alpha1-antitrypsin Deficiency Clinical Trial
Official title:
Multi-center Study of the Liver Disease in European Patients With alpha1-antitrypsin Deficiency
Alpha1-antitrypsin deficiency (AATD) is the third most common genetic disorder leading to
death worldwide. Apart from lung disease, AATD also leads to liver involvement in up to 50%
of patients. Hence, liver involvement is the second most common cause of morbidity and
mortality in AATD patients. But the natural history of disease in adults is not well
understood and specific therapies are still in the phase of preclinical studies. Despite
these facts and the therapeutic and preventative potential, the AATD-related liver disease
is still largely being neglected by both the patients and the healthcare professionals.
To improve the hepatologic care of patients with AATD, the investigators initiated a
prospective multi-center study in Europe that systematically evaluates the liver function in
these patients and their relatives. The investigators cooperate with both patient
organizations as well as with lung centers specialized on AATD-related lung disease.
Alpha1-antitrypsin deficiency (AAT deficiency) is a frequently overlooked metabolic
disorder. Apart from lung disease, AAT deficiency also leads to liver disease. This can
affect people of all ages and all ethnic groups. Although involvement of the liver is the
second most common cause of decreased quality of life and life expectancy in Alpha1
patients, no preventative care plan, like that one implemented to avoid lung involvement,
has yet been drawn up.
Chronic liver involvement therefore often remains undetected until a very late stage in
diagnosed cases of AAT deficiency. This is compounded by the fact that the patients affected
generally have only unspecific symptoms if any at all. Moreover, routine diagnostic
measurements (e.g. liver function tests) often reveal no abnormalities. In the case of a
late diagnosis, the diverse complications of liver disease can no longer be effectively
prevented.
Liver involvement in AAT deficiency can lead to liver cirrhosis or liver cancer. Liver
cirrhosis is the life-threatening consequence of many liver disorders and carries a poor
prognosis. Besides AAT deficiency, many other - potentially treatable - conditions, such as
viral hepatitis, excessive alcohol consumption and diabetes, can cause liver damage. Liver
cirrhosis itself leads to many, often life-threatening secondary disorders such as heavy
bleeding or liver cancer. It is therefore crucial that liver disorders such as AAT
deficiency are diagnosed at an early stage, so as to prevent complications and to treat
concomitant risk factors.
The investigators collaborate with various patient support groups and other hospitals
specialising in AAT deficiency-associated lung disease. Together with their collaborators,
the investigators hope to improve the care of affected patients and help to bring about
therapeutic advances.
The aim of this study is to clarify how liver function is modified in patients with AAT
deficiency. For this, among other things, the investigators use:
(i) modern ultrasound-based scanners for non-invasive measurement of the degree of liver
scarring.
(ii) Specialized liver parameters in blood samples, which also provide information on any
existing liver disorders (iii) Questionnaire.
Study participants receive a full, cost-free analysis of their individual liver involvement
and are given appropriate recommendations for disease prevention. The examinations provide a
relief to many and to everybody,the investigators are able to offer an individual liver
damage prevention plan.
All adult patients (of every genotype) as well as any family members interested will be
studied and advised. Besides the specialist clinic in Aachen (Germany), free examinations
throughout and even outside of Germany will be offered.
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