
Search Clinical Trials
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LY4268989 (MORF-057) Co-Administered With Mirikizumab in Adults With Moderately to Severely Active1
Eli Lilly and Company
Ulcerative Colitis
The main purpose of the study is to evaluate the effectiveness and safety of LY4268989
when given with mirikizumab compared to mirikizumab alone in adult participants with
moderately to severely active ulcerative colitis (UC).
Study participation will last approximately 118 weeks, including 104 we1 expand
The main purpose of the study is to evaluate the effectiveness and safety of LY4268989 when given with mirikizumab compared to mirikizumab alone in adult participants with moderately to severely active ulcerative colitis (UC). Study participation will last approximately 118 weeks, including 104 weeks of treatment and may include up to 21 visits. Type: Interventional Start Date: Nov 2025 |
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Assessing the Impact of Muvalaplin on Major Cardiovascular Events in Adults With Elevated Lipoprote1
Eli Lilly and Company
Elevated Lp(a)
Atherosclerotic Cardiovascular Disease (ASCVD)
The purpose of this study is to evaluate the efficacy of muvalaplin in reducing
cardiovascular risk in participants with high lipoprotein(a) who have cardiovascular
disease or are at risk of a heart attack or stroke. expand
The purpose of this study is to evaluate the efficacy of muvalaplin in reducing cardiovascular risk in participants with high lipoprotein(a) who have cardiovascular disease or are at risk of a heart attack or stroke. Type: Interventional Start Date: Sep 2025 |
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A Study to Learn About the Study Medicine Ibuzatrelvir in Adults With COVID-19 Who Are Severely Imm1
Pfizer
COVID-19 Infection
This is a Phase 3, randomized, actively controlled, double-blinded, double-dummy,
superiority study to evaluate the efficacy and safety of ibuzatrelvir alone and in
combination with remdesivir IV compared to remdesivir IV alone for the treatment of
symptomatic COVID-19 in severely immunocompromised1 expand
This is a Phase 3, randomized, actively controlled, double-blinded, double-dummy, superiority study to evaluate the efficacy and safety of ibuzatrelvir alone and in combination with remdesivir IV compared to remdesivir IV alone for the treatment of symptomatic COVID-19 in severely immunocompromised adult participants who are non-hospitalized or are hospitalized for observation or study intervention administration but do not require supplemental oxygen for COVID-19. Type: Interventional Start Date: Jul 2025 |
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Testing the Addition of an Anti-Cancer Drug, Gemcitabine, to Usual Treatment (BCG Alone) in People1
Alliance for Clinical Trials in Oncology
Recurrent Non-Muscle Invasive Bladder Carcinoma
Stage 0a Bladder Cancer AJCC v8
Stage I Bladder Cancer AJCC v8
This phase III trial compares the effect of adding gemcitabine to intravesical Bacillus
Calmette Guerin (BCG) versus intravesical BCG alone in patients with non-muscle invasive
bladder cancer that has come back after a period of improvement (recurrent). Gemcitabine
is a chemotherapy drug that block1 expand
This phase III trial compares the effect of adding gemcitabine to intravesical Bacillus Calmette Guerin (BCG) versus intravesical BCG alone in patients with non-muscle invasive bladder cancer that has come back after a period of improvement (recurrent). Gemcitabine is a chemotherapy drug that blocks the cells from making deoxyribonucleic acid (DNA) and may kill cancer cells. Intravesical BCG is a solution containing the live BCG bacteria that is placed in the bladder via a catheter (intravesical). When the solution comes into direct contact with the bladder wall, it stimulates the body's immune system which kills tumor cells. Giving gemcitabine with intravesical BCG may kill more tumor cells in patients with recurrent non-muscle invasive bladder cancer. Type: Interventional Start Date: Jul 2025 |
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Colchicine to Reduce Your SympToms And Lower Levels of Inflammation, Zeroing in on Effective CPPD D1
Brigham and Women's Hospital
CPPD - Calcium Pyrophosphate Deposition Disease
The goal of this clinical trial is to learn if colchicine reduces levels of proteins
indicating inflammation in the blood in individuals with calcium pyrophosphate deposition
(CPPD) disease. The trial will also test the effect of colchicine on joint symptoms in
CPPD disease. The main questions it a1 expand
The goal of this clinical trial is to learn if colchicine reduces levels of proteins indicating inflammation in the blood in individuals with calcium pyrophosphate deposition (CPPD) disease. The trial will also test the effect of colchicine on joint symptoms in CPPD disease. The main questions it aims to answer are: - Does colchicine reduce the level of interleukin 18 (IL-18) in the blood of individuals with CPPD disease? - Does colchicine reduce pain scores in individuals with CPPD disease? Researchers will compare colchicine once daily to a placebo (a look-alike pill that contains no drug) to see if colchicine works to treat CPPD disease. Participants will: - Take colchicine or a placebo every day for 6 months - Visit the clinic 3 times in 6 months for joint examinations, surveys, and blood tests. Each visit will last 2-3 hours. - Speak on the telephone with researchers for about 4 times over 6 months. Each phone call will last about 5 minutes. Type: Interventional Start Date: Jul 2026 |
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A Study to Assess the Efficacy and Safety of Induction and Maintenance Therapy With Afimkibart (RO71
Hoffmann-La Roche
Moderately to Severely Active Crohns Disease
This Phase III, multicenter, double-blind, placebo-controlled treat-through study will
evaluate the efficacy and safety of induction and maintenance therapy with Afimkibart
(also known as RO7790121) in participants with moderately to severely active Crohn's
disease (CD). expand
This Phase III, multicenter, double-blind, placebo-controlled treat-through study will evaluate the efficacy and safety of induction and maintenance therapy with Afimkibart (also known as RO7790121) in participants with moderately to severely active Crohn's disease (CD). Type: Interventional Start Date: Mar 2025 |
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Study of Tirzepatide for Recovery and Alcohol Use Management
Brigham and Women's Hospital
Alcohol Use Disorder (AUD)
This is a pilot, 4-week, double-blind, placebo-controlled, randomized trial of
individuals with alcohol use disorder (AUD) to receive weekly injections of either
tirzepatide (n=10) or matching placebo (n=10). The primary aim is to determine the
effects of tirzepatide on cue-reactivity among individ1 expand
This is a pilot, 4-week, double-blind, placebo-controlled, randomized trial of individuals with alcohol use disorder (AUD) to receive weekly injections of either tirzepatide (n=10) or matching placebo (n=10). The primary aim is to determine the effects of tirzepatide on cue-reactivity among individuals with AUD. The secondary aim is to assess the safety and preliminary efficacy of tirzepatide for AUD. Type: Interventional Start Date: Sep 2025 |
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Atomoxetine and DAW2022 on OSA Severity
Brigham and Women's Hospital
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is common and has major health implications but treatment
options are limited. In previous research atomoxetine and oxybutynin showed promising
effect at reducing OSA severity, however they reduced arousal threshold, one of the key
traits responsible for OSA. Since oxy1 expand
Obstructive sleep apnea (OSA) is common and has major health implications but treatment options are limited. In previous research atomoxetine and oxybutynin showed promising effect at reducing OSA severity, however they reduced arousal threshold, one of the key traits responsible for OSA. Since oxybutynin was used mainly as a hypnotic, but it is burdened by several anti-cholinergic side effects, DAW2020, a hypnotic which prolonged the total sleep time in a previous trial in OSA patients, could be a better candidate to associate with atomoxetine. Type: Interventional Start Date: Jun 2022 |
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Rescue Pharmacotherapy for OSA
Brigham and Women's Hospital
Obstructive Sleep Apnea
Persistent obstructive sleep apnea (OSA) is common in people treated with mandibular
advancement device (MAD) or hypoglossal nerve stimulation (HGNS). For most patients,
these treatments are the last line of defense. If MAD or HGNS do not work, then patients
are left to suffer the consequences of u1 expand
Persistent obstructive sleep apnea (OSA) is common in people treated with mandibular advancement device (MAD) or hypoglossal nerve stimulation (HGNS). For most patients, these treatments are the last line of defense. If MAD or HGNS do not work, then patients are left to suffer the consequences of undertreated OSA. In this study, the investigators want to test the addition of a drug treatment to their regimen. Endotypes will be targeted pharmacologically with one of the following drugs: acetazolamide for a high loop gain, atomoxetine-plus-eszopiclone for poor pharyngeal muscle compensation, or trazodone for a low arousal threshold. This aim is expected to provide treatment strategies for rescuing non-responders to MAD or HGNS therapy. Type: Interventional Start Date: Jul 2023 |
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Study of Efficacy and Safety of LNP023 in Participants With Active Lupus Nephritis Class III-IV, +/1
Novartis Pharmaceuticals
Lupus Nephritis
The overall purpose of this two-part study is to evaluate the efficacy, safety and
tolerability of iptacopan (LNP023) in addition to standard of care treatment. expand
The overall purpose of this two-part study is to evaluate the efficacy, safety and tolerability of iptacopan (LNP023) in addition to standard of care treatment. Type: Interventional Start Date: Aug 2022 |
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Urologic Lymphadenectomy in AMIGO
Brigham and Women's Hospital
Urologic Cancer
Lymph Node Metastasis
This research study involves the use of two navigation systems, the 3D Slicer-based
navigation system, and the Siemens Monaco systems, to simplify the complexity of
image-guided lymphadenectomy procedures (surgery to remove one or more lymph nodes) in
patients with urological cancer. expand
This research study involves the use of two navigation systems, the 3D Slicer-based navigation system, and the Siemens Monaco systems, to simplify the complexity of image-guided lymphadenectomy procedures (surgery to remove one or more lymph nodes) in patients with urological cancer. Type: Interventional Start Date: Apr 2022 |
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Defibrotide for the Treatment of Severe COVID-19
Brigham and Women's Hospital
Covid19
The goal of this study is to evaluate the safety and feasibility of defibrotide in
COVID-19 pneumonia. expand
The goal of this study is to evaluate the safety and feasibility of defibrotide in COVID-19 pneumonia. Type: Interventional Start Date: Jan 2021 |
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AMI Construction in Lower Extremity Residual Limbs
Brigham and Women's Hospital
Amputation
This study will involve the development of a novel approach to lower extremity residual
limb surgical revision that offers the promise of augmenting volitional motor control,
restore proprioception and reverse atrophy expand
This study will involve the development of a novel approach to lower extremity residual limb surgical revision that offers the promise of augmenting volitional motor control, restore proprioception and reverse atrophy Type: Interventional Start Date: Feb 2020 |
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Deceased Uterine Transplant in Absolute Uterine Infertility (AUIF)
Brigham and Women's Hospital
Infertility of Uterine Origin
Our study will explore the feasibility of initiating a deceased donor uterine transplant
program in addition to the existing living donor IRB at BWH.
Using the template established by teams around the world, we will identify emotionally
and socially stable females of reproductive age with intact o1 expand
Our study will explore the feasibility of initiating a deceased donor uterine transplant program in addition to the existing living donor IRB at BWH. Using the template established by teams around the world, we will identify emotionally and socially stable females of reproductive age with intact ovaries who are unable to gestate a child due to congenital or acquired uterine factor infertility. After careful screening, participants will undergo egg harvest, in vitro fertilization, and embryo cryopreservation using standard methods. Women who successfully complete the fertilization of at least six euploid embryos will be eligible to be placed on the waitlist for a deceased donor uterus transplant. After a successful transplant and a period of observation to ensure normal menstrual cycle and graft viability (anticipate six months), embryo implantation will be undertaken. Following an embryo transfer, gestation will be carefully monitored by our high-risk pregnancy specialists. Medical research interventions include the surgical implantation of a uterus utilizing techniques by teams that have applied this approach successfully, close post-transplant follow up including immunosuppression therapy tailored to established standards during pregnancy minimizing fetal risks, and careful management of pregnancy. After childbearing is complete (at most two gestations), the donor uterus will be removed either during Cesarean or during an elective procedure. In addition, open ended interviews and surveys will be conducted to elicit ethical and psychosocial concerns arising from the experience of subjects and their families, health care providers, and the wider community. The investigator's intent is to monitor outcomes for transplant recipients as well as the live born infants for 30 days after removal of the transplanted uterus. It is estimated that the time from screening to a potential live birth will be a minimum of 22 months, but likely between 24 - 36 months depending on organ availability. Type: Interventional Start Date: Jul 2026 |
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A Study of CDX-622 in Participants With Mild to Moderate Asthma
Celldex Therapeutics
Mild to Moderate Asthma
This is a study to determine the safety, pharmacodynamics (PD), and pharmacokinetics (PK)
of CDX-622 in adults with mild to moderate asthma. expand
This is a study to determine the safety, pharmacodynamics (PD), and pharmacokinetics (PK) of CDX-622 in adults with mild to moderate asthma. Type: Interventional Start Date: Jun 2026 |
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Menstrual Cup for Early Endometrial Cancer Detection in Lynch Syndrome
Jessica D. St. Laurent, MD
Endometrial Cancer
Lynch Syndrome
Screening
Early Detection of Cancer
Study Goal:
This pilot study wants to find out if using a menstrual cup can be a good, non-invasive
way to collect samples from the lining of the uterus (called the endometrium) to help
screen for endometrial cancer. This is especially important for women who have a higher
chance of getting this c1 expand
Study Goal: This pilot study wants to find out if using a menstrual cup can be a good, non-invasive way to collect samples from the lining of the uterus (called the endometrium) to help screen for endometrial cancer. This is especially important for women who have a higher chance of getting this cancer, such as those with a genetic condition called Lynch syndrome. Main Questions the Study Will Answer: 1. Can a menstrual cup collect enough uterine lining (endometrial tissue) for doctors to examine under a microscope? 2. Are the samples from the menstrual cup as useful for diagnosis as samples taken using the usual method (called an endometrial biopsy or EMB)? 3. Is using a menstrual cup at home easy, effective, and comfortable for participants? 4. Can scientists grow small lab models of the uterus (called organoids) from the menstrual cup samples and from biopsy samples? What Will Happen in the Study: - Participants will use a menstrual cup at home to collect menstrual blood. - They will also have a standard endometrial biopsy done by a healthcare provider. - After both collections, participants will fill out a short survey about how comfortable and easy it was to use the menstrual cup. What the Study Will Measure: - Feasibility: How well participants are able to use the menstrual cup and send in the sample. - Sample Quality: Whether the menstrual cup collects enough good-quality tissue for testing, and how it compares to biopsy samples. - Participant Experience: How women feel about using the menstrual cup, based on the survey. - Lab Testing: Whether researchers can successfully grow endometrial organoids from both types of samples. Why This Study Matters: If this method works, it could offer a gentler, more convenient way for women to get checked for endometrial cancer-especially those who need regular screening. It could also make it easier to collect samples for research and improve early detection of cancer. Type: Interventional Start Date: Nov 2025 |
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Comparing Digital Therapy, Trazodone, and Daridorexant for Menopause-Related Insomnia Symptoms
Brigham and Women's Hospital
Menopausal Women
Insomnia
The goal of this clinical trial is to learn how three current insomnia therapies
(trazodone, daridorexant, cognitive behavioral therapy for insomnia) compare with each
other in peri- and post-menopausal women. It will also learn about the safety of the
treatments. The main questions it aims to answ1 expand
The goal of this clinical trial is to learn how three current insomnia therapies (trazodone, daridorexant, cognitive behavioral therapy for insomnia) compare with each other in peri- and post-menopausal women. It will also learn about the safety of the treatments. The main questions it aims to answer are: Which commonly used insomnia therapies are most effective and safe for improving insomnia symptoms in peri- and post-menopausal people? How well do the treatments work for people from different backgrounds, who are at different stages of menopause, and who have different conditions common during menopause (e.g., sleep apnea, mood disturbance, etc.)? What medical problems do participants have when using these treatments? Participants will: Be asked to take trazodone every night, take daridorexant every night, or participate in an online behavioral program for insomnia, for a total of 12 months. Participate in a total of one in-person visit and 7 virtual visits (phone calls) over the 12 months. Wear (and keep) a Fitbit and fill out a daily sleep diary for at least 4 weeks over the 12 months. Fill out online surveys 4 times over the 12 months. Type: Interventional Start Date: Feb 2026 |
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Practical Geriatric Assessment in Older Adults With Non-Small Cell Lung Cancer Undergoing Stereotac1
Brigham and Women's Hospital
Lung Cancer (NSCLC)
Geriatric Assessment
Stereotactic Body Radiation Therapy (SBRT)
National guidelines recommend that older adults with cancer undergo a special health
assessment before starting cancer treatment. This type of assessment evaluates physical
function, nutrition, social support, psychological well-being, medical conditions (both
cancer-related and non-cancer-related)1 expand
National guidelines recommend that older adults with cancer undergo a special health assessment before starting cancer treatment. This type of assessment evaluates physical function, nutrition, social support, psychological well-being, medical conditions (both cancer-related and non-cancer-related), and cognitive function. The results can help doctors make better treatment decisions and determine whether additional support services-such as nutrition counseling, physical therapy, or social work-would be beneficial. Even though these assessments are recommended, they are not typically used because they need to be performed by a specialist and can take over an hour to complete. Given these challenges, a 10-15-minute assessment called the Practical Geriatric Assessment (PGA) was recently developed. The PGA can be completed by any healthcare provider and helps identify older adults who may need extra support alongside their cancer treatment. While the PGA has the potential to make geriatric assessments more accessible, the investigators do not yet know whether patients will find it useful or easy to complete. Additionally, it is unclear whether using the PGA will lead to more referrals for recommended supportive care services. This study aims to address these questions. The investigators will evaluate whether using the PGA impacts the number of patients referred to recommended supportive care services. Investigators will also evaluate how participants feel about completing the PGA, including how easy or difficult it is, and to assess the feasibility of implementing this survey on a larger scale. Finally, the investigators will use facial photographs and audio-visual data from the PGA to develop and evaluate artificial intelligence algorithm(s) to identify vulnerable patients who might benefit from additional supportive care services; namely, FaceAge, a validated deep learning model capable of estimating biological age from still facial images. Type: Interventional Start Date: May 2025 |
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Targeted Treatment for Metastatic Prostate Cancer, The PREDICT Trial
Alliance for Clinical Trials in Oncology
Castration-Resistant Prostate Carcinoma
Stage IVB Prostate Cancer AJCC v8
This phase II trial evaluates whether genetic testing in prostate cancer is helpful in
deciding which study treatment patients are assigned. Patient cancer tissue samples are
obtained from a previous surgery or biopsy procedure and tested for deoxyribonucleic acid
(DNA) and ribonucleic acid (RNA) a1 expand
This phase II trial evaluates whether genetic testing in prostate cancer is helpful in deciding which study treatment patients are assigned. Patient cancer tissue samples are obtained from a previous surgery or biopsy procedure and tested for deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) abnormalities or mutations in their cancer. Valemetostat tosylate is in a class of medications called EZH1/EZH2 inhibitors. It blocks proteins called EZH1 and EZH2, which may help slow or stop the spread of tumor cells. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Cabazitaxel injection is in a class of medications called microtubule inhibitors. It works by slowing or stopping the growth of tumor cells. Abiraterone acetate blocks tissues from making androgens (male hormones), such as testosterone. This may cause the death of tumor cells that need androgens to grow. It is a type of anti-androgen. Enzalutamide is in a class of medications called androgen receptor inhibitors. It works by blocking the effects of androgen (a male reproductive hormone) to stop the growth and spread of tumor cells. Lutetium Lu 177 vipivotide tetraxetan is in a class of medications called radiopharmaceuticals. It works by targeting and delivering radiation directly to tumor cells which damages and kills these cells. Assigning patients to targeted treatment based on genetic testing may help shrink or slow the cancer from growing Type: Interventional Start Date: Feb 2025 |
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Study of Single Doses of SBT777101 in Subjects With Rheumatoid Arthritis
Sonoma Biotherapeutics, Inc.
Rheumatoid Arthritis
This study will test the safety and effects of SBT777101 when given as a single dose to
subjects with rheumatoid arthritis. It is the first study of this treatment being done in
humans. Increasing dose levels will be given after the safety at lower dose levels is
shown. Following completion of the1 expand
This study will test the safety and effects of SBT777101 when given as a single dose to subjects with rheumatoid arthritis. It is the first study of this treatment being done in humans. Increasing dose levels will be given after the safety at lower dose levels is shown. Following completion of the initial single ascending dose cohorts, the study may evaluate alternative administration regimens of SBT777101, including split-dose administration. In the split-dose cohort, participants may receive two intravenous infusions of SBT777101 derived from a single manufacturing process, administered approximately 6 weeks apart. The study will continue to evaluate safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary clinical activity. Type: Interventional Start Date: Mar 2024 |
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Testing Shorter Duration Radiation Therapy Versus the Usual Radiation Therapy in Patients With High1
NRG Oncology
Prostate Adenocarcinoma
Stage III Prostate Cancer AJCC v8
Stage IVA Prostate Cancer AJCC v8
This phase III trial compares stereotactic body radiation therapy (SBRT), (five
treatments over two weeks using a higher dose per treatment) to usual radiation therapy
(20 to 45 treatments over 4 to 9 weeks) for the treatment of high-risk prostate cancer.
SBRT uses special equipment to position a p1 expand
This phase III trial compares stereotactic body radiation therapy (SBRT), (five treatments over two weeks using a higher dose per treatment) to usual radiation therapy (20 to 45 treatments over 4 to 9 weeks) for the treatment of high-risk prostate cancer. SBRT uses special equipment to position a patient and deliver radiation to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period of time. This trial is evaluating if shorter duration radiation prevents cancer from coming back as well as the usual radiation treatment. Type: Interventional Start Date: Dec 2023 |
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CB-103 With Either Lenvatinib or Abemaciclib in Patients With NOTCH ACC
Glenn J. Hanna
Adenoid Cystic Carcinoma
Metastatic Adenoid Cystic Carcinoma
Recurrent Adenoid Cystic Carcinoma
The goal of this study is to treat patients with NOTCH active advanced adenoid cystic
carcinoma (ACC) tumors with a combination or two different oral medications to slow tumor
growth and improve survival outcomes.
The names of the study drugs involved in this study are:
- CB-103 (an oral NOTCH1 expand
The goal of this study is to treat patients with NOTCH active advanced adenoid cystic carcinoma (ACC) tumors with a combination or two different oral medications to slow tumor growth and improve survival outcomes. The names of the study drugs involved in this study are: - CB-103 (an oral NOTCH pathway inhibitor) - Abemaciclib (CDK4/6 inhibitor) - Lenvatinib (a vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI)) Type: Interventional Start Date: Jun 2023 |
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A Multicenter Trial Assessing the Impact of Lipoprotein(a) Lowering With Pelacarsen (TQJ230) on the1
Novartis Pharmaceuticals
Aortic Stenosis
The purpose of this study is to evaluate the efficacy, safety and tolerability of
pelacarsen (TQJ230) administered subcutaneously once monthly compared to placebo in
slowing the progression of calcific aortic valve stenosis. expand
The purpose of this study is to evaluate the efficacy, safety and tolerability of pelacarsen (TQJ230) administered subcutaneously once monthly compared to placebo in slowing the progression of calcific aortic valve stenosis. Type: Interventional Start Date: Mar 2024 |
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Risk Reducing Salpingectomy With Delayed Oophorectomy as an Alternative to Risk- Reducing Salpingo-1
M.D. Anderson Cancer Center
Ovarian Cancer
Fallopian Tube Cancer
This is a prospective preference study that will evaluate non-inferiority of the
innovative treatment (RRS with delayed RRO) as compared to the standard treatment (RRSO)
with respect to high grade serous (ovarian) cancer incidence expand
This is a prospective preference study that will evaluate non-inferiority of the innovative treatment (RRS with delayed RRO) as compared to the standard treatment (RRSO) with respect to high grade serous (ovarian) cancer incidence Type: Interventional Start Date: May 2022 |
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Evaluation of a New Strategy for Protocolized Antibiotic Care for Severe Open Fractures: SEXTANT 2
Major Extremity Trauma Research Consortium
Post Operative Surgical Site Infection
The PRCT evaluates infection outcomes as well as fracture and antibiotic-related
complications to include the emergence of resistant bacteria associated with two
different antibiotic strategies in the treatment of Gustilo type IIIB tibia and hindfoot
fractures (calcaneus and talus) and selected III1 expand
The PRCT evaluates infection outcomes as well as fracture and antibiotic-related complications to include the emergence of resistant bacteria associated with two different antibiotic strategies in the treatment of Gustilo type IIIB tibia and hindfoot fractures (calcaneus and talus) and selected IIIA fractures of the tibia and trauma-related transtibial amputations that are performed in the "zone-of-injury". This study will be conducted in established METRC level 1 trauma centers. The patients will be randomized as close to admission as possible to either 1) Standard of Care (SOC) prophylactic open fracture protocol, including the use of topical antibiotic as per the usual practice of the surgeon or 2) experimental protocol (SEXTANT). The SEXTANT protocol includes application of wound bioburden-targeted topical Vancomycin powder and Tobramycin powder antibiotic treatment at the time of final wound closure/coverage combined with 72 hours of systemic antibiotic coverage targeted to both gram-positive and gram-negative pathogens. The study will compare the results of the current SOC prophylactic coverage to the strategic wound bioburden treatment (SEXTANT) protocol. Up until the time of definitive wound closure/coverage, all patients will be treated per the usual regimen of the surgeon / center and in accordance with current Trauma Quality Improvement Program (TQIP) and Surgical Quality Improvement Program (SQIP) recommendations for the care of open fractures.14,15,17 It includes the administration of systemic antibiotics as close to the time of injury as possible. In the definitive wound closure/coverage procedure post-operative period, participants in the intervention arm will receive 72 hours of systemic antibiotic therapy targeted at the modern wound bioburden, and patients in the usual care arm will receive post-operative care per the usual practice of their surgeon. All other activities related to follow-up and related treatments will proceed per the usual practice of the surgeon. Type: Interventional Start Date: May 2021 |