Chest CT Biomarkers as Prognostic Predictors in SSc-ILD

NCT ID: NCT06472362

Last Updated: 2025-09-11

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

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-11-01

Study Completion Date

2026-03-31

Brief Summary

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The goal of this retrospective observational study is to investigate whether novel imaging biomarkers of airways, vessels, and overall extent of fibrosis at baseline predict ILD progression, vasculopathy development, and survival in SSc-ILD.

Detailed Description

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Interstitial lung disease (ILD or lung fibrosis=stiffening of the lungs by scar tissue) develops in over half of patients with systemic sclerosis (SSc). Whilst ILD remains stable in some patients, at least a third have progressively increasing fibrosis. There is a pressing need for accurate indicators that identify a) patients at higher risk of progression, needing immediate treatment to prevent further irreversible ILD; and b) patients at lower risk, not needing treatment.

In this study the prognostic potential and accuracy of machine-learning derived biomarkers to evaluate abnormalities that are difficult to quantify visually will be investigated. Whether novel high resolution computed tomography (HRCT) imaging biomarkers of airways, vessels, and overall extent of fibrosis at baseline can predict ILD progression, vasculopathy development, and survival will be investigated in a cohort of approximately 1,000 SSc-ILD patients.

The algorithm scores will be evaluated against survival using Cox proportional hazards modelling, while mixed effects model analysis will be used to assess links with change in lung function: forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLco), and carbon monoxide transfer coefficient (Kco). The airway algorithm measuring traction bronchiectasis (dilatation of the airways due to surrounding fibrosis) may predict worsening of FVC, reflective of ILD progression. The vessel algorithm may predict decline in KCO, a marker of pulmonary vascular involvement. Exploratory analyses evaluating change in HRCT fibrosis extent over time for patients with repeat HRCTs will also be performed, and whether composite outcomes of change in HRCT and lung function variables improve long term outcome prediction and pave the way to their use in clinical trials and routine clinical use. Patients with trivial changes on CT will also be included to assess for very early changes that could be predictive of future decline. These algorithms will be combined with the findings of our previous study, which suggest that a certain type of pattern on CT called UIP predicts shorter survival.

Conditions

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Systemic Sclerosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Interventions

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HRCT biomarkers

HRCT imaging biomarkers of airways, vessels, and overall extent of fibrosis

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* diagnosed with SSc
* ≥18 years old
* HRCT between 01/01/1990 and 31/12/2019

Exclusion Criteria

* Patients who do not have SSc
* \<18 years old
* lack of availability of HRCT imaging data
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Imperial College London

OTHER

Sponsor Role collaborator

Royal Free and University College Medical School

OTHER

Sponsor Role collaborator

The Leeds Teaching Hospitals NHS Trust

OTHER

Sponsor Role collaborator

Hannover Medical School

OTHER

Sponsor Role collaborator

University of Siena

OTHER

Sponsor Role collaborator

Università Politecnica delle Marche

OTHER

Sponsor Role collaborator

Azienda Ospedaliero Universitaria di Sassari

OTHER

Sponsor Role collaborator

Bichat Hospital

OTHER

Sponsor Role collaborator

Royal Brompton & Harefield NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elisabetta A Renzoni

Role: PRINCIPAL_INVESTIGATOR

Royal Brompton and Harefield Hospitals

Locations

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Bichat-Claude Bernard hospital

Paris, , France

Site Status

Hanover Medical School

Hanover, , Germany

Site Status

Marche Polytechnic University

Ancona, , Italy

Site Status

Sassari University

Sassari, , Italy

Site Status

Siena University Hospital

Siena, , Italy

Site Status

Leeds Hospital/University of Leeds

Leeds, , United Kingdom

Site Status

Royal Brompton Hospital

London, , United Kingdom

Site Status

Countries

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France Germany Italy United Kingdom

Other Identifiers

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RBH2

Identifier Type: -

Identifier Source: org_study_id

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