Viewing Study NCT03478917



Ignite Creation Date: 2024-05-06 @ 11:17 AM
Last Modification Date: 2024-10-26 @ 12:43 PM
Study NCT ID: NCT03478917
Status: COMPLETED
Last Update Posted: 2023-07-17
First Post: 2018-03-23

Brief Title: Early Diagnosis of Sickle Acute Chest Syndrome Using a Combination of Plasma Bimarkers and Chest Imaging
Sponsor: National Heart Lung and Blood Institute NHLBI
Organization: National Institutes of Health Clinical Center CC

Study Overview

Official Title: Studies to Facilitate the Early Diagnosis of Sickle Acute Chest Syndrome Using a Combination of Plasma Biomarkers and Chest Imaging
Status: COMPLETED
Status Verified Date: 2023-07-13
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: False
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: None
Brief Summary: Background

Painful vasoocclusive crisis VOC occurs in people with sickle cell disease SCD People with VOC have many visits to the hospital About 10 30 percent of these people will go on to develop acute chest syndrome ACS ACS can cause further ill health It can also cause death Researchers want to find ways to diagnose ACS more quickly To do this they want to use stored blood samples and scans from a study the DeNOVO trial that was closed in 2015 They want to see if scans and samples taken of people with VOC who later developed ACS could help diagnose ACS faster The data of people in the DeNOVO study who did not develop ACS will serve as controls

Objectives

To look at data from the DeNOVO trial to find a way to diagnose ACS more quickly

Eligibility

People 10 85 years old who took part in NHLBI Protocol number 05-H-0019 the DeNOVO trial The trial lasted from 2004 to 2008 The study was closed in November 2015

Design

Scans and intact frozen samples from a study that was closed in 2015 will be studied No new participants will be enrolled

Detailed Description: Painful vasoocclusive crisis VOC is the most frequent acute clinical manifestation of sickle cell disease SCD frequently necessitating emergency department visits andor hospitalization Approximately 10-30 of patients admitted to the hospital with a VOC will go on to develop acute chest syndrome ACS a complication of SCD resulting in significant morbidity and mortality While ACS related mortality appears to be improving in the United States the number of hospital admissions for ACS is on the rise Unfortunately the diagnosis of ACS is often delayed with up to 50 of cases diagnosed two to three days after an admission for VOC The clinical diagnosis of ACS is often delayed as it mimics other respiratory diseases Furthermore the lack of definitive laboratory and radiological biomarkers further confounds the ability to detect rapidly progressive ACS a phenotype accounting for considerable ACS-related mortality Currently a key criterion for the diagnosis of ACS is the presence of new airspace disease on a chest radiograph in a sickle cell patient with respiratory symptoms However the appearance of abnormalities on chest radiography CXR often lags behind clinical signs and diagnostic techniques such as computed tomography CT which tends to reveal radiologic changes much earlier than CXR Early diagnosis and treatment of ACS improves outcomes hence the scientific rationale to perform such studies and develop diagnostic algorithms to facilitate early detection of ACS

In the current study proposal we will utilize stored blood samples and review CT scans and CXRs from 65 participants of the DeNOVO trial NHLBI protocol 05-H-0019 This multicenter trial conducted between 2004-08 at 11 centers including the NIH showed that among patients with SCD hospitalized with VOC the use of inhaled nitric oxide compared with placebo did not improve time to crisis resolution In this study patients enrolled at the NIH study site had baseline admission research blood drawn and thoracic CT scans performed A repeat CT scan and repeat blood work was subsequently obtained during the development of ACS The archived data from this subset of the study cohort therefore provides an opportunity to rigorously test the hypothesis that CT scans performed early in the setting of VOC in patients going on to develop ACS would have utility in the rapid diagnosis of this condition Furthermore the availability of stored plasma samples from this cohort permits the study of both imaging and plasma biomarkers in a prospectively defined sample of SCD patients Specifically we will identify patients admitted with VOC that went on to develop ACS and study their CT scans and plasma to determine whether these biomarkers will rapidly diagnose ACS The patients in the same study who did not develop ACS will serve as controls

Study Oversight

Has Oversight DMC: None
Is a FDA Regulated Drug?: False
Is a FDA Regulated Device?: False
Is an Unapproved Device?: None
Is a PPSD?: None
Is a US Export?: None
Is an FDA AA801 Violation?: None
Secondary IDs
Secondary ID Type Domain Link
18-H-N065 None None None