Monitoring of Early Disease Progression in Hereditary Transthyretin Amyloidosis

Active, not recruiting

• Conditions: Transthyretin Amyloidosis; Amyloid Cardiomyopathy; Amyloid; AL Amyloidosis; Amyloidosis; Amyloid Neuropathies, Familial; Amyloid - Primary

• Registration Number: NCT03431896
• Lead Sponsor: The Cleveland Clinic

Brief Summary

This study measures circulating, misfolded ATTR oligomers in asymptomatic ATTRm amyloidosis genetic carriers longitudinally over five years.

Detailed Description

Recent advances in genetic testing have allowed for pathogenic mutation identification in family members of affected individuals prior to onset of symptoms. While the presence of mutation and the corresponding TTR kinetic stability have been directly linked to disease development, the molecular drivers of tissue specific degeneration have not been defined. We hypothesize that soluble misfolded TTR oligomer species may be circulating within the blood of these patients possibly years prior to amyloid deposition and could serve as an early biomarker and/or driver for disease development. In this line, The Scripps Research Institute has developed a peptide-based probe that specifically labels and integrates into misfolded TTR oligomers allowing the relative circulating concentration in the bloodstream to be determined. Longitudinal monitoring of untreated, asymptomatic TTR amyloid genetic carriers utilizing the Scripps probe is likely to provide novel insight into early disease progression. We also plan to utilize the Scripps probe to monitor disease progression in TTR amyloid genetic carriers currently undergoing treatment by observing how treatments affect the circulating misfolded TTR oligomers. Through enhanced understanding of early disease progression and treatment efficacy, our hope is to limit amyloid accumulation in cardiac and nerve tissue and delay the development of the invariably fatal TTR amyloid cardiomyopathy/neuropathy.

Study Timeline

• Study Start: 2018-02-01
• Study First Submitted: 2018-02-07
• Study First Submitted QC: 2018-02-07
• Study First Posted: 2018-02-13
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-17
• Last Update Posted: 2025-04-18
• Primary Completion: 2026-09-30
• Study Completion: 2026-12-31

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Patients with known hereditary ATTR amyloidosis genetic mutations as identified by genetic testing.

Exclusion Criteria

• Patients with ATTR amyloidosis identified as wild-type.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Average % change in oligomers in patients with new onset TTR amyloid symptoms	Annually over 5 years	Change (%) for oligomer level at the time of TTR amyloid symptoms compared to baseline

Secondary Outcome Measures

Name	Time	Method
% change of oligomer levels relative to baseline level in patients with ATTR specific medication changes	Annually over 5 years	Change (%) for oligomer level at the time of ATTR specific medication changes compared to baseline

Trial Locations

Locations (1)

Cleveland Clinic; 🇺🇸 Cleveland, Ohio, United States