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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04026360
Other study ID # SCILD
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date July 1, 2011
Est. completion date December 31, 2050

Study information

Verified date November 2020
Source University Hospital Inselspital, Berne
Contact Philipp Latzin, MD PhD
Phone 0041 31 632 94 93
Email philipp.latzin@insel.ch
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

This study collects data on microbiological factors and lung function parameters (e.g. spirometry, body plethysmography, lung-MRI) to assess their interaction on the lung growth and lung development of infants and children with Cystic Fibrosis (CF).


Description:

Background: Cystic fibrosis (CF) is the most common lethal inherited disease in North European populations, affecting approximately 1:2500 live births. It is a multisystem disorder with respiratory morbidity and mortality being the leading cause of death. Lung disease in CF is characterized by neutrophil-dominated inflammation and chronic bacterial infection of the airways, which results in deterioration of lung function and premature death [1]. Despite improved survival in successive birth cohorts, the current median survival age of patients with CF is about 40 years [2]. Understanding the initiating events of CF lung disease (e.g viral infections and microbiome) and their influence on disease progression throughout early childhood is essential to improve survival through targeted early interventions. Objectives: The overarching aim of this study is to identify early life predictors of disease progression in children with CF. Therefore, this study implies three objectives, as follows: i) to investigate the effect of respiratory viral infections on microbiota dynamics in the first year of life in infants with CF, and to examine their influence on lung function at 1 year of age; ii) to examine whether deficits in lung function in the first year of life in infants with CF persist to pre- and school age and adolescence and are associated with impaired functional and structural abnormalities at 3, 6, 9, 12, 15 and 18 years of age; and iii) to determine the principal drivers of impaired lung function at 1 year and impaired lung function and structural outcomes at 3, 6, 9, 12, 15 and 18 years of age in individuals with CF. Methods: Lung function, magnetic resonance imaging (MRI), respiratory symptoms and quality of life questionnaires, microbiology, medical history and clinical data will be collected during each phase of the study. Recruitment and participation: Infants with CF diagnosed by NBS will be recruited at the time of their first lung function test in Bern at the age of 4-8 weeks. As part of the protocol for the diagnosis and follow-up of CF infants diagnosed by NBS, which has been implemented by the Task Force for CF NBS on behalf of the Swiss Working Group for Cystic Fibrosis, optional infant lung function at the University Children's Hospital of Bern is proposed to all parents of newly diagnosed CF infants. Information collected: Lung function data: - Tidal breathing parameters (minute ventilation, respiratory rate, tidal volume, tidal expiratory flow, tidal inspiratory flow, time to peak expiratory flow) averaged over 100 breaths - Multiple breath washout (FRC, LCI, moment ratios) and single breath washout (molar mass) - Spirometric forced expiratory volume loops (FVC, FEV1, PEF, MEF50) - Body plethysmography (airway resistance, lung volumes: TLC, FRC, RV) - Respiratory Rate over 60 seconds - Fractional exhaled nitric oxide (marker of airway inflammation) - Resistance interrupter measurement - Electric nose - Forced oscillation technique - Electrical impedance tomography - Impedance plethysmography Microbiological data: - Nasal swabs (respiratory virus and bacterial diagnostics, as well as host transcriptome analysis) - Pharyngeal swabs (bacterial colonization and microbiota analysis) - Sputum (to analyse the neutrophils) Blood count (hemoglobin concentration, hematocrit, leukocyte number, lymphocyte number, lymphocyte count, eosinophil count, basophil count, monocyte count, promyelocyte count, myelocyte count, platelet count, immunoglobulin E level, interleukins, Granulocyte-Monocyte-Colony Forming Unit, Tumor Necrosis Factor alpha, Interferon gamma and Interferon lambda) Urine (to estimate the tobacco exposure during pregnancy (amount of Cotinine) and the content of caffeine and steroid profile) Lung MRI: Functional and structural images of the lung Skin-Prick Test (test for pollen, trees, house dust mite, cat and dog) Questionnaires (to assess quality of life) Medical history (information on respiratory symptoms, pulmonary exacerbations, hospitalisations and regular therapy) Study database: All study data is recorded in an Access-database with SQL Servers by electronic Case Report Forms. The database is accordant to the HFG and was adapted together with the CTU. Funding: Schweizerischer Nationalfonds (SNF), Schweizerische Gesellschaft für Cystische Fibrose (CFCH), Departement Lehre und Forschung des Inselspitals Bern


Recruitment information / eligibility

Status Recruiting
Enrollment 500
Est. completion date December 31, 2050
Est. primary completion date August 31, 2050
Accepts healthy volunteers No
Gender All
Age group N/A to 18 Years
Eligibility Inclusion Criteria: - Infants with a confirmed diagnosis of CF by NBS - Age <=18 years - Written informed consent by patient and/or parent Exclusion Criteria: - Need for respiratory support for more than three days - Severe malformations or known diseases other than CF - Maternal drug abuse - Known severe maternal disease - Severe Problems of communication - Pacemaker, continuous glucose monitor

Study Design


Related Conditions & MeSH terms


Intervention

Other:
no intervention


Locations

Country Name City State
Switzerland University Children's Hospital Bern Bern

Sponsors (5)

Lead Sponsor Collaborator
University Hospital Inselspital, Berne Centre Hospitalier Universitaire Vaudois, Kantonsspital Aarau, University Children's Hospital Basel, University Children's Hospital, Zurich

Country where clinical trial is conducted

Switzerland, 

Outcome

Type Measure Description Time frame Safety issue
Primary Multiple Breath Washout Longitudinal assessment of lung volume and ventilation inhomogeneity Every third year from the age of 4-8 weeks/1 year till 18 years.
Primary Spirometry Longitudinal assessment of long volumes. Every third year from the age of 4-8 weeks/1 year till 18 years.
Primary Body plethysmography Longitudinal assessment of ventilation inhomogeneity. Every third year from the age of 4-8 weeks/1 year till 18 years.
Primary Magnetic Resonance Imaging (MRI) Longitudinal assessment of regional lung perfusion and ventilation At the age of 4-8 weeks, 1, 3, 6, 9, 12, 15 and 18 years
Primary Nasal swabs Longitudinal assessment of viral and bacterial colonization of the nasal swab At the age of 4-8 weeks, 1, 3, 6, 9, 12, 15 and 18 years
Primary Weekly swabs Respiratory virus and bacterial diagnostic Weekly from the visit at the age of 4-8 weeks till the age of 1 year
Primary Swabs during respiratory infection Respiratory viruses and Bacteria, changes of the microbial flora From the visit at the age of 4-8 weeks till the age of 1 year
Primary Routine swabs in CF Longitudinal assessment of bacterial changes, changes of the resistome (genes conferring antibiotic resistance) and the changes of the microbial flora At the age of 4-8 weeks, 1 year and at each 3-monthly clinic visit during the age of 3, 6, 9, 12, 15 and 18 years
Secondary Respiratory Rate (RR) The number of breaths over 60 seconds From the visit at the age of 4-8 weeks till the age of 1 year
Secondary Sweat test Sweat Chloride concentration At the age of 3, 6, 9, 12, 15 and 18 years