Clinical Genetics and Screening for Idiopathic Pulmonary Fibrosis (GENESI)

July 22, 2024 updated by: RICHELDI LUCA, Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Background:

Idiopathic pulmonary fibrosis (IPF) is the most common and severe form of interstitial lung disease. Between 2% and 20% of patients with IPF have a family history of the disease, which is considered the strongest risk factor. Therefore, genetic testing has been increasingly considered as a potential tool to identify patients at risk of developing IPF.

According to some studies, genetic testing (particularly of MUC5B and TERT mutations) could be useful to rapidly identify unidentified and/or asymptomatic individuals (in families as well as in the general population) who have interstitial lung anomalies (ILA) that may indicate a initial stage of pulmonary fibrosis. Finding efficient screening methods and associated targeted treatments for IPF may be essential to improving the prognosis and quality of life of those suffering from this disease.

Objectives of the study:

The study involves two populations of study subjects:

  • patients with FPF and sporadic IPF
  • first-degree relatives of patients with FPF and sporadic IPF (biological relatives, not spouses)

The primary objective is to determine the prevalence rates of interstitial lung abnormalities in at-risk relatives of patient with IPF and FPF.

Study design:

Multicenter, cross-sectional study without drug and without device conducted in two major Italian tertiary referral hospitals.

The entire project is expected to last 24 months.

Study Overview

Study Type

Observational

Enrollment (Estimated)

600

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

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study involves two populations of study subjects:

  • patients with FPF and sporadic IPF
  • first-degree relatives of patients with FPF and sporadic IPF (biological relatives, not spouses).

Description

Criteria for PATIENTS:

Inclusion Criteria:

  1. patients aged ≥18 years when signing the informed consent
  2. diagnosis of IPF based on 2022 ATS/ERS/JRS/ALAT Guidelines as confirmed by the investigator based on chest HRCT scan and if available surgical lung biopsy
  3. diagnosis of FPF defined as the presence of fibrotic ILD in at least two members of the same biological family
  4. at least one 1st degree relative >40 years of age.

Exclusion Criteria:

  1. patients with Interstitial Lung Diseases other than Idiopathic Pulmonary Fibrosis, including but not limited to patients with granulomatous lung disease, autoimmune/collagen vascular disease associated interstitial lung disease, and drug induced interstitial lung disease
  2. unwilling or unable to sign informed consent

Criteria for FIRST DEGREE BIOLOGICAL RELATIVES:

Inclusion Criteria:

a. subjects aged ≥40 years

Exclusion Criteria:

  1. previous diagnosis of IPF
  2. a history of severe or poorly controlled anxiety, severe or poorly controlled depression according to the opinion of the investigators, suicidal ideation, or other psychiatric illness requiring hospitalization
  3. unwilling or unable to sign informed consent 400 first-degree relatives of participating patients will be recruited

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients with FPF and sporadic IPF
A chest high-resolution computed tomography (HRCT) scan will be performed
Spirometry and diffusing capacity of the lung for carbon monoxide (DLCO) measurements will be performed
Lung sounds will be recorded using a manual approach with a digital stethoscope
Clinical laboratory tests will be collected from each participant
A sample of genomic DNA from peripheral blood lymphocytes will be collected for DNA sequencing
First-degree relatives of patients with FPF and sporadic IPF
A chest high-resolution computed tomography (HRCT) scan will be performed
Spirometry and diffusing capacity of the lung for carbon monoxide (DLCO) measurements will be performed
Lung sounds will be recorded using a manual approach with a digital stethoscope
Clinical laboratory tests will be collected from each participant
A sample of genomic DNA from peripheral blood lymphocytes will be collected for DNA sequencing

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Prevalence of ILA
Time Frame: At subject enrollment
The prevalence of ILA in first-degree relatives of patients with IPF, expressed as proportion of subjects with ILAs in the overall relatives population
At subject enrollment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Association between ILA and genetic variants
Time Frame: At subject enrollment

To assess the risk of ILA in first-degree relatives of patients with FPF and sporadic IPF associated with clinically relevant mutations.

Univariate and multivariate logistic regression analysis will be utilized to assess the association between genetic variants and ILA

At subject enrollment

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 (Estimated)

September 1, 2024

Primary Completion (Estimated)

September 1, 2026

Study Completion (Estimated)

September 1, 2026

Study Registration Dates

First Submitted

July 16, 2024

First Submitted That Met QC Criteria

July 22, 2024

First Posted (Actual)

July 25, 2024

Study Record Updates

Last Update Posted (Actual)

July 25, 2024

Last Update Submitted That Met QC Criteria

July 22, 2024

Last Verified

July 1, 2024

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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