Assistente per la classificazione dei progetti di ricerca sull'essere umano

Il Categoriser è uno strumento che aiuta a classificare e a categorizzare i progetti di ricerca.


Non è adatto a progetti di ricerca che prevedono diversi tipi di interventi. Per categorizzare questi progetti, o per altre domande riguardanti la categorizzazione, consigliamo di contattare direttamente la commissione d’etica competente.


Il risultato del Categoriser deve essere interpretato come indicativo e non è giuridicamente vincolante.

Applicabilità LRUm

Il progetto di ricerca rientra nel campo d'applicazione della legge sulla ricerca umana?
Spiegazione
Il campo d'applicazione della legge sulla ricerca umana comprende la ricerca sulle malattie dell’essere umano e sulla struttura e sulla funzione del corpo umano con persone, su persone decedute, embrioni e feti, con materiale biologico o dati sanitari codificati. Nel campo d'applicazione della legge non rientrano la ricerca sugli embrioni in vitro né la ricerca su materiale biologico anonimizzato o con dati sanitari personali raccolti in forma anonima e anonimizzati. Per ricerca s'intende la ricerca metodologica volta all’acquisizione di conoscenze generalizzabili. La ricerca sulle malattie dell'essere umano comprende la ricerca sulle cause, la prevenzione, la diagnosi, la terapia e l’epidemiologia dei disturbi della salute umana sul piano fisico e psichico. Per ricerca sulla struttura e sulla funzione del corpo umano s'intende la ricerca fondamentale, in particolare sull’anatomia, la fisiologia e la genetica del corpo umano, nonché la ricerca non correlata alla malattia, relativa agli interventi sul corpo umano.
Esempi di sperimentazioni (8)
Risposta

No

Titolo di studio

A large Swiss cohort of patients with inflammatory bowel disease shifts from oral to intravenous iron supplementation therapy over time

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Background

In 2007, leading international experts in the field of inflammatory bowel disease recommended intravenous iron supplements over oral iron supplements because they were more effective and easier to tolerate.

Methods

The Helsana insurance database provided data from adults (aged 18 or older) living in Switzerland, who suffered from Crohn's disease. Helsana is a Swiss health insurance company that covers 18% of the Swiss population (1.2 million individuals). Helsana anonymised data (stripping names, date of birth and address). Data were automatically generated at Helsana quarters, and required no additional manipulation. We analysed the data to determine what percentage of patients with inflammatory bowel disease were prescribed iron therapy, and described the dynamics of intravenous versus oral iron prescription.

Because

This project was based on a study protocol that defines the exact procedures to be used. It included a relatively large number of persons and was not based on individual cases ("method-driven search for generalizable knowledge", defined as research by HRA). The goal was to determine what percentage of patients with inflammatory bowel disease was prescribed iron therapy, and to describe the dynamics of intravenous versus oral iron prescription. The Helsana insurance database provided data from adults who lived in Switzerland and suffered from Crohn's disease ("health-related personal data"). Helsana’s database was automatically generated, and required no additional manipulation. Data were anonymized by an independent institution (Helsana), not involved in the project and separated in time and space. The anonymised database did not include personal identifiers (insurance number, name, date of birth or address). This "research that involves anonymised health-related data" fell outside the scope of HRA.

Risposta

Yes

Titolo di studio

Physical activity and energy expenditure across occupational categories

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Background

Physical activity is defined as bodily movements produced by skeletal muscles that result in energy expenditure. This study measured the amount of physical activity, based energy expenditure and other performance criteria that people use during a normal working day. The study focused on differences between occupational categories. The results of this study were used to develope a campaign to prevent sedentary behaviour.

Methods

300 healthy adults (aged 18-65 years), employed full-time in Canton Basel in Switzerland, were enrolled in the study. Participants were stratified by occupational category according to the ISCO-88, and were then grouped into 3 classes (low, middle and high occupational activity). Data on duration of average daily activity, total and active energy expenditure, and daily step counts were collected over 7 consecutive days, using a Sense Wear Mini bracelet (no CE-marking). Participants were asked to wear the Sense Wear Mini bracelet during working hours. The primary outcome was difference in average daily active energy expenditure during working time between the occupational categories.

Because

This project was based on a study protocol that defines the exact procedures to be used. It included a relatively large number of persons and was not based on individual cases ("method-driven search for generalizable knowledge", defined as research by HRA). 300 healthy adults ("persons") employed full-time employed Canton Basel, Switzerland, were asked to register their energy expenditure during working time by wearing a Sense Wear Mini bracelet (no CE-marking). The investigator measured the difference in average daily active energy expenditure during working hours for the different occupational categories, defined according to ISCO-88 ("research concerning the structure and function of the human body").

Risposta

No

Titolo di studio

What do physicians think of somatoform disorders?

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Background

Somatoform disorders are characterised by physical symptoms that are not fully explained by a general medical condition. Somatoform disorders are common, but many healthcare workers are confused by the diagnostic terminology and are reluctant to use these diagnostic labels.

Methods

Child psychiatrists, forensic psychiatrists, gastroenterologists, and other physicians from different practice settings were identified through professional societies, like the Academy of Psychosomatic Medicine, American Psychiatric Association, and the American College of Physicians. They were invited to respond to an anonymous Internet survey. By eliciting the views of physicians who see patients with somatoform disorders, we explored their confusion about diagnostic terminology and their reluctance to use these diagnostic labels.

Because

This project was based on a study protocol, in which the exact procedures used to generate generalizable data (method-driven search for generalizable knowledge) were defined. Researchers used a web-based survey to anonymously collect (“anonymously collected data”) data from physicians. The survey contained questions that elicited physicians’ views on disorders that may include physical symptoms not fully explained by a general medical condition. The aim of the study was to explore confusion about diagnostic terminology, and physicians’ reluctance to use these diagnostic labels.

Risposta

No

Titolo di studio

Status epilepticus: a possible association with human metapneumovirus infection

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Background

Human metapneumovirus is a relatively new addition to the many viruses that cause respiratory illness in infants and children. Data on the association of human metapneumovirus with neurologic complications is limited.

Methods

In this report, we described two toddlers with human metapneumovirus infection who presented in status epilepticus and went on to develop respiratory failure. Data was collected from the routine hospital health record.

Because

This project was not based on a study protocol, and did not define the exact procedures used to identify and describe the cases. Instead it described two cases identified during routine clinical practice. Thus, it was not "method-driven search for generalizable knowledge". It is not classified as research by the HRA.

Risposta

Yes

Titolo di studio

Balance in young female ballet students suffering from chronic knee pain: The effect of physiotherapy with and without a mirror.

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Background

In literature there is general consensus that using a mirror improves proprioception. During rehabilitation, a mirror is very useful for improving stability. In some sports, such as dancing, mirrors are widely used in training. This study evaluated the effectiveness of physiotherapy with mirror on balance in young dancers.

Methods

This study included young dancers (aged 19-25) suffering from chronic knee pain. They were randomly assigned to receive physiotherapy, one to one, with a mirror (mirror- group) or without a mirror (non-mirror group). Their balance was evaluated by BESS (Balance Error Scoring System), which consists of three stances (double limb, single limb, and tandem) on two surfaces (firm and foam). Errors were assessed at each stance and summed to create the two subtotal scores (firm and foam surface) and the final total score (BESS). The BESS was measured at recruitment (T0) and again after 6 months of dance lessons (T1). Primary outcome was difference in total BESS between the groups.

Because

This project was based on a study protocol that defined the exact procedures to be used. It included a relatively large number of persons and was not based on individual cases ("method-driven search for generalizable knowledge", defined as research by HRA). Female dancers ("persons"), between 19-25 years old, suffering from chronic knee pain, were randomly assigned to take ballet lessons with or without a mirror. This study investigated the effect of using a mirror on the dancers’ balance ("research concerning function of the human body").

Risposta

Yes

Titolo di studio

Randomized controlled trial in adults with headache recurrence after emergency department discharge, comparing the efficacy of oral sumatriptan to naproxen

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Background

Migraine and other acute primary headaches are treated with a variety of parenteral medications in the emergency department. It is not clear which medication is best to prescribe to primary headache patients when they are discharged. This study compared the efficacy of oral sumatriptan to naproxen for treatment of post-ED recurrent primary headache.

Methods

Adults aged 18 years or older who suffered from headache recurrence after discharge from an emergency department were randomized to either naproxen (Trade®) 500 mg or sumatriptan (Sumatriptan Spirig HC®) 100 mg. This was an open trial: patients and physicians knew who was given which medication. Both products were provided in the original package. The packages had trial-specific labels and were handed out by a hospital pharmacist. Patients were followed-up by telephone 48 hours after emergency department discharge. The primary outcome was change in pain intensity, measured during a two-hour period after ingestion. The change in the group that received 500 mg naproxen (Trade®) was compared to the change in the group that received 100 mg sumatriptan (Sumatriptan Spirig HC®). This difference was measured on a validated 11-point (0–10) verbal Numerical Rating Scale (NRS).

Because

This project was based on a study protocol which defined the exact procedures to be used. The study is designed to answer a disease related research question. It includes a relatively large number of persons and is not based on individual cases ("method-driven search for generalizable knowledge"); thus, it is classified as research according to HRA). Adults (“persons”) who suffered from headache ("research concerning human diseases") after discharge from an emergency department were treated with either 500 mg naproxen (Trade®) or 100 mg sumatriptan (Sumatriptan Spirig HC®).

Tipo di progetto

Il progetto di ricerca è condotto su persone vivente?
Spiegazione
Con ciò si intende la ricerca intesa come studio clinico classico al quale una persona partecipa per un periodo più o meno lungo nonché la ricerca per la quale una persona mette a disposizione il proprio materiale biologico o i propri dati sanitari personali. Da una parte vi rientrano i progetti nei quali l’azione di prelievo o raccolta è accompagnata dalla valutazione del materiale o dei dati personali per rispondere a un quesito scientifico posto nell’ambito di un progetto di ricerca per così dire «concreto». Ne sono un esempio gli studi osservazionali o i progetti di ricerca con medicamenti di tipo «fase IV». Dall'altra vi rientrano anche i progetti nei quali il prelievo di materiale biologico e la raccolta di dati personali avviene nella prospettiva di lavori di ricerca futuri, singolarmente ancora ignoti. Se i progetti di ricerca non sono ancora noti o descritti in dettaglio, si parla di «motivi di ricerca». Di norma il materiale e i dati sono conservati in banche biologiche o banche dati oppure in un registro nella prospettiva di un riutilizzo successivo ai sensi degli articoli 32–33 LRUm nell’ambito di un progetto di ricerca ancora da definire.
Esempi di sperimentazioni (3)
Risposta

No

Titolo di studio

Optimal positioning for emergent needle thoracotomy: a cadaver-based study.

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Background

Needle thoracotomy is an emergent procedure designed to relieve tension pneumothorax. The procedure often fails because the needle does not penetrate into the thoracic cavity. Advanced Trauma Life Support guidelines recommend placement in the second intercostal space, midclavicular line, using a 5-cm needle. This study was evaluated placement in the fifth intercostal space, midaxillary line, where tube thoracotomy is routinely performed.

Methods

Twenty unpreserved adult cadavers were evaluated. A standard 14-gauge 5-cm needle was placed in both the fifth intercostal space at the midaxillary line and the traditional second intercostal space at the midclavicular line, in both the right and left chest walls. The needles were secured and thoracotomy was then performed to assess penetration into the pleural cavity. The rate of successful needle placement between fifth intercostal space at the midaxillary line, and the traditional second intercostal space at the midclavicular line on the right and left sites, was compared.

Because

Unpreserved adult cadavers ("deceased persons") were used in this research project.

Risposta

Yes

Titolo di studio

Randomized controlled trial in adults with headache recurrence after emergency department discharge, comparing the efficacy of oral sumatriptan to naproxen

Visualizza studio
Background

Migraine and other acute primary headaches are treated with a variety of parenteral medications in the emergency department. It is not clear which medication is best to prescribe to primary headache patients when they are discharged. This study compared the efficacy of oral sumatriptan to naproxen for treatment of post-ED recurrent primary headache.

Methods

Adults aged 18 years or older who suffered from headache recurrence after discharge from an emergency department were randomized to either naproxen (Trade®) 500 mg or sumatriptan (Sumatriptan Spirig HC®) 100 mg. This was an open trial: patients and physicians knew who was given which medication. Both products were provided in the original package. The packages had trial-specific labels and were handed out by a hospital pharmacist. Patients were followed-up by telephone 48 hours after emergency department discharge. The primary outcome was change in pain intensity, measured during a two-hour period after ingestion. The change in the group that received 500 mg naproxen (Trade®) was compared to the change in the group that received 100 mg sumatriptan (Sumatriptan Spirig HC®). This difference was measured on a validated 11-point (0–10) verbal Numerical Rating Scale (NRS).

Because

Adults ("persons") who suffered from headache after discharge from an emergency department were included in this research project.

Risposta

No

Titolo di studio

The role of satiety mechanisms in genetic risk of obesity (follow-up study).

Visualizza studio
Background

Obesity is highly heritable, and researchers are identifying the specific genes involved. Discovering the mechanisms through which obesity-related genes influence weight will help pinpoint novel targets for intervention. This study tested the hypothesis that satiety responsiveness is an intermediate behavioural phenotype associated with genetic predisposition to obesity in children.

Methods

We used genetic data that was collected previously in a population-based twin birth cohort, with twins born in 1996 (National Twins Cohort). In the original cohort study children made up the cohort; one child was randomly selected from each twin pair. Buccal swabs were used to extract DNA. Genome-wide genotyping was done with SNP array, using standard experimental protocols. Children were assigned a unique ID number and the data did not include their names or addresses. We created a polygenic risk score (PRS) comprising 28 common obesity-related single-nucleotide polymorphisms that had been identified in a meta-analysis of obesity-related genome-wide association studies. The primary outcome was the association between the PRS, adiposity, and satiety responsiveness.

Because

We analysed existing genetic data from children, which we collected during a population-based twin birth cohort ("genetic data").

Il progetto di ricerca corrisponde a una sperimentazione clinica ai sensi dell'OSRUm o dell'OSRUm-Dmed?
Spiegazione
Per sperimentazione clinica s'intende un progetto di ricerca con persone volto a verificare l'efficacia di un intervento relativo alla salute. Per «verifica dell'efficacia» s'intende che lo sperimentatore (principal investigator) sottopone a intervento persone selezionate secondo uno specifico protocollo di sperimentazione approvato dalle autorità d'esame, misurandone quindi gli effetti sulla salute o sulla struttura e funzione del corpo umano. Negli interventi relativi alla salute rientrano in particolare la somministrazione o l'impiego di agenti terapeutici o l'adozione di altre misure terapeutiche al fine di studiarne l'effetto su prevenzione, diagnosi, terapia, cure palliative o riabilitative di una malattia. Una sperimentazione clinica con un dispositivo medico è un'indagine sistematica di un dispositivo condotta su una o più persone per valutare la sicurezza o la prestazioni del dispositivo. I progetti di ricerca che non prevedono alcun intervento attuato e da analizzare secondo un piano sperimentale prospettico predefinito, in particolare i cosiddetti 'studi osservazionali', non sono considerati sperimentazioni cliniche.
Esempi di sperimentazioni (10)
Risposta

Yes

Titolo di studio

Multi-modal effects of thyroid hormone replacement for untreated older adults with subclinical hypothyroidism: a randomised placebo-controlled trial

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Background

Subclinical hypothyroidism is a common condition (81,8%) among older men and women. Thyroid hormone affects many physiological systems, including the vascular tree, heart, skeletal muscle, and brain. Thyroxin is substituted to overcome thyroid hormone deficiency, and may offer multisystem benefits to older people with subclinical hypothyroidism. This multicentre randomised placebo controlled trial aimed to assess the effects of thyroxin replacement in older adults who have persistent subclinical hypothyroidism.

Methods

Men aged ≥65 years, who suffered from subclinical hypothyroidism, were randomized to either a thyroxin (Eltroxin-LF®) starting dose of 50 μg daily p.o. (reduced to 25 μg daily in subjects <50 kg body weight, or if known coronary heart disease) or a matching placebo p.o. Eltroxin-LF®. (The manufacturer of Eltroxin-LF® provided placebo tablets that looked identical.) Subjects were reviewed face-to-face by study nurses at recruitment, study baseline, 6-8 weeks after baseline, after each dose change, 12 months, and annually thereafter. Study nurses made interim telephone contact at 6, 18, 30, and 42 months; possible cardiovascular and serious adverse events were recorded. The primary outcome included fatal and non-fatal cardiovascular events (fatal and non-fatal acute myocardial infarction and stroke; amputations for peripheral vascular disease; revascularisations for atherosclerotic vascular disease, including for acute coronary syndrome; heart failure hospitalisations).

Because

The investigator randomly allocated ("prospectively assigned") men ("persons") who suffered from subclinical hypothyroidism to receive either thyroxin (Eltroxin-LF®) or placebo ("health-related intervention (therapeutic measure)"). The purpose of the study was to compare the number of fatal and non-fatal cardiovascular events ("to investigate its effect on health").

Risposta

Yes

Titolo di studio

Randomized controlled trial in adults with headache recurrence after emergency department discharge, comparing the efficacy of oral sumatriptan to naproxen

Visualizza studio
Background

Migraine and other acute primary headaches are treated with a variety of parenteral medications in the emergency department. It is not clear which medication is best to prescribe to primary headache patients when they are discharged. This study compared the efficacy of oral sumatriptan to naproxen for treatment of post-ED recurrent primary headache.

Methods

Adults aged 18 years or older who suffered from headache recurrence after discharge from an emergency department were randomized to either naproxen (Trade®) 500 mg or sumatriptan (Sumatriptan Spirig HC®) 100 mg. This was an open trial: patients and physicians knew who was given which medication. Both products were provided in the original package. The packages had trial-specific labels and were handed out by a hospital pharmacist. Patients were followed-up by telephone 48 hours after emergency department discharge. The primary outcome was change in pain intensity, measured during a two-hour period after ingestion. The change in the group that received 500 mg naproxen (Trade®) was compared to the change in the group that received 100 mg sumatriptan (Sumatriptan Spirig HC®). This difference was measured on a validated 11-point (0–10) verbal Numerical Rating Scale (NRS).

Because

In this research project, the investigator randomly assigned ("prospectively assigned") adults ("persons") who suffered from headache after discharge from an emergency department to receive either 500 mg naproxen (Trade®) or 100 mg sumatriptan (Sumatriptan Spirig HC®) ("health related intervention (therapeutic measure)"). The project assessed between-group difference in change in in pain intensity over the 2-hour period after they took the drugs ("to investigate its effect on health").

Risposta

No

Titolo di studio

Elderly patients with venous thromboembolism (SWITCO65+): a longitudinal study of the Swiss Cohort

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Background

Venous thromboembolism is common and significantly increases morbidity, mortality, and costs of care. Although most patients with venous thromboembolism are ≥65 years, there is little data on medical outcomes in older patients. We conducted a prospective multicentre cohort study of in- and outpatients ≥65 years, who have acute venous thromboembolism. All five Swiss university and four high-volume non-university hospitals participate in the study. Their goal is to determine the clinical and biological factors and processes of care that drive short- and long-term medical outcomes, health-related quality of life, and use of medical resources in elderly patients with acute venous thromboembolism.

Methods

Elderly patients (≥65 years) with venous thromboembolism were enrolled in the cohort. We followed-up participants from October, 2012, to December, 2013. Follow-up included a telephone interview, two surveillance face-to-face evaluations during the first year, semi-annual contacts, and periodic review of patients' hospital charts. We collected blood samples from all participants at baseline and at 12 months follow-up and established a biobank. We extracted serum, plasma RNA and DNA from the blood. Blood samples were assayed with a standard haematology panel. They were processed and vialed within 1 h of collection and transported in batches to a central laboratory where they were stored at -80°C. The same laboratory analysed all the samples we collected. The primary medical outcome was recurrence of symptomatic, objectively confirmed venous thromboembolism during the follow-up period, defined as new or recurrent pulmonary embolism or deep vein thrombosis (proximal and/or distal).

Because

Researchers used telephone interviews, clinical exams and face-to-face visits to follow up adults ("persons") who suffered from venous thromboembolism. Researchers established a biobank with the blood samples they collected from all participants at enrolment and at 12 months. The study determined the recurrence of symptomatic, objectively confirmed venous thromboembolism during the follow-up period, defined as new or recurrent pulmonary embolism or deep vein thrombosis (proximal and/or distal). This project involved no health-related interventions (according to OClin).

Risposta

Yes

Titolo di studio

Balance in young female ballet students suffering from chronic knee pain: The effect of physiotherapy with and without a mirror.

Visualizza studio
Background

In literature there is general consensus that using a mirror improves proprioception. During rehabilitation, a mirror is very useful for improving stability. In some sports, such as dancing, mirrors are widely used in training. This study evaluated the effectiveness of physiotherapy with mirror on balance in young dancers.

Methods

This study included young dancers (aged 19-25) suffering from chronic knee pain. They were randomly assigned to receive physiotherapy, one to one, with a mirror (mirror- group) or without a mirror (non-mirror group). Their balance was evaluated by BESS (Balance Error Scoring System), which consists of three stances (double limb, single limb, and tandem) on two surfaces (firm and foam). Errors were assessed at each stance and summed to create the two subtotal scores (firm and foam surface) and the final total score (BESS). The BESS was measured at recruitment (T0) and again after 6 months of dance lessons (T1). Primary outcome was difference in total BESS between the groups.

Because

The investigator randomly assigned ("prospectively assigned") female dancers suffering from chronic knee pain to receive physiotherapy either with or without a mirror. The study assessed between-groups difference via the Balance Error Scoring System ("to investigate its effect on health"). The purpose was to increase our understanding of the use of mirrors during rehabilitation, as a tool to improve stability ("therapeutic measure").

Risposta

Yes

Titolo di studio

Effect of and intervention designed to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables: Active for Life School Year-based cluster randomised controlled trial.

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Background

This study investigated the effectiveness of a school-based intervention to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables.

Methods

Participants were children in school year 4 (age 8-9 years) at recruitment and baseline assessment, and in year 5 during the intervention and follow-up assessments. Schools were randomly allocated to receive either the Active for Life intervention or standard teaching. The Active for Life intervention provided teacher training, lessons, and child-parent interactive homework plans, the materials required for lessons and homework, and written materials for school newsletters and parents. Schools in the control group received standard teaching. Pre-specified primary outcomes were accelerometer assessed minutes of moderate to vigorous physical activity per day, accelerometer assessed minutes of sedentary behaviour per day, and reported daily consumption of servings of fruit and vegetables.

Because

The investigator randomly assigned ("prospectively assigned") primary schools to receive either standard teaching or the Active for Life intervention to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables. The study assessed the between-group difference in minutes of moderate to vigorous physical activity per day, minutes of sedentary behaviour per day, and reported daily consumption of servings of fruit and vegetables ("to investigate its effect on health").

Risposta

Yes

Titolo di studio

Prospective Evaluation of Etravirine for HIV-infected Patients in Need of Lipid-lowering Drugs

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Background

Dyslipidaemia, characterized by raised triglyceride and low-density lipoprotein cholesterol and reduced high-density lipoprotein cholesterol levels, is common in HIV-infected individuals. Dyslipidaemia has been associated with HIV infection and antiretroviral therapy. This study evaluated the frequency with which the replacement of Lopinavir/Ritonavir, Atazanavir/Nitonavir, Darunavir/Ritonavir or Efavirenz by Etravirin (Intelence®) in dyslipidemic patients with suppressed viremia made it unnecessary to administer statins.

Methods

The study included HIV-infected patients, aged 18-70 years, on statin treatment for at least 3 months, and on a stable (> 3 months) antiretroviral therapy treatment that included at least one of the following drugs: Lopinavir/Ritonavir, Atazanavir/Nitonavir, Darunavir/Ritonavir or Efavirenz. Statin treatment of dyslipidemic HIV patients on antiretroviral drugs was interrupted during 4 weeks. At week 4, patients who qualified for a lipid lowering drug (calculated LDL-C≥ 3mmol/L) replaced lopinavir/ritonavir, atazanavir/ritonavir, darunavir/ritonavir or efavirenz with Etravirine (Intelence®), 400 mg/day, once daily. The primary outcome was the proportion of patients that no longer qualified for statin treatment at 12 weeks (after 8 weeks of Etravirine treatment).

Because

The investigator asked HIV infected adults on statin treatment for at least 3 months, and on a stable antiretroviral therapy treatment, to interrupt their statin treatment for 4 weeks. At week 4, patients who qualified for a lipid lowering drug replaced their antiretroviral treatment with Etravirine (Intelence®), 400 mg/day, once daily ("prospectively assigned"). The study assessed the proportion of patients who no longer qualified for statin treatment after 8 weeks of Etravirine (Intelence®) treatment ("to investigate its effects on health or on the structure and function of the human body").

Risposta

Yes

Titolo di studio

Emergency ultrasound-assisted examination of skin and soft tissue infections in the paediatric emergency department.

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Background

This study evaluated the test characteristics of clinical examinations of paediatric patients, supplemented with bedside emergency ultrasound, and compared them to clinical examination alone, to identify skin and soft tissue infections that require drainage. The ultrasound device bears a CE mark, but is not used as intended. Since the bedside emergency ultrasound was added to clinical practice and the investigation of the clinical performance of adding bedside ultrasound was the goal of the study, the study qualifies as a clinical trial (and not as an observational study according to HRO chapter 2). - The study is conducted by an academic sponsor, who does not intend to use the data generated in the study to establish or demonstrate the conformity of the device for the new purpose investigated in the study.

Methods

This was a prospective study of clinical examinations, supplemented with bedside emergency ultrasound, as a diagnostic test to evaluate patients 2 months to 19 years old. These patients were evaluated for skin and soft tissue infections in a paediatric emergency department. Each patient was clinically examined by the responsible physician (standard) and by an independent radiologist, who performed a bedside emergency ultrasound (result not communicated to the responsible physician). The reference standard that determined if a lesion required drainage was defined as "pus expressed at the time of the emergency department visit or within 2 days by follow-up assessment". The primary outcome was the degree of agreement between clinical exam alone, and clinical exam supplemented with ultrasound, on the number of lesions that required drainage within 2 weeks after clinical examination. No other study-related procedures were performed except for the ultrasound.

Because

The performance of an ultrasound device (“medical device”) was systematically tested in children ("persons") aged 2 months to 19 years, who suffered from skin and soft tissue lesions. The goal was to examine how consistent two examination techniques were in diagnosing lesions that require drainage.

Oggetto in esame

Il progetto di ricerca è condotto con materiale biologico o dati genetici esistenti?
Spiegazione
In questo caso si tratta di progetti di ricerca che prevedono la riutilizzazione di dati genetici o materiale biologico. Con ciò s'intendono campioni e dati personali ottenuti in passato nell’ambito di un trattamento o di un precedente progetto di ricerca.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

The role of satiety mechanisms in genetic risk of obesity (follow-up study).

Visualizza studio
Background

Obesity is highly heritable, and researchers are identifying the specific genes involved. Discovering the mechanisms through which obesity-related genes influence weight will help pinpoint novel targets for intervention. This study tested the hypothesis that satiety responsiveness is an intermediate behavioural phenotype associated with genetic predisposition to obesity in children.

Methods

We used genetic data that was collected previously in a population-based twin birth cohort, with twins born in 1996 (National Twins Cohort). In the original cohort study children made up the cohort; one child was randomly selected from each twin pair. Buccal swabs were used to extract DNA. Genome-wide genotyping was done with SNP array, using standard experimental protocols. Children were assigned a unique ID number and the data did not include their names or addresses. We created a polygenic risk score (PRS) comprising 28 common obesity-related single-nucleotide polymorphisms that had been identified in a meta-analysis of obesity-related genome-wide association studies. The primary outcome was the association between the PRS, adiposity, and satiety responsiveness.

Because

We analysed existing genetic data from children, which we collected during a population-based twin birth cohort ("genetic data").

Il progetto di ricerca è condotto con materiale biologico o dati genetici esistenti codificati?
Spiegazione
In questo caso si tratta di progetti di ricerca che prevedono la riutilizzazione di dati genetici o materiale biologico riferibili a una determinata persona tramite un codice. Con ciò s'intendono campioni e dati personali ottenuti in passato nell’ambito di un trattamento o di un precedente progetto di ricerca.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

The role of satiety mechanisms in genetic risk of obesity (follow-up study).

Visualizza studio
Background

Obesity is highly heritable, and researchers are identifying the specific genes involved. Discovering the mechanisms through which obesity-related genes influence weight will help pinpoint novel targets for intervention. This study tested the hypothesis that satiety responsiveness is an intermediate behavioural phenotype associated with genetic predisposition to obesity in children.

Methods

We used genetic data that was collected previously in a population-based twin birth cohort, with twins born in 1996 (National Twins Cohort). In the original cohort study children made up the cohort; one child was randomly selected from each twin pair. Buccal swabs were used to extract DNA. Genome-wide genotyping was done with SNP array, using standard experimental protocols. Children were assigned a unique ID number and the data did not include their names or addresses. We created a polygenic risk score (PRS) comprising 28 common obesity-related single-nucleotide polymorphisms that had been identified in a meta-analysis of obesity-related genome-wide association studies. The primary outcome was the association between the PRS, adiposity, and satiety responsiveness.

Because

We analysed existing genetic data from children, which we collected during a population-based twin birth cohort ("genetic data"). Children were assigned a unique ID number ("existing encoded genetic data") and the data did not include their names or addresses.

Il progetto di ricerca è condotto con materiale biologico o dati genetici esistenti non codificati?
Spiegazione
In questo caso si tratta di progetti di ricerca che prevedono la riutilizzazione di dati genetici o materiale biologico riferibili a informazioni univoche su una determinata persona. Con ciò s'intendono campioni e dati personali ottenuti in passato nell’ambito di un trattamento o di un precedente progetto di ricerca.
Il progetto di ricerca è condotto con dati sanitari non genetici esistenti?
Spiegazione
In questo caso si tratta di progetti di ricerca che prevedono la riutilizzazione di dati non genetici. Con ciò s'intendono dati personali ottenuti in passato nell’ambito di un trattamento o di un precedente progetto di ricerca.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

The prevalence and impact of depression in self-referred clients attending an employee assistance program: a cross-sectional study

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Background

This study determined the prevalence and characteristics of employed adults with depression, who attended an external employee assistance program.

Methods

We obtained data from 9,105 of 10,794 employees suffering from depression who self-referred to an external employee assistance program. The data manager of the assistance program, who was not involved in our project, prepared and provided us with the data. Employees attending the assistance program were coded using a unique identifying number. Data included employees’ age (but not exact date of birth) and language region. Outcome measures included the self-rated nine-item Patient Health Questionnaire (PHQ-9), filled out routinely prior the first counselling visit as part of the assistance program.

Because

Researchers analysed existing data from employed adults who suffered from a first episode of depression and who self-referred to an external employee assistance program. The assistance program collected the data for purposes other than our research project (it was routinely collected in the standard assistance program ["existing health-related data"]).

Il progetto di ricerca è condotto con dati codificati non genetici esistenti?
Spiegazione
In questo caso si tratta di progetti di ricerca che prevedono la riutilizzazione di dati non genetici riferibili a una determinata persona tramite un codice. Con ciò s'intendono dati personali ottenuti in passato nell’ambito di un trattamento o di un precedente progetto di ricerca.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

The prevalence and impact of depression in self-referred clients attending an employee assistance program: a cross-sectional study

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Background

This study determined the prevalence and characteristics of employed adults with depression, who attended an external employee assistance program.

Methods

We obtained data from 9,105 of 10,794 employees suffering from depression who self-referred to an external employee assistance program. The data manager of the assistance program, who was not involved in our project, prepared and provided us with the data. Employees attending the assistance program were coded using a unique identifying number. Data included employees’ age (but not exact date of birth) and language region. Outcome measures included the self-rated nine-item Patient Health Questionnaire (PHQ-9), filled out routinely prior the first counselling visit as part of the assistance program.

Because

Researchers analysed existing data from employed adults who suffered from a first episode of depression and who self-referred to an external employee assistance program ("existing health-related data"). Participants’ names or other identifying information were not included in the data. Participants were coded with a unique identifying number ("encoded non-genetic data"). The key that linked a subject’s unique identifying number with their personal data was held by the data manager of the assistance program, who was not involved in the research project.

Il progetto di ricerca è condotto con dati non codificati non genetici esistenti?
Spiegazione
In questo caso si tratta di progetti di ricerca che prevedono la riutilizzazione di dati non genetici riferibili a informazioni univoche su una determinata persona. Con ciò s'intendono dati personali ottenuti in passato nell’ambito di un trattamento o di un precedente progetto di ricerca.
Il progetto di ricerca è condotto su persone decedute?
Spiegazione
In questo caso si tratta di progetti di ricerca su persone dichiarate morte ai sensi della legge sui trapianti e decedute da meno di 70 anni. Va tenuto presente che la ricerca su parti di persone decedute non vale come ricerca con materiale biologico ai sensi dell'articolo 3 lettera e LRUm, bensì rientra anch'essa nella ricerca su persone decedute.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

Optimal positioning for emergent needle thoracotomy: a cadaver-based study.

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Background

Needle thoracotomy is an emergent procedure designed to relieve tension pneumothorax. The procedure often fails because the needle does not penetrate into the thoracic cavity. Advanced Trauma Life Support guidelines recommend placement in the second intercostal space, midclavicular line, using a 5-cm needle. This study was evaluated placement in the fifth intercostal space, midaxillary line, where tube thoracotomy is routinely performed.

Methods

Twenty unpreserved adult cadavers were evaluated. A standard 14-gauge 5-cm needle was placed in both the fifth intercostal space at the midaxillary line and the traditional second intercostal space at the midclavicular line, in both the right and left chest walls. The needles were secured and thoracotomy was then performed to assess penetration into the pleural cavity. The rate of successful needle placement between fifth intercostal space at the midaxillary line, and the traditional second intercostal space at the midclavicular line on the right and left sites, was compared.

Because

Unpreserved adult cadavers ("deceased persons") were used in this research project.

Il progetto di ricerca è condotto su embrioni e feti provenienti da interruzioni di gravidanza e da aborti spontanei, compresi i nati morti?
Spiegazione
In questo caso si tratta di progetti di ricerca che si avvalgono di embrioni e feti provenienti da interruzioni di gravidanza e da aborti spontanei, compresi i nati morti. Un aborto spontaneo è un’interruzione prematura della gravidanza con la perdita spontanea dell’embrione o del feto di un peso inferiore a 500 grammi. Per morte fetale si intende il parto di un figlio che, separato dall’utero materno, non dà più segni di vita e pesa più di 500 grammi. Se il decesso del bambino avviene subito dopo la nascita, la ricerca è retta dal capitolo 5 LRUm, poiché indipendentemente dal peso o dall’età il bambino è considerato persona deceduta.

Studio di osservazione: rischi per i partecipanti

Nel progetto di ricerca vengono adottate misure che comportano rischi e incomodi minimi per i partecipanti alla sperimentazione?
Spiegazione
Una misura per il prelievo di materiale biologico o per la raccolta di dati sanitari personali con rischi e incomodi minimi è un trattamento attinente a vari settori della ricerca sull'essere umano che, con tutta probabilità, non è collegabile con alcun effetto particolare sulla persona interessata, o tutt'al più solo con disturbi psicofisici di lieve entità e temporanei (e a questo riguardo anche disagi di tipo sociale, avendo per esempio un effetto stigmatizzante). In tale definizione rientrano ad esempio le inchieste e le osservazioni, i prelievi di sangue periferico venoso o capillare e le agobiopsie su una piccola superficie cutanea, il prelievo o la raccolta di sostanze organiche senza misure invasive (in particolare campioni di saliva, urina e feci) o gli strisci. Rientrano nella definizione anche le tomografie a risonanza magnetica senza mezzo di contrasto, le ecografie o gli elettrogrammi. Infine, sono compresi anche gli esami con dispositivi medici provvisti di contrassegno di conformità senza mezzo di contrasto oppure con medicamenti omologati che possono emettere radiazioni ionizzanti, se la dose effettiva è inferiore a 5 mSv per progetto di ricerca e per persona interessata. La valutazione di rischi e incomodi deve avvenire con la massima obiettività possibile, tenendo conto della condizione effettiva e del grado di vulnerabilità della persona che partecipa alla sperimentazione, ma anche in base allo stato attuale delle conoscenze.
Esempi di sperimentazioni (3)
Risposta

Yes

Titolo di studio

Rituximab-induced pulmonary function changes: a prospective cohort study

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Background

This study investigated whether rituximab, a drug commonly prescribed to patients with rheumatoid arthritis or inflammatory myositis, was associated with subclinical interstitial lung disease. We measured surrogate markers (by spirometry) of interstitial lung disease before, during and after treatment with rituximab, in patients with rheumatoid arthritis or inflammatory myositis for whom a de novo rituximab treatment was indicated.

Methods

Subjects aged ≥18 years with established diagnosis of rheumatoid arthritis or inflammatory myositis, for whom a de novo rituximab treatment was indicated, were evaluated by spirometry for surrogate markers of interstitial lung disease (forced vital capacity and diffusing capacity of the lung for carbon monoxide). We measured surrogate markers (by spirometry) immediately before initiation of rituximab therapy and 2, 4, 8 weeks and 6 months after initiation of rituximab therapy. We defined a reduction in forced vital capacity of ≥10% or a fall of ≥15% in diffusing capacity of the lung for carbon monoxide as indicative for subclinical interstitial lung disease. The primary outcome was the rate of interstitial lung disease 6 months after treatment with rituximab.

Because

Spirometry is a common test that measures body function. It is non-invasive test; patients blow into a tube. Spirometry poses minimal risk to patients.

Nel progetto di ricerca vengono adottate misure che comportano rischi e incomodi più che minimi per i partecipanti alla sperimentazione?
Spiegazione
Una misura per il prelievo di materiale biologico o per la raccolta di dati sanitari personali con rischi e incomodi minimi è un trattamento attinente a vari settori della ricerca sull'essere umano che, con tutta probabilità, non è collegabile con alcun effetto particolare sulla persona interessata, o tutt'al più solo con disturbi psicofisici di lieve entità e temporanei (e a questo riguardo anche disagi di tipo sociale, avendo per esempio un effetto stigmatizzante). In tale definizione rientrano ad esempio le inchieste e le osservazioni, i prelievi di sangue periferico venoso o capillare e le agobiopsie su una piccola superficie cutanea, il prelievo o la raccolta di sostanze organiche senza misure invasive (in particolare campioni di saliva, urina e feci) o gli strisci, le tomografie a risonanza magnetica senza mezzo di contrasto, le ecografie o gli elettrogrammi nonché gli esami con dispositivi medici provvisti di contrassegno di conformità senza mezzo di contrasto oppure con medicamenti omologati che possono emettere radiazioni ionizzanti, se la dose effettiva è inferiore a 5 mSv per progetto di ricerca e per persona interessata. La valutazione di rischi e incomodi deve avvenire con la massima obiettività possibile, tenendo conto della condizione effettiva e del grado di vulnerabilità della persona che partecipa alla sperimentazione, ma anche in base allo stato attuale delle conoscenze. Se le misure vanno oltre quelle summenzionate o ad esempio la vulnerabilità della persona che partecipa alla sperimentazione porta a rischi o incomodi maggiori, si parla di misure che comportano rischi e incomodi di entità più che minima per tali persone.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

Prevalence of cam and pincer-type deformities revealed by hip MRI in asymptomatic young Swiss females: a cross-sectional study

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Background

Femoroacetabular impingement may cause early osteoarthritis (OA) in the non-dysplastic hip. This study determined the prevalence of both femoral and acetabular types of impingement in young females.

Methods

We conducted a population-based cross-sectional study of asymptomatic young females. All participants completed a set of questionnaires and had their hips clinically examined. A random sample of women was subsequently invited for contrast enhanced magnetic resonance images (MRI) of the hip (contrast media injected intra-articularly). MRIs were read to detect cam-type deformities, increased acetabular depths, labral lesions, and impingement pits. We estimated the prevalence of cam-type deformities and increased acetabular depth, and the relationships between deformities and signs of joint damage.

Because

Healthy women completed a questionnaire and had their hips clinically examined. We used magnetic resonance images (MRI) of the hip and contrast agent to determine the prevalence of cam-type deformities in a random sample of participants. Magnetic resonance image and contrast agent are invasive procedures and are more than minimally risky and burdensome for participants.

Tipo d'intervento

Nella sperimentazione viene esaminato un medicamento (comprese le combinazioni secondo l'art. 2 cpv. 1 lett. f e g Ordinanza relativa ai dispositivi medici (ODmed) del 1° luglio 2020)?
Spiegazione
I medicamenti sono prodotti di origine chimica o biologica destinati ad avere un’azione medica sull’organismo umano o animale o dichiarati tali, utilizzati segnatamente ai fini della diagnosi, della prevenzione o del trattamento di malattie, ferite e handicap; sono medicamenti anche il sangue e i suoi derivati. Le combinazioni di cui all'art. 2 par. 1 let. f e g ODmed sono i seguenti prodotti: - Let. f: combinazioni inseparabili di un prodotto destinato alla dispensazione di un medicinale e di un medicinale che sono destinati esclusivamente ad essere utilizzati in questa combinazione e non sono riutilizzabili; - comma g: le associazioni che, al momento dell'immissione in commercio o della messa in servizio, contengono, oltre al dispositivo, come parte integrante, un medicinale che ha una funzione principale.
Esempi di sperimentazioni (4)
Risposta

No

Titolo di studio

Optimal duration of dual antiplatelet therapy after coronary stent implantation

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Background

Patients receiving a coronary stent during a percutaneous corornary intervention need to take dual antiplatelet therapy after the procedure. The aim of the antiplatelet therapy is to prevent patients from stent-related blood clots and other major adverse cardiovascular events following the implantation. Dual antiplatelet therapy consists of regular intake of oral aspirin and a second anti clotting drug. The aim of the study was to evaulate the optimal duration of such a dual antiplatelet therapy.

Methods

Patients undergoing stent placement for the treatment of coronary artery lesions were randomized to receive a prescription for clopidogrel for 12 months or 24 months. In addition, all patients received a prescription for aspirin life-long. Patients were responsible to obtain the prescribed treatment with the prescription at their local pharmacy. Randomized prescriptions specified the International Nonproprietary Name (INN) and therefore left the descision on which specific preparation (proprietary medicinal product) to be handed to the patient at the discretion of the pharmacist. Patients were assessed every 6 months. Patients in the 12-month arm were reminded to stop treatment of clopidogrel at the 12-month visit and patients in the 24-month arm at the 24-month visit. Patients were followed-up for 5 years. The trial had two primary outcomes: 1) the composite of all-cause death and major cardiovasular events at 24-month follow-up; 2) major bleeding events at 24-month follow-up.

Because

Although the effects of different length of clopidogrel treatment are investigated ("medicinal products") in this clinical trial the allocation actually randomized prescriptions. Drugs were not provided by investigators. The choice of the specific preparation (proprietary medicinal product) was left at the discretion of the pharmacist and not documented. Therefore, the trial took a pragmatic, real-world approach and had no direct control on the actual preparation used.

Risposta

Yes

Titolo di studio

Randomized trial of behavioural activation and antidepressant medication in the treatment of adolescents with major depression: a randomized trial

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Background

Those diagnosed with depression are overwhelmed by sadness that lasts for at least two weeks. Other symptoms include changes in appetite or sleep patterns, lack of energy or motivation, and even thoughts of suicide. Those diagnosed with depressions often need medication, therapy, or a combination of the two to relieve their symptoms and regain their normal function. This study sought to determine if behavioural activation therapy (a psychological intervention) was as effective as antidepressant medication (fluoxetine) for adolescents diagnosed with depression.

Methods

This study randomly allocated adolescents between 12-16 years old, who met criteria for Major Depressive Disorder, to receive behavioural activation therapy or fluoxetine (Fluoxetin-Mepha®) over the course of 18 weeks. Those randomized to fluoxetine visited their psychiatrist regularly but did not receive psychotherapy. Those who received behavioural activation therapy received between 18-20 one-hour sessions of individual therapy that focused on increasing enjoying and rewarding behaviours. The primary outcome was the difference in mean change of depressive symptoms as measured with the Children's Depression Rating Scale - Revised (CDRS-R).

Because

The effects of behavioural therapy and fluoxetine (Fluoxetin-Mepha®) were investigated (Fluoxetin-Mepha® is a "medicinal product") in this randomised-controlled trial.

Risposta

Yes

Titolo di studio

Randomized controlled trial in adults with headache recurrence after emergency department discharge, comparing the efficacy of oral sumatriptan to naproxen

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Background

Migraine and other acute primary headaches are treated with a variety of parenteral medications in the emergency department. It is not clear which medication is best to prescribe to primary headache patients when they are discharged. This study compared the efficacy of oral sumatriptan to naproxen for treatment of post-ED recurrent primary headache.

Methods

Adults aged 18 years or older who suffered from headache recurrence after discharge from an emergency department were randomized to either naproxen (Trade®) 500 mg or sumatriptan (Sumatriptan Spirig HC®) 100 mg. This was an open trial: patients and physicians knew who was given which medication. Both products were provided in the original package. The packages had trial-specific labels and were handed out by a hospital pharmacist. Patients were followed-up by telephone 48 hours after emergency department discharge. The primary outcome was change in pain intensity, measured during a two-hour period after ingestion. The change in the group that received 500 mg naproxen (Trade®) was compared to the change in the group that received 100 mg sumatriptan (Sumatriptan Spirig HC®). This difference was measured on a validated 11-point (0–10) verbal Numerical Rating Scale (NRS).

Because

This clinical trial investigated the effects of naproxen (Trade®) 500 mg and sumatriptan (Sumatriptan Spirig HC®) 100 mg. (Both are "medicinal products").

Nella sperimentazione viene esaminato un prodotto secondo l'art. art. 2a cpv. 2 Legge sugli agenti terapeutici (LATer) (Stato al 26 maggio 2021)?
Spiegazione
Un prodotto ai sensi dell'art. 2a cpv. 2 LATer è un prodotto che contiene o consiste in tessuti o cellule umane devitalizzate o loro derivati e non è un prodotto terapeutico (cioè non è un medicinale ai sensi dell'art. 4 cpv. 1 lett. a e non è un dispositivo medico ai sensi dell'art. 4 cpv. 1 lett. b LATer) ma ha una funzione come prodotto terapeutico.
Nella sperimentazione viene esaminato un dispositivo medico-diagnostico in vitro (DIV) o su un altro prodotto ai sensi dell articolo 1, paragrafo 1, della Ordinanza relativa ai dispositivi medico-diagnostici in vitro (ODIV) (Stato 26 maggio 2022)?
Spiegazione
Definizione secondo l‘ordinanza relativa ai dispositivi medico-diagnostici in vitro (ODIV) del 4 maggio 2022 : I dispositivi medico-diagnostici in vitro sono dispositivi medici composti da un reagente, un prodotto reattivo, un calibratore, materiale di controllo, un kit, uno strumento, un apparecchio, un’attrezzatura o un sistema, utilizzato da solo o in combinazione, destinati a essere impiegati in vitro per l’esame di campioni provenienti dal corpo umano, compresi sangue e tessuti donati, esclusivamente o principalmente allo scopo di fornire informazioni: 1. su un processo o uno stato fisiologico o patologico, 2. su una disabilità fisica o intellettiva congenita, 3. sulla predisposizione a una condizione clinica o a una malattia, 4. per determinare la sicurezza e la compatibilità con potenziali soggetti riceventi, 5. per prevedere la risposta o le reazioni a un trattamento, 6. per definire o monitorare le misure terapeutiche.
Nella sperimentazione viene esaminato un dispositivo medico (esclusi i dispositivi medici diagnostici in vitro) o qualsiasi altro dispositivo di cui all'articolo 1 dell'ordinanza relativa ai dispositivi medici (OdMed) (Stato 26 maggio 2022)?
Spiegazione
I dispositivi medici sono prodotti, compresi strumenti, apparecchi, diagnosi in vitro, software e altro materiale o sostanze, destinati o dichiarati essere destinati ad uso medico, e il cui effetto principale non è raggiunto con un medicamento. I prodotti secondo l'articolo 1 paragrafo 1 dell'ordinanza sui dispositivi medici (ad esempio quelli senza uno scopo medico come le lenti a contatto puramente cosmetiche) sono trattati come dispositivi medici.
Esempi di sperimentazioni (2)
Risposta

Yes

Titolo di studio

Percutaneous coronary revascularization: a randomized comparison of a sirolimus-eluting stent with biodegradable polymer and an everolimus-eluting stent with a durable polymer

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Background

Drug-eluting coronary artery stents that release therapeutic agents locally, in a controlled fashion, have improved the safety and efficacy of percutaneous coronary interventions. This study compares the safety and efficacy of a sirolimus-eluting stent with a biodegradable polymer with that of an everolimus-eluting stent with a durable polymer. This is a prospective multicentre randomized controlled non-inferiority trial in patients who underwent percutaneous coronary intervention during routine clinical practice.

Methods

Subjects aged ≥18 years, who have a symptomatic coronary artery disease (including chronic stable angina, silent ischemia, and acute coronary syndromes including NSTE-ACS and STE-ACS), are randomized for treatment either with the CE-marked Orsiro® stent system (sirolimus-eluting stent with a biodegradable polymer) or a CE-marked Xience PRIME® stent system (everolimus-eluting stent with a durable polymer). Primary endpoints are target lesion failure (defined as the composite of cardiac death, as well as target vessel myocardial infarction, and clinically driven target-lesion revascularization). No off-label use and no additional invasive or burdensome procedures in addition to those performed under the normal conditions of use of the two devices are described in the study protocol.

Because

The effects of the Orsiro® stent system and the Xience PRIME® stent system were investigated (both "medical devices") in this clinical trial.

Risposta

Yes

Titolo di studio

Emergency ultrasound-assisted examination of skin and soft tissue infections in the paediatric emergency department.

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Background

This study evaluated the test characteristics of clinical examinations of paediatric patients, supplemented with bedside emergency ultrasound, and compared them to clinical examination alone, to identify skin and soft tissue infections that require drainage. The ultrasound device bears a CE mark, but is not used as intended. Since the bedside emergency ultrasound was added to clinical practice and the investigation of the clinical performance of adding bedside ultrasound was the goal of the study, the study qualifies as a clinical trial (and not as an observational study according to HRO chapter 2). - The study is conducted by an academic sponsor, who does not intend to use the data generated in the study to establish or demonstrate the conformity of the device for the new purpose investigated in the study.

Methods

This was a prospective study of clinical examinations, supplemented with bedside emergency ultrasound, as a diagnostic test to evaluate patients 2 months to 19 years old. These patients were evaluated for skin and soft tissue infections in a paediatric emergency department. Each patient was clinically examined by the responsible physician (standard) and by an independent radiologist, who performed a bedside emergency ultrasound (result not communicated to the responsible physician). The reference standard that determined if a lesion required drainage was defined as "pus expressed at the time of the emergency department visit or within 2 days by follow-up assessment". The primary outcome was the degree of agreement between clinical exam alone, and clinical exam supplemented with ultrasound, on the number of lesions that required drainage within 2 weeks after clinical examination. No other study-related procedures were performed except for the ultrasound.

Because

The performance of an ultrasound device (“medical device”) was systematically tested in children ("persons").

Nella sperimentazione viene esaminato un intervento che non preveda né l'utilizzazione di un agente terapeutico o di un espianto standardizzato, né l'esecuzione di un trapianto?
Spiegazione
In questo caso s'intendono gli interventi studiati nel quadro di sperimentazioni cliniche e ai quali i partecipanti, sulla base di un protocollo di sperimentazione, vengono precedentemente assegnati. Tali interventi non possono tuttavia essere considerati un agente terapeutico secondo le definizioni della legge sugli agenti terapeutici, un prodotto secondo l'art. 2a comma 2 LATer, un espianto standardizzato o un trapianto. Pertanto, le disposizioni riguardano in particolare le sperimentazioni che analizzano metodi o procedure mediche o in altro modo relative alla salute, per esempio in ambito chirurgico, fisioterapico, ergoterapico o in altri settori, compresa la sfera psichiatrica e psicoterapeutica. Esse contemplano i trattamenti e le metodologie manuali, anche se eseguiti con strumenti, a condizione che tali dispositivi non siano oggetto dello studio (p. es. provvedimenti infermieristici, metodologie operative o di massaggio), ma includono anche tutti gli interventi verbali, ad esempio istruzioni o guide, nonché l’esposizione mirata di una persona a determinate condizioni ambientali naturali o artificiali. A decidere la tipologia d'intervento è il contesto d’uso nella sperimentazione clinica. Anche un semplicissimo trattamento quotidiano (prendere il sole) può quindi trasformarsi in un intervento clinico se utilizzato metodicamente nella ricerca (p. es. nella depressione).
Esempi di sperimentazioni (4)
Risposta

Yes

Titolo di studio

Optimal duration of dual antiplatelet therapy after coronary stent implantation

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Background

Patients receiving a coronary stent during a percutaneous corornary intervention need to take dual antiplatelet therapy after the procedure. The aim of the antiplatelet therapy is to prevent patients from stent-related blood clots and other major adverse cardiovascular events following the implantation. Dual antiplatelet therapy consists of regular intake of oral aspirin and a second anti clotting drug. The aim of the study was to evaulate the optimal duration of such a dual antiplatelet therapy.

Methods

Patients undergoing stent placement for the treatment of coronary artery lesions were randomized to receive a prescription for clopidogrel for 12 months or 24 months. In addition, all patients received a prescription for aspirin life-long. Patients were responsible to obtain the prescribed treatment with the prescription at their local pharmacy. Randomized prescriptions specified the International Nonproprietary Name (INN) and therefore left the descision on which specific preparation (proprietary medicinal product) to be handed to the patient at the discretion of the pharmacist. Patients were assessed every 6 months. Patients in the 12-month arm were reminded to stop treatment of clopidogrel at the 12-month visit and patients in the 24-month arm at the 24-month visit. Patients were followed-up for 5 years. The trial had two primary outcomes: 1) the composite of all-cause death and major cardiovasular events at 24-month follow-up; 2) major bleeding events at 24-month follow-up.

Because

Although the effects of different length of clopidogrel treatment are investigated ("medicinal products") in this clinical trial the allocation actually randomized prescriptions. Drugs were not provided by investigators. The choice of the specific preparation (proprietary medicinal product) was left at the discretion of the pharmacist and not documented. Therefore, the trial took a pragmatic, real-world approach and had no direct control on the actual preparation used.

Risposta

Yes

Titolo di studio

Randomized trial of behavioural activation and antidepressant medication in the treatment of adolescents with major depression: a randomized trial

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Background

Those diagnosed with depression are overwhelmed by sadness that lasts for at least two weeks. Other symptoms include changes in appetite or sleep patterns, lack of energy or motivation, and even thoughts of suicide. Those diagnosed with depressions often need medication, therapy, or a combination of the two to relieve their symptoms and regain their normal function. This study sought to determine if behavioural activation therapy (a psychological intervention) was as effective as antidepressant medication (fluoxetine) for adolescents diagnosed with depression.

Methods

This study randomly allocated adolescents between 12-16 years old, who met criteria for Major Depressive Disorder, to receive behavioural activation therapy or fluoxetine (Fluoxetin-Mepha®) over the course of 18 weeks. Those randomized to fluoxetine visited their psychiatrist regularly but did not receive psychotherapy. Those who received behavioural activation therapy received between 18-20 one-hour sessions of individual therapy that focused on increasing enjoying and rewarding behaviours. The primary outcome was the difference in mean change of depressive symptoms as measured with the Children's Depression Rating Scale - Revised (CDRS-R).

Because

The effects of behavioural therapy and fluoxetine (Fluoxetin-Mepha®) were investigated (Fluoxetin-Mepha® is a "medicinal product") in this randomised-controlled trial. Behavioural therapy (psychotherapy) is not a medicinal product/device, a transplant or transplant product, a gene therapy, or a pathogenic organism.

Risposta

Yes

Titolo di studio

Effect of and intervention designed to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables: Active for Life School Year-based cluster randomised controlled trial.

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Background

This study investigated the effectiveness of a school-based intervention to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables.

Methods

Participants were children in school year 4 (age 8-9 years) at recruitment and baseline assessment, and in year 5 during the intervention and follow-up assessments. Schools were randomly allocated to receive either the Active for Life intervention or standard teaching. The Active for Life intervention provided teacher training, lessons, and child-parent interactive homework plans, the materials required for lessons and homework, and written materials for school newsletters and parents. Schools in the control group received standard teaching. Pre-specified primary outcomes were accelerometer assessed minutes of moderate to vigorous physical activity per day, accelerometer assessed minutes of sedentary behaviour per day, and reported daily consumption of servings of fruit and vegetables.

Because

The study asked if the Active for Life intervention increased physical activity, reduced sedentary behaviour, and increased children’s fruit and vegetable more than standard teaching did. A teaching intervention is not a medicinal product or device, a transplant or transplant product, a gene therapy, or a pathogenic organism.

Nella sperimentazione viene esaminato un espianto standardizzato?
Spiegazione
Per espianti standardizzati si intendono prodotti fabbricati con organi, tessuti o cellule di origine umana o animale, che possono essere standardizzati o il cui processo di fabbricazione può essere standardizzato. In base alle definizioni e alle delimitazioni attualmente in discussione in seno all'UE, Swissmedic tra gli altri interpreta (d'intesa con l'UFSP) questa descrizione come segue: «è definito espianto standardizzato un prodotto destinato a essere trasferito sull'essere umano e che è composto da o contiene organi, tessuti o cellule vitali autogenici, allogenici o xenogenici fabbricati secondo processi standardizzati. Generalmente questi organi, tessuti o cellule sono stati sottoposti a una manipolazione tale che le caratteristiche biologiche, le funzioni fisiologiche o le proprietà strutturali originali risultano modificate (secondo la definizione dell'allegato I della proposta di regolamento UE del 23 maggio 2007 sui medicinali per terapie avanzate)». Per espianti standardizzati si intendono prodotti fabbricati con organi, tessuti o cellule di origine umana o animale, che possono essere standardizzati o il cui processo di fabbricazione può essere standardizzato. In base alle definizioni e alle delimitazioni attualmente in discussione in seno all'UE, Swissmedic tra gli altri interpreta (d'intesa con l'UFSP) questa descrizione come segue: «è definito espianto standardizzato un prodotto destinato a essere trasferito sull'essere umano e che è composto da o contiene organi, tessuti o cellule vitali autogenici, allogenici o xenogenici fabbricati secondo processi standardizzati. Generalmente questi organi, tessuti o cellule sono stati sottoposti a una manipolazione tale che le caratteristiche biologiche, le funzioni fisiologiche o le proprietà strutturali originali risultano modificate (secondo la definizione dell'allegato I della proposta di regolamento UE del 23 maggio 2007 sui medicinali per terapie avanzate)».
Nella sperimentazione vengono esaminati una terapia genica o un organismo patogeno?
Spiegazione
Per sperimentazioni cliniche della terapia genica vanno intese quelle sperimentazioni in cui vengono studiati gli effetti dell'inserzione di materiale genetico nelle cellule somatiche (in vivo ed ex vivo) per fini terapeutici. Rientrano nella definizione anche le sperimentazioni cliniche in cui vengono studiati come medicamenti gli organismi geneticamente modificati censiti dall’ordinanza sull’emissione deliberata nell’ambiente (OEDA) e in particolare i virus competenti per la replicazione. Il materiale genetico biologicamente attivo è costituito da sequenze di DNA e di RNA che non sono in grado di autoriprodursi (p. es. i plasmidi), ma che possono essere trasferite, svolgere un'azione patogena o infettiva o che, in generale, sono in grado di provocare un effetto mirato o prevedibile in un organismo, come ad esempio un'espressione proteica, una risposta immunitaria o l'inibizione della divisione cellulare. Possono essere essere geneticamente modificate. Nell'OEDA il materiale genetico biologicamente attivo è parificato ai microorganismi. Vi rientrano infine le sperimentazioni cliniche che analizzano gli effetti degli organismi patogeni utilizzati come medicamenti per la prevenzione o la terapia di malattie. Ai sensi dell’OEDA, sono organismi patogeni gli organismi che possono causare malattie nell'uomo, negli animali e nelle piante addomesticati, nella flora e nella fauna selvatiche o in altri organismi.

Medicamento: stato dell'omologazione

Il medicamento è omologato in Svizzera?
Spiegazione
Un medicamento è omologato se l’Istituto svizzero per gli agenti terapeutici (Swissmedic) ne ha autorizzato l'immissione in commercio (smercio e dispensazione) in Svizzera. L'elenco dei medicamenti omologati può essere consultato al sito Internet di Swissmedic (http://www.swissmedicinfo.ch/).
Esempi di sperimentazioni (3)
Risposta

Yes

Titolo di studio

Symptomatic therapy for uncomplicated lower urinary tract infections in an ambulatory setting: a randomized, double-blind trial

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Background

Most urinary tract infections are uncomplicated. The disease is benign and self-limited, and the primary goal of treatment is symptom relief rather than cure. The study was designed to determine if initial symptomatic treatment, followed by optional delayed antibiotic treatment, was non-inferior to immediate antibiotic treatment, followed by optional delayed antibiotic treatment, in resolving symptoms.

Methods

Women 18-70 years old, who had acute uncomplicated urinary tract infections, were randomly allocated to receive symptomatic treatment (diclofenac [Olfen®] 75 mg twice daily, followed by optional, delayed antibiotic treatment with a single dose of 3 g fosfomycin, if the patient thought it was necessary) or to receive immediate antibiotic treatment (norfloxacin [Norfloxacin-Teva®] 400 mg twice daily, for three days, followed by optional, delayed antibiotic treatment with single dose of 3 g fosfomycin if the patient thought it was necessary). To ensure blinding, Olfen® and Norfloxacin-Teva® were encapsulated in a GMP-facility by a pharmacist. Patients kept a diary for 10 days, in which they described symptoms. The researchers followed up with a telephone interview on days 10 and 30. The primary outcome of the trial was the proportion of patients whose symptoms resolved on day 4.

Because

This randomized-controlled, double-blind trial investigated the effects of diclofenac (Olfen®) and norfloxacin (Norfloxacin-Teva®), which are "medicinal products"). Both are "authorised" for the Swiss market (approval number for Olfen®: 55164 (Swissmedic) and Norfloxacin-Teva®: 55602 (Swissmedic)).

Risposta

No

Titolo di studio

A comparison of the efficacy of secukinumab and ustekinumab in patients with plaque-type psoriasis: a randomized-controlled trial.

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Background

This study compared the efficacy of secukinumab to ustekinumab (Stelara®) in patients that have plaque-type psoriasis.

Methods

Adults, aged 18 or older, who suffered from moderate to severe plaque type psoriasis for at least 6 months before randomization, were randomly allocated to receive secukinumab 300 mg once every weeks (at weeks 0, 1, 2, 3), followed by monthly dosing starting at week 4 and continuing through week 48, or to receive ustekinumab (Stelara®) 45mg once a week (at weeks 0, 4, 8 and 12). Severity and extent of psoriasis was measured using the PASI score (Psoriasis Area and Severity Index). Primary outcome was the difference in the proportion of PASI 90 responders after 16 weeks.

Because

The effects of secukinumab and ustekinumab (Stelara®) were investigated in this clinical trial. Ustekinumab (Stelara®) is "authorised" for the Swiss market (approval number Stelara®: 61267 [Swissmedic]). However, secukinumab does not have a marketing authorisation in Switzerland.

Risposta

Yes

Titolo di studio

Randomized controlled trial in adults with headache recurrence after emergency department discharge, comparing the efficacy of oral sumatriptan to naproxen

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Background

Migraine and other acute primary headaches are treated with a variety of parenteral medications in the emergency department. It is not clear which medication is best to prescribe to primary headache patients when they are discharged. This study compared the efficacy of oral sumatriptan to naproxen for treatment of post-ED recurrent primary headache.

Methods

Adults aged 18 years or older who suffered from headache recurrence after discharge from an emergency department were randomized to either naproxen (Trade®) 500 mg or sumatriptan (Sumatriptan Spirig HC®) 100 mg. This was an open trial: patients and physicians knew who was given which medication. Both products were provided in the original package. The packages had trial-specific labels and were handed out by a hospital pharmacist. Patients were followed-up by telephone 48 hours after emergency department discharge. The primary outcome was change in pain intensity, measured during a two-hour period after ingestion. The change in the group that received 500 mg naproxen (Trade®) was compared to the change in the group that received 100 mg sumatriptan (Sumatriptan Spirig HC®). This difference was measured on a validated 11-point (0–10) verbal Numerical Rating Scale (NRS).

Because

This clinical trial investigated the effects of naproxen (Trade®) 500 mg and sumatriptan (Sumatriptan Spirig HC®) 100 mg. Both are “authorised” for the market in Switzerland, and are provided “as is”, unchanged except for their labels. (Approval numbers for sumatriptan/[Sumatriptan Spirig HC®]: 58466, 58512, 58513 [Swissmedic]; and, for naproxen/[Trade®]: 51480 [Swissmedic]).

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Nello studio viene utilizzato un placebo oppure la condizione originale del medicamento utilizzato o del suo imballaggio è modificata?
Spiegazione
L'omologazione di un medicamento da parte dell'Istituto svizzero per gli agenti terapeutici (Swissmedic) comprende la sua fabbricazione (incl. metodo, caratterizzazione, imballaggio ecc.), le informazioni relative al medicamento, le modalità di dispensazione e d’uso. Se la condizione originale (p. es. forma galenica, composizione, imballaggio, caratterizzazione ecc.) del medicamento è modificata rispetto a quella autorizzata da Swissmedic, la risposta alla domanda è «sì». La risposta alla domanda è «sì» anche se nell'ambito della sperimentazione clinica viene utilizzato unn placebo non autorizzato da Swissmedic per tale modalità di utilizzazione.
Esempi di sperimentazioni (5)
Risposta

No

Titolo di studio

Enzalutamide monotherapy in hormone-naive prostate cancer: primary analysis of an open-label, single-arm, phase 2 study

Visualizza studio
Background

The androgen receptor inhibitor enzalutamide (Xtandi®) was approved to treat metastatic castration-resistant prostate cancer that has progressed on docetaxel. This study assessed the activity and safety of enzalutamide monotherapy in men with hormone-naive prostate cancer.

Methods

Men at least 18 years old, with hormone-naive prostate cancer, for whom hormone therapy was indicated, and who had non-castration levels of testosterone and prostate-specific antigen of 2 ng/mL or greater at screening, and an Eastern Cooperative Oncology Group score of 0, received oral enzalutamide (Xtandi®) 160 mg/day. The primary outcome, measured at week 25, was the proportion of patients in whom a prostate-specific antigen had declined 80% or more.

Because

This clinical trial investigated the effects of enzalutamide (Xtandi®) 160 mg/day. Xtandi® is “authorised” for the market in Switzerland, and is provided “as is”. The medicinal product was provided in its original package but labelled with a trial-specific sticker (label). However, the label did not cover any pharmaceutically relevant information.

Risposta

Yes

Titolo di studio

Symptomatic therapy for uncomplicated lower urinary tract infections in an ambulatory setting: a randomized, double-blind trial

Visualizza studio
Background

Most urinary tract infections are uncomplicated. The disease is benign and self-limited, and the primary goal of treatment is symptom relief rather than cure. The study was designed to determine if initial symptomatic treatment, followed by optional delayed antibiotic treatment, was non-inferior to immediate antibiotic treatment, followed by optional delayed antibiotic treatment, in resolving symptoms.

Methods

Women 18-70 years old, who had acute uncomplicated urinary tract infections, were randomly allocated to receive symptomatic treatment (diclofenac [Olfen®] 75 mg twice daily, followed by optional, delayed antibiotic treatment with a single dose of 3 g fosfomycin, if the patient thought it was necessary) or to receive immediate antibiotic treatment (norfloxacin [Norfloxacin-Teva®] 400 mg twice daily, for three days, followed by optional, delayed antibiotic treatment with single dose of 3 g fosfomycin if the patient thought it was necessary). To ensure blinding, Olfen® and Norfloxacin-Teva® were encapsulated in a GMP-facility by a pharmacist. Patients kept a diary for 10 days, in which they described symptoms. The researchers followed up with a telephone interview on days 10 and 30. The primary outcome of the trial was the proportion of patients whose symptoms resolved on day 4.

Because

This randomized-controlled, double-blind trial investigated the effects of diclofenac (Olfen®) and norfloxacin (Norfloxacin-Teva®), which are "medicinal products"). Both are "authorised" for the Swiss market. Neither product was provided in the original state (authorised), but were encapsulated instead.

Risposta

Yes

Titolo di studio

Multi-modal effects of thyroid hormone replacement for untreated older adults with subclinical hypothyroidism: a randomised placebo-controlled trial

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Background

Subclinical hypothyroidism is a common condition (81,8%) among older men and women. Thyroid hormone affects many physiological systems, including the vascular tree, heart, skeletal muscle, and brain. Thyroxin is substituted to overcome thyroid hormone deficiency, and may offer multisystem benefits to older people with subclinical hypothyroidism. This multicentre randomised placebo controlled trial aimed to assess the effects of thyroxin replacement in older adults who have persistent subclinical hypothyroidism.

Methods

Men aged ≥65 years, who suffered from subclinical hypothyroidism, were randomized to either a thyroxin (Eltroxin-LF®) starting dose of 50 μg daily p.o. (reduced to 25 μg daily in subjects <50 kg body weight, or if known coronary heart disease) or a matching placebo p.o. Eltroxin-LF®. (The manufacturer of Eltroxin-LF® provided placebo tablets that looked identical.) Subjects were reviewed face-to-face by study nurses at recruitment, study baseline, 6-8 weeks after baseline, after each dose change, 12 months, and annually thereafter. Study nurses made interim telephone contact at 6, 18, 30, and 42 months; possible cardiovascular and serious adverse events were recorded. The primary outcome included fatal and non-fatal cardiovascular events (fatal and non-fatal acute myocardial infarction and stroke; amputations for peripheral vascular disease; revascularisations for atherosclerotic vascular disease, including for acute coronary syndrome; heart failure hospitalisations).

Because

The effects of thyroxin (Eltroxin-LF®) and placebo were investigated in this clinical trial. Eltroxin-LF® is "authorised" for the Swiss market. The placebo was manufactured specifically for this research project. Aspects related to good manufacturing practice need to be checked by Swissmedic.

Risposta

No

Titolo di studio

Randomized controlled trial in adults with headache recurrence after emergency department discharge, comparing the efficacy of oral sumatriptan to naproxen

Visualizza studio
Background

Migraine and other acute primary headaches are treated with a variety of parenteral medications in the emergency department. It is not clear which medication is best to prescribe to primary headache patients when they are discharged. This study compared the efficacy of oral sumatriptan to naproxen for treatment of post-ED recurrent primary headache.

Methods

Adults aged 18 years or older who suffered from headache recurrence after discharge from an emergency department were randomized to either naproxen (Trade®) 500 mg or sumatriptan (Sumatriptan Spirig HC®) 100 mg. This was an open trial: patients and physicians knew who was given which medication. Both products were provided in the original package. The packages had trial-specific labels and were handed out by a hospital pharmacist. Patients were followed-up by telephone 48 hours after emergency department discharge. The primary outcome was change in pain intensity, measured during a two-hour period after ingestion. The change in the group that received 500 mg naproxen (Trade®) was compared to the change in the group that received 100 mg sumatriptan (Sumatriptan Spirig HC®). This difference was measured on a validated 11-point (0–10) verbal Numerical Rating Scale (NRS).

Because

This clinical trial investigated the effects of naproxen (Trade®) 500 mg and sumatriptan (Sumatriptan Spirig HC®) 100 mg. Both are “authorised” for the market in Switzerland, and are provided “as is”. The medicinal product was provided in its original package but labelled with a trial-specific sticker (label). However, the label did not cover any pharmaceutically relevant information. This modification is not manufactering according to the Therapeutics Product Act (TPA).

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Medicamento: utilizzazione

Il medicamento viene utilizzato nella sperimentazione conformemente all'informazione professionale?
Spiegazione
Il medicamento da esaminare nell'ambito della sperimentazione è impiegato secondo l'informazione professionale approvata dall'Istituto se sono rispettate le specifiche d'impiego secondo l'informazione professionale relativa a proprietà (indicazioni), posologia, modalità di somministrazione e gruppo di pazienti.
Esempi di sperimentazioni (2)
Risposta

No

Titolo di studio

Enzalutamide monotherapy in hormone-naive prostate cancer: primary analysis of an open-label, single-arm, phase 2 study

Visualizza studio
Background

The androgen receptor inhibitor enzalutamide (Xtandi®) was approved to treat metastatic castration-resistant prostate cancer that has progressed on docetaxel. This study assessed the activity and safety of enzalutamide monotherapy in men with hormone-naive prostate cancer.

Methods

Men at least 18 years old, with hormone-naive prostate cancer, for whom hormone therapy was indicated, and who had non-castration levels of testosterone and prostate-specific antigen of 2 ng/mL or greater at screening, and an Eastern Cooperative Oncology Group score of 0, received oral enzalutamide (Xtandi®) 160 mg/day. The primary outcome, measured at week 25, was the proportion of patients in whom a prostate-specific antigen had declined 80% or more.

Because

This clinical trial investigated the effects of enzalutamide (Xtandi®) 160 mg/day in men aged 18 or older with hormone-naive prostate cancer, for whom hormone therapy was indicated and who had non-castration levels of testosterone. Enzalutamide (Xtandi®) was not given in combination with hormone therapy. Enzalutamide (Xtandi®) is approved in combination with luteinising hormone-releasing hormone analogues to treat patients with metastatic castration-resistant prostate cancer, who already received docetaxel therapy. Use of enzalutamide (Xtandi®) within this clinical trial does not correspond with approved uses.

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Si devia dall'informazione professionale solo per quanto riguarda l'indicazione e la posologia?Si devia dall'informazione professionale solo per quanto riguarda l'indicazione e la posologia?
Spiegazione
L'impiego del medicamento da esaminare si discosta dalle specifiche riportate nell'informazione professionale solo per quanto concerne indicazioni terapeutiche o posologia prescritta. Se il medicamento viene impiegato con modalità di somministrazione che si discostano dalla modalità di somministrazione prescritta nell'informazione professionale, la risposta alla domanda è «no».L'impiego del medicamento da esaminare si discosta dalle specifiche riportate nell'informazione professionale solo per quanto concerne indicazioni terapeutiche o posologia prescritta. Se il medicamento viene impiegato con modalità di somministrazione che si discostano dalla modalità di somministrazione prescritta nell'informazione professionale, la risposta alla domanda è «no».
Esempi di sperimentazioni (1)

Medicamento: indicazione

L'indicazione rientra nello stesso gruppo di malattie della classificazione ICD-10 come è riportata nell'informazione professionale (fa stato il gruppo di malattie definito con il codice a tre posizioni)?L'indicazione rientra nello stesso gruppo di malat
Spiegazione
L'impiego del medicamento da esaminare si discosta in misura minima dalle indicazioni terapeutiche riportate nell'informazione professionale allorché la malattia oggetto della sperimentazione clinica rientra nel gruppo di indicazioni corrispondente a quello riportato nell'informazione professionale. Il gruppo in cui rientra l'indicazione terapeutica principale della sperimentazione è definito dal codice a tre cifre del sistema di classificazione monoasse e monogerarchico, la cosiddetta «Classificazione statistica internazionale delle malattie e dei problemi sanitari correlati» ICD-10 (http://apps.who.int/classifications/icd10/browse/2010/en). Con l'impiego del medicamento nella sperimentazione per un'indicazione associabile al medesimo gruppo di almeno un'altra indicazione elencata nell'informazione professionale, i rischi e gli incomodi per i partecipanti restano paragonabili con quelli derivanti dall'impiego per un'indicazione ammessa. Ciò in virtù dell'affinità con il trattamento standard e dell'impiego autorizzato del farmaco. L'impiego del medicamento da esaminare si discosta in misura minima dalle indicazioni terapeutiche riportate nell'informazione professionale allorché la malattia oggetto della sperimentazione clinica rientra nel gruppo di indicazioni corrispondente a quello riportato nell'informazione professionale. Il gruppo in cui rientra l'indicazione terapeutica principale della sperimentazione è definito dal codice a tre cifre del sistema di classificazione monoasse e monogerarchico, la cosiddetta «Classificazione statistica internazionale delle malattie e dei problemi sanitari correlati» ICD-10 (http://apps.who.int/classifications/icd10/browse/2010/en). Con l'impiego del medicamento nella sperimentazione per un'indicazione associabile al medesimo gruppo di almeno un'altra indicazione elencata nell'informazione professionale, i rischi e gli incomodi per i partecipanti restano paragonabili con quelli derivanti dall'impiego per un'indicazione ammessa. Ciò in virtù dell'affinità con il trattamento standard e dell'impiego autorizzato del farmaco.
Esempi di sperimentazioni (2)
Risposta

Yes

Titolo di studio

Enzalutamide monotherapy in hormone-naive prostate cancer: primary analysis of an open-label, single-arm, phase 2 study

Visualizza studio
Background

The androgen receptor inhibitor enzalutamide (Xtandi®) was approved to treat metastatic castration-resistant prostate cancer that has progressed on docetaxel. This study assessed the activity and safety of enzalutamide monotherapy in men with hormone-naive prostate cancer.

Methods

Men at least 18 years old, with hormone-naive prostate cancer, for whom hormone therapy was indicated, and who had non-castration levels of testosterone and prostate-specific antigen of 2 ng/mL or greater at screening, and an Eastern Cooperative Oncology Group score of 0, received oral enzalutamide (Xtandi®) 160 mg/day. The primary outcome, measured at week 25, was the proportion of patients in whom a prostate-specific antigen had declined 80% or more.

Because

This clinical trial investigates the effects of enzalutamide (Xtandi®) 160 mg/day in men aged 18 or older with hormone-naive prostate cancer, for whom hormone therapy was indicated and who had non-castration levels of testosterone. Xtandi® is approved in combination with luteinising hormone-releasing hormone analogues to treat patients with metastatic castration-resistant prostate cancer, who have already received docetaxel therapy. Hormone-naive prostate cancer falls within the same ICD-10 group as the approved indication (metastatic castration-resistant prostate cancer, for those who have previously received docetaxel therapy C61: Malignant neoplasm of prostate).

Medicamento: posologia

La malattia cui è destinato il medicamento nell'ambito della sperimentazione clinica è una malattia autolimitante?
Spiegazione
Una malattia è definita autolimitante quando la guarigione avviene da sola o senza misure terapeutiche.
Esempi di sperimentazioni (2)
Risposta

No

Titolo di studio

Enzalutamide monotherapy in hormone-naive prostate cancer: primary analysis of an open-label, single-arm, phase 2 study

Visualizza studio
Background

The androgen receptor inhibitor enzalutamide (Xtandi®) was approved to treat metastatic castration-resistant prostate cancer that has progressed on docetaxel. This study assessed the activity and safety of enzalutamide monotherapy in men with hormone-naive prostate cancer.

Methods

Men at least 18 years old, with hormone-naive prostate cancer, for whom hormone therapy was indicated, and who had non-castration levels of testosterone and prostate-specific antigen of 2 ng/mL or greater at screening, and an Eastern Cooperative Oncology Group score of 0, received oral enzalutamide (Xtandi®) 160 mg/day. The primary outcome, measured at week 25, was the proportion of patients in whom a prostate-specific antigen had declined 80% or more.

Because

This clinical trial investigates the effects of enzalutamide (Xtandi®) 160 mg/day in men aged 18 or older with hormone-naive prostate cancer, for whom hormone therapy was indicated and who had non-castration levels of testosterone. Self-limiting diseases resolve spontaneously, with or without treatment. Untreated hormone-naive prostate cancer does not resolve spontaneously.

Risposta

No

Titolo di studio

Randomized trial of behavioural activation and antidepressant medication in the treatment of adolescents with major depression: a randomized trial

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Background

Those diagnosed with depression are overwhelmed by sadness that lasts for at least two weeks. Other symptoms include changes in appetite or sleep patterns, lack of energy or motivation, and even thoughts of suicide. Those diagnosed with depressions often need medication, therapy, or a combination of the two to relieve their symptoms and regain their normal function. This study sought to determine if behavioural activation therapy (a psychological intervention) was as effective as antidepressant medication (fluoxetine) for adolescents diagnosed with depression.

Methods

This study randomly allocated adolescents between 12-16 years old, who met criteria for Major Depressive Disorder, to receive behavioural activation therapy or fluoxetine (Fluoxetin-Mepha®) over the course of 18 weeks. Those randomized to fluoxetine visited their psychiatrist regularly but did not receive psychotherapy. Those who received behavioural activation therapy received between 18-20 one-hour sessions of individual therapy that focused on increasing enjoying and rewarding behaviours. The primary outcome was the difference in mean change of depressive symptoms as measured with the Children's Depression Rating Scale - Revised (CDRS-R).

Because

The effects of behavioural therapy and fluoxetine (Fluoxetin-Mepha®) were investigated in this randomized-controlled trial, which included adolescents between 12-16 years old, who suffered from major depressive disorder. A self-limiting disease is one that resolves spontaneously, with or without specific treatment. Major depression disorder is not considered a self-limiting disease. (The estimated remission rate of untreated major depression within 12 months is about 50%, though the rates may be higher in adolescents [Whiteford HA et al. Psychol Med 2013; 43: 1569-85]).

La posologia è più bassa rispetto all'informazione specialistica
Spiegazione

Medicamento: trattamento standard

L'utilizzazione corrisponde a un trattamento standard riportato come tale in una direttiva redatta secondo criteri qualitativi riconosciuti a livello internazionale?L'utilizzazione corrisponde a un trattamento standard riportato come tale in una diretti
Spiegazione
Un impiego del medicamento da esaminare corrisponde a uno standard medico quando è riportato come tale in una linea guida redatta secondo criteri di qualità riconosciuti a livello internazionale. Le modalità d’impiego standardizzate di medicamenti sono descritte in linee guida di prassi clinica (clinical practice guidelines), ovvero di trattamento medico relativamente a utilità, sicurezza ed efficacia. Se nella sperimentazione clinica la modalità d’impiego del medicamento corrisponde effettivamente alle disposizioni indicate in una linea guida di ampio respiro e basata sulla forza probante di dati concreti, è possibile concludere che il rischio dell’intervento in esame è comparabile al rischio della terapia standard solitamente adottata nella pratica medica. Negli ultimi decenni si sono affermati standard di qualità che dovrebbero ispirare la redazione di orientamenti medici per essere riconosciuti nella prassi medica e a livello internazionale. Tra questi vi è il cosiddetto AGREE II (Appraisal of Guidelines for Research and Evaluation), per lo sviluppo di direttive e la valutazione del rigore logico e della trasparenza metodologica, con cui è stata messa a punto una linea guida. Lo strumento è stato nel frattempo adottato da numerose organizzazioni internazionali, raccomandato dall’OMS per lo sviluppo e la valutazione di linee guida e utilizzato per esaminare la qualità di numerose linee direttive di varie discipline, poi descritte nella letteratura scientifica. Recentemente, su insistenza del Congresso degli Stati Uniti l’Institute of Medicine (IOM) dell’Accademia delle scienze ha perfezionato, sulla base dell’AGREE II, gli standard per linee guida mediche, concretizzando determinati aspetti come ad esempio la gestione dei conflitti d’interesse, il finanziamento dell’elaborazione della linea guida e la richiesta di una verifica sistematica delle evidenze esistenti. Un impiego del medicamento da esaminare corrisponde a uno standard medico quando è riportato come tale in una linea guida redatta secondo criteri di qualità riconosciuti a livello internazionale. Le modalità d’impiego standardizzate di medicamenti sono descritte in linee guida di prassi clinica (clinical practice guidelines), ovvero di trattamento medico relativamente a utilità, sicurezza ed efficacia. Se nella sperimentazione clinica la modalità d’impiego del medicamento corrisponde effettivamente alle disposizioni indicate in una linea guida di ampio respiro e basata sulla forza probante di dati concreti, è possibile concludere che il rischio dell’intervento in esame è comparabile al rischio della terapia standard solitamente adottata nella pratica medica. Negli ultimi decenni si sono affermati standard di qualità che dovrebbero ispirare la redazione di orientamenti medici per essere riconosciuti nella prassi medica e a livello internazionale. Tra questi vi è il cosiddetto AGREE II (Appraisal of Guidelines for Research and Evaluation), per lo sviluppo di direttive e la valutazione del rigore logico e della trasparenza metodologica, con cui è stata messa a punto una linea guida. Lo strumento è stato nel frattempo adottato da numerose organizzazioni internazionali, raccomandato dall’OMS per lo sviluppo e la valutazione di linee guida e utilizzato per esaminare la qualità di numerose linee direttive di varie discipline, poi descritte nella letteratura scientifica. Recentemente, su insistenza del Congresso degli Stati Uniti l’Institute of Medicine (IOM) dell’Accademia delle scienze ha perfezionato, sulla base dell’AGREE II, gli standard per linee guida mediche, concretizzando determinati aspetti come ad esempio la gestione dei conflitti d’interesse, il finanziamento dell’elaborazione della linea guida e la richiesta di una verifica sistematica delle evidenze esistenti.
Esempi di sperimentazioni (2)
Risposta

Yes

Titolo di studio

Enzalutamide monotherapy in hormone-naive prostate cancer: primary analysis of an open-label, single-arm, phase 2 study

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Background

The androgen receptor inhibitor enzalutamide (Xtandi®) was approved to treat metastatic castration-resistant prostate cancer that has progressed on docetaxel. This study assessed the activity and safety of enzalutamide monotherapy in men with hormone-naive prostate cancer.

Methods

Men at least 18 years old, with hormone-naive prostate cancer, for whom hormone therapy was indicated, and who had non-castration levels of testosterone and prostate-specific antigen of 2 ng/mL or greater at screening, and an Eastern Cooperative Oncology Group score of 0, received oral enzalutamide (Xtandi®) 160 mg/day. The primary outcome, measured at week 25, was the proportion of patients in whom a prostate-specific antigen had declined 80% or more.

Because

This clinical trial investigates the effects of enzalutamide (Xtandi®) 160 mg/day in men aged 18 or older with hormone-naive prostate cancer, for whom hormone therapy was indicated and who had non-castration levels of testosterone. Xtandi® was not be given in combination with hormone therapy. Thus it does not comply with the intended use recommended by the European Association of Urology guidelines on prostate cancer (treatment guideline developed in accordance with international quality criteria).

PDF riassuntivo
Risposta

No

Titolo di studio

Randomized trial of behavioural activation and antidepressant medication in the treatment of adolescents with major depression: a randomized trial

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Background

Those diagnosed with depression are overwhelmed by sadness that lasts for at least two weeks. Other symptoms include changes in appetite or sleep patterns, lack of energy or motivation, and even thoughts of suicide. Those diagnosed with depressions often need medication, therapy, or a combination of the two to relieve their symptoms and regain their normal function. This study sought to determine if behavioural activation therapy (a psychological intervention) was as effective as antidepressant medication (fluoxetine) for adolescents diagnosed with depression.

Methods

This study randomly allocated adolescents between 12-16 years old, who met criteria for Major Depressive Disorder, to receive behavioural activation therapy or fluoxetine (Fluoxetin-Mepha®) over the course of 18 weeks. Those randomized to fluoxetine visited their psychiatrist regularly but did not receive psychotherapy. Those who received behavioural activation therapy received between 18-20 one-hour sessions of individual therapy that focused on increasing enjoying and rewarding behaviours. The primary outcome was the difference in mean change of depressive symptoms as measured with the Children's Depression Rating Scale - Revised (CDRS-R).

Because

The effects of behavioural therapy and fluoxetine (Fluoxetin-Mepha®) were investigated in this randomized-controlled trial, which included adolescents between 12-16 years old, who suffered from major depressive disorder. There is no treatment guideline that recommends prescribing antidepressants to this population without also prescribing psychotherapy.

Prodotti ai sensi dell’art. 2a cpv. 2 LATer (restanti prodotti DEVIT)

Il prodotto ai sensi dell‘art. 2a cpv. 2 LATer è stato dichiarato a Swissmedic per poter essere utilizzato in Svizzera?
Spiegazione
L'uso del prodotto secondo l'art. 2a cpv. 2 LATer è vietato in Svizzera?
Spiegazione
L'istituto svizzero per gli agenti terapeutici (Swissmedic) può vietare l'utilizzo di prodotti medici in Svizzera.
Il prodotto secondo l'art. 2a cpv. 2 LATer è usato secondo le istruzioni per l'uso?
Spiegazione
Di regola, un dispositivo di uso medico corrisponde una specifica (cosiddette istruzioni per l'uso), che descrive l'impiego conforme del prodotto.

DIV: influenza diretta sul paziente

Si può escludere che il risultato del test individuale con DIV abbia un impatto sul trattamento o sulla gestione del partecipante allo studio sottoposto a test (si tratta cioè di uno studio non interventistico delle prestazioni)?
Spiegazione
Uno studio interventistico delle prestazioni significa che il risultato individuale del test può avere un impatto sul trattamento o sulla gestione del partecipante allo studio. Ciò può avvenire solo se i risultati individuali del test sono comunicati al partecipante allo studio o al medico curante. In uno studio non interventistico delle prestazioni non è previsto che i risultati individuali del test siano comunicati al partecipante allo studio o al medico curante.

DIV: Riutilizzo di materiale biologico o di dati relativi alla salute

Lo studio riutilizza esclusivamente materiale biologico già esistente o dati sanitari già raccolti?
Spiegazione
Esistente significa che i dati sulla salute o il materiale biologico sono già stati raccolti in una fase precedente e che non si stanno reclutando partecipanti allo studio per il progetto di ricerca.

IVD: utilizzazione

Il materiale biologico sarà prelevato attraverso interventi chirurgici invasivi, o ai partecipanti allo studio verranno applicate procedure invasive o gravose in aggiunta alle normali condizioni di utilizzo del prodotto oggetto di studio?
Spiegazione
Procedure come un prelievo di sangue venoso o una biopsia cutanea su una piccola superficie non sono generalmente considerate chirurgicamente invasive o gravose.

DIV: prodotto vietato

 L'immissione sul mercato, la messa in servizio o l'utilizzo di DIV sono vietati in Svizzera?
Spiegazione
Swissmedic può vietare gli DIV con marchio CE in Svizzera.

IVD: marcatura CE

Il DIV è dotato di un marchio di conformità?
Spiegazione
Per marchio di conformità si intende il marchio CE o il marchio svizzero di conformità MD.
Il DIV viene utilizzato secondo le istruzioni per l'uso?
Spiegazione
Di regola, a un contrassegno di conformità (marcatura CE) di un dispositivo di uso medico corrisponde una specifica (cosiddette istruzioni per l'uso), che descrive l'impiego conforme del prodotto.

Si applica almeno uno dei seguenti criteri: 1) il materiale biologico è prelevato dai partecipanti allo studio tramite interventi chirurgici invasivi, esclusivamente a scopo di studio 2) procedure invasive o gravose sono applicate ai partecipanti allo studio in aggiunta alle normali condizioni di utilizzo del prodotto oggetto di studio.
Spiegazione
Procedure come un prelievo di sangue venoso o una biopsia cutanea su una piccola superficie non sono generalmente considerate chirurgicamente invasive o gravose.

Dispositivo medico: marcatura CE

Il dispositivo medico dispone di un marchio di conformità?
Spiegazione
Per contrassegno di conformità s'intende la marcatura CE.
Esempi di sperimentazioni (2)
Risposta

Yes

Titolo di studio

Percutaneous coronary revascularization: a randomized comparison of a sirolimus-eluting stent with biodegradable polymer and an everolimus-eluting stent with a durable polymer

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Background

Drug-eluting coronary artery stents that release therapeutic agents locally, in a controlled fashion, have improved the safety and efficacy of percutaneous coronary interventions. This study compares the safety and efficacy of a sirolimus-eluting stent with a biodegradable polymer with that of an everolimus-eluting stent with a durable polymer. This is a prospective multicentre randomized controlled non-inferiority trial in patients who underwent percutaneous coronary intervention during routine clinical practice.

Methods

Subjects aged ≥18 years, who have a symptomatic coronary artery disease (including chronic stable angina, silent ischemia, and acute coronary syndromes including NSTE-ACS and STE-ACS), are randomized for treatment either with the CE-marked Orsiro® stent system (sirolimus-eluting stent with a biodegradable polymer) or a CE-marked Xience PRIME® stent system (everolimus-eluting stent with a durable polymer). Primary endpoints are target lesion failure (defined as the composite of cardiac death, as well as target vessel myocardial infarction, and clinically driven target-lesion revascularization). No off-label use and no additional invasive or burdensome procedures in addition to those performed under the normal conditions of use of the two devices are described in the study protocol.

Because

The effects of the Orsiro® stent system and the Xience PRIME® stent system were investigated in this trial. Both passed the required conformity assessment procedure, and so both stent systems bear a CE mark (conformity mark).

PDF riassuntivo
Risposta

Yes

Titolo di studio

A single arm, multi-centre clinical trial to evaluate the HeartWare® ventricular assist system (VAS) for destination therapy of advanced heart failure

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Background

Routine treatment with left ventricular assist devices (LVADs) bridges transplantation for patients with advanced heart failure. We aim to determine the safety and effectiveness of the HeartWare® Ventricular Assist System in patients with chronic advanced stage left ventricular ineligible for cardiac transplantation. The HeartWare® Ventricular Assist System is marketed in several countries, but the use of the System in Switzerland has been prohibited by Swissmedic.

Methods

We include patients with advanced heart failure symptoms (Stage D/NYHA Class IIIB or IV, ≥18 years old) who have received and failed optimal medical therapy, and are ineligible for cardiac transplantation. All patients receive the HeartWare® Ventricular Assist System. The primary endpoint of the trial is survival and freedom of re-interventions until cardiac transplantation.

Because

This trial investigated the effects of the HeartWare® Ventricular Assist System ("medical device"). The device passed the required conformity assessment procedure and bears a CE mark.

Dispositivo medico: utilizzazione

La messa a disposizione sul mercato, la messa in servizio o l'applicazione del dispositivo medico sono vietati in Svizzera?
Spiegazione
L'Istituto svizzero per gli agenti terapeutici (Swissmedic) può vietare in Svizzera dispositivi medici con marcatura CE.
Esempi di sperimentazioni (1)
Risposta

Yes

Titolo di studio

A single arm, multi-centre clinical trial to evaluate the HeartWare® ventricular assist system (VAS) for destination therapy of advanced heart failure

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Background

Routine treatment with left ventricular assist devices (LVADs) bridges transplantation for patients with advanced heart failure. We aim to determine the safety and effectiveness of the HeartWare® Ventricular Assist System in patients with chronic advanced stage left ventricular ineligible for cardiac transplantation. The HeartWare® Ventricular Assist System is marketed in several countries, but the use of the System in Switzerland has been prohibited by Swissmedic.

Methods

We include patients with advanced heart failure symptoms (Stage D/NYHA Class IIIB or IV, ≥18 years old) who have received and failed optimal medical therapy, and are ineligible for cardiac transplantation. All patients receive the HeartWare® Ventricular Assist System. The primary endpoint of the trial is survival and freedom of re-interventions until cardiac transplantation.

Because

This trial investigated the effects of the HeartWare® Ventricular Assist System ("medical device"). The device passed the required conformity assessment procedure and bears a CE mark. However, use of the HeartWare® Ventricular Assist System was prohibited in Switzerland during conduct of the trial.

L'IVD viene utilizzato secondo le istruzioni per l'uso?
Spiegazione
Di regola, a un contrassegno di conformità (marcatura CE) di un dispositivo medico corrisponde una specifica (cosiddette istruzioni per l'uso), che descrive l'impiego conforme del dispositivo medico.

Dispositivo medico: aggiuntive procedure

Ci sono procedure aggiuntive invasive o onerose intraprese nello studio rispetto al trattamento standard?
Spiegazione
Quando si conduce uno studio clinico, procedure invasive aggiuntive o procedure che sono onerose per il soggetto possono essere utilizzate specificamente per lo studio, che altrimenti non sarebbero intraprese nella cura standard. Le procedure aggiuntive che sono gravose possono includere un'ampia varietà di interventi diversi, questo può includere procedure che possono causare dolore, disagio, paura, rischi potenziali o complicazioni/effetti collaterali, disturbi della vita e delle attività personali, o esperienze altrimenti spiacevoli. Ulteriori procedure che sono invasive includono (ma non si limitano a) la penetrazione all'interno del corpo attraverso la superficie del corpo, anche attraverso le membrane mucose degli orifizi del corpo, o la penetrazione di una cavità del corpo attraverso un orifizio del corpo.

Intervento senza agenti terapeutici: rischi per i partecipanti

L'intervento è associato con rischi e incomodi estremamente minimi per i partecipanti alla sperimentazione?
Spiegazione
Gli interventi da esaminare nel quadro di sperimentazioni cliniche, che non sono intesi come agenti terapeutici secondo le definizioni della legge sugli agenti terapeutici, come espianti standardizzati o come trapianto, possono comportare rischi e incomodi minimi o di entità più che minima per le persone che partecipano alla sperimentazione. Tra gli interventi che comportano rischi e incomodi minimi vanno considerati quelli che, con tutta probabilità, non sono collegabili con alcun effetto particolare sulla persona interessata, o tutt'al più solo con disturbi psicofisici di lieve entità e temporanei (e a questo riguardo anche disagi di tipo sociale, avendo per esempio un effetto stigmatizzante). La valutazione di rischi e incomodi deve avvenire con la massima obiettività possibile, tenendo conto della condizione effettiva e del grado di vulnerabilità della persona che partecipa alla sperimentazione, ma anche in base allo stato attuale delle conoscenze.
Esempi di sperimentazioni (4)
Risposta

Yes

Titolo di studio

Optimal duration of dual antiplatelet therapy after coronary stent implantation

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Background

Patients receiving a coronary stent during a percutaneous corornary intervention need to take dual antiplatelet therapy after the procedure. The aim of the antiplatelet therapy is to prevent patients from stent-related blood clots and other major adverse cardiovascular events following the implantation. Dual antiplatelet therapy consists of regular intake of oral aspirin and a second anti clotting drug. The aim of the study was to evaulate the optimal duration of such a dual antiplatelet therapy.

Methods

Patients undergoing stent placement for the treatment of coronary artery lesions were randomized to receive a prescription for clopidogrel for 12 months or 24 months. In addition, all patients received a prescription for aspirin life-long. Patients were responsible to obtain the prescribed treatment with the prescription at their local pharmacy. Randomized prescriptions specified the International Nonproprietary Name (INN) and therefore left the descision on which specific preparation (proprietary medicinal product) to be handed to the patient at the discretion of the pharmacist. Patients were assessed every 6 months. Patients in the 12-month arm were reminded to stop treatment of clopidogrel at the 12-month visit and patients in the 24-month arm at the 24-month visit. Patients were followed-up for 5 years. The trial had two primary outcomes: 1) the composite of all-cause death and major cardiovasular events at 24-month follow-up; 2) major bleeding events at 24-month follow-up.

Because

This randomized-controlled, open trial investigates the effects of different lengths of clopidogrel treatment. Clopidogrel is a drug and various proprietary medicinal products are "authorised" for the Swiss market (e.g. approval number for Plavix®: 54509 (Swissmedic)). It is reasonable to assume that pharmacies will only provide authorised products to the patients. All authorised clopidogrel preparations are approved for prevention of atherothrombotic events in patients who received a coronary stent. The recommended dosing schedule is corresponds to dosing schedule in the protocol. Length of treatment is not explicitly mentioned in the package insert but only mentioned as long-term.Therefore, indication and dosage of clopidogrel in this research project corresponds with the approved indication.

Risposta

Yes

Titolo di studio

Effect of and intervention designed to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables: Active for Life School Year-based cluster randomised controlled trial.

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Background

This study investigated the effectiveness of a school-based intervention to increase physical activity, reduce sedentary behaviour, and increase children’s consumption of fruit and vegetables.

Methods

Participants were children in school year 4 (age 8-9 years) at recruitment and baseline assessment, and in year 5 during the intervention and follow-up assessments. Schools were randomly allocated to receive either the Active for Life intervention or standard teaching. The Active for Life intervention provided teacher training, lessons, and child-parent interactive homework plans, the materials required for lessons and homework, and written materials for school newsletters and parents. Schools in the control group received standard teaching. Pre-specified primary outcomes were accelerometer assessed minutes of moderate to vigorous physical activity per day, accelerometer assessed minutes of sedentary behaviour per day, and reported daily consumption of servings of fruit and vegetables.

Because

The study asked if the Active for Life intervention increased physical activity, reduced sedentary behaviour, and increased children’s fruit and vegetable more than standard teaching did. Teaching interventions do not create more than minimal risk or stress to participants.

Risposta

Yes

Titolo di studio

Balance in young female ballet students suffering from chronic knee pain: The effect of physiotherapy with and without a mirror.

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Background

In literature there is general consensus that using a mirror improves proprioception. During rehabilitation, a mirror is very useful for improving stability. In some sports, such as dancing, mirrors are widely used in training. This study evaluated the effectiveness of physiotherapy with mirror on balance in young dancers.

Methods

This study included young dancers (aged 19-25) suffering from chronic knee pain. They were randomly assigned to receive physiotherapy, one to one, with a mirror (mirror- group) or without a mirror (non-mirror group). Their balance was evaluated by BESS (Balance Error Scoring System), which consists of three stances (double limb, single limb, and tandem) on two surfaces (firm and foam). Errors were assessed at each stance and summed to create the two subtotal scores (firm and foam surface) and the final total score (BESS). The BESS was measured at recruitment (T0) and again after 6 months of dance lessons (T1). Primary outcome was difference in total BESS between the groups.

Because

The investigator randomly assigned ("prospectively assigned") female dancers suffering from chronic knee pain to receive physiotherapy either with or without a mirror. The study assessed between-groups difference via the Balance Error Scoring System ("to investigate structure and function on the human body"). Dancing in front of a mirror creates minimal risk or stress in participants.

Intervento senza agenti terapeutici: trattamento standard

L'esecuzione corrisponde a un trattamento standard riportato come tale in una direttiva redatta secondo criteri qualitativi riconosciuti a livello internazionale?
Spiegazione
Un impiego dell'intervento da esaminare corrisponde a uno standard medico quando è riportato come tale in una linea guida redatta secondo criteri di qualità riconosciuti a livello internazionale. Le modalità d’impiego standardizzate di medicamenti sono descritte in linee guida di prassi clinica (clinical practice guidelines), ovvero di trattamento medico relativamente a utilità, sicurezza ed efficacia. Se nella sperimentazione clinica la modalità d’impiego del medicamento corrisponde effettivamente alle disposizioni indicate in una linea guida di ampio respiro e basata sulla forza probante di dati concreti, è possibile concludere che il rischio dell’intervento in esame è comparabile al rischio della terapia standard solitamente adottata nella pratica medica. Negli ultimi decenni si sono affermati standard di qualità che dovrebbero ispirare la redazione di orientamenti medici per essere riconosciuti nella prassi medica e a livello internazionale. Tra questi vi è il cosiddetto AGREE II (Appraisal of Guidelines for Research and Evaluation), per lo sviluppo di direttive e la valutazione del rigore logico e della trasparenza metodologica, con cui è stata messa a punto una linea guida. Lo strumento è stato nel frattempo adottato da numerose organizzazioni internazionali, raccomandato dall’OMS per lo sviluppo e la valutazione di linee guida e utilizzato per esaminare la qualità di numerose linee direttive di varie discipline, poi descritte nella letteratura scientifica. Recentemente, su insistenza del Congresso degli Stati Uniti l’Institute of Medicine (IOM) dell’Accademia delle scienze ha perfezionato, sulla base dell’AGREE II, gli standard per linee guida mediche, concretizzando determinati aspetti come ad esempio la gestione dei conflitti d’interesse, il finanziamento dell’elaborazione della linea guida e la richiesta di una verifica sistematica delle evidenze esistenti.

Espianto standardizzato: stato dell'omologazione

L'espianto standardizzato è omologato in Svizzera?
Spiegazione
Un espianto standardizzato è omologato se l’Istituto svizzero per gli agenti terapeutici (Swissmedic) ne ha autorizzato l'immissione in commercio (smercio e dispensazione) in Svizzera. L'elenco degli espianti standardizzati omologati può essere consultato al sito Internet di Swissmedic (http://www.swissmedicinfo.ch/).

Espianto standardizzato: utilizzazione

L'espianto standardizzato viene utilizzato nella sperimentazione conformemente all'informazione professionale?
Spiegazione
L'espianto standardizzato da esaminare è impiegato secondo l'informazione professionale approvata dall'Istituto se sono rispettate le specifiche d'impiego secondo l'informazione professionale relativa a proprietà (indicazioni), posologia, modalità di somministrazione, gruppo di pazienti.
Si devia dall'informazione professionale solo per quanto riguarda l'indicazione e la posologia?
Spiegazione
L'impiego dell'espianto standardizzato da esaminare si discosta dalle specifiche riportate nell'informazione professionale solo per quanto concerne indicazioni terapeutiche o posologia prescritta. Se l'espianto standardizzato viene impiegato con modalità di somministrazione che si discostano dalla modalità di somministrazione prescritta nell'informazione professionale, la risposta alla domanda è «no».

Espianto standardizzato: indicazione

L'indicazione rientra nello stesso gruppo di malattie della classificazione ICD-10 come è riportata nell'informazione professionale (fa stato il gruppo di malattie definito con il codice a tre posizioni)?
Spiegazione
L'impiego dell'espianto standardizzato da esaminare si discosta in misura minima dalle indicazioni terapeutiche riportate nell'informazione professionale allorché la malattia oggetto della sperimentazione clinica rientra nel gruppo di indicazioni corrispondente a quello riportato nell'informazione professionale. Il gruppo in cui rientra l'indicazione terapeutica principale della sperimentazione è definito dal codice a tre cifre del sistema di classificazione monoasse e monogerarchico, la cosiddetta «Classificazione statistica internazionale delle malattie e dei problemi sanitari correlati» ICD-10 (http://apps.who.int/classifications/icd10/browse/2010/en). Con l'impiego dell'espianto standardizzato per un'indicazione associabile al medesimo gruppo di almeno un'altra indicazione elencata nell'informazione professionale, i rischi e gli incomodi per i partecipanti restano paragonabili con quelli derivanti dall'impiego per un'indicazione ammessa. Ciò in virtù dell'affinità con il trattamento standard e dell'impiego autorizzato dell'espianto standardizzato.

Espianto standardizzato: posologia

La malattia cui è destinato l'espianto standardizzato nell'ambito della sperimentazione clinica è una malattia autolimitante?
Spiegazione
Una malattia è definita autolimitante quando la guarigione avviene da sola o senza misure terapeutiche.
La posologia è più bassa rispetto all'informazione specialistica
Spiegazione

Espianto standardizzato: trattamento standard

L'utilizzazione corrisponde a un trattamento standard riportato come tale in una direttiva redatta secondo criteri qualitativi riconosciuti a livello internazionale?
Spiegazione
Un impiego dell'espianto standardizzato da esaminare corrisponde a uno standard medico quando è riportato come tale in una linea guida redatta secondo criteri di qualità riconosciuti a livello internazionale. Le modalità d’impiego standardizzate di questo tipo di espianti sono descritte in linee guida di prassi clinica (clinical practice guidelines), ovvero di trattamento medico relativamente a utilità, sicurezza ed efficacia. Se nella sperimentazione clinica la modalità d’impiego dell'espianto standardizzato corrisponde effettivamente alle disposizioni indicate in una linea guida di ampio respiro e basata sulla forza probante di dati concreti, è possibile concludere che il rischio dell’intervento in esame è comparabile al rischio della terapia standard solitamente adottata nella pratica medica. Negli ultimi decenni si sono affermati standard di qualità che dovrebbero ispirare la redazione di orientamenti medici per essere riconosciuti nella prassi medica e a livello internazionale. Un contributo sostanziale al perfezionamento dei criteri di qualità per le linee guida mediche è stato fornito nel 2002 dalle raccomandazioni del Consiglio d’Europa per lo sviluppo di direttive mediche, in base alle quali una collaborazione internazionale ha elaborato nel 2009 uno strumento, conosciuto come AGREE II (Appraisal of Guidelines for Research and Evaluation), per lo sviluppo di direttive e la valutazione del rigore logico e della trasparenza metodologica con cui è stata messa a punto una linea guida. Lo strumento è stato nel frattempo adottato da numerose organizzazioni internazionali, raccomandato dall’OMS per lo sviluppo e la valutazione di linee guida e utilizzato per esaminare la qualità di numerose linee direttive di varie discipline, poi descritte nella letteratura scientifica. Recentemente, su insistenza del Congresso degli Stati Uniti l’Institute of Medicine (IOM) dell’Accademia delle scienze ha perfezionato, sulla base dell’AGREE II, gli standard per linee guida mediche, concretizzando determinati aspetti come ad esempio la gestione dei conflitti d’interesse, il finanziamento dell’elaborazione della linea guida e la richiesta di una verifica sistematica delle evidenze esistenti.

Terapia genica/organismi patogeni: stato dell'omologazione

La terapia genica o l'organismo patogeno sono omologati in Svizzera?
Spiegazione
La terapia genica o l'organismo patogeno sono omologati se l’Istituto svizzero per gli agenti terapeutici (Swissmedic) ne ha autorizzato l'immissione in commercio (smercio e dispensazione) in Svizzera. L'elenco delle terapie geniche e degli organismi patogeni omologati può essere consultato al sito Internet di Swissmedic (http://www.swissmedicinfo.ch/).

Terapia genica/organismi patogeni: utilizzazione

La terapia genica o l'organismo patogeno vengono utilizzati nella sperimentazione conformemente all'informazione professionale?
Spiegazione
La terapia genica o l'organismo patogeno da esaminare nell'ambito della sperimentazione sono impiegati secondo l'informazione professionale approvata dall'Istituto, se sono rispettate le specifiche d'impiego secondo l'informazione professionale relativa a proprietà (indicazioni), posologia, modalità di somministrazione, gruppo di pazienti.
Si devia dall'informazione professionale solo per quanto riguarda l'indicazione e la posologia?
Spiegazione
La terapia genica o l'organismo patogeno da esaminare si discostano dall'informazione professionale solo per quanto concerne indicazioni terapeutiche o posologia prescritta. Se la terapia genica o l'organismo patogeno vengono impiegati con modalità di somministrazione che si discostano dalla modalità di somministrazione prescritta nell'informazione professionale, la risposta alla domanda è «no».

Terapia genica/organismi patogeni: indicazione

L'indicazione rientra nello stesso gruppo di malattie della Classificazione ICD-10 come è riportato nell'informazione professionale (fa stato il gruppo di malattie definito con il codice a tre posizioni)?
Spiegazione
L'impiego della terapia genica o dell'organismo patogeno da esaminare si discosta in misura minima dalle indicazioni terapeutiche riportate nell'informazione professionale allorché la malattia oggetto della sperimentazione clinica rientra nel gruppo di indicazioni corrispondente a quello riportato nell'informazione professionale. Il gruppo di indicazioni è definito dal codice a tre cifre del sistema di classificazione monoasse e monogerarchico, la cosiddetta «Classificazione statistica internazionale delle malattie e dei problemi sanitari correlati» ICD-10 (http://apps.who.int/classifications/icd10/browse/2010/en). Con l'impiego della terapia genica o dell'organismo patogeno per un'indicazione associabile al medesimo gruppo di almeno un'altra indicazione elencata nell'informazione professionale, i rischi e gli incomodi per i partecipanti restano paragonabili con quelli derivanti dall'impiego per un'indicazione ammessa. Ciò in virtù dell'affinità con il trattamento standard e dell'impiego autorizzato della terapia genica o dell'organismo patogeno.

Terapia genica/organismi patogeni: posologia

La malattia cui è destinata la terapia genica o l'organismo patogeno nell'ambito della sperimentazione clinica è una malattia autolimitante?
Spiegazione
Una malattia è definita autolimitante quando la guarigione avviene da sola o senza misure terapeutiche.
La posologia è più bassa rispetto a quanto specificato nell'informazione professionale.
Spiegazione
-

Terapia genica/organismi patogeni: trattamento standard

L'utilizzazione corrisponde a un trattamento standard riportato come tale in una direttiva redatta secondo criteri qualitativi riconosciuti a livello internazionale?
Spiegazione
Un impiego della terapia genica o dell'organismo patogeno da esaminare corrisponde a uno standard medico quando è riportato come tale in una linea guida redatta secondo criteri di qualità riconosciuti a livello internazionale. Le modalità d’impiego standardizzate della terapia genica o dell'organismo patogeno sono descritte in linee guida di prassi clinica (clinical practice guidelines), ovvero di trattamento medico relativamente a utilità, sicurezza ed efficacia. Se nella sperimentazione clinica la modalità d’impiego della terapia genica o dell'organismo patogeno corrisponde effettivamente alle disposizioni indicate in una linea guida di ampio respiro e basata sulla forza probante di dati concreti, è possibile concludere che il rischio dell’intervento in esame è comparabile al rischio della terapia standard solitamente adottata nella pratica medica. Negli ultimi decenni si sono affermati standard di qualità che dovrebbero ispirare la redazione di orientamenti medici per essere riconosciuti nella prassi medica e a livello internazionale. Un contributo sostanziale al perfezionamento dei criteri di qualità per le linee guida mediche è stato fornito nel 2002 dalle raccomandazioni del Consiglio d’Europa per lo sviluppo di direttive mediche, in base alle quali una collaborazione internazionale ha elaborato nel 2009 uno strumento, conosciuto come AGREE II (Appraisal of Guidelines for Research and Evaluation), per lo sviluppo di direttive e la valutazione del rigore logico e della trasparenza metodologica con cui è stata messa a punto una linea guida. Lo strumento è stato nel frattempo adottato da numerose organizzazioni internazionali, raccomandato dall’OMS per lo sviluppo e la valutazione di linee guida e utilizzato per esaminare la qualità di numerose linee direttive di varie discipline, poi descritte nella letteratura scientifica. Recentemente, su insistenza del Congresso degli Stati Uniti l’Institute of Medicine (IOM) dell’Accademia delle scienze ha perfezionato, sulla base dell’AGREE II, gli standard per linee guida mediche, concretizzando determinati aspetti come ad esempio la gestione dei conflitti d’interesse, il finanziamento dell’elaborazione della linea guida e la richiesta di una verifica sistematica delle evidenze esistenti.