[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"leadSponsorName\":\"Ottawa Hospital Research Institute\",\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:":648},{"pageToken":4,"total":5,"offset":6,"count":7,"results":8},null,70,0,25,[9,46,77,107,134,162,188,218,247,275,302,322,346,367,393,424,448,465,491,516,538,560,580,602,623],{"id":10,"slug":11,"hasResults":12,"nctId":13,"briefTitle":14,"officialTitle":15,"acronym":16,"eligibilityCriteria":17,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":29,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":34,"lastUpdatePostDateStruct":35,"startDateStruct":38,"completionDateStruct":40,"leadSponsor":42,"locationsCount":45},"100649389","phase-2-mycophenolate-after-stem-cell-transplant-for-systemic-sclerosis-100649389",false,"NCT07734012","Mycophenolate After Stem Cell Transplant for Systemic Sclerosis","Immunomodulatory Maintenance Therapy Post-Autologous Hematopoietic Stem Cell Transplantation for Prevention of Systemic Sclerosis Relapse: A Pilot Randomized Trial","IMPACT-SSc","Inclusion Criteria:\n\n* Consenting participants 18 years of age or older who are initiating AHSCT at The Ottawa Hospital for management of SSc.\n\nExclusion Criteria:\n\n* Exclusion criteria are focused on patient safety, namely inability to receive treatment with\n\nMMF due to contraindications as determine at time of randomization (day 90 \u002F clinic visit #3) including:\n\n* Renal insufficiency (eGFR \\\u003C25 mL\u002Fminute\u002F1.73m2) or\n* Neutropenia (ANC \\\u003C1.0 x 103\u002FmcL) or\n* Thrombocytopenia (platelet count \\\u003C50 000\u002FmcL)\n* Previously documented intolerance.\n* Pregnant or breastfeeding - Women of childbearing potential who are not willing to use a highly effective method of contraception for the duration of study participation will be excluded","ALL","18 Years",{"count":21,"type":22},6,"ESTIMATED","INTERVENTIONAL",[25],"PHASE2","A pilot single center randomized trial to test whether a full-scale RCT evaluating the role of post-AHSCT maintenance immunosuppression with MMF in preventing disease relapse is feasible .\n\nWe are studying whether a brief course of treatment with MMF after AHSCT will serve to prevent disease relapse.",[28],"Systemic Sclerosis (SSc)",[30,31,32],"Systemic sclerosis","Stem cell transplant","Mycophenolate mofetil","NOT_YET_RECRUITING","2026-08-05",{"date":36,"type":37},"2026-08-07","ACTUAL",{"date":39,"type":22},"2026-08",{"date":41,"type":22},"2029-12",{"name":43,"class":44},"Ottawa Hospital Research Institute","OTHER",1,{"id":47,"slug":48,"hasResults":12,"nctId":49,"briefTitle":50,"officialTitle":51,"acronym":52,"eligibilityCriteria":53,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":54,"targetDuration":4,"studyType":23,"phases":56,"briefSummary":58,"conditions":59,"keywords":61,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":68,"lastUpdatePostDateStruct":69,"startDateStruct":71,"completionDateStruct":73,"leadSponsor":75,"locationsCount":76},"100650660","blood-transfusion-strategies-during-major-surgery-100650660","NCT07748663","Blood Transfusion Strategies During Major Surgery","The TOPGUN Trial: Threshold for Operative and Postoperative Hemoglobin Trigger for Red Blood Cell Transfusion","TOPGUN","Inclusion Criteria:\n\n* Adult patients, age ≥18.\n* Elective or urgent surgery.\n* Risk of red blood cell transfusion of at least 10 percent.\n* Preoperative hemoglobin of less than 130 g\u002FL.\n* Intraoperative hemoglobin of \\\u003C 100 g\u002FL at any time during surgery.\n\nExclusion Criteria:\n\n* Active major hemorrhage as indication for surgery (e.g. ruptured aneurysm, polytrauma, etc.)\n* Acute coronary syndrome or myocardial infarction within the past 6 weeks.\n* Cardiac surgery, lung transplantation, or liver transplantation as the indication for surgery (a history of such surgery is allowed)\n* Surgery for moderate to severe (Glasgow Coma Scale (GCS) score ≤ 12) traumatic brain injury\n* Sickle cell disease (sickle cell trait is allowed)\n* Pregnancy or obstetrical surgery\n* Patient refusal of blood products\n* Inability to provide consent\n* Previous randomization in the TOPGUN(-Pilot) trial",{"count":55,"type":22},5058,[57],"NA","The goal of this randomized clinical trial is to address the uncertainty surrounding blood transfusion strategies in the operating room for adult patients undergoing major surgery. The main question it aims to answer is:\n\nDoes a higher hemoglobin threshold for blood transfusion during surgery reduce the risk of serious complications or death after surgery compared with a lower hemoglobin threshold?\n\nResearchers will compare a liberal and a restrictive transfusion strategy during surgery and the first few hours of recovery.\n\nParticipants will be randomly assigned to one of two blood transfusion strategies. Blood transfusions will be given to maintain either a higher hemoglobin level (90-100 g\u002FL) or a lower hemoglobin level (70-80 g\u002FL) during surgery and while in the recovery room after surgery. Participants will also complete questionnaires about their quality of life and recovery at 30 and 90 days after surgery.",[60],"Perioperative Red Blood Cell Transfusion",[62,63,64,65,66,67],"Anesthesiology","Blood Transfusion","Cancer Outcomes","Perioperative Care","Perioperative Complications","Surgery","2026-07-31",{"date":70,"type":37},"2026-08-06",{"date":72,"type":22},"2026-08-19",{"date":74,"type":22},"2035-03-31",{"name":43,"class":44},2,{"id":78,"slug":79,"hasResults":12,"nctId":80,"briefTitle":81,"officialTitle":82,"acronym":83,"eligibilityCriteria":84,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":85,"targetDuration":4,"studyType":23,"phases":87,"briefSummary":89,"conditions":90,"keywords":94,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":99,"lastUpdatePostDateStruct":100,"startDateStruct":102,"completionDateStruct":104,"leadSponsor":106,"locationsCount":45},"100464865","phase-1-modafinil-to-improve-fatiguability-100464865","NCT05333250","Modafinil to Improve Fatiguability","Modafinil to Improve Fatiguability (MODIFY): Modafinil vs. Placebo Vanguard RCT","MODIFY","Inclusion Criteria:\n\n1. 18 years of age or older with stage III or IV cancer diagnosis\n2. Estimated prognosis ≥ 3 months\n3. Eastern Cooperative Oncology Group (ECOG) Score 0-2\n4. Experiencing cancer-related fatigue, defined as a score of 4 or greater on the Fatigue item of the Edmonton Symptom Assessment System-revised-constipation\u002Fsleep (ESAS-r-cs)\n5. Ability to understand and communicate in English\n6. Ability to give first-person informed consent\n\nExclusion Criteria:\n\n* Currently receiving or have received cytotoxic chemotherapy in the last 6 weeks\n* Allergy to modafinil or placebo contents\n* Dose change of prednisone or dexamethasone in the past 7 days or planned dose change during study period\n* Blood transfusion in the last 2 weeks\n* Hemoglobin lower than 80 g\u002FL measured in the last 4 weeks\n* TSH above normal range in the last 4 weeks\n* Severe liver dysfunction (total bilirubin \\>3x upper limit of normal, or aspartate aminotransferase or alanine aminotransferase \\>5x upper limit of normal)\n* Known brain metastasis or primary brain tumor\n* Documented dementia diagnosis\n* Documented major psychiatric illness including major depressive episode, bipolar disorder, schizophrenia\n* Uncontrolled hypertension as defined by a blood pressure greater than 140\u002F90mmHg\n* Unstable angina\n* Recent (\\\u003C6 months previous) myocardial infarction\n* Evidence of left ventricular hypertrophy or ischemia on ECG\n* Arrythmia (e.g., atrial fibrillation)\n* Coronary artery disease with Canadian Cardiovascular Society Symptoms Class \\>1\n* Taking high dose selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants\n* Taking any benzodiazepine at any dose\n* Taking any amphetamine at any dose\n* Taking any monoamine oxidase inhibitor (MAOI) at any dose\n* Taking any azole anti-fungal medication (e.g., fluconazole, itraconazole, or ketoconazole)\n* Taking any of the following medications at any dose:\n\n  1. Methylphenidate\n  2. Cyclosporine\n  3. Propranolol\n  4. Phenytoin\n  5. S-mephenytoin\n  6. Warfarin\n  7. Triazolam\n  8. Ethinyl estradiol\n  9. Clomipramine\n  10. Midodrine\n  11. Antipyrine\n* Inability to ingest oral capsule\n* Pregnancy or lactation, or trying to conceive\n* Any other history, condition, therapy, or uncontrolled intercurrent illness which could, in the opinion of the Qualified Medical Investigator, affect compliance with study requirements or which would make the participant unsuitable for this study.\n* Simultaneous participation in another interventional clinical study (e.g., Phase 1-3 clinical studies) or treatment with any investigational medicinal product within 30 days prior to screening visit that could, in the judgment of the Qualified Medical Investigator, affect the patient's participation in or outcome of this clinical trial.",{"count":86,"type":22},40,[88,25],"PHASE1","Cancer-related fatigue (CRF) and cancer-related cognitive impairment (CRCI) are among the most commonly reported disabling symptoms experienced by patients with advanced cancer. However, there are currently limited evidence-based pharmacologic interventions available. The investigators will conduct a Vanguard Randomized Clinical Trial (RCT) to estimate the effect of modafinil in managing CRF and CRCI, and to test the feasibility of carrying out the study.",[91,92,93],"Cancer-related Cognitive Difficulties","Cancer-related Problem\u002FCondition","Fatigue",[95,93,96,97],"Cancer","Cognitive Impairment","Modafinil","RECRUITING","2026-07-24",{"date":101,"type":37},"2026-07-27",{"date":103,"type":37},"2026-03-16",{"date":105,"type":22},"2028-03",{"name":43,"class":44},{"id":108,"slug":109,"hasResults":12,"nctId":110,"briefTitle":111,"officialTitle":112,"acronym":4,"eligibilityCriteria":113,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":114,"targetDuration":4,"studyType":23,"phases":116,"briefSummary":117,"conditions":118,"keywords":121,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":127,"lastUpdatePostDateStruct":128,"startDateStruct":129,"completionDateStruct":131,"leadSponsor":133,"locationsCount":45},"100649019","implementation-of-acute-heart-failure-checklist-100649019","NCT07727304","Implementation of Acute Heart Failure Checklist","An Implementation Study to Improve Care of Patients With Acute Heart Failure in the Emergency Department","Inclusion Criteria:\n\n* All resident and staff physicians managing patients with AHF in the ED are the primary study participants and this includes emergency, medicine, cardiology, and hospitalists.\n* The patients that will be included are consecutive adults age \\>18 years and who present to the ED with recent onset of or recent increase in shortness of breath due to AHF, as determined by health records review.\n* Eligibility of patients will be reviewed by the blinded study Steering Committee.\n* Included will be both patients subsequently admitted to hospital and those discharged from the ED, as both will be impacted by the recommendations of the CAEP AHF Checklist.\n\nExclusion Criteria:\n\n* who do not fit the definition of AHF;\n* if the primary reason for the ED visit was not AHF (e.g. pneumonia, pulmonary embolism);\n* who have acute myocardial infarction (either ST elevation or non-ST elevation) diagnosed in the ED, because the primary problem for these patients is not heart failure and they require specialized treatment beyond the scope of the Checklist; or\n* who are considered terminal, with death expected within 60 days.",{"count":115,"type":22},5040,[57],"Patients with acute heart failure (AHF) commonly present to the emergency department (ED) with difficulty breathing and often have poor outcomes or death. Care of AHF is very complex and, unfortunately, there are no specific guidelines for how physicians should manage AHF in the ED. The investigators recently created the Canadian Association of Emergency Physicians (CAEP) AHF Best Practices Checklist, a concise document that provides specific guidance for ED care.\n\nOur ultimate goal is to conduct a 12-site cluster study to introduce the CAEP AHF Checklist in multiple EDs. Before the investigators can do so, it is essential to demonstrate feasibility in a smaller-scale study. Our objective for this application is to conduct an internal pilot study to demonstrate feasibility of measuring implementation outcomes and refine the protocol if necessary. The investigators will develop strategies to encourage successful adoption of the Checklist by physicians in the ED and allocate 4 large Ontario EDs to implement the Checklist for 1,700 adult AHF patients.\n\nThis study will be very important for patients and the healthcare system. If the investigators show that the CAEP AHF Checklist improves patient management and outcomes, this would lead to widespread uptake of the Checklist by all EDs in Canada.",[119,120],"Acute Heart Failure (AHF)","Implementation Research",[122,123,124,125,126],"Best Practices Checklist","Acute Heart Failure","Emergency Department","Guidelines","Implementation","2026-07-22",{"date":101,"type":37},{"date":130,"type":22},"2026-08-01",{"date":132,"type":22},"2030-06-01",{"name":43,"class":44},{"id":135,"slug":136,"hasResults":12,"nctId":137,"briefTitle":138,"officialTitle":139,"acronym":4,"eligibilityCriteria":140,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":141,"targetDuration":4,"studyType":23,"phases":143,"briefSummary":145,"conditions":146,"keywords":148,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":127,"lastUpdatePostDateStruct":154,"startDateStruct":156,"completionDateStruct":158,"leadSponsor":160,"locationsCount":161},"100549948","phase-3-colchicine-to-quench-the-inflammatory-response-after-deep-vein-thrombosis-the-conquer-dvt-pilot-trial-100549948","NCT06440694","Colchicine to Quench the Inflammatory Response After Deep Vein Thrombosis (The Conquer-DVT Pilot Trial)","Colchicine to Quench the Inflammatory Response After Deep Vein Thrombosis: A Randomized Controlled Pilot Trial","Inclusion Criteria:\n\n* Consenting patients 18 years of age or older with a first, acute, symptomatic proximal (popliteal vein or more proximal) objectively confirmed DVT of the lower extremity will be eligible to participate in the study.\n\nExclusion Criteria:\n\n1. History of an allergic reaction or significant sensitivity to colchicine.\n2. Requirement of colchicine for other indications.\n3. Active or chronic diarrhea, or documented inflammatory bowel disease (i.e., Crohn's disease or ulcerative colitis), collagenous colitis or irritable bowel syndrome or existing blood dyscrasias.\n4. Known or suspected, recent (\\\u003C30 days) or active infections (acute or chronic).\n5. History of cirrhosis, chronic active hepatitis, or severe liver disease.\n6. Recent (\\\u003C30 days) or chronic use of systemic (oral, intravenous) immunosuppressive drugs (including but not limited to steroids, tumor necrosis factor-alpha blockers, cyclosporine).\n7. Known active cancer.\n8. Any of the following as measured within the past 1-3 months or at screening: alanine, or aspartate aminotransferase \\>3 times the upper limit of normal, total bilirubin \\>2 times the upper limit of normal and a creatinine clearance by Cockcroft-Gault formula \\\u003C30 mL\u002Fmin.\n9. Pregnancy, breast feeding or may be considering pregnancy during the study period or women of childbearing potential unwilling to use appropriate contraception during sex;\n10. The use of medication with known drug-to-drug interactions (including but not limited to erythromycin or clarithromycin).\n11. Unable or unwilling to provide consent.",{"count":142,"type":22},150,[144],"PHASE3","This trial seeks to assess the feasibility of a full-scale, double-blind, placebo-controlled, randomized trial assessing whether low-dose colchicine (0.5 mg daily) reduces the risk of post-thrombotic syndrome (PTS) in patients with proximal lower extremity deep vein thrombosis (DVT).",[147],"Venous Thromboembolism",[149,150,151,152,153],"Proximal Lower Extremity Deep Vein Thrombosis","Randomized Trial","Colchicine","Post Thrombotic Syndrome","Inflammation",{"date":155,"type":37},"2026-07-23",{"date":157,"type":37},"2025-07-07",{"date":159,"type":22},"2027-12-01",{"name":43,"class":44},4,{"id":163,"slug":164,"hasResults":12,"nctId":165,"briefTitle":166,"officialTitle":167,"acronym":4,"eligibilityCriteria":168,"healthyVolunteers":12,"sex":18,"minAge":169,"maxAge":4,"enrollmentInfo":170,"targetDuration":4,"studyType":23,"phases":172,"briefSummary":173,"conditions":174,"keywords":177,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":181,"lastUpdatePostDateStruct":182,"startDateStruct":183,"completionDateStruct":185,"leadSponsor":186,"locationsCount":187},"100546356","phase-3-reducing-gastrointestinal-bleeding-with-proton-pump-inhibitor-therapy-in-acute-venous-thromboembolism-100546356","NCT06393868","Reducing Gastrointestinal Bleeding With Proton Pump Inhibitor Therapy in Acute Venous Thromboembolism","Reducing Gastrointestinal Bleeding With Proton Pump Inhibitor Therapy in Acute Venous Thromboembolism: Pilot Randomized Study (RADIANT Study)","Inclusion Criteria:\n\n1. Male or female 65 years or older at the time of enrolment. Enrolment is limited to older adults as age is an important non-modifiable risk factor for bleeding. This will ensure the study population includes participants who may be more likely to benefit from omeprazole (compared to those with no risk factors) because all participants will have at least 1 risk factor for bleeding.\n2. Newly diagnosed VTE which includes VTE at any site such as (but not limited to) DVT of upper or lower limbs, PE, cerebral vein thrombosis, portal vein thrombosis, other splanchnic vein thrombosis.\n3. Planned for 3 months (90 days) or more of therapeutic anticoagulation with any anticoagulant.\n4. Patient or delegate is able and willing to comply with follow-up examinations contained within the consent form.\n\nExclusion Criteria:\n\n1. Therapeutic anticoagulation therapy for more than 7 days\n2. Currently prescribed PPI for regular daily use (patients receiving H2 receptor antagonists will not be excluded),\n3. Previous upper GI bleeding,\n4. Need for dual antiplatelet therapy,\n5. Contraindications to omeprazole (hypersensitivity to omeprazole, or other substituted benzimidazole PPIs, concomitant use with products that contain rilpivirine, significant drug interactions, up to the discretion of the site investigator),\n6. Life expectancy is less than 3 months.","65 Years",{"count":171,"type":22},360,[144],"The investigators are studying whether treatment with a proton pump inhibitor called omeprazole reduces gastrointestinal bleeding in older adults taking blood thinners for a blood clot (venous thromboembolism). The purpose of this study, a pilot study or a feasibility study, is to test the study plan and determine whether enough participants will join a larger study and accept the study procedures.",[147,175,176],"Gastro Intestinal Bleeding","Blood Clot",[178,179,180],"Omeprazole","VTE","GI Bleeding","2026-07-20",{"date":127,"type":37},{"date":184,"type":37},"2024-11-06",{"date":105,"type":22},{"name":43,"class":44},7,{"id":189,"slug":190,"hasResults":12,"nctId":191,"briefTitle":192,"officialTitle":193,"acronym":4,"eligibilityCriteria":194,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":195,"targetDuration":4,"studyType":23,"phases":197,"briefSummary":199,"conditions":200,"keywords":203,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":209,"lastUpdatePostDateStruct":210,"startDateStruct":212,"completionDateStruct":214,"leadSponsor":216,"locationsCount":217},"100612372","phase-4-evaluating-dose-timing-morning-vs-evening-of-endocrine-based-therapies-in-metastatic-breast-and-prostate-cancers-100612372","NCT07252726","Evaluating Dose Timing (Morning vs Evening) of Endocrine-based Therapies in Metastatic Breast and Prostate Cancers","A Randomised, Multicentre Trial Evaluating the Dose Timing (Morning vs Evening) of Endocrine-based Therapies in Metastatic Breast and Prostate Cancers (REaCT-CHRONO-MetBP Pilot Study)","Cohort A (Breast Cohort) Inclusion Criteria\n\n* Patients with metastatic hormonal receptor positive breast cancer\n* Plan to receive endocrine therapy and a CDK4\u002F6 inhibitor (either Ribociclib or Palbociclib) in the first-line metastatic setting\n* Age ≥18 years\n* Able to provide oral consent\n* Willing and able to complete questionnaires as per study protocol\n\nCohort A (Breast Cohort) Exclusion Criteria\n\n* Any contraindication in taking endocrine therapy and CDK4\u002F6 inhibitor in the morning or evening\n* Plan to receive abemaciclib (as this requires twice a day dosing)\n\nCohort B (Prostate Cancer) Inclusion Criteria\n\n* Patients with metastatic castrate sensitive prostate cancer\n* Plan to receive androgen receptor pathway inhibitor (either enzalutamide, apalutamide or abiraterone acetate) in combination with androgen deprivation therapy\n* Age ≥18 years\n* Able to provide oral consent\n* Willing and able to complete questionnaires as per study protocol\n\nCohort B (Prostate Cancer) Exclusion Criteria\n\n* Any contraindication in taking androgen receptor pathway inhibitor in the morning or evening\n* Plan to receive darolutamide (as this requires twice a day dosing)\n* Plan to receive docetaxel in combination with androgen receptor pathway inhibitor",{"count":196,"type":22},50,[198],"PHASE4","The REaCT-CHRONO-MetBP Pilot study will compare morning and evening administration of endocrine-based therapy in metastatic breast and prostate cancers.\n\nParticipants with metastatic breast or prostate cancer will be randomly placed in one of two groups: a morning group and an evening group. The group assignment will determine whether they take their endocrine therapy in the morning or the evening. The primary outcome of this pilot study is to evaluate the feasibility of study procedures in order to conduct a larger definitive trial in the future. The secondary outcomes include comparing quality of life, tolerability, and efficacy outcomes between the morning and evening groups for each of the two cancer cohorts (metastatic breast and prostate cancer).",[201,202],"Metastatic Breast Cancer","Metastatic Prostate Cancer",[204,205,206,207,208],"Chronotherapy","breast cancer","prostate cancer","endocrine therapy","metastatic cancer","2026-07-15",{"date":211,"type":37},"2026-07-17",{"date":213,"type":37},"2026-02-02",{"date":215,"type":22},"2033-03",{"name":43,"class":44},3,{"id":219,"slug":220,"hasResults":12,"nctId":221,"briefTitle":222,"officialTitle":223,"acronym":224,"eligibilityCriteria":225,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":226,"targetDuration":4,"studyType":23,"phases":227,"briefSummary":228,"conditions":229,"keywords":232,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":209,"lastUpdatePostDateStruct":240,"startDateStruct":242,"completionDateStruct":244,"leadSponsor":246,"locationsCount":76},"100581473","the-feasibility-and-efficacy-of-dose-timing-morning-vs-evening-of-temozolomide-in-the-treatment-of-glioblastoma-100581473","NCT06850766","The Feasibility and Efficacy of Dose Timing (Morning vs Evening) of Temozolomide in the Treatment of Glioblastoma","A Randomized, Multicentre Pilot Trial Evaluating the Feasibility and Efficacy of Dose Timing (Morning vs Evening) of Temozolomide in the Treatment of Glioblastoma","TMZ-CHRONO","Inclusion Criteria:\n\n* 18 years of age or older\n* Newly diagnosed IDH-wildtype glioblastoma\n* Completed maximal safe brain tumor resection\n* Completed post-operative brain RT\n* Plan to proceed with up to 6 cycles of adjuvant TMZ within 8 weeks of completing post-operative RT\n* Able and willing to provide oral informed consent\n\nExclusion Criteria:\n\n* Unable or unwilling to complete study questionnaires\n* Metastatic or incurable cancer other than IDH-wild type glioblastoma",{"count":196,"type":22},[57],"The body's biological functions follow a circadian rhythm, meaning that individual biological functions in the body change over a 24-hour cycle. There is evidence suggesting that the body and cancer cells may react differently to anti-cancer treatment based on the time of day they are exposed. In fact, researchers have already found that giving anti-cancer treatments at a particular time of the day works better in rectal and ovarian cancer. Temozolomide (TMZ) is a chemotherapy pill\u002Fcapsule commonly given to patients with newly diagnosed glioblastoma after brain surgery and radiation treatment. However, there is no current standard for what time of day TMZ should be taken for the treatment of glioblastoma.\n\nIn the current study, participants are randomly placed in one of two groups: a morning group and an evening group. Based on this group placement, participants are instructed to either take their TMZ in the morning or in the evening and record the date and time they take their TMZ in a pill diary. Participants will wear a wrist actigraphy device for the first cycle of TMZ. The primary goal of the study is to understand if taking TMZ at a prescribed time of day (morning\u002Fevening) is feasible in adults with glioblastoma. This is a pilot trial, and the investigators hypothesize that it will be feasible for glioblastoma patients to take TMZ at the prescribed time of day. The secondary goals of this study are to evaluate participant recruitment, safety, health-related quality of life, biological timing of TMZ delivery, and changes in condition over time. This pilot study will help investigators plan for a larger, pragmatic randomized clinical trial in the future.",[230,231],"IDH-Wildtype Glioblastoma","Glioblastoma (GBM)",[233,234,235,236,237,238,239],"temozolomide","chronotherapy","dose timing","cancer","oncology","glioblastoma","chemotherapy",{"date":241,"type":37},"2026-07-16",{"date":243,"type":37},"2025-05-08",{"date":245,"type":22},"2031-11",{"name":43,"class":44},{"id":248,"slug":249,"hasResults":12,"nctId":250,"briefTitle":251,"officialTitle":251,"acronym":252,"eligibilityCriteria":253,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":254,"targetDuration":4,"studyType":23,"phases":256,"briefSummary":257,"conditions":258,"keywords":260,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":267,"lastUpdatePostDateStruct":268,"startDateStruct":270,"completionDateStruct":272,"leadSponsor":274,"locationsCount":217},"100645928","phase-4-spiro-first-a-pragmatic-primary-care-embedded-pilot-trial-of-renin-guided-first-line-antihypertensive-therapy-100645928","NCT07687160","SPIRO-First: A Pragmatic Primary Care-Embedded Pilot Trial of Renin-Guided First-Line Antihypertensive Therapy","SPIRO-First","Inclusion Criteria:\n\n1. Age ≥18 years.\n2. Under the care of a primary care clinician in Ontario.\n3. Standardized office systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg.\n4. Mean daytime baseline ABPM systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg.\n5. Treating primary care clinician has independently determined that initiation of antihypertensive pharmacotherapy is clinically indicated.\n6. Either:\n\n   * Not currently receiving antihypertensive therapy, OR\n   * Receiving a single antihypertensive medication (ACE inhibitor, ARB, thiazide\u002Fthiazide-like diuretic, or calcium channel blocker) which the treating primary care clinician considers safe to discontinue for a 2-week washout period.\n7. Suppressed renin defined as direct renin concentration \\\u003C6 ng\u002FL (\\\u003C10 mU\u002FL) measured under routine outpatient conditions. Suppressed renin was selected as the primary biologic enrichment criterion because it is the physiologic hallmark of sodium-retaining, aldosterone-mediated hypertension and is more pragmatically scalable in primary care than complex biochemical primary aldosteronism (PA) definitions.\n8. In the opinion of the treating primary care clinician, outpatient participation in the study is appropriate.\n\nExclusion Criteria:\n\n1. Standardized office systolic blood pressure \\>170 mmHg if untreated OR \\>150 mmHg if receiving one antihypertensive medication.\n2. Known diagnosis of PA requiring specialist-directed management.\n3. Known secondary hypertension requiring disease-specific therapy.\n4. Current use of MR antagonists.\n5. Known intolerance or contraindication to spironolactone, candesartan, hydrochlorothiazide, or amlodipine.\n6. eGFR \\\u003C30 mL\u002Fmin\u002F1.73 m2.\n7. Serum potassium ≥5.0 mmol\u002FL.\n8. Serum sodium \\\u003C135 mmol\u002FL.\n9. Pregnancy, breastfeeding, or intention to become pregnant during the study period. Women of childbearing potential must have a negative pregnancy test prior to randomization.\n10. Participation in another interventional study likely to affect blood pressure.\n11. Inability to provide consent",{"count":255,"type":22},30,[198],"The goal of this clinical trial is to determine whether a renin-guided antihypertensive treatment strategy is feasible to implement in community primary care clinics and to explore whether spironolactone improves blood pressure control in adults with low-renin hypertension.\n\nThe main questions it aims to answer are:\n\nIs it feasible to identify, recruit, randomize, and follow adults with low-renin hypertension in a pragmatic primary care-based clinical trial?\n\nDoes first-line treatment with spironolactone result in greater reductions in ambulatory blood pressure compared with standard first-line antihypertensive therapy among adults with low-renin hypertension?\n\nResearchers will compare spironolactone 25 mg daily with standard first-line antihypertensive therapy (candesartan, hydrochlorothiazide, or amlodipine) to determine whether spironolactone provides better blood pressure control in adults with low-renin hypertension.\n\nParticipants will:\n\nUndergo blood pressure assessments, blood tests, and ambulatory blood pressure monitoring (ABPM) to determine eligibility.\n\nBe randomly assigned to receive either spironolactone or a standard first-line antihypertensive medication for 12 weeks.\n\nComplete follow-up visits and laboratory testing to monitor blood pressure response, kidney function, electrolyte levels, medication adherence, and side effects.\n\nUndergo repeat blood pressure measurements and ABPM at the end of the study.",[259],"Hypertension",[261,262,263,264,265,266],"hypertension","Renin-Guided Therapy","Antihypertensive treatment","Spironolactone","Precision Medicine","Primary aldosteronism","2026-07-10",{"date":269,"type":37},"2026-07-13",{"date":271,"type":22},"2026-09-01",{"date":273,"type":22},"2028-02",{"name":43,"class":44},{"id":276,"slug":277,"hasResults":12,"nctId":278,"briefTitle":279,"officialTitle":280,"acronym":281,"eligibilityCriteria":282,"healthyVolunteers":283,"sex":18,"minAge":19,"maxAge":284,"enrollmentInfo":285,"targetDuration":4,"studyType":23,"phases":287,"briefSummary":289,"conditions":290,"keywords":293,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":267,"lastUpdatePostDateStruct":296,"startDateStruct":298,"completionDateStruct":299,"leadSponsor":301,"locationsCount":4},"100645559","early-phase-1-a-pilot-study-of-commercially-available-bowel-preparation-regimens-packaged-and-ingested-via-vegan-capsules-100645559","NCT07700277","A Pilot Study of Commercially Available Bowel Preparation Regimens Packaged and Ingested Via Vegan Capsules","A Pilot Study of Commercially Available Bowel Preparation Regimens Packaged and Ingested Via Vegan Capsules: Safety, Tolerability, Feasibility, and Preliminary Cleansing Effectiveness","CLEAR-CAP","Inclusion Criteria:\n\n* Age 18 to 75 years.\n* Scheduled for elective outpatient colonoscopy for a screening, surveillance, or diagnostic indication.\n* Has previously undergone colonoscopy using a conventional bowel preparation solution, without requiring repeat colonoscopy because of poor bowel preparation.\n* Able to provide informed consent.\n* Willing and able to comply with study procedures, including timed dosing, required clear-fluid intake, and capsule preparation procedures for participants enrolled in Part III.\n* Able to swallow solids, liquids, and pills without difficulty.\n\nExclusion Criteria:\n\n* Higher risk for clinically significant fluid or electrolyte shifts, including chronic renal impairment, severely reduced renal function, congestive cardiac failure, unstable cardiovascular disease, or any other condition in which large-volume fluid intake or rapid catharsis may be unsafe.\n* Baseline clinically significant electrolyte abnormalities.\n* Diabetes mellitus, gastroparesis, gastric retention, intestinal dysmotility, or any other condition that may impair gastric emptying, gastrointestinal transit, mixing, dissolution, or passage of the bowel preparation.\n* Current use of medications that may impair gastrointestinal motility or safe bowel preparation completion, including opioid medications, anticholinergic medications, or glucagon-like peptide-1 receptor agonists.\n* Known or suspected gastrointestinal obstruction, bowel obstruction, ileus, bowel perforation, gastrointestinal perforation, or any condition associated with increased risk of obstruction or perforation.\n* Acute abdominal or gastrointestinal condition in which bowel preparation may be unsafe, including acute surgical abdomen, acute appendicitis, gastroenteritis, diverticulitis, toxic colitis, toxic megacolon, severe colitis requiring urgent care, or another acute inflammatory, infectious, or structural gastrointestinal condition judged by the investigator to make participation unsafe.\n* Known gastrointestinal ulceration or clinically significant active gastrointestinal bleeding, including unexplained rectal bleeding.\n* Active nausea or vomiting at screening or before bowel preparation administration that, in the opinion of the investigator, would interfere with safe ingestion of the assigned capsule-based bowel preparation regimen.\n* Emergency colonoscopy, including colonoscopy for lower gastrointestinal bleeding or any clinical condition requiring urgent endoscopic evaluation that would not allow adherence to the study bowel preparation protocol.\n* Known hypersensitivity, allergy, or intolerance to Bi-PegLyte, Pico-Salax, bisacodyl, polyethylene glycol, sodium picosulfate, magnesium oxide, citric acid, electrolytes contained in the formulations, HPMC\u002Fhypromellose capsules, or any ingredient in the formulation or product container.\n* Pregnancy or known or suspected pregnancy at screening or before bowel preparation administration.\n* Capsule-specific feasibility or safety concern, including dysphagia, esophageal dysmotility, achalasia, esophageal stricture, high risk of aspiration, anatomical abnormality affecting swallowing, or any condition in which swallowing a large number of capsules is considered unsafe.\n* Practical or adherence-related concern, including inability to follow timed dosing instructions, inability to comply with the required clear-fluid intake, lack of reliable contact, or anticipated nonadherence to study procedures.\n* For Part III only: inability or unwillingness to self-prepare capsules using study-provided materials and instructions; inadequate manual dexterity or vision to prepare capsules safely and accurately; inability to complete the teach-back procedure, if required; or unwillingness to follow the standardized home preparation workflow, including use only of study-supplied materials, preparation within the defined time window, and storage as instructed.\n* Any contraindication listed in the product monograph for Bi-PegLyte or Pico-Salax.",true,"75 Years",{"count":286,"type":22},80,[288],"EARLY_PHASE1","The goal of this clinical trial is to learn whether bowel preparation powders used before colonoscopy can be taken as capsules instead of being mixed and drunk as a liquid. Bowel preparation is the medicine people take to clean the bowel before a colonoscopy.\n\nThis study will include adults aged 18 to 75 years who are already scheduled for an outpatient colonoscopy and who have had a colonoscopy before.\n\nThe main questions this study aims to answer are:\n\n1. Can participants swallow and complete a large number of bowel preparation capsules with the required clear fluids?\n2. Can the capsules be prepared accurately and practically by a pharmacy or by participants at home?\n3. Is the capsule-based bowel preparation safe and well tolerated?\n4. Does the capsule-based bowel preparation clean the bowel well enough for colonoscopy?\n\nParticipants will take approved bowel preparation products, Pico-Salax or Bi-PegLyte, in vegan hydroxypropyl methylcellulose capsules. They will take the capsules with clear fluids using a split-dose schedule before colonoscopy.\n\nThe study will happen in three parts. First, researchers will test two capsule sizes using Pico-Salax capsules prepared by a partner pharmacy. Then, researchers will test Bi-PegLyte capsules using the capsule size selected from the first part. Finally, some participants will prepare the capsules themselves at home using study instructions and materials.\n\nResearchers will measure how many capsules and how much fluid participants complete, symptoms during preparation, safety blood tests, participant satisfaction, and bowel cleanliness during colonoscopy.",[291,292],"Lower Gastrointestinal Disorder","Tolerance",[294,295],"Colonoscopy","Bowel preparation",{"date":297,"type":37},"2026-07-14",{"date":130,"type":22},{"date":300,"type":22},"2027-12-30",{"name":43,"class":44},{"id":303,"slug":304,"hasResults":12,"nctId":305,"briefTitle":306,"officialTitle":307,"acronym":4,"eligibilityCriteria":308,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":309,"targetDuration":4,"studyType":23,"phases":311,"briefSummary":312,"conditions":313,"keywords":4,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":316,"startDateStruct":317,"completionDateStruct":319,"leadSponsor":321,"locationsCount":45},"100646168","the-proaktive-trial-100646168","NCT07696624","The PROAKTIVE Trial","PRO-Active Rehabilitation Prior to Kidney Transplantation to ImproVe Patient-centered Recovery Evaluation","Inclusion Criteria:\n\n* Age ≥18 years\n* Scheduled, or on the pathway, for kidney transplant surgery\n* Expected surgery date between at least 4 weeks from enrollment\n* Access to internet-enabled device\n* Email address\n\nExclusion Criteria:\n\n* Inability to read and communicate in English\n* Cognitive impairment preventing ability to provide informed consent independently\n* No telephone\u002Fcell phone\n* Any of the following cardiovascular conditions:\n\n  1. Severe valvular heart disease that limits a patient's ability to ambulate on level ground, or is associated with syncope or dyspnea\n  2. Severe cardiac dysrhythmias that limit a patient's ability to ambulate on level ground, or is associated with syncope or dyspnea\n  3. Recent myocardial infarction (within 6 weeks prior to enrollment - based on the Heart and Stroke Foundation's HeartWalk program)",{"count":310,"type":22},45,[57],"The PRO-Active rehabilitation prior to Kidney Transplantation to ImproVe patient-centered recovery Evaluation trial tests an approach where people are supported to exercise, improve diet, and receive emotional support at home before and after kidney transplant surgery to understand the ideal process and benefits.",[314,67],"Kidney Transplant; Complications","2026-07-06",{"date":267,"type":37},{"date":318,"type":22},"2027-01",{"date":320,"type":22},"2029-03",{"name":43,"class":44},{"id":323,"slug":324,"hasResults":12,"nctId":325,"briefTitle":326,"officialTitle":327,"acronym":328,"eligibilityCriteria":329,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":330,"targetDuration":4,"studyType":23,"phases":332,"briefSummary":333,"conditions":334,"keywords":336,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":340,"startDateStruct":341,"completionDateStruct":343,"leadSponsor":345,"locationsCount":45},"100645813","phase-2-debridement-phage-antibiotics-for-pji-100645813","NCT07698002","\"Debridement PhagE AnTibiotics for PJI\"","A Randomized Feasibility Clinical Trial of Phage Therapy in Periprosthetic Joint Infections Treated With Debridement Antibiotic Implant Retention (DAIR) Procedure.","DePHEAT-PJI","Inclusion Criteria:\n\n* Patients are 18 years or older\n* Patients have been diagnosed with bacterial PJI caused by a single organism (either S. aureus or P. aeruginosa) confirmed through synovial fluid cultures.\n* Patients are undergoing DAIR surgical procedure for hip or knee PJI\n* Patients are clinically stable and independently mobile\n* Patients are willing and able to consent\n\nExclusion Criteria:\n\n* Patients have cultured multiple bacteria, and it is difficult for physicians to determine which bacteria is causing the disease\n* Patients develop a life-threatening condition or a condition that leads to deterioration of the patient's medical condition and that is unrelated to the known PJI as cerebrovascular accident, angina, cancer.\n* Patient's clinical condition is no longer stable and deteriorating, for example, if the patient develops sepsis secondary to PJI prior to the commencement of the phage therapy.\n* Patients who have only been through a hemiarthroplasty or uni-compartmental arthroplasty with infected implant component\n* Patients receiving any immunomodulating or immunosuppressive therapy medications for malignancy or autoimmune disease (with exception to inflammatory arthritis), chronic glucocorticoid use (≥ 20mg of prednisolone daily for at least 1 month with another cause of immunosuppression), and history of solid organ and\u002For bone marrow transplantation.\n* Presence of concurrent active viral infection, or history of uncontrolled HIV (CD4 count \\\u003C200 cells\u002FuL).\n* Patient is pregnant or breast feeding",{"count":331,"type":22},10,[25,144],"Total joint replacement (TJR) has revolutionized care provided for patients suffering from disabling joint pain. Unfortunately, periprosthetic joint infection (PJI) remains a devastating complication and the leading cause of failure after TJR. Current standard treatment for PJI requires multiple surgical revisions of the infected prosthesis in combination with a prolonged course of systemic antibiotic therapy. Debridement Antibiotic and Implant Retention (DAIR) procedure is one of the surgical options that is routinely used to manage PJI, due to its lower risk of morbidity and surgical cost. DAIR is often used for patients who present with an acute PJI or who cannot tolerate a complex implant revision. However, the overall success rate for DAIR is ranging between 60-70%. DAIR failures are often attributed to the residual infection and biofilm burden left behind on the retained implant surface, which cannot be targeted effectively with post-operative systemic antibiotics. Therefore, research has been ongoing to identify non-surgical multidrug resistance (MDR) treatment adjuncts that can synergize the therapeutic effects of antibiotics in PJI care.\n\nNumerous preclinical bone and joint infection models have clearly demonstrated such therapeutic benefits using bacteriophages (phages). Phages target bacterial cells and breakdown biofilm that it forms on the implant surface. Each bacterial strain tends to have a particular phage that is susceptible to that bacterial strain. Due to this phage specificity and the fact that bacteria can still develop resistance against a single phage, the concept of using a phage cocktail (mixture of 2 or more phage candidates) has been the preferred treatment approach for applying phage therapy. Using a phage cocktail provides a broader spectrum of bacterial strain coverage and makes it harder for the bacteria to develop resistance. Published literature has considered phage therapy to be safe for direct administration at the infection site with minimal adverse events provided that the phage preparation administered meets Good Manufacturing Practice (GMP).\n\nThe DePHEAT PJI trail, is a prospective, single center, 1:1 non-blinded feasibility randomized controlled trial (RCT) that aims to assess the safety and the effectiveness of the experimental phage therapy cocktails for patients with hip or knee PJI caused by either Staphylococcus (S.) aureus or Pseudomonas (P.) aeruginosa and comparing it to standardized therapy.\n\nThe investigator hypothesizes that this pilot RCT will help evaluate the practicality and potential risks associated with adding phage therapy to the conventional standard of care treatment plan. This will initiate the development of a necessary infrastructure for future phage trials and programs that expand our understanding on the benefits of using phage therapy for acute PJI.",[335],"Periprosthetic Infection",[337,338,339],"Phage therapy","Periprosthetic Joint Infection","Bacteriophage",{"date":269,"type":37},{"date":342,"type":22},"2026-07-02",{"date":344,"type":22},"2028-08-01",{"name":43,"class":44},{"id":347,"slug":348,"hasResults":12,"nctId":349,"briefTitle":350,"officialTitle":351,"acronym":4,"eligibilityCriteria":352,"healthyVolunteers":12,"sex":18,"minAge":353,"maxAge":4,"enrollmentInfo":354,"targetDuration":4,"studyType":23,"phases":356,"briefSummary":357,"conditions":358,"keywords":4,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":360,"startDateStruct":362,"completionDateStruct":364,"leadSponsor":366,"locationsCount":45},"100641566","the-accelerate-pilot-trial-100641566","NCT07655414","The ACCELERATE Pilot Trial","Advancing Cognition and Cognitive Reserve Before ELective Surgery to Enhance Cognitive Recovery And TrajEctories (ACCELERATE)Trial: a Pilot Multicenter Randomized Trial","Inclusion Criteria:\n\n* Age \\>\u002F= 60 years\n* Planned, inpatient, surgical procedures: abdominal, orthopedic, spine, thoracic, pelvic, ENT, and vascular\n* Clinical Frailty Scale (CFS) score \\>\u002F= 4\n* Expected time to surgery \\>\u002F= 4 weeks\n* Cognitive capacity to independently consent for surgery\n\nExclusion Criteria:\n\n* Cardiac and intracranial neurosurgery procedures\n* Visual impairment\n* Lack of English fluency","60 Years",{"count":355,"type":22},103,[57],"The Advancing Cognition and Cognitive reserve before ELective surgery to Enhance cognitive Recovery And TrajEctories (ACCELERATE) Pilot Trial estimates whether our novel, coach-supported cognitive prehabilitation strategy will achieve adequate intervention adherence in the context of a feasible multicenter trial protocol.",[359],"Surgery Complications",{"date":361,"type":37},"2026-07-07",{"date":363,"type":22},"2026-09",{"date":365,"type":22},"2029-09",{"name":43,"class":44},{"id":368,"slug":369,"hasResults":12,"nctId":370,"briefTitle":371,"officialTitle":372,"acronym":373,"eligibilityCriteria":374,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":375,"targetDuration":4,"studyType":23,"phases":377,"briefSummary":378,"conditions":379,"keywords":381,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":386,"startDateStruct":388,"completionDateStruct":390,"leadSponsor":392,"locationsCount":217},"100497159","phase-4-evaluating-omission-of-granulocyte-colony-stimulating-factors-in-breast-cancer-patients-receiving-paclitaxel-portion-of-dose-dense-adriamycin-cyclophosphamide-and-paclitaxel-chemotherapy-100497159","NCT05753618","Evaluating Omission of Granulocyte Colony-stimulating Factors in Breast Cancer Patients Receiving Paclitaxel Portion of Dose-dense Adriamycin-cyclophosphamide and Paclitaxel Chemotherapy","A Randomized Pragmatic Trial Evaluating Omission of Granulocyte Colony-stimulating Factors in Breast Cancer Patients Receiving Paclitaxel Portion of Dose-dense Adriamycin-cyclophosphamide and Paclitaxel Chemotherapy (REaCT-OGF)","REaCT-OGF","Inclusion Criteria:\n\n* Patients with early-stage or locally-advanced breast cancer receiving neoadjuvant or adjuvant DD-AC\u002FT chemotherapy requiring primary febrile neutropenia prophylaxis with G-CSF\n* Able to provide verbal consent\n* Able to complete questionnaires in English or French\n\nExclusion Criteria:\n\n* No access to pegfilgrastim or filgrastim prior to randomization\n* Metastatic cancer\n* Known hypersensitivity to filgrastim or pegfilgrastim or one of its components\n* Patients received prior cytotoxic chemotherapy within the last 5 years\n* Patients with uncontrolled inter-current illness that would limit compliance with study requirements or other significant diseases or disorders that, in the investigator's opinion, would exclude the subject from participating in the study",{"count":376,"type":22},242,[198],"The goal of this randomized, pragmatic clinical trial is to evaluate the omission of granulocyte colony-stimulating factors (G-CSF) in breast cancer patients receiving paclitaxel portion of dose-dense adriamycin-cyclophosphamide and paclitaxel (DD-AC\u002FT) chemotherapy. Participants will be randomized to either take G-CSF while on the paclitaxel portion of DD-AC\u002FT chemotherapy or to omit G-CSF while on the paclitaxel portion of DD-AC\u002FT chemotherapy.",[380],"Early-stage Breast Cancer",[382,383,384,385],"Filgrastim","Pegfilgrastim","Bone pain","Paclitaxel",{"date":387,"type":37},"2026-07-08",{"date":389,"type":37},"2023-04-17",{"date":391,"type":22},"2026-10",{"name":43,"class":44},{"id":394,"slug":395,"hasResults":12,"nctId":396,"briefTitle":397,"officialTitle":398,"acronym":399,"eligibilityCriteria":400,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":401,"targetDuration":4,"studyType":23,"phases":403,"briefSummary":404,"conditions":405,"keywords":410,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":418,"lastUpdatePostDateStruct":419,"startDateStruct":420,"completionDateStruct":421,"leadSponsor":423,"locationsCount":45},"100644116","phase-3-naproxen-versus-placebo-as-adjunct-treatment-of-cellulitis-100644116","NCT07665476","Naproxen Versus Placebo as Adjunct Treatment of Cellulitis","Naproxen Versus Placebo as Adjunct Treatment of Cellulitis: A Randomized Controlled Trial","NVP","Inclusion Criteria:\n\n* adults (age ≥18 years)\n* diagnosed with cellulitis and\n* determined by the treating physician to be eligible for outpatient treatment with oral cephalexin\n\nExclusion Criteria:\n\nThese are appropriate exclusions according to eligibility for treatment with naproxen in clinical practice, and the investigators believe that relatively few patients will be excluded.\n\nThe investigators will exclude participants for any of the following reasons:\n\n1. Age \\\u003C18 years;\n2. Patient already taking oral antibiotics or NSAIDs;\n3. Treating physician decides IV antibiotics are required;\n4. Skin abscess requiring incision and drainage;\n5. Known prior skin or soft tissue infection secondary to methicillin-resistant Staphylococcus aureus (MRSA);\n6. Cellulitis secondary to a human or animal bite;\n7. Penetrating wound or water exposure resulting in cellulitis;\n8. Surgical site infection;\n9. Pregnancy or breastfeeding;\n10. Prior gastric bypass surgery;\n11. Patients on dual antiplatelet therapy;\n12. Patients on warfarin, low molecular weight heparin, or direct oral anticoagulant therapy;\n13. Severe uncontrolled heart failure, or coronary artery bypass grafting (CABG) surgery within 14 days prior to the index visit, or planned CABG surgery within 21 days following the index visit.;\n14. History of gastric\u002Fduodenal ulcer or gastrointestinal bleeding in the past 12 months;\n15. Known kidney impairment with an estimated glomerular filtration rate \\\u003C30 mL\u002Fmin documented on the electronic health record at any time within the past three months;\n16. Known hyperkalemia documented on the electronic health record at any time within the past three months;\n17. Liver cirrhosis;\n18. Inflammatory bowel disease;\n19. History of asthma, urticaria or allergic reactions after taking NSAIDs or aspirin;\n20. Allergy to cephalosporins or history of anaphylaxis to penicillin; (u) Inability to provide informed consent.\n\nExclusion criteria (i) through (s) are known contraindications to NSAIDs.",{"count":402,"type":22},884,[144],"Cellulitis is a painful bacterial skin infection commonly seen in Canadian emergency departments. Cellulitis has a negative impact on patients' quality of life and productivity. While this is a bacterial infection, there is evidence inflammation also contributes to the disabling symptoms of pain, redness and swelling. Some studies have suggested that a nonsteroidal anti-inflammatory drug (NSAID) such as naproxen in addition to antibiotics may control inflammation and speed recovery. However, these studies have had too few patients to tell if there is a true benefit.\n\nThe investigators are proposing a randomized controlled trial of patients with cellulitis to compare oral naproxen (500 mg twice daily) plus oral antibiotics versus placebo plus oral antibiotics. The investigators will compare the proportion of patients who have an early clinical response (reduction in area of redness ≥20% at 72 hours), cure, treatment failure, adverse events, and hospital admission.\n\nIf naproxen proves to be superior to placebo, this simple, low-cost intervention will speed time to recovery with less pain for patients, and may potentially reduce treatment failure and time missed from activities. The results of this trial will help inform future cellulitis treatment guidelines.",[406,407,408,409],"Cellulitis","Skin Disease, Infectious","Infection","Skin and Soft Tissue Infections (SSTIs)",[411,412,406,413,414,415,416,417],"Infectious Diseases","Emergency Medicine","naproxen","antibiotics","oral antibiotics","cephalexin","anti-inflammatories","2026-07-03",{"date":361,"type":37},{"date":271,"type":22},{"date":422,"type":22},"2031-12-01",{"name":43,"class":44},{"id":425,"slug":426,"hasResults":12,"nctId":427,"briefTitle":428,"officialTitle":429,"acronym":430,"eligibilityCriteria":431,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":432,"targetDuration":4,"studyType":23,"phases":433,"briefSummary":434,"conditions":435,"keywords":437,"overallStatus":33,"whyStopped":4,"lastUpdateSubmitDate":441,"lastUpdatePostDateStruct":442,"startDateStruct":444,"completionDateStruct":445,"leadSponsor":447,"locationsCount":45},"100644411","early-phase-1-a-simplified-regimen-to-prevent-nausea-and-vomiting-using-netupitantpalonosetron-in-germ-cell-cancer-patients-receiving-chemotherapy-100644411","NCT07662200","A Simplified Regimen to Prevent Nausea and Vomiting Using Netupitant\u002FPalonosetron in Germ Cell Cancer Patients Receiving Chemotherapy","A Pilot Feasibility Study of a Steroid-Sparing Anti-Nausea and Vomiting Regimen With Netupitant\u002FPalonosetron for Patients With Germ Cell Tumours Receiving Multi-Day Cisplatin-Based Chemotherapy at The Ottawa Hospital","SPARROW-GC","1. Diagnosis of germ cell cancer\n2. Indication for outpatient treatment using a standard 5-day cisplatin-based chemotherapy regimen",{"count":331,"type":22},[288],"This is a single-site, open-label, randomized pilot feasibility study conducted at The Ottawa Hospital Cancer Centre. A total of 10 participants will be randomized 1:1 to either the experimental or control arm.\n\nThe purpose of this study is to evaluate recruitment capability, intervention adherence, data completeness, and safety prior to consideration of a potential future multi-centre randomized trial.",[436],"Germ Cell Cancer",[430,438,439,440],"Netupitant","Palonosetron","Steroid-Sparing Anti-Nausea and Vomiting Regimen","2026-06-18",{"date":443,"type":37},"2026-06-23",{"date":39,"type":22},{"date":446,"type":22},"2028-08",{"name":43,"class":44},{"id":449,"slug":450,"hasResults":12,"nctId":451,"briefTitle":452,"officialTitle":4,"acronym":4,"eligibilityCriteria":453,"healthyVolunteers":12,"sex":454,"minAge":19,"maxAge":4,"enrollmentInfo":4,"targetDuration":4,"studyType":455,"phases":4,"briefSummary":456,"conditions":457,"keywords":459,"overallStatus":460,"whyStopped":4,"lastUpdateSubmitDate":461,"lastUpdatePostDateStruct":462,"startDateStruct":4,"completionDateStruct":4,"leadSponsor":464,"locationsCount":45},"100577428","bacteriophage-clinical-trial-for-periprosthetic-joint-infection-of-multidrug-resistant-pseudomonas-aeruginosa-100577428","NCT06798168","Bacteriophage Clinical Trial for Periprosthetic Joint Infection of Multidrug Resistant Pseudomonas Aeruginosa","Inclusion Criteria:\n\n* Patient is clinically stable and independently mobile\n* Patient has been diagnosed with a multidrug resistant chronic bacterial PJI and has exhausted all other non-debilitating treatment options (including DAIR and antibiotic therapy)\n\nExclusion Criteria:\n\n* Patient has cultured multiple bacteria and it is difficult for physicians to determine which bacteria is causing the disease\n* Patient develops a life threatening condition or a condition that leads to deterioration of the patients medical condition and that is unrelated to the known PJI as cerebrovascular accident, angina, cancer.\n* Patient's clinical condition is no longer stable and deteriorating for example, if the patient develops sepsis secondary to PJI prior to the commencement of the phage therapy.","FEMALE","EXPANDED_ACCESS","This is a single patient study (SPS) that aims to test the bacteriophage treatment as an experimental treatment on a patient suffering from chronic periprosthetic joint infection (PJI) of the right hip. This patients has been suffering from an infection in the right sided hip arthroplasty with a multidrug resistant (MDR) strain of Pseudomonas aeruginosa bacteria. All treatment options for this type of infection have been exhausted. If this patient remains without treatment then there is a high risk of mortality secondary to sepsis and the only remaining surgical option for this patient is a hind quarter amputation which will be a devastating surgery that will largely affect this patients quality of life. However, a large number of published case series have shown the positive impact of combining bacteriophage therapy with antibiotics to achieve a synergistic antibacterial effect and overcome possible resistance development to clear the infection. Therefore the investigators intend to try the bacteriophage therapy on this patients infected hip in the aim to control the infection and improve the patients quality of life.",[458],"Joint Infection",[337,338,339],"AVAILABLE","2026-06-01",{"date":463,"type":37},"2026-06-04",{"name":43,"class":44},{"id":466,"slug":467,"hasResults":12,"nctId":468,"briefTitle":469,"officialTitle":470,"acronym":471,"eligibilityCriteria":472,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":473,"targetDuration":4,"studyType":23,"phases":475,"briefSummary":476,"conditions":477,"keywords":4,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":482,"lastUpdatePostDateStruct":483,"startDateStruct":485,"completionDateStruct":487,"leadSponsor":489,"locationsCount":490},"100481049","evaluating-xperience-advanced-surgical-irrigation-100481049","NCT05543941","Evaluating XPERIENCE™ Advanced Surgical Irrigation","Evaluating XPERIENCE™ Advanced Surgical Irrigation on Risk of Periprosthetic Joint Infection: A Multicenter Randomized Controlled Trial","XPERIENCE","Inclusion Criteria:\n\n1. Male and female patients aged 18 years or older\n2. Diagnosis of osteoarthritis, inflammatory arthritis, osteonecrosis, or post-traumatic arthritis to the affected joint.\n3. Primary TKA, THA, and HR\n4. Subjects receiving both cemented or uncemented orthopaedic implants\n5. Willing and able to sign written consent, follow study protocol and attend follow-up\n\nExclusion Criteria:\n\n1. Inability or refusal to sign informed consent form\n2. Non-English or French speaking, and no licensed translator, family member or substitute decision maker available.\n3. Prior arthroplasty procedure to the affected joint\n4. Procedures involving solid HA implants\n5. Oncologic diagnosis to the affected joint.\n6. Non-TKA, THA or HR prosthesis (i.e., hemiarthroplasty, unicompartmental arthroplasty etc.)\n7. Allergy to any of the components of XP Advanced Surgical Irrigation\n8. Allergy to iodine\n9. Presence of concurrent active infection, primary immunodeficiency, history of uncontrolled HIV (CD4 count \\\u003C200 cells\u002FuL), treatment with immunomodulatory medications for malignancy or autoimmune disease (with exception to inflammatory arthritis), chronic glucocorticosteroid use (≥20 mg of prednisone daily for at least 1 month with another cause of immunosuppression), and solid organ and\u002For bone marrow transplantation.\n10. History of septic arthritis to the affected joint within two years of surgery(1).\n11. History of steroid injection to the affected joint within the three months preceding surgery.\n12. Simultaneous bilateral total joint arthroplasty",{"count":474,"type":22},7600,[57],"A prospective, multi-center, double-arm, parallel, interventional, randomized, controlled clinical trial to assess the rate of periprosthetic joint infection (PJI) in patients undergoing primary total knee arthroplasty (TKA), total hip arthroplasty (THA) or hip resurfacing (HR) with XPERIENCE™ (XP) Advanced Surgical Irrigation versus dilute Betadine (DB).",[478,479,480,481],"Hip Osteoarthritis","Hip Arthritis","Knee Osteoarthritis","Knee Arthritis","2026-05-25",{"date":484,"type":37},"2026-05-28",{"date":486,"type":37},"2023-04-01",{"date":488,"type":22},"2027-12-31",{"name":43,"class":44},8,{"id":492,"slug":493,"hasResults":12,"nctId":494,"briefTitle":495,"officialTitle":496,"acronym":4,"eligibilityCriteria":497,"healthyVolunteers":12,"sex":18,"minAge":498,"maxAge":4,"enrollmentInfo":499,"targetDuration":4,"studyType":23,"phases":501,"briefSummary":502,"conditions":503,"keywords":505,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":482,"lastUpdatePostDateStruct":510,"startDateStruct":511,"completionDateStruct":513,"leadSponsor":515,"locationsCount":490},"100433208","phase-4-evaluating-harms-and-benefits-of-endocrine-therapy-in-patients-70-years-of-age-with-lower-risk-breast-cancer-100433208","NCT04921137","Evaluating Harms and Benefits of Endocrine Therapy in Patients ≥70 Years of Age With Lower Risk Breast Cancer","A Randomised, Multicentre Trial Evaluating Harms and Benefits of Endocrine Therapy in Patients ≥70 Years of Age With Lower Risk Breast Cancer (REaCT-70)","Inclusion Criteria:\n\n* New invasive estrogen and\u002For progesterone receptor-positive (ER+ and\u002For PR+), HER2-negative (HER2-) invasive breast carcinoma diagnosis as per ASCO-CAP guidelines\n* The primary tumour characteristics are either: Grade 1 and ≤3 cm on microscope exam, OR Grade 2 and ≤2 cm on microscope exam, OR Grade 3 and ≤1 cm on microscope exam\n* Treated with standard loco-regional therapy: breast conserving surgery followed by adjuvant radiotherapy OR total mastectomy\n* Axillary node-negative (cN0 or pN0)\n* Able to provide oral consent and complete questionnaires in French or English as per study protocol\n\nExclusion Criteria:\n\n* Metastatic cancer","70 Years",{"count":500,"type":22},500,[198],"The current standard of care for stage 1 hormone receptor-positive (HR+) breast cancer consists of breast-conserving surgery followed by adjuvant radiotherapy (RT) and endocrine therapy (ET) for at least 5 years. The benefit of adjuvant ET for older patients is mitigated because of their increase risk of death from other causes and shorter time horizon to live. Clinical and pathological factors such as low-intermediate grade, tumor size ≤2 cm, and older age have been used in a few studies to identify patients with a lower risk of recurrence that might benefit from adjuvant therapy de-escalation, i.e. omission of RT or ET. Since there is no dedicated randomized clinical trial (RCT) conducted to evaluate the omission of ET, there is clinical equipoise as to whether we can omit adjuvant ET in older patients with lower-risk early-stage breast cancer. Therefore, we propose a randomised, multicentre trial evaluating harms and benefits of endocrine therapy in patients ≥70 years of age with lower risk breast cancer.",[504],"Breast Cancer",[506,507,508,509],"Radiation therapy","Endocrine therapy","Older patients","Adjuvant therapy",{"date":484,"type":37},{"date":512,"type":37},"2021-08-19",{"date":514,"type":22},"2036-05",{"name":43,"class":44},{"id":517,"slug":518,"hasResults":12,"nctId":519,"briefTitle":520,"officialTitle":521,"acronym":522,"eligibilityCriteria":523,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":524,"targetDuration":4,"studyType":23,"phases":526,"briefSummary":527,"conditions":528,"keywords":4,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":530,"lastUpdatePostDateStruct":531,"startDateStruct":533,"completionDateStruct":535,"leadSponsor":537,"locationsCount":45},"100551598","pancreatic-insulin-production-capacity-pipc---a-feasibility-study-100551598","NCT06462170","Pancreatic Insulin Production Capacity (PIPC) - a Feasibility Study","The Feasibility of an Innovative Protocol to Demonstrate the Impact of Positive Energy Balance on Pancreatic Insulin Production Capacity (PIPC)","PIPC","Inclusion Criteria:\n\n1. Consent provided\n2. Age \\>= 18 years.\n3. Diagnosed as type 2 diabetes mellitus.\n4. Not on insulin therapy.\n\nExclusion Criteria:\n\n1. Diagnosed as another form of diabetes mellitus.\n2. Allergic to one or more ingredients in Boost meal replacement shake.\n3. Unable to fast since midnight and attend in person for the morning protocol.",{"count":525,"type":22},90,[57],"The standard treatment for Type 2 diabetes involves management of the disease based on average of blood glucose control over the past few months.\n\nIn this study, the investigators test for the participants' ability to produce insulin, which is the hormone that the body makes to control blood sugar levels. The body produces insulin in response to eating. The participants will drink a meal replacement shake, and then test the blood for levels of insulin produced over 2 hours.\n\nWith blood tests taken five times over two hours, the investigators will measure the blood glucose (sugar), and insulin levels. This study will assess the differences in insulin produced in the participants and try to understand the reasons for these differences.",[529],"Type 2 Diabetes","2026-04-30",{"date":532,"type":37},"2026-05-06",{"date":534,"type":37},"2024-06-24",{"date":536,"type":22},"2026-12-31",{"name":43,"class":44},{"id":539,"slug":540,"hasResults":12,"nctId":541,"briefTitle":542,"officialTitle":542,"acronym":543,"eligibilityCriteria":544,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":545,"targetDuration":4,"studyType":547,"phases":4,"briefSummary":548,"conditions":549,"keywords":4,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":552,"lastUpdatePostDateStruct":553,"startDateStruct":555,"completionDateStruct":557,"leadSponsor":559,"locationsCount":45},"100594175","variability-and-post-op-aes-does-preoperative-cardiopulmonary-variability-assessment-identify-risk-of-postoperative-adverse-events-following-thoracic-surgery-100594175","NCT07016022","Variability and Post-op AEs: Does Preoperative CardioPulmonary Variability Assessment Identify Risk of Postoperative Adverse Events Following Thoracic Surgery","CPVA","Inclusion Criteria:\n\n* Adult patient (≥18 years of age)\n* Patients undergoing major thoracic resection for lung, esophageal or gastric cancer or mediastinal tumour (at least lobectomy, pneumonectomy, esophagectomy, gastrectomy, or mediastinal tumour resection)\n\nExclusion Criteria:\n\n* Urgent\u002Femergent cases\n* Patients with pre-existing atrial fibrillation or arrhythmia (persistent\u002Fparoxysmal)\n* Patients that are pacemaker dependent\n* Patients unable to participate in preoperative testing protocol (CardioPulmonary Variability Assessment)\n* Patients that are pregnant",{"count":546,"type":22},130,"OBSERVATIONAL","Major thoracic surgery is high risk as it carries a significant risk of postoperative Adverse Events (AEs), where patients experience complications and do not recover as expected. These AEs can increase the risk of mortality, hospital length of stay, as well as healthcare costs. The investigators' aim is to improve surgical safety by pioneering a marked advance in preoperative prediction of postoperative AEs that will enable individualized targeted perioperative pathways to prevent postoperative AEs. Given that illness and stress are associated with a loss in physiologic variability (e.g. heart and respiration rate), the investigators will use heart and lung variability assessments to improve prediction of postoperative AEs. Therefore, this study aims to assess the feasibility of implementing a preoperative CardioPulmonary variability assessment; determine if preoperative CardioPulmonary variability is associated with postoperative AEs; and determine if this variability assessment is superior and complementary to existing measures of risk and frailty.",[550,551],"Thoracic Cancer","Complication,Postoperative","2026-04-27",{"date":554,"type":37},"2026-05-01",{"date":556,"type":37},"2025-07-01",{"date":558,"type":22},"2026-07-01",{"name":43,"class":44},{"id":561,"slug":562,"hasResults":12,"nctId":563,"briefTitle":564,"officialTitle":565,"acronym":566,"eligibilityCriteria":567,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":568,"targetDuration":4,"studyType":23,"phases":570,"briefSummary":571,"conditions":572,"keywords":4,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":552,"lastUpdatePostDateStruct":575,"startDateStruct":576,"completionDateStruct":578,"leadSponsor":579,"locationsCount":45},"100555374","the-strive-before-surgery-trial-100555374","NCT06511258","The STRIVE Before Surgery Trial","The STRIVE Before Surgery Pilot Trial: a Vanguard Pragmatic Multicenter Randomized Trial of Structured TRaining to Improve Fitness in a Virtual Environment (STRIVE) Before Surgery","STRIVE","Inclusion Criteria:\n\n1. Age ≥18 years\n2. Scheduled, or on the pathway, for inpatient abdominal, thoracic, pelvic, head-and-neck or vascular surgery\n3. Expected surgery date between 3 and 12 weeks from enrollment\n4. Valid provincial health insurance number\n5. Access to internet-enabled device\n6. Email address\n\nExclusion Criteria:\n\n1. Inability to read and communicate in English\n2. Cognitive impairment preventing ability to provide informed consent independently\n3. No telephone\u002Fcell phone\n4. Cardiac, neurological or orthopedic procedure\n5. Surgery with no curative intent (palliative surgery)\n6. Patient not interested in participating in the context of their TAPA score\n7. Any of the following cardiovascular conditions:\n\n   1. Severe valvular heart disease that limits a patient's ability to ambulate on level ground, or is associated with syncope or dyspnea\n   2. Severe cardiac dysrhythmias that limit a patient's ability to ambulate on level ground, or is associated with syncope or dyspnea\n   3. Recent myocardial infarction (within 6 weeks prior to enrollment - based on the Heart and Stroke Foundation's HeartWalk program)",{"count":569,"type":22},902,[57],"The STRIVE Before Surgery Trial evaluates patient-reported disability at 90 days after surgery following participating in a home-based multimodal prehabilitation program supported through an online platform. Half of the participants will be randomized into the prehabilitation group, while the other half will be randomized into the control group.",[573,574],"Surgery-Complications","Disability Physical",{"date":554,"type":37},{"date":577,"type":37},"2024-09-05",{"date":422,"type":22},{"name":43,"class":44},{"id":581,"slug":582,"hasResults":12,"nctId":583,"briefTitle":584,"officialTitle":585,"acronym":586,"eligibilityCriteria":587,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":588,"targetDuration":4,"studyType":23,"phases":590,"briefSummary":591,"conditions":592,"keywords":4,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":594,"lastUpdatePostDateStruct":595,"startDateStruct":597,"completionDateStruct":599,"leadSponsor":600,"locationsCount":601},"100478202","liberation-from-mechanical-ventilation-using-extubation-advisor-decision-support-100478202","NCT05506904","Liberation From Mechanical Ventilation Using Extubation Advisor Decision Support","Liberation From Mechanical Ventilation Using Extubation Advisor Decision Support: The Multicentre (LEADS) Pilot Trial","LEADS","Inclusion Criteria:\n\n* Critically ill adults (age≥18)\n* Invasive ventilation for \\>48 hours\n* Who are expected to undergo an initial SBT within the next 48 hours with a view to extubation as per treating MDs. As per the FAST trial, an SBT will be defined as a focused assessment on low ventilator settings \\[T-piece, continuous positive airway pressure (CPAP), or PS \\\u003C 8 cm H2O regardless of positive end-expiratory pressure (PEEP)\n\nExclusion Criteria:\n\n* Suffer from known or suspected peripheral severe myopathy or neuropathy, or limb weakness or paralysis or central (e.g., post arrest, large intracranial stroke or bleed) injury or Glasgow Coma Scale (GCS) \\\u003C 6\n* Do not wish to be re-intubated as part of their treatment goals\n* Were previously extubated during the same ICU admission\n* Have undergone 1 or more SBTs where the SBT was clearly documented in the chart and\u002For the PS was reduced to the SBT level of 8 or less during the 24 hour period prior to randomization\n* Already have a tracheostomy\n* Are moribund or expected to die.",{"count":589,"type":22},200,[57],"Timely and safe extubation in critically ill patients is vitally important as prolonged mechanical ventilation and failed attempts at extubation are associated with increased morbidity, mortality, costs, intensive care unit (ICU) stays, and a risk for aerosolization of COVID-19 to health care providers. A Spontaneous Breathing Trial (SBT) is the current standard of care to assess a patient's readiness for extubation. However, SBTs are performed in various ways and have poor ability to predict successful extubation on their own. There is an urgent need to improve and standardize extubation decision-making. In a prior multicenter study, the investigators showed that decreased respiratory rate variability during SBTs predicted extubation failure better than other predictive indices.\n\nThe Extubation Advisor (EA) tool combines clinician's assessments of extubation readiness with predictive analytics and risk mitigation strategies for individual patients. In a single centre observational study, the investigators demonstrated the ability to deliver EA reports to the bedside and acceptability of this decision-support tool to respiratory therapists (RTs) and physicians (MDs).\n\nThe investigators will conduct the Liberation from mechanical ventilation using EA Decision Support (LEADS) Pilot Trial to assess feasibility outcomes. They will include critically ill adults who are invasively ventilated for \\>48 hours and are ready to undergo an SBT.\n\nPatients in the intervention arm undergo an EA assessment and treating clinicians (RTs, MDs) will receive an EA report for each SBT conducted. The EA report will help to guide extubation decision-making. Patients in the control arm receive standard care. SBTs will be directed by clinicians.\n\nThe primary feasibility outcome will reflect the ability to recruit the desired population. The investigators will also assess the usefulness of the tool to MDs and complete an analysis of resource utilization to inform future economic analyses of cost-effectiveness. The investigators aim to recruit 1 to 2 patients\u002Fmonth\u002Fcenter.\n\nThe LEADS trial is novel and low-risk. It is the first trial to evaluate use of a bedside decision support tool to assist ICU clinicians with extubation decision-making. The LEADS pilot trial will inform the design of a future, large-scale randomized controlled trial that is expected to enhance the care delivered to critically ill patients, improve extubation outcomes, and inform extubation practice in ICUs.",[593],"Airway Extubation","2026-04-17",{"date":596,"type":37},"2026-04-22",{"date":598,"type":37},"2024-04-22",{"date":536,"type":22},{"name":43,"class":44},12,{"id":603,"slug":604,"hasResults":12,"nctId":605,"briefTitle":606,"officialTitle":606,"acronym":607,"eligibilityCriteria":608,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":609,"targetDuration":4,"studyType":23,"phases":611,"briefSummary":612,"conditions":613,"keywords":615,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":594,"lastUpdatePostDateStruct":618,"startDateStruct":619,"completionDateStruct":621,"leadSponsor":622,"locationsCount":490},"100411813","phase-4-comparison-of-bleeding-risk-between-rivaroxaban-and-apixaban-in-patients-with-atrial-fibrillation-100411813","NCT04642430","COmparison of Bleeding Risk Between Rivaroxaban and Apixaban in Patients With Atrial Fibrillation","COBRRA-AF","Inclusion Criteria:\n\n* Age ≥ 18 years old\n* Confirmed new diagnosis of AF on ECG with an indication to start anticoagulation according to Canadian Cardiovascular Society guidelines\n\nExclusion Criteria:\n\n* Creatinine clearance =\\\u003C15 ml\u002Fmin calculated using the Cockcroft-Gault formula\n* Any contraindication for anticoagulation with apixaban or rivaroxaban as determined by the treating physician such as, but not limited to:\n\n  * active bleeding\n  * history of mechanical valve\n  * other indication for anticoagulation (e.g. mechanical valves, venous thrombosis)\n  * dual antiplatelet agent use\n  * known liver disease with coagulopathy\n  * use of contraindicated medications (strong inducers\u002Finhibitors of CYP 3A4\u002F5, P-glycoprotein)\n  * pregnancy or breastfeeding",{"count":610,"type":22},3018,[198],"Atrial Fibrillation (AF) affects 200,000 Canadians and increases risk of stroke, morbidity and mortality. Having a stroke can affect a patient's ability to speak, eat, walk, work, care for themselves, and interact with others. Not only can it ruin one's life, but it can also be fatal. A stroke occurs when blood flow to the brain is blocked by a clot, depriving brain cells of oxygen. In people with atrial fibrillation, blood flow is sluggish in the top chambers of the heart, and blood clots can form there. When a piece of a clot breaks off, it can travel to the brain and cause a stroke. That's where blood thinners come in. Blood thinners, or anticoagulants, decrease the chances of blood clots forming in the heart, reducing the risk of stroke. Studies show that blood thinners are highly effective at reducing the risk of stroke by up to 95%.\n\nThe conventional blood thinner is warfarin, taken by mouth. Warfarin requires regular blood tests to make sure a patient getting the correct dose. The patient also may have to avoid certain foods since the medication can interact with them. Newer blood thinners, known as direct-oral anticoagulants (DOACs) are available, which do not require regular blood tests and do not interact with foods. Two of the new blood thinners are called rivaroxaban and apixaban. Like warfarin, they can be taken by mouth, and studies have shown them to be as effective as warfarin.\n\nBoth rivaroxaban and apixaban have been approved for stroke prevention in AF by Health Canada. However, there have been no direct head-to-head comparisons of these two anticoagulants, meaning comparative safety data is not available. Increasing use of DOACs for stroke prevention in AF and patient values around bleeding highlight the need for a comparison trial to ensure patients receive the anticoagulant with the greatest balance of benefit to potential harm.\n\nThe trial is to assess bleeding rates and superiority of using apixaban versus rivaroxaban in patients with non-valvular atrial fibrillation.",[614],"Atrial Fibrillation",[616,617],"Stroke Prevention","Bleed",{"date":596,"type":37},{"date":620,"type":37},"2021-07-06",{"date":488,"type":22},{"name":43,"class":44},{"id":624,"slug":625,"hasResults":12,"nctId":626,"briefTitle":627,"officialTitle":628,"acronym":629,"eligibilityCriteria":630,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":631,"targetDuration":4,"studyType":23,"phases":632,"briefSummary":633,"conditions":634,"keywords":4,"overallStatus":98,"whyStopped":4,"lastUpdateSubmitDate":640,"lastUpdatePostDateStruct":641,"startDateStruct":643,"completionDateStruct":645,"leadSponsor":647,"locationsCount":45},"100628625","advanced-brain-imaging-tka-fmri-tka-100628625","NCT07464080","Advanced Brain Imaging-TKA (fMRI-TKA)","Brain Network-based Precision Medicine to Predict Dissatisfaction Following Total Knee Arthroplasty","fMRI-TKA","Inclusion Criteria:\n\n1. Male and female patients aged 18 years or older\n2. Primary TKA\n3. Diagnosis of osteoarthritis, inflammatory arthritis, or osteonecrosis\n\nExclusion Criteria:\n\n1. Inability or refusal to sign informed consent form\n2. Non-English or French speaking, and no licensed translator, family member or substitute decision maker available\n3. History of major neurological disorders (e.g traumatic brain injury, epilepsy, multiple sclerosis\n4. Cognitive impairment or dementia\n5. Revision and\u002For Bilateral TKA\n6. Chronic Opioid use",{"count":196,"type":22},[57],"Knee replacement surgery is a common and effective treatment for pain and mobility loss, yet up to 1 in 5 patients remain dissatisfied after surgery due to ongoing pain or difficulty with daily activities. Currently, clinicians cannot reliably predict which patients will experience these challenges.\n\nThis study uses MRI scan of the brain to investigate whether specific patterns of brain activity can predict patient satisfaction after total knee arthroplasty (TKA). By comparing brain networks before surgery and afterward, and linking these changes to patient-reported pain and function, we aim to identify brain-based markers that can help predict outcomes, to improve satisfaction after knee replacement surgery.",[635,636,637,638,639],"Knee Osteoarthritis (Knee OA)","Knee Pain Chronic","Brain Network Connectivity","Patient Satisfaction","Brain MRI","2026-03-09",{"date":642,"type":37},"2026-03-11",{"date":644,"type":22},"2026-04-01",{"date":646,"type":22},"2028-12-31",{"name":43,"class":44},""]