Cystic Fibrosis Clinical Trial
Official title:
Longitudinal Assessment of Risk Factors For and Impact of Pseudomonas Aeruginosa Acquisition and Early Anti-Pseudomonal Treatment in Children With CF
The purpose of this study is to better define risk factors preceding first isolation of Pseudomonas aeruginosa (Pa) from respiratory cultures in cystic fibrosis (CF) lung disease and to better define clinical outcomes associated with acquisition of Pa. This study will also collect and bank DNA samples for current and future studies designed to enhance the understanding of the pathogenesis of CF.
The EPIC Observational Study is a longitudinal, prospective, observational study that was
originally conducted at 59 sites. The current five-year extension study is being conducted at
54 sites.
The EPIC Observational Study will serve as a freestanding epidemiologic study of the risk
factors for and clinical impact of initial Pa acquisition and anti-pseudomonal therapy.
Defining the risk factors for Pa acquisition can potentially allow for preventive measures
and identification of high-risk populations requiring closer monitoring. Despite rigorous
data collection, previous studies have been limited by small sample sizes and by conduct at
one or two centers. This study will include a much larger sample size from many more centers
than previous studies. It will thus provide for more generalizable results and more precise
risk estimates for previously identified risk factors for Pa acquisition, and it will allow
for exploration of novel risk factors not included in earlier studies. Better understanding
of the clinical outcomes associated with Pa acquisition and the outcomes associated with
different types of anti-pseudomonal therapies will inform the development of rational early
intervention treatment regimens. Better knowledge about temporal relationships between
respiratory signs and symptoms, Pa serology, and CF airway microbiology may lead to improved
strategies for early detection of Pa and could have important implications for the timing of
interventions aimed at preventing or treating early Pa acquisition. Finally, this study will
serve as an important source of Pa and S. aureus isolates, serum samples, and DNA samples
that will be used and banked for studies designed to enhance the understanding of the
pathogenesis of CF, e.g., microarray investigations of early Pa isolates, investigations to
identify proteomic biomarkers of airway inflammation, and investigations to identify genetic
factors related to CF disease progression, including early lung disease, and clinical
outcomes.
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