Crossville

Researchers are evaluating adults with primary open angle glaucoma (POAG) who have undergone a specific type of eye surgery called ab-interno goniotomy using the C-Rex Instrument. This observational real-world study collects data on the safety and effectiveness of this surgical procedure. The study follows participants for 12 months after surgery to observe changes in eye pressure and any complications related to the device. Participants receive the goniotomy surgery with the C-Rex Instrument, a manual surgical tool designed to perform the procedure inside the eye. Data is gathered from the visit before surgery, details of the surgery itself, and multiple visits up to one year after the procedure. The study focuses on the surgical details, eye pressure measurements, use of glaucoma medications, and any device-related safety events. During the 12-month follow-up, researchers collect information on intraocular pressure (IOP), medication use, and any complications related to the device. The main outcome measured is the percentage of eyes that achieve at least a 20% reduction in IOP compared to baseline values. Participants are monitored regularly throughout the year to track these outcomes and ensure safety.

Researchers are studying whether using the Quest AD-Detect blood test during hospitalization for cognitive issues like delirium or encephalopathy can help identify underlying Alzheimer's disease earlier. The trial focuses on patients aged 60 to 90 years who have no prior diagnosis of dementia but are currently hospitalized with cognitive problems that may be caused by toxic or metabolic conditions. The study aims to see if this blood test can distinguish Alzheimer's disease from other causes of cognitive impairment in the hospital setting. Participants will have blood collected while they are hospitalized, and this blood will be tested using the Quest AD-Detect blood test. After discharge, patients will have a follow-up visit with the Neurology Clinic six months later to review their risk assessment and diagnosis based on the blood test results. This approach helps researchers evaluate the test's ability to detect Alzheimer's disease early in hospitalized patients with cognitive symptoms. During the study, researchers will monitor the percentage of patients who received a cognitive diagnosis and test positive for Alzheimer's biomarkers from enrollment through the six-month follow-up. The study includes clinical evaluations and testing during hospitalization and a follow-up appointment to assess outcomes. This process helps determine the effectiveness of the blood test in identifying Alzheimer's disease in this patient group over time.

Researchers are evaluating if a modified form of metaxalone 640 mg can reduce pain in adults aged 18 to 80 years who experience new low back or leg pain due to acute lumbosacral musculoskeletal conditions, including spinal stenosis and sciatica. This is a double-blind, randomized, placebo-controlled Phase 4 study comparing the active drug to a look-alike placebo. The purpose is to measure changes in pain and how it affects physical activity and sleep over one week. Participants will be randomly assigned to receive either metaxalone 640 mg oral tablets along with standard care or a placebo that looks the same but contains no active drug. The study consists of an initial pilot phase followed by a larger phase with more participants to confirm results. Treatments are taken as oral tablets, and participants continue their usual care. During the study, participants will complete surveys on Day 1 before starting treatment and again on Day 7 to report pain levels, pain quality, and how pain affects their physical activity and sleep. Researchers will monitor changes in pain using a Numeric Pain Scale from Day 1 to Day 7. Participants must be able to respond to text or email reminders for surveys. The total study duration for each participant is 7 days of treatment and follow-up.

Researchers are evaluating treatments for adults with psoriatic arthritis (PsA) who have not responded well to tumor necrosis factor inhibitors (TNFi). The study aims to compare switching to guselkumab, a selective interleukin 23 inhibitor, versus switching to another TNFi called golimumab. This Phase 3 trial tests whether changing to a new mechanism of action provides better results than trying a second TNFi, addressing an important question for patients with PsA who have inadequate responses to current therapy. Participants will receive either guselkumab or golimumab, both given as subcutaneous injections. The study is open-label and randomized, meaning both patients and researchers know which treatment is given, and patients are randomly assigned to one of the two options. The trial will observe patients over 12 months to assess treatment effectiveness. During the study, participants will have regular assessments including measuring disease activity with the clinical Disease Activity index for Psoriatic Arthritis (cDAPSA) and evaluating psoriasis severity. Researchers will monitor safety and treatment response through these measures and the Investigator Global Assessment of Psoriasis. The total participation duration is 12 months, allowing time to capture treatment effects and side effects.

Researchers are evaluating treatment strategies for people with active rheumatoid arthritis (RA) who have not improved despite using tumor necrosis factor inhibitor (TNFi) biologic drugs. The study compares switching to a non-TNFi biologic drug (such as rituximab, abatacept, tocilizumab, or sarilumab) versus switching to a targeted synthetic disease-modifying antirheumatic drug (tsDMARD) like tofacitinib, baricitinib, or upadacitinib. This comparative effectiveness research addresses a critical gap in evidence, as current treatment choices are often based on physician experience or insurance preferences rather than strong data. The study uses patient-reported outcomes (PROs) to provide meaningful information for patient-centered care. Participants will be assigned to receive either a non-TNFi biologic or a tsDMARD as their new treatment for active RA after TNFi biologic therapy. The study allows participants to continue certain conventional synthetic DMARDs (such as methotrexate, sulfasalazine, hydroxychloroquine, or leflunomide) if they have been stable on these for a specified period. Treatment choice is supported by insurance or patient assistance programs to ensure access. This pragmatic trial is designed to reflect real-world practice and includes patients with comorbidities to assess effectiveness and safety in a broad population. During the study, participants will be monitored for changes in functional ability over 12 months using the Health Assessment Questionnaire (HAQ), a sensitive measure for RA impact. Researchers will also evaluate quality of life, productivity, and side effects. The study aims to generate evidence that helps patients and payers make informed decisions about RA treatments based on outcomes that matter most to patients. Total participation includes baseline assessments and follow-up evaluations throughout the 12-month treatment period.