Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT00001373
Other study ID # 940105
Secondary ID 94-HG-0105
Status Recruiting
Phase
First received
Last updated
Start date March 10, 1994

Study information

Verified date June 5, 2024
Source National Institutes of Health Clinical Center (CC)
Contact Amanda K Ombrello, M.D.
Phone (301) 827-4258
Email ombrelloak@mail.nih.gov
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

This study is designed to explore the genetics and pathophysiology of diseases presenting with intermittent fever, including familial Mediterranean fever, TRAPS, hyper-IgD syndrome, and related diseases. The following individuals may be eligible for this natural history study: 1) patients with known or suspected familial Mediterranean fever, TRAPS, hyper-IgD syndrome or related disorders; 2) relatives of these patients; 3) healthy, normal volunteers 7 years of age or older. Patients will undergo a medical and family history, physical examination, blood and urine tests. Additional tests and procedures may include the following: 1. X-rays 2. Consultations with specialists 3. DNA sample collection (blood or saliva sample) for genetic studies. These might include studies of specific genes, or more complete sequencing of the genome. 4. Additional blood samples a maximum of 1 pint (450 ml) during a 6-week period for studies of white cell adhesion (stickiness) 5. Leukapheresis for collecting larger amounts of white cells for study. For this procedure, whole blood is collected through a needle in an arm vein. The blood flows through a machine that separates it into its components. The white cells are removed and the rest of the blood is returned to the body through another needle in the other arm. Patients may be followed approximately every 6 months to monitor symptoms, adjust medicine dosages, and undergo routine blood and urine tests. They will receive genetic counseling by the study team on the risk of having affected children and be advised of treatment options. Participating relatives will undergo a medical and family history, possibly with a review of medical records, physical examination, blood and urine tests. Additional procedures may include a 24-hour urine collection, X-rays, and consultations with medical specialists. A DNA sample (blood or saliva) will also be collected for genetic studies. Additional blood samples of no more than 550 mL during an 8-week period may be requested for studies of white cell adhesion (stickiness). Relatives who have familial Mediterranean fever, TRAPS, or hyper-IgD syndrome will receive the same follow-up and counseling as described for patients above. Normal volunteers and patients with gout will have a brief health interview and check of vital signs (blood pressure and pulse) and will provide a blood sample (up to 90 ml, or 6 tablespoons). Additional blood samples of no more than 1 pint over a 6-week period may be requested in the future.


Description:

This is an exploratory natural history protocol that enrolls patients with known or as yet undiagnosed disorders of inflammation. Blood, saliva, or buccal samples will be collected for genetic analysis, blood samples will be obtained for immunologic and other functional studies, a small number of subjects may undergo skin biopsy, leukapheresis, or bone marrow aspiration and biopsy, and some subjects will be provided standard medical care follow up, with retrospective analysis of the clinical data gathered during follow up. The primary objective is to discover the genetic basis of human disorders of inflammation. The secondary objective is to enumerate immunologic features and genotype-phenotype associations in specific autoinflammatory diseases. The tertiary objective is to describe the clinical features of poorly characterized or newly defined disorders of inflammation. This protocol provided clinical support for the identification of the gene mutated in familial Mediterranean fever (FMF), the discovery of the TNF receptor-associated periodic syndrome (TRAPS), the identification of NLRP3 mutations in the neonatal-onset multisystem inflammatory disease (NOMID), the discovery of the deficiency of the IL-1 receptor antagonist (DIRA), and the proposal of the now widely accepted concept of autoinflammatory disease. During the last decade the protocol has provided the clinical foundation for the discovery of ten more monogenic autoinflammatory diseases, seven of which were previously unrecognized as distinct diseases. The protocol has also permitted numerous studies delineating the mechanisms of autoinflammation and its connections with the human innate immune system. The work catalyzed by this protocol has provided the conceptual basis for a number of targeted therapies. During the next decade the objective will be to utilize cutting edge genomic technologies to further advance discovery.


Recruitment information / eligibility

Status Recruiting
Enrollment 5000
Est. completion date
Est. primary completion date
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 2 Months to 115 Years
Eligibility - INCLUSION CRITERIA: There are three populations that will be included in this study: subjects with known or suspected autoinflammatory diseases, family members of subjects with known or suspected autoinflammatory diseases, and healthy controls. In order to be eligible to participate in this study as a subject with known or suspected autoinflammatory disease, an individual must meet all of the following criteria: 1. Stated willingness to participate in study procedures (which at the very least includes providing a mail-in sample for genetic analysis); 2. Regardless of gender, at least one month of age; 3. A medical history that, in the expert opinion of the study team, is consistent with the possibility of autoinflammatory disease; and 4. Ability of the subject, parents (in the case of children), or Legally Authorized Representative to understand and the willingness to sign a written informed consent document. In order to be eligible to participate in this study as a family member of a subject with known or suspected autoinflammatory disease, an individual must meet all of the following criteria: 1. Stated willingness to participate in study procedures (which at the very least includes providing a mail-in sample for genetic analysis); 2. Regardless of gender, at least one month of age; 3. Relationship, either by blood or marriage, to an individual enrolled or about to be enrolled in the study with known or suspected autoinflammatory disease; 4. Likelihood, in the expert opinion of the study team, that analysis of a sample from the individual would advance genetic or functional analysis of the affected relative s possible autoinflammatory condition; and 5. Ability of the subject, parents (in the case of children), or Legally Authorized Representative to understand and the willingness to sign a written informed consent document. In order to be eligible to participate in this study as a healthy volunteer, an individual must meet all of the following criteria: 1. Stated willingness to participate in study procedures for healthy volunteers; 2. Regardless of gender, at least one year old, and not pregnant (by history of a missed menstrual period); 3. Likelihood, in the expert opinion of the study team, that a sample from the individual would advance the functional analysis of an autoinflammatory condition under study; and 4. Ability of the subject or parents (in the case of children) to understand and the willingness to sign a written informed consent document. EXCLUSION CRITERIA: For any of the three categories of subjects, an individual will be excluded from participation in this study if he or she has a medical condition that would, in the opinion of the investigators, confuse the interpretation of the study.

Study Design


Related Conditions & MeSH terms


Locations

Country Name City State
United States Johns Hopkins University Baltimore Maryland
United States National Institutes of Health Clinical Center Bethesda Maryland
United States Walter Reed National Medical Center Bethesda Maryland
United States University of Pittsburgh Pittsburgh Pennsylvania
United States Childrens National Medical Center Washington District of Columbia

Sponsors (4)

Lead Sponsor Collaborator
National Human Genome Research Institute (NHGRI) Duke University, Merck Sharp & Dohme LLC, University of Massachusetts, Worcester

Country where clinical trial is conducted

United States, 

References & Publications (3)

Aksentijevich I, Kastner DL. Genetics of monogenic autoinflammatory diseases: past successes, future challenges. Nat Rev Rheumatol. 2011 Jul 5;7(8):469-78. doi: 10.1038/nrrheum.2011.94. — View Citation

Bulua AC, Mogul DB, Aksentijevich I, Singh H, He DY, Muenz LR, Ward MM, Yarboro CH, Kastner DL, Siegel RM, Hull KM. Efficacy of etanercept in the tumor necrosis factor receptor-associated periodic syndrome: a prospective, open-label, dose-escalation study. Arthritis Rheum. 2012 Mar;64(3):908-13. doi: 10.1002/art.33416. — View Citation

Hashkes PJ, Spalding SJ, Giannini EH, Huang B, Johnson A, Park G, Barron KS, Weisman MH, Pashinian N, Reiff AO, Samuels J, Wright DA, Kastner DL, Lovell DJ. Rilonacept for colchicine-resistant or -intolerant familial Mediterranean fever: a randomized trial. Ann Intern Med. 2012 Oct 16;157(8):533-41. doi: 10.7326/0003-4819-157-8-201210160-00003. Erratum In: Ann Intern Med. 2014 Feb 18;160(4):291-2. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Genetic linkage in autoinflammatory dise discovery of genetic associations to autoinflammatory disorders annually
See also
  Status Clinical Trial Phase
Completed NCT02948283 - Metformin Hydrochloride and Ritonavir in Treating Patients With Relapsed or Refractory Multiple Myeloma or Chronic Lymphocytic Leukemia Phase 1
Completed NCT03706599 - Fever Infants and Therapeutic Education in Emergency Department N/A
Not yet recruiting NCT05649891 - Checklists Resuscitation Emergency Department N/A
Not yet recruiting NCT01782183 - Thermographic Characteristics of Sore Throat by Thermographic Camera N/A
Withdrawn NCT00800696 - Preventive Oral Care N/A
Completed NCT02689193 - IDIS Project Work Package 2: Establishing a Biobank at ITM and Collaborating Centres
Completed NCT02212990 - The Effect of Prophylactic Antipyretics on Immune Responses and Fever After 2014-2015 and 2015-2016 Inactivated Influenza Vaccine N/A
Completed NCT01869699 - Effects of Intravenous Acetaminophen on Body Temperature and Hemodynamic Responses in Febrile Critically Ill Adults Phase 4
Completed NCT01911143 - A Retrospective, Blinded Validation of a Host-response Based Diagnostics N/A
Completed NCT01194557 - Introducing Rapid Diagnostic Tests Into the Private Health Sector N/A
Completed NCT01559675 - Trial Comparing Low Dose and High Dose Steroids in Patients Undergoing Colorectal Surgery N/A
Completed NCT00969176 - Pharmacokinetics, -Dynamics and Safety of Intravenous Paracetamol in Neonates Phase 2/Phase 3
Completed NCT00940654 - The Fever and Antipyretic in Critically Illness Evaluation Study N/A
Recruiting NCT00729976 - Oral Versus Rectal Ibuprofen for Fever in Young Children - a Randomized Control Study. Phase 4
Recruiting NCT00389272 - Adding a Second Drug for Febrile Children Treated With Acetaminophen N/A
Completed NCT00257790 - The Tobramycin Study Phase 4
Recruiting NCT05033613 - Home Blood Pressure Monitoring Before and After COVID-19 Vaccination in Patients at High Risk of Cardiovascular Disease
Completed NCT02595827 - Non-inferiority Trial of Conditional vs Universal Follow up for Children With Fever in Democratic Republic of Congo Phase 3
Recruiting NCT06061575 - Comparison of the Efficacy of Paracetamol and Ibuprofen in the Management of Fever in Sepsis Patients Phase 4
Recruiting NCT06038617 - Safety of Simultaneous mRNA COVID-19 Vaccine With Other Childhood Vaccines in Young Children Phase 4