We may be able to rescue a generation of patients who are being abandoned to progressive injury to their heart from previous-generation pacemakers. This is because there is no randomised evidence to show that they would fare better with upgrade to modern pacing strategies. Today, if patients who require pacemakers for slow heart rates have even mildly impaired heart function, they receive modern pacing strategies (via His bundle, left bundle or biventricular pacing) rather than traditional right ventricular (RV pacing. ...

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MAT is an international,multicenter,prospective,parallel-group,randomised,double-blind,placebo-controlled trial. The double-blind period will be preceded by a 6-week,single-blind (participants will remain blind),active run-in phase in which all potential participants will receive metformin sustained release (SR) with fortnightly dose increments. The aim of this run-in phase is to ensure the randomisation of participants who tolerate the treatment regimen and to increase the likelihood of high treatment adherence during long term follow-up. Randomised participants will receive study medication for an average of 3.5 years (up to ...

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Raised blood pressure (BP) during and following pregnancy affects around 80,000 women each year in the UK, and can lead to very serious problems such as pre-eclampsia or stroke. After birth, a women’s BP can remain elevated, but in most cases returns to normal over 2–12 weeks. During this period, medication needs to be adjusted to achieve the correct control. Research suggests that better BP control during this period is associated with improved long-term health outcomes. This trial aims to ...

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This study is a Phase 3, open-label, multi-center, randomized study to evaluate the efficacy and safety of elranatamab monotherapy versus the investigator’s choice of elotuzumab, pomalidomide, dexamethasone (EPd) or pomalidomide, bortezomib, dexamethasone (PVd) or carfilzomib, dexamethasone (Kd) in participants with RRMM who have received at least 1 but no more than 4 prior lines of therapy including an anti-CD38 antibody and lenalidomide. Participants will have RRMM and relapsed or refractory to the last anti-myeloma treatment regimen and will not have ...

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This is a multi-centre Randomised Controlled Trial that will investigate the feasibility of self-monitoring of hypertension,self-testing for proteinuria and remote titration of medication in a group of pregnant women with hypertension.

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Cirrhosis, progressive scaring of the liver- has many causes, principally, excessive alcohol intake, fatty-liver and viral infections. Unlike many chronic diseases, cirrhosis deaths are increasing rapidly year-on-year. It is the third commonest cause of premature, UK working-age deaths, with 62,000 years of working-life lost each year and NHS care costs of £4.53bn annually. One quarter of all UK cirrhosis patients are at-risk of acute decompensation, whereby complications such as fluid-overload, confusion and infections arise, requiring hospital-emergency treatment. Currently, decompensated cirrhosis patients ...

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Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory disease affecting 1 in 1000 children with around 12,000 children with JIA in England and Wales [1,2]. Delay in diagnosis and under-treatment lead to joint damage,disability and reduced quality of life [3]. In the UK and most of the world,children and young people with new-onset poly-articular Juvenile Idiopathic Arthritis (pcJIA) are commenced on corticosteroids and methotrexate [2,4,5]. As methotrexate can take several months to have an effect,corticosteroids are used to rapidly control ...

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Nearly 30,000 infants under one are admitted to hospitals in England each year with bronchiolitis, a common viral chest infection. Half of them need oxygen treatment through ‘nasal cannula’ (thin tubes inserted into the nostrils). Most infants respond to nasal cannula oxygen alone, but some need additional breathing support. In these infants, different treatments such as ‘humidified’ (moist) standard oxygen (HSO), high-flow nasal cannula (HFNC) and ‘CPAP’ (pressurised oxygen delivered through the nose) are used. However, it is not clear ...

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Rectal cancer (cancer of the lower part of the bowel) is one of the most prevalent forms of cancer, and affects approximately 14,000 people each year in the UK. The treatment for the majority of these patients is surgical removal of the affected part of the bowel, following which the bowel is joined back together. Some patients may also require chemotherapy and radiotherapy. One consequence of the treatment of bowel cancer is a severe form of bowel dysfunction called major Low Anterior Resection Syndrome ...

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A coronary artery bypass graft (CABG) is a surgical procedure used to treat coronary heart disease. It diverts blood around narrowed or clogged parts of the major arteries to improve blood flow and oxygen supply to the heart. Like all organs in the body, the heart needs a constant supply of blood which comes through arteries called coronaries. Over time, these arteries can become narrowed and hardened by the build-up of fatty deposits called atherosclerosis plaques. CABG involves taking a blood ...

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