Gaucher Disease Clinical Trial
Official title:
A 1.5 Years Prospective Study Designed to Delineate the Cause of the Thrombocytopathy in Gaucher Disease Patients
In Gaucher disease type I bleeding is a common presenting symptom, that may manifest itself
as frequent nose bleeds, easy bruising but can also cause substantial bleeding after
surgical or dental procedures and may occur in association with pregnancy or delivery . The
bleeding tendency is usually considered to be secondary to thrombocytopenia However 50,000
platelets are enough in healthy people to give a normal bleeding time but are associated
with significant bleeding tendencies in Gaucher patients. Bleeding tendency might be
attributed by genetic inherited or Gaucher related coagulation factors abnormalities which
in some cases stabilize with ERT. However, In other cases the etiology is an abnormality of
platelet function. This thrombocytopathy has not been delineated and apart from a few
aggregation studies, no systematic analysis has been published that convincingly shows the
cause of the disturbed function. While, experience shows that enzyme replacement (ERT, i.e:
imiglucerase, Cerezyme®) reduces this bleeding tendency, in part due to the improvement in
the thrombocyte count and elevation in coagulation factors, it is less clear what effect ERT
has on the thrombocytopathy. This has clinical significance when patients need to be
prepared for surgery or delivery or in the event of a major bleed. There is no consensus as
to how patients should be prepared or treated. Different centres use different approaches.
When the procedure is elective ERT is appropriate but in other situations DDAVP, fresh
frozen plasma and platelet infusion are possible treatments. Even activated factor VII has
been used when bleeding was not controlled. As in any other coagulation abnormality,
treatment should be tailored to the specific cause of the bleeding diathesis. The aim of
this study is to define the etiology of platelet dysfunction in Gaucher patients.
Hypothesis: The investigators expect to see a difference between platelets activation
profile among imiglucerase treated and untreated patients with at least a partial
restoration of platelets function due to treatment commencement.
Status | Recruiting |
Enrollment | 70 |
Est. completion date | November 2018 |
Est. primary completion date | November 2018 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Gaucher disease patients - Patients who do not receive any medicine that affects platlats Exclusion Criteria: - Treatment with enzyme replacement therapy other than Imiglucerase |
Observational Model: Case Control, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
Israel | Rambam Medical Center | Haifa | |
Israel | Rabin Medical Center | Petach Tikva |
Lead Sponsor | Collaborator |
---|---|
Rabin Medical Center | Genzyme, a Sanofi Company |
Israel,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Measure thrombocytopathy in a cohort of 70 Gaucher patients using a set of platelet function tests. | • 70 Gaucher patients managed (treated and untreated controls) will be subjected to a panel of platelets function tests (aggregation test, closure time and FACS analysis). | 3 years | No |
Secondary | Evaluating the impact of Imiglucerase treatment on platelet function | Platelet function during the 3 years of study will be analyzed versus Imiglucerase treatment status and duration taking into consideration genotype, age at diagnosis, spleen status and Gaucher disease severity at treatment initiation | 3 years | No |
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