and will last for at least 12 months, with follow-up to evaluate changes from baseline in physical function and other outcomes important to patients.