MedPath

Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension

Completed
Conditions
Hypertension, Pulmonary
Registration Number
NCT02610660
Lead Sponsor
Association for Pediatric Pulmonary Hypertension
Brief Summary

The TOPP-2 registry is an international, non-interventional, prospective registry including children and adolescents newly diagnosed with pulmonary hypertension (PH) to gain further insights in the disease course and long-term outcome of PH in childhood.

Patients will undergo clinical assessments and receive standard medical care, as determined by treating physicians in their daily clinical practice. The TOPP-2 registry is specifically designed to capture the variables that have been proposed as treatment goals in PePH and the reasons for changes in treatment strategy.

The TOPP-2 registry uses the new clinical classification of PH as outlined at the 5th World Symposium for Pulmonary Hypertension (WSPH) in Nice 2013 and includes new characterizations for children with PH.

The registry is planned and implemented under the scientific leadership of the Association for Pediatric Pulmonary Hypertension (PePH), independently from the financial sponsors.

All enrolled patients will have a follow-up period of 18 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
388
Inclusion Criteria
  • Patient must be an incident patient, i.e.newly diagnosed with PH

  • Age at time of diagnosis is at least 3 months and less than 18 years

  • Patients must present with PH belonging to one of the following categories

    • Group 1 according to updated Nice clinical classification
    • Group 3 according to updated Nice clinical classification
    • Group 4 according to updated Nice clinical classification
    • Group 5 according to updated Nice clinical classification
  • PH confirmed by heart catheterisation (HC)

  • At HC, the patient must present with mean pulmonary arterial pressure (PAP) of at least 25 mmHg at rest, a pulmonary vascular resistance index (PVRi) equal to or below 3 Wood units*m^2 and mean pulmonary arterial wedge pressure (PAWP) below or equal to 15 mmHg

  • In case of congenital heart disease (CHD) patients who had undergone palliative procedure or repair to close systemic to pulmonary shunt, the diagnosis of PH must have been confirmed by HC at least 6 months after surgery/palliative procedure took place

  • For patients with PAH-CHD open shunt, only those considered not operable due to advanced pulmonary vascular disease are eligible

  • Patients to be included into the registry, and/or their legal guardians, must give informed consent. Where applicable patients will be asked for their written assent

  • Participating sites must agree to adhere to the recommendations of the WSPH 2015 Nice, Pediatric Taskforce.

Exclusion Criteria
  • Patients belonging to Group 2 according to updated Nice clinical classification

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
TransplantationOver registry run-time (5.5 years)
DeathOver registry run-time (5.5 years)
Adverse eventsOver registry run-time (5.5 years)
Secondary Outcome Measures
NameTimeMethod
Type of treatmentOver registry run-time (5.5 years)

Type of treatment (drug, mono/combination, administration route)

Worsening of echocardiographic parameters (ECHO)Over registry run-time (5.5 years)

Parameters encompass TAPSE and RV/LV dimension ratio

Increase in Brain Natriuretic Peptide (BNP)Over registry run-time (5.5 years)
Escalation of treatmentOver registry run-time (5.5 years)
Hospitalisation related to pulmonary arterial hypertension (PAH)Over registry run-time (5.5 years)
Potts shuntOver registry run-time (5.5 years)
Switch in treatmentOver registry run-time (5.5 years)
Increase in N-terminal-proBNP (NT-proBNP)Over registry run-time (5.5 years)
Use/initiation of i.v./s.c. prostanoidsOver registry run-time (5.5 years)
Time to clinical worseningOver registry run-time (5.5 years)

Various composites of above parameters

Decline in 6-minute walk test (6MWT)Over registry run-time (5.5 years)
Decline in Panama functional classOver registry run-time (5.5 years)
Atrial septostomyOver registry run-time (5.5 years)
Reasons for treatment changeOver registry run-time (5.5 years)
Decline in WHO functional classOver registry run-time (5.5 years)

Trial Locations

Locations (32)

The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

National Heart Institute

🇲🇽

Mexico City, Mexico

University Children's Hospital

🇨🇭

Zurich, Switzerland

Hôpital des Enfants

🇨🇭

Geneva, Switzerland

Hospital Pediátrico La Misericordia

🇨🇴

Bogota, Colombia

Keio University

🇯🇵

Tokyo, Japan

Stanford Children's Hospital

🇺🇸

Palo Alto, California, United States

University of Colorado Denver School of Medicine, Children's Hospital Colorado

🇺🇸

Aurora, Colorado, United States

St Louis Children's Hospital

🇺🇸

Saint Louis, Missouri, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Children's National Medical Center

🇺🇸

Washington, District of Columbia, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Vanderbilt University Children's Hospital

🇺🇸

Nashville, Tennessee, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

Seattle Children's Hospital

🇺🇸

Seattle, Washington, United States

Royal Children's Hospital

🇦🇺

Melbourne, Australia

Primary Children's Hospital

🇺🇸

Salt Lake City, Utah, United States

University of São Paulo

🇧🇷

São Paulo, Brazil

Fu Wai Hospital

🇨🇳

Beijing, China

University Children's Hospital Ulm

🇩🇪

Ulm, Germany

Institute of Cardiology

🇭🇺

Budapest, Hungary

Université Paris Descartes

🇫🇷

Paris, France

University of Padova

🇮🇹

Padova, Italy

Toho Universit Omori Medical Center

🇯🇵

Tokyo, Japan

Beatrix Children's Hospital, University Medical Center Groningen

🇳🇱

Groningen, Netherlands

Hadassah, Hebrew University Medical Center

🇮🇱

Jerusalem, Israel

The Queen Silvia's Children's Hospital

🇸🇪

Gothenburg, Sweden

Children's Memorial

🇵🇱

Warsaw, Poland

King Fahd Armed Forces Hospital

🇸🇦

Jeddah, Saudi Arabia

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