Evaluation of Primex's PGX Assay to Assess the Clinical Utility of Pharmacogenomics

January 7, 2015 updated by: Primex Clinical Laboratories, Inc.

Protocol For The Evaluation of Primex's PGX Assay

Primex's PGX assay is an in vitro, semi automated assay, intended for the determination of certain genes involved in drug metabolism utilizing buccal swabs. Detection of certain genotypes is used as an aid in the selection of appropriate medications based on the individuals' specific genotype and should be used in conjunction with other clinical information. The results from this tests constitutes one parameter in a multicriterion medication selection process, encompassing both clinical and laboratory-based assessments.

Study Overview

Detailed Description

The way a person responds to a drug (this includes both positive and negative reactions) is a complex trait that is influenced by many different genes. Without knowing all of the genes involved in drug response, scientists have found it difficult to develop genetic tests that could predict a person's response to a particular drug. Once scientists discovered that people's genes show small variations (or changes) in their nucleotide (DNA base) content, all of that changed-genetic testing for predicting drug response is now possible. Pharmacogenomics is a science that examines the inherited variations in genes that dictate drug response and explores the ways these variations can be used to predict whether a patient will have a good response to a drug, a bad response to a drug, or no response at all.

The Gene super family of Cytochrome P450 is primarily responsible for clearance of the different drugs and variations in different genes affect the metabolism of different classes of drugs. In our test we have concentrated on the genes and specific variations of those genes which have been studied best and already have existing and convincing data by peer reviewed journals.

Since one of the major classes of drugs that are affected by the Cytochrome P450 pathway are anti-coagulants, we have also added certain genes that are involved in coagulation variations of which might have additive affects on the coagulation status of the patient. Having this information can aid the physician in making better decisions when prescribing or dosing anti-coagulants.

Description of the Primex PGX Assay:

DNA is isolated from subject buccal swabs and is subjected to PCR and Real Time PCR for determination of the genetic variations detailed above. After the variations are determined, known effects of the variations (i.e. reduced activity or hyperactivity) are reported to a pharmacist and these effects in combination with the subjects medication list are used to further establish clinical significance or utility. The physician then can make a decision to change the medication as recommended. If the physician makes any changes to the subject's medication regimen, then in 3 months he/she will assess the changes and reports the findings; hence establishment of the clinical utility of our test.

Analytical Performance Objectives:

Assess the reproducibility of Primex's PGX assay with samples run in replicates of 3, twice a day, for a minimum 5 days.

Clinical Performance Evaluation Objectives:

Assess the clinical performance characteristics of Primex's PGX assay for the genotypes determined in the different genes of the CYP450 gene super family and genes related to coagulation by Life Technology's QuantSudio 12kFlex open array real time PCR system. There are no predicate devices therefore the clinical utility will be assessed by predicted phenotype and the number of effective changes made by the physicians to the subject's drug regimen.

Acceptance criteria for comparison of the Primex's PGX assay results to clinical changes made to the subject's drug regimen:

The clinical sensitivity and specificity of the Primex's PGX assay results to clinical changes made are a minimum of 65% and 90%, respectively. Results of the prior drug regimen changes before Primex's PGX testing will be provided and may be used for comparative analysis.

Investigator Feedback:

At the conclusion of the clinical study, the investigator will assess the clinical performance characteristics evaluated and acceptability of the Primex's PGX assay in a written report/letter to the sponsor.

Study Type

Observational

Enrollment (Anticipated)

100000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • California
      • Van Nuys, California, United States, 91406
        • Recruiting
        • Research and Development Institute
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

A minimum of 10,000 buccal swab samples will be identified for inclusion in the study as follows:

  • A minimum of 8700 specimens from subjects who are on multiple medications of which at least 2 are affected by the pathways tested and the physician made changed to their drug regimen based on the assay interpretations
  • A minimum of 5200 specimens from subjects who are on multiple medications of which at least 2 are affected by the pathways tested and the physician made no changes based on the assay interpretations
  • A minimum of 1100 apparently healthy subjects.

Study subjects may be enrolled prospectively, from collection sites.

Description

Inclusion Criteria:

  • Buccal swab sample prospectively collected under Informed Consent
  • Remnant Buccal swab sample meeting the FDA requirements for use of leftover specimen
  • Samples from at least one of the following groups:
  • specimens from subjects who are on multiple medications of which at least 2 are affected by the pathways tested and the physician made changed to their drug regimen based on the assay interpretations
  • subjects who are on multiple medications of which at least 2 are affected by the pathways tested and the physician made no changes based on the assay interpretations
  • Subjects with Chronic disease
  • Subjects with different ethnic backgrounds
  • Subjects from different geographical areas
  • Apparently healthy subjects
  • Clinical information required per CRF is available

Exclusion Criteria:

- Samples that do not meet all inclusion criteria

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Clinical Utility of Primex's PGX assay as measured by medication change/no-change by the physician based on Primex's PGX assay results as an aid in the prediction of drug response
Time Frame: 6 Months
6 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2013

Primary Completion (Anticipated)

October 1, 2017

Study Completion (Anticipated)

October 1, 2019

Study Registration Dates

First Submitted

January 5, 2015

First Submitted That Met QC Criteria

January 7, 2015

First Posted (Estimate)

January 12, 2015

Study Record Updates

Last Update Posted (Estimate)

January 12, 2015

Last Update Submitted That Met QC Criteria

January 7, 2015

Last Verified

January 1, 2015

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • RDI-PGX-80801.01

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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