- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02342964
Comparison of Non-invasive Measurement Methods of Hepatic Fibrosis in Cystic Fibrosis (MUCO-FIBRO)
Comparative Study of Different Non-invasive Measurement Methods of Hepatic Fibrosis in Cystic Fibrosis
Non-invasive methods of the quantification of fibrosis may help to assess the development of fibrosis at a specific moment of the evolution of the disease, in the order to decide the initiation of treatment with ursodeoxycholic acid which may slow the progression to hepatic cirrhosis:
- FibroTest,
- The ultrasound impulse elastography, Fibroscan (FS)
- Ultrasound Elastography by ShearWave (SWE)
- Magnetic resonance elastography (MRE). The purpose of this study is to assess the contribution of these methods in the diagnosis of hepatic fibrosis during the evolution of the cystic fibrosis.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The incidence of hepatobiliary disease in cystic fibrosis in the first 10 years of life is 2.5 to 1.8 / 100 patient-years, significantly decreasing during the second decade; generally 30-40% of children develop hepatic disease before 12 years. However, the hepatobiliary damage varies in its clinical and histological expression. The typical histological appearance of the liver is the focal biliary cirrhosis (or fibrosis) characterized by a heterogeneous distribution of portal fibrosis in the liver.
Complications of cirrhosis are responsible for 2.5% of deaths in patients with cystic fibrosis and represent the second cause of death after lung disease if we exclude deaths secondary to lung transplantation.
The diagnosis of hepatic disease at an early stage of development and the assessment of the progression of fibrosis are so difficult in the absence of sensitive and specific non-invasive diagnostic tests.
Non-invasive assessment of hepatic fibrosis is an important topic of study in recent years, because of the emergence of biological methods and quantitative elastography methods using ultrasound or Magnetic Resonance Imagery (MRI) and allowing quantification of the hepatic elasticity, which is assumed to be a reflection of fibrosis. The advantages of these methods are numerous:
- The assessment of wider hepatic parenchyma then hepatic biopsy, allowing overcome the sampling bias
- Painless and non-invasive methods for the patient
- Simple to make
- Do not require hospitalization and can be performed as outpatient
- Immediately known results
- Can be repeated as often as necessary during the patient's follow-up
- Lower cost, morbidity and mortality compared to hepatic biopsy. Several non-invasive methods of fibrosis diagnosis have been studied in adults primarily for viral diseases and helped to limit the indications of hepatic biopsy. However, no method is now validated for the early diagnosis of hepatic disease and monitoring of children with cystic fibrosis.
The main objective of the study is to assess the contribution of FibroTest, the ultrasound impulse elastography, Fibroscan (FS), the ultrasound elastography by ShearWave (SWE) and Magnetic Resonance Elastography (MRE ) in the diagnosis of hepatic fibrosis in cystic fibrosis.
The secondary objectives are following :
- To study the correlations between the fibrosis quantitative results obtained through the four techniques of measurement and the matches between the results of four techniques using the standards available at t0 and after a year (t1).
- Study the correlations between clinical, biological and ultrasound endpoints of hepatic disease and various non-invasive measurement methods of fibrosis.
- Evaluate the area under the ROC curve of the different tests and the diagnostic performance tests using analytical methods without gold standard by classifying the children into two groups: the presence of advanced fibrosis (stages F2 to F4 ) or not (F0 and F1 stages), contracting by a committee according to the results of any biopsy, clinical, laboratory and ultrasound endpoints independent on the tests.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Paris, France, 75015
- Hopital Necker
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Children with cystic fibrosis aged 6-18 years. The diagnosis of cystic fibrosis will be based on testing the abnormal sweat (> 60 mEq / L of chloride sweat) and / or on the presence of two pathogen mutations of CFTR.
- Written consent of parents or holders of parental rights.
- Affiliated or benefiting from a national social insurance
Exclusion Criteria:
- Presence of another disease associated with cystic fibrosis that may be responsible for a chronic hepatic disease such as deficiency of alpha-1antitrypsine ZZ genotype or chronic infection by virus B or C.
- Child grafted
- Actual febrile pulmonary infection that can change the value of Fibrotest
- Important peri-hepatic ascites preventing the elasticity measurements by Fibroscan®
- Severe respiratory insufficient preventing attainment of Magnetic Resonance Imagery
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: MUCO-FIBRO
Measures of hepatic elasticity
|
Measure of hepatic elasticity by four non-invasive methods: Fibroscan, Fibrotest, SWE, MRE. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measure of hepatic elasticity by Fibro Test
Time Frame: Day 0
|
The value of hepatic elasticity measured by each of the tests performed on the same day in the same patient
|
Day 0
|
Measure of hepatic elasticity by the ultrasound impulse elastography, Fibroscan (FS)
Time Frame: Month 12
|
The value of hepatic elasticity measured by each of the tests performed on the same day in the same patient.
|
Month 12
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measure of hepatic elasticity by Ultrasound Elastography by ShearWave (SWE):
Time Frame: Day 0
|
The existence of advanced hepatic fibrosis (stages F2 to F4) will be defined by the presence of clinical, and / or biological and / or ultrasound abnormalities, defining two groups of children (F + :children with advanced fibrosis, F-: children with little or no fibrosis
|
Day 0
|
Measure of hepatic elasticity by Magnetic resonance elastography (MRE):
Time Frame: Month 12
|
The existence of advanced hepatic fibrosis (stages F2 to F4) will be defined by the presence of clinical, and / or biological and / or ultrasound abnormalities, defining two groups of children (F + :children with advanced fibrosis, F-: children with little or no fibrosis
|
Month 12
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Dominique Debray, MD, PhD, 00 33 1 44 49 41 52
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- RCB-2013-A01579-36
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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