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临床试验/NCT03240653
NCT03240653招募中不适用

Predictive Measures to Stratify Clinical Outcomes in Children and Adults With Gaucher Disease and Responses to Specific Therapies

Cambridge University Hospitals NHS Foundation Trust8 个研究点 分布在 1 个国家目标入组 250 人开始时间: 2014年1月1日最近更新:
适应症

试验速览

阶段
不适用
状态
招募中
入组人数
250
试验地点
8
主要终点
Bone avascular necrosis

研究概览

简要总结

The purpose of this research is to review data already collected and to collect new data from adults and children in England with Gaucher Disease to determine clinical factors which predict severity and response to therapy of Gaucher disease especially in the areas of bone, cancer and brain conditions.

详细描述

Gaucher disease is part of a rare group of genetic metabolic diseases which are caused by an inherited deficiency of the enzyme glucocerebrosidase. The most common form, Type 1 affects 1 in 40,000 to 60,000 individuals in the general population. In Type 1 symptoms may appear at any time from infancy to old age. The disease is associated with anaemia (a decrease in the amount of red blood cells), fatigue (tiredness), bruising and an increased tendency to bleed. An enlarged spleen and liver with stomach swelling may also occur as well as bone pain, fractures and bone deterioration. Type 1 was formerly considered not to affect the brain or nervous system. Some patients with Type 1 Gaucher disease have no symptoms, while others develop serious symptoms that can be life threatening; latterly Parkinsonism and Dementia with Lewy bodies has been noted to occur with increased frequency in patients with this variant of Gaucher disease compared with healthy control subjects in an age-matched population.

In Gaucher Disease Type 3 the brain and spinal cord are affected. Type 3 is rare and affects fewer than 1 in 100,000 people. The brain and spinal cord symptoms in Type 3 are less severe than in those who have evidence of florid neurologocal disease in infancy years of age. The symptoms of the brain and spinal cord appear in early to late childhood, and patients with Type 3 Gaucher disease live often, but not always, well into adulthood.

Gaucher disease is not gender-specific and its signs and symptoms may appear in affected individuals at any age, with Type 3 being commonly diagnosed in childhood. Although individuals from any ethnic background may develop Gaucher disease, Type 1 Gaucher disease is most common among Jews of Ashkenazi (Eastern European) descent. Among this group, about 1 in 900 people are at risk of Gaucher disease.

There are approximately 280 people in England diagnosed with Gaucher Disease, who receive treatment or management at one of the treating hospitals.

Patients with Gaucher disease have an increased risk of developing myeloma and Parkinson's disease. Myeloma, also known as multiple myeloma, is a type of bone marrow cancer affecting the white blood cells of the immune system which generate antibodies. Approximately 1 in 10 Gaucher patients have a specific blood protein - a monoclonal antibody called a paraprotein, which is found in both malignant and non-malignant conditions, including myeloma.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Retrospective

入排标准

性别
All
接受健康志愿者

入选标准

  • Each patient must meet all of the following criteria to be enrolled in this study:
  • Confirmed biochemical diagnosis of Type I, Type II or Type III Gaucher disease
  • Written Ethics Committee (EC) approved informed consent obtained from the patient, or patient's parent or legal guardian and patient assent if appropriate
  • Male or Female patients, no age limitation
  • Willing and able to comply with study schedule and procedures
  • Deceased patients for whom the EC determines that patient data can be collected without a new consent from the patient

排除标准

  • Patients meeting any of the following criteria will be excluded from the study:
  • Unrelated co-morbid condition limiting life expectancy to less than 6 months
  • Patient or if applicable, parent or legal guardian is unable to comprehend, sign and date the EC approved informed consent form and patient assent as appropriate
  • If determined unsuitable for the study by the investigator

结局指标

主要结局

Bone avascular necrosis

时间窗: 2029

MRI will allow us to assess new avascular necrosis events (osteonecrosis).

Fragility Fracture

时间窗: 2029

Dual energy absorptive photiometry (DEXA) will allow us to measure the bone mineral density (BMD g/cm2) to enable stratification into treatment strands and predict and prevent future fragility fractures.

Bone Marrow Involvement

时间窗: 2029

MRI will allow us to assess the extent of Bone Marrow involvement and thus response to treatment by using the Bone Marrow Burden Score (BMB). The BMB is a semi quantitative MRI scoring system, using the sagittal T1 and T2 images of the lumbar spine and the coronal T1 and T2 of the femurs.

Cognitive Function

时间窗: 2029

Addenbrooke's Cognitive Examination - ACE-R and National Adult Reading Test are used in combinations to establish attention and orientation, memory, fluency, language and visuospatial orientation

Neurological Physical Assessment

时间窗: 2029

Modified Severity Scoring Tool (MSSt) is used to monitor neurological manifestations of NGD (Type III).

Multiple Myeloma

时间窗: 2029

Characterisation of new biomarkers in the peripheral blood mononuclear cells. (PBMCs), lipid analysis and Metabolomics screen.

Neurological outcome

时间窗: 2029

Presence of saccadic ocular deficits

Disease Severity

时间窗: 2029

Biochemical biomarkers (PARC/CCL18 ng/ml and Chitotriosidase umol/L/h) will be used to perform decease severity and follow-up response to treatment.

次要结局

  • Biobank(2020)
  • EyeSeeCam(2029)
  • Quality of life and disease severity measures(2029)
  • Parkinson severity(2029)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Timothy Cox MD

Professor of Medicine Emeritus, Director of Research, Honorary Consultant

Cambridge University Hospitals NHS Foundation Trust

研究点 (8)

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