Giant Cell Arteritis: Improving Use of Ultrasound Evaluation

NCT ID: NCT02523625

Last Updated: 2015-08-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

250 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-10-31

Study Completion Date

2018-06-30

Brief Summary

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Giant cell arteritis (GCA) is an inflammatory disease causing new, unaccustomed headache in the elderly and which can lead to blindness in 20-30% of untreated cases. The study group have previously shown that ultrasound is a viable non-invasive alternative to temporal artery biopsy in diagnosing GCA. However, there is significant variation in ultrasound assessment (measuring a dark "halo" around the abnormal blood vessels) between sonographers in different centres, requiring a labour intensive and time consuming training programme. The study group propose to standardise the training programme, and use ultrasound and clinical evaluation to define changes occurring over time and with treatment in patients with a diagnosis of GCA made based on ultrasound changes alone. The study group will explore the use of algorithms to automate or semi-automate image interpretation.

Detailed Description

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Objectives and Project Plan:

* Project Purpose:

The purpose of the project is to develop the technology to reliably acquire and analyse ultrasound images through the use of a training programme which are comparable to those from scanning by an expert sonographer in the diagnosis (i.e. as a diagnostic tool) and monitoring of patients with GCA following treatment (i.e. as a response indicator), and patient stratification according to initial or early scan changes to determine the most appropriate treatment (i.e. as a prognostic tool).

* End Point:

The end point will be the production of an effective training programme which can be used to obtain reproducible accurate ultrasound images of the temporal artery which can be automatically analysed and used in real time in the management of patients with suspected or confirmed giant cell arteritis.

* Milestones:

The project is in 3 phases. In phase 1 (0-12 months) the study group will create a bank of images for training from healthy volunteers and patients with GCA; in phase 2 (13-18 months) the study group will test the programme on sonographers assessing patients with GCA; in phase 3 (19-42 months) the study group will acquire serial images, clinical data, serum and plasma from cohorts of patients with newly diagnosed and flaring GCA so that they can analyse and develop new software algorithms. The study group can use images already acquired from a previous diagnostic study in GCA, and test the algorithms on the new cohorts..

Conditions

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Giant Cell Arteritis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Healthy volunteers

Age and gender matched to patient groups to undergo ultrasound of temporal and axillary arteries

Ultrasound of temporal and axillary arteries

Intervention Type DEVICE

Each patient will have a clinical assessment and ultrasound examination of both temporal and axillary arteries

Patients with headache

Patients with new headache not due to GCA to undergo ultrasound of temporal and axillary arteries

Ultrasound of temporal and axillary arteries

Intervention Type DEVICE

Each patient will have a clinical assessment and ultrasound examination of both temporal and axillary arteries

Patients with GCA (new)

Patients with new diagnosis of GCA to undergo ultrasound of temporal and axillary arteries

Ultrasound of temporal and axillary arteries

Intervention Type DEVICE

Each patient will have a clinical assessment and ultrasound examination of both temporal and axillary arteries

Patients with GCA (flare)

Patients with apparent flare of GCA to undergo ultrasound of temporal and axillary arteries

Ultrasound of temporal and axillary arteries

Intervention Type DEVICE

Each patient will have a clinical assessment and ultrasound examination of both temporal and axillary arteries

Interventions

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Ultrasound of temporal and axillary arteries

Each patient will have a clinical assessment and ultrasound examination of both temporal and axillary arteries

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Healthy volunteer or
* Patient with a suspected diagnosis of GCA but found not to have GCA
* Recent diagnosis of GCA within 1 month or
* Suspected flare of GCA within one month
* Ability to provide written informed consent

Exclusion Criteria

* Unable to provide written informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Lisbon

OTHER

Sponsor Role collaborator

University of Oxford

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Raashid A Luqmani, DM FRCP

Role: PRINCIPAL_INVESTIGATOR

University of Oxford

Central Contacts

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Raashid A Luqmani, DM FRCP

Role: CONTACT

01865227971

Jana Vaskova

Role: CONTACT

01865227971

References

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Ponte C, Rodrigues AF, O'Neill L, Luqmani RA. Giant cell arteritis: Current treatment and management. World J Clin Cases. 2015 Jun 16;3(6):484-94. doi: 10.12998/wjcc.v3.i6.484.

Reference Type RESULT
PMID: 26090367 (View on PubMed)

Diamantopoulos AP, Myklebust G. Long-term inflammation in the temporal artery of a giant cell arteritis patient as detected by ultrasound. Ther Adv Musculoskelet Dis. 2014 Jun;6(3):102-3. doi: 10.1177/1759720X14521109. No abstract available.

Reference Type RESULT
PMID: 24891881 (View on PubMed)

Schmidt WA. Ultrasound in vasculitis. Clin Exp Rheumatol. 2014 Jan-Feb;32(1 Suppl 80):S71-7. Epub 2014 Feb 17.

Reference Type RESULT
PMID: 24529335 (View on PubMed)

Diamantopoulos AP, Haugeberg G, Hetland H, Soldal DM, Bie R, Myklebust G. Diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: a consecutive case series. Arthritis Care Res (Hoboken). 2014 Jan;66(1):113-9. doi: 10.1002/acr.22178.

Reference Type RESULT
PMID: 24106211 (View on PubMed)

Muratore F, Boiardi L, Restuccia G, Macchioni P, Pazzola G, Nicolini A, Germano G, Possemato N, Cavazza A, Cavuto S, Cimino L, Pipitone N, Catanoso M, Addimanda O, Salvarani C. Comparison between colour duplex sonography findings and different histological patterns of temporal artery. Rheumatology (Oxford). 2013 Dec;52(12):2268-74. doi: 10.1093/rheumatology/ket258. Epub 2013 Sep 17.

Reference Type RESULT
PMID: 24046471 (View on PubMed)

Habib HM, Essa AA, Hassan AA. Color duplex ultrasonography of temporal arteries: role in diagnosis and follow-up of suspected cases of temporal arteritis. Clin Rheumatol. 2012 Feb;31(2):231-7. doi: 10.1007/s10067-011-1808-0. Epub 2011 Jul 9.

Reference Type RESULT
PMID: 21743987 (View on PubMed)

Other Identifiers

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9776

Identifier Type: -

Identifier Source: org_study_id

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