PredIcting SterOid DepeNdEnt LivEr InjuRy with Polyreactive Immunoglobulin G

NCT ID: NCT05810480

Last Updated: 2024-10-16

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

RECRUITING

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-06-06

Study Completion Date

2027-01-31

Brief Summary

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The investigators identified polyreactive immunoglobulin G (pIgG) in adults (published in Hepatology: https://doi.org/10.1002/hep.32134) and children (in preparation). Quantification of these pIgG using a "home-made" ELISA facilitates the diagnosis of autoimmune hepatitis (AIH) as compared to non-AIH liver diseases and healthy controls. Positivity for pIgG was independent from ANA/SMA positivity and equally diagnostic for AIH even when conventional autoantibodies (ANA/SMA/SLA/LKM) were negative.

Additionally, the frequency of pIgG was lower than conventional autoantibodies (ANA, SMA) in vaccinia/drug associated severe liver injury in a retrospective multicenter study after Covid-19 vaccination (https://doi.org/10.1016/j.jhepr.2022.100605).

Aims of the study The study aims to evaluate the diagnostic capacity of pIgG to predict AIH in comparison to other liver diseases prospectively. To avoid diagnostic inaccuracy between AIH with long-term need for an immunosuppression and drug induced liver injury with autoimmune features, which can be indistinguishable from AIH at baseline and which has a very low relapse rate after a short steroid course, a follow-up after six months is obligatory for inclusion.

Therefore, the investigators will collect one serum sample from every patient (without immunosuppressive treatment) that presents to the respective hospital for evaluation of liver disease by liver biopsy within one year after initiation of the study and that provided written informed consent. Follow-up for evaluation of steroid dependency at six months after diagnosis is obligatory.

Detailed Description

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Conditions

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Autoimmune Hepatitis Autoimmune Liver Disease

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Autoimmune Hepatitis

This group includes patients with a diagnosis of Autoimmune Hepatitis according to the simplified diagnostic criteria by Hennes et al. made by the local treating physician. The diagnosis of autoimmune hepatitis additionally requires steroid dependency \> six months for this study to discriminate Autoimmune Hepatitis from autoimmune like drug-induced liver injury (DILI) which are hard to discriminate at diagnosis and with the latter often being treating with a short course of corticosteroids less than six months. One serum sample will be stored for anonymized evaluation of serum autoantibodies

polyreactive immunoglobulin G

Intervention Type DIAGNOSTIC_TEST

Polyreactive immunoglobulin G will be tested centralized in Hannover as published (Taubert, Engel et al., Hepatology, 2022). The current standard diagnostic autoantibodies (e.g. ANA, anti-SMA, anti-LKM, anti-LC1, anti-SLA/L) will be tested centrally in Hannover according to current guidelines.

non-autoimmune hepatitis liver disease

This group includes patients with a diagnosis of any non-viral liver disease that is not autoimmune hepatitis and whose diagnosis necessitated a diagnostic liver biopsy in the work-up of the liver disease for local care. One serum sample will be stored for anonymized evaluation of serum autoantibodies

polyreactive immunoglobulin G

Intervention Type DIAGNOSTIC_TEST

Polyreactive immunoglobulin G will be tested centralized in Hannover as published (Taubert, Engel et al., Hepatology, 2022). The current standard diagnostic autoantibodies (e.g. ANA, anti-SMA, anti-LKM, anti-LC1, anti-SLA/L) will be tested centrally in Hannover according to current guidelines.

Interventions

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polyreactive immunoglobulin G

Polyreactive immunoglobulin G will be tested centralized in Hannover as published (Taubert, Engel et al., Hepatology, 2022). The current standard diagnostic autoantibodies (e.g. ANA, anti-SMA, anti-LKM, anti-LC1, anti-SLA/L) will be tested centrally in Hannover according to current guidelines.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Conventional diagnostic autoantibodies

Eligibility Criteria

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Inclusion Criteria

* Diagnostic liver biopsy for the work-up of any liver disease
* Informed consent
* Definition of any liver disease according to current societal guidelines

Exclusion Criteria

* No ongoing immunosuppression at the liver biopsy or prior to the liver biopsy
* Liver biopsies for the grading or staging of an already known liver disease (e.g. non-alcoholic fatty liver disease (NAFLD), Hepatitis B/D Virus Infections (HBV/HDV Infection), …)
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hannover Medical School

OTHER

Sponsor Role lead

Responsible Party

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Engel, Bastian Dr.

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bastian Engel, Dr.

Role: PRINCIPAL_INVESTIGATOR

Hannover Medical School

Richard Taubert, Dr.

Role: PRINCIPAL_INVESTIGATOR

Hannover Medical School

Locations

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University Medical Centre Aachen

Aachen, , Germany

Site Status RECRUITING

University Hospital Bonn

Bonn, , Germany

Site Status RECRUITING

University Medical Center Hamburg-Eppendorf

Hamburg, , Germany

Site Status RECRUITING

Hannover Medical School

Hanover, , Germany

Site Status RECRUITING

University Medical Center Heidelberg

Heidelberg, , Germany

Site Status RECRUITING

University Hospital Schleswig-Holstein, Location Lübeck

Lübeck, , Germany

Site Status RECRUITING

University Hospital Magdeburg

Magdeburg, , Germany

Site Status RECRUITING

Rostock University Medical Centre

Rostock, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Bastian Engel, Dr.

Role: CONTACT

+49 511 532 6766

Richard Taubert, Dr.

Role: CONTACT

+49 511 532 6766

Facility Contacts

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Tony Bruns, MD, Prof.

Role: primary

Karsten Grosse, MD

Role: backup

Leona Dold, MD

Role: primary

Marcial Sebode, MD

Role: primary

Bastian Engel, MD

Role: primary

+495115326766

Richard Taubert, MD

Role: backup

+495115326766

Norman Junge, MD

Role: backup

Uta Merle, MD, Prof.

Role: primary

Jessica Seessle, MD

Role: backup

Henrike Dobbermann, MD

Role: primary

Verena Keitel-Anselmino, MD, Prof.

Role: primary

Theresia Blattmann, MD

Role: primary

References

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Taubert R, Engel B, Diestelhorst J, Hupa-Breier KL, Behrendt P, Baerlecken NT, Suhs KW, Janik MK, Zachou K, Sebode M, Schramm C, Londono MC, Habes S; UK-AIH Consortium; Oo YH, Lalanne C, Pape S, Schubert M, Hust M, Dubel S, Thevis M, Jonigk D, Beimdiek J, Buettner FFR, Drenth JPH, Muratori L, Adams DH, Dyson JK, Renand A, Graupera I, Lohse AW, Dalekos GN, Milkiewicz P, Stangel M, Maasoumy B, Witte T, Wedemeyer H, Manns MP, Jaeckel E. Quantification of polyreactive immunoglobulin G facilitates the diagnosis of autoimmune hepatitis. Hepatology. 2022 Jan;75(1):13-27. doi: 10.1002/hep.32134. Epub 2021 Dec 5.

Reference Type BACKGROUND
PMID: 34473365 (View on PubMed)

Other Identifiers

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PIONEER

Identifier Type: -

Identifier Source: org_study_id

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