PRospective Evaluation of Interstitial Lung DIsease Progression With Quantitative CT

NCT ID: NCT05609201

Last Updated: 2024-05-14

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

ENROLLING_BY_INVITATION

Total Enrollment

54 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-06-01

Study Completion Date

2024-10-31

Brief Summary

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The interstitial lung diseases (ILD) are a heterogenous group of conditions with varying degrees of inflammation and scarring (fibrosis) of the lungs. ILD progression is unpredictable, making prognostication challenging. A proportion of patients will develop inexorably progressive disease termed progressive fibrosing ILD (PF-ILD).

Forced vital capacity (FVC), a lung function variable, is routinely used to monitor disease progression. However FVC can be a poor disease marker as it can be influenced by patient effort and can be difficult to perform. High resolution computed tomography (HRCT) is a necessary investigation for suspected fibrotic-ILD, making it a promising tool for research.

A quantitative-CT (qCT) approach uses computer software to analyse HRCT scans and has advantage over visual radiologist assessments which are limited by inter/intra-observer variance. The investigators will undertake a feasibility study to determine whether baseline and longitudinal qCT can predict and quantify disease progression in fibrotic-ILD.

The endothelial glycocalyx (EG) is a mesh-like layer that lines the small blood vessels. Injury to this layer has been implicated in non-thoracic fibrotic diseases. Telomeres are repetitive genetic sequences which cap chromosomes preventing their damage during cell replication. Prematurely shortened leucocyte telomere lengths (LTL) have been demonstrated in a wide range of ILDs. We will evaluate role of measuring EG health and LTL in disease prognostication.

Adult participants with fibrotic-ILD from 3 centres in England will be recruited alongside healthy controls. Case (disease) participants will undergo investigations at 0, 6 and 12 months from recruitment including:

* HRCT with quantitative analysis (qCT)
* Lung function testing
* EG and LTL measurement
* Health related quality of life assessments

The primary outcome will assess the correlation of disease progression status measured by standard of care (FVC) with baseline qCT and EG assessment. Healthy controls will only undergo EG assessment at all time points. Feasibility outcomes will be assessed including recruitment, consent and attrition rates.

The results will inform a subsequent multi-centre study to assess the clinical benefit of disease monitoring with the measures assessed in this study.

Detailed Description

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Conditions

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Interstitial Lung Disease

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Cases

36 participants with a multidisciplinary team diagnosis of IPF or non-IPF fibrotic-ILD

HRCT Thorax

Intervention Type DIAGNOSTIC_TEST

HRCT Thorax at 0, 6 and 12 months

Glycocheck Endothelial Glycocalyx Assessment

Intervention Type DEVICE

Measure of EG degradation using GlycoCheck Microvascular Health Score at 0, 6 and 12 months

Blood biomarkers

Intervention Type DIAGNOSTIC_TEST

Endothelial glycocalyx degradation blood biomarkers and angiogenesis markers at 0, 6 and 12 months

Peripheral leucocyte telomere length

Intervention Type DIAGNOSTIC_TEST

HT-STELA (High-throughput single telomere length assessment) at 0, 6 and 12 months

Pulmonary function testing

Intervention Type DIAGNOSTIC_TEST

Pulmonary Function Tests (Spirometry and Gas Transfer) and 6-minute walk distance at 0, 6 and 12 months

Patient reported outcome measures

Intervention Type DIAGNOSTIC_TEST

Electronic collection of patient reported outcome measures

Healthy Control

5 Age, sex and ethnicity matched controls

Glycocheck Endothelial Glycocalyx Assessment

Intervention Type DEVICE

Measure of EG degradation using GlycoCheck Microvascular Health Score at 0, 6 and 12 months

Blood biomarkers

Intervention Type DIAGNOSTIC_TEST

Endothelial glycocalyx degradation blood biomarkers and angiogenesis markers at 0, 6 and 12 months

Peripheral leucocyte telomere length

Intervention Type DIAGNOSTIC_TEST

HT-STELA (High-throughput single telomere length assessment) at 0, 6 and 12 months

Interventions

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HRCT Thorax

HRCT Thorax at 0, 6 and 12 months

Intervention Type DIAGNOSTIC_TEST

Glycocheck Endothelial Glycocalyx Assessment

Measure of EG degradation using GlycoCheck Microvascular Health Score at 0, 6 and 12 months

Intervention Type DEVICE

Blood biomarkers

Endothelial glycocalyx degradation blood biomarkers and angiogenesis markers at 0, 6 and 12 months

Intervention Type DIAGNOSTIC_TEST

Peripheral leucocyte telomere length

HT-STELA (High-throughput single telomere length assessment) at 0, 6 and 12 months

Intervention Type DIAGNOSTIC_TEST

Pulmonary function testing

Pulmonary Function Tests (Spirometry and Gas Transfer) and 6-minute walk distance at 0, 6 and 12 months

Intervention Type DIAGNOSTIC_TEST

Patient reported outcome measures

Electronic collection of patient reported outcome measures

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Multidisciplinary team diagnosis of IPF or non-IPF fibrotic-ILD
* Treatment naivety to anti-fibrotic therapy at entry to study
* Adult ≥18 years \<85
* Informed consent

Exclusion Criteria

* Forced expiratory volume in 1s/FVC \<0.7,
* Significant other respiratory pathology including emphysema \>15% on CT (radiologist determined)
* Evidence of ILD exacerbation at the time of CT
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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North Bristol NHS Trust

OTHER

Sponsor Role collaborator

Royal United Hospitals Bath NHS Foundation Trust

OTHER

Sponsor Role collaborator

Royal Devon and Exeter NHS Foundation Trust

OTHER

Sponsor Role collaborator

University of Exeter

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Giles Dixon

Role: PRINCIPAL_INVESTIGATOR

University of Exeter

Locations

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University of Exeter Medical School

Exeter, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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2021-22-54

Identifier Type: -

Identifier Source: org_study_id

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