Early Prediction of Outcomes Following Optic Neuritis: Development and Acceptability of a Prognostic Tool (MS Predictor)
Early Prediction of Outcomes Following Optic Neuritis: Development and Acceptability of a Prognostic Tool (MS Predictor)
The goal of this observational study is to determine whether genetic information, together with clinical information, can be used to improve prediction of future multiple sclerosis (MS) diagnosis after a first-time episode of optic neuritis. The study will also investigate visual outcomes, quality of life, healthcare use, and the acceptability of using genetic information to predict future health outcomes in people with optic neuritis.
The main outcomes that we aim to assess are:
- Incident diagnosis of MS following a first episode of optic neuritis, including time to MS diagnosis.
- Visual outcomes following optic neuritis, including visual acuity, visual field, and colour vision.
- Clinical care received following optic neuritis, including specialist review, investigations/tests
- Health-related and vision-related quality of life.
- Health economic impacts and healthcare utilisation after experiencing optic neuritis
- Knowledge, attitudes, and practices/behaviours about using genetic information to predict future MS disease risk.
If consented, participants will:
- Allow researchers to review information from their medical records relating to their optic neuritis diagnosis, investigations, treatments, and outcomes.
- Be invited to provide a saliva sample for genetic analysis.
- Complete questionnaires about their lifestyle/risk factors, quality of life, and views on genetic risk prediction.
- Allow researchers to track long-term health outcomes using information from their NHS records
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Tasanee Braithwaite, Doctor of Medicine (Oxon)
- Telefonnummer: +44 20 7188 7188
- E-mail: tasanee.braithwaite@kcl.ac.uk
Studiesteder
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London, Det Forenede Kongerige, EC1V 2PD
- Moorfields Eye Hospital NHS Foundation Trust
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Kontakt:
- Neringa Jurkute, MD, PhD, FEBOphth
- Telefonnummer: +44 20 7253 3411
- E-mail: n.jurkute@nhs.net
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Ledende efterforsker:
- Neringa Jurkute, MD, PhD, FEBOphth
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London, Det Forenede Kongerige, SE5 9RS
- King's College Hospital NHS Foundation Trust
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Kontakt:
- James McHugh, FRCOphth
- Telefonnummer: +44 20 3299 9000
- E-mail: james.mchugh@kcl.ac.uk
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Ledende efterforsker:
- James McHugh, FRCOphth
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London, Det Forenede Kongerige, SE1 7EH
- Guy's and St Thomas' NHS Foundation Trust
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Kontakt:
- Tasanee Braithwaite, FRCOphth
- Telefonnummer: +44 20 7188 7188
- E-mail: tasanee.braithwaite@kcl.ac.uk
-
Ledende efterforsker:
- Tasanee Braithwaite, FRCOphth
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Aged 16 years and above at time of consent
- Previous episode of optic neuritis diagnosed at one of the participating sites
Exclusion Criteria:
- Patients for whom data relating to the first episode of ON are not available in the medical record at a participating site
- Children <16 years at the time of recruitment
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Participants Who Have Experienced Optic Neuritis
Participants with a history of a first episode of optic neuritis recruited from the 3 participating NHS hospitals. Participants will undergo retrospective review of clinical records, complete questionnaires, and may provide a saliva sample for genetic analysis. Participants will be invited to consent to longer term prospective outcome assessment. |
Not applicable - No intervention as this is an observation study
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Incident Multiple Sclerosis Diagnosis Following a First Episode of Optic Neuritis
Tidsramme: Extracted from retrospective record at baseline, and reviewed before study end to capture any new events occurring during the 12 month study period.
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Occurrence of a diagnosis of multiple sclerosis following a first episode of optic neuritis.
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Extracted from retrospective record at baseline, and reviewed before study end to capture any new events occurring during the 12 month study period.
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Visual Acuity (LogMAR)
Tidsramme: From the date of first optic neuritis diagnosis until the last available follow-up assessment (up to 15 years).
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Visual acuity (LogMAR) measured at first diagnosis of optic neuritis and at subsequent follow-up assessments.
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From the date of first optic neuritis diagnosis until the last available follow-up assessment (up to 15 years).
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Visual Field Mean Deviation (dB)
Tidsramme: From the date of first optic neuritis diagnosis until the last available follow-up assessment (up to 15 years).
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Visual field mean deviation (Decibels) measured at first diagnosis of optic neuritis and at subsequent follow-up assessments
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From the date of first optic neuritis diagnosis until the last available follow-up assessment (up to 15 years).
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Colour Vision (Number of Ishihara Plates Correctly Identified)
Tidsramme: From the date of first optic neuritis diagnosis until the last available follow-up assessment (up to 15 years).
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Colour vision assessed using Ishihara pseudoisochromatic plates and reported as the number of plates correctly identified.
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From the date of first optic neuritis diagnosis until the last available follow-up assessment (up to 15 years).
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Number of Healthcare Consultations Following Optic Neuritis Diagnosis
Tidsramme: 12 months
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Number of healthcare consultations attended following optic neuritis diagnosis, reported by consultation type, including primary care appointments, emergency department attendances, neuro-ophthalmology, neurology, and other relevant specialist clinics.
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12 months
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Number of Investigations Performed Following Optic Neuritis Diagnosis
Tidsramme: 12 months
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Number of investigations performed following optic neuritis diagnosis, reported by investigation type, including OCT, visual field testing, MRI, VEP, blood tests, and CSF analysis.
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12 months
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Time to Diagnostic Investigations Following Optic Neuritis Diagnosis (Days)
Tidsramme: 12 months
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Time interval (days) from optic neuritis diagnosis to each investigation, reported by investigation type.
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12 months
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Time to Treatment Following Optic Neuritis Diagnosis (Days)
Tidsramme: 12 months
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Time interval (Days) from optic neuritis diagnosis to initiation of first treatment course, reported by treatment type.
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12 months
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Number of Treatment Episodes Following Optic Neuritis Diagnosis
Tidsramme: 12 months
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Number of treatment episodes received following optic neuritis diagnosis, reported by treatment type (e.g.
intravenous corticosteroids, oral corticosteroids, plasma exchange, intravenous immunoglobulin, disease-modifying therapies).
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12 months
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Health-Related Quality of Life (EuroQol 5-Dimension 5-Level Questionnaire [EQ-5D-5L])
Tidsramme: Measured at baseline recruitment and repeated 3-12 months later
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Health-related quality of life assessed using the EuroQol 5-Dimension 5-Level Questionnaire (EQ-5D-5L).
The EQ-5D-5L descriptive system comprises five domains, each scored on five levels.
Higher levels indicate worse health status and poorer health-related quality of life.
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Measured at baseline recruitment and repeated 3-12 months later
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Vision-Related Quality of Life (National Eye Institute Visual Function Questionnaire-25 [NEI-VFQ-25])
Tidsramme: Baseline and repeated 3-12 months later
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Vision-related quality of life assessed using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) composite score.
Scores range from 0 to 100, with higher scores indicating better vision-related quality of life.
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Baseline and repeated 3-12 months later
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Optic Neuritis-Related Quality of Life (Semi-Structured Questionnaire)
Tidsramme: Measured at baseline recruitment and repeated 3-12 months later
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Participant-reported optic neuritis-related quality of life and lived experiences, including symptoms, treatment impacts, emotional well-being, activities of daily living, social participation and personal relationships, explored using a bespoke semi-structured questionnaire
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Measured at baseline recruitment and repeated 3-12 months later
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Fatigue (Patient-Reported Outcomes Measurement Information System [PROMIS] Fatigue 6a)
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Fatigue assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue 6a instrument.
Raw scores are converted to T-scores with a mean of 50 and standard deviation of 10 in the reference population.
Higher scores indicate greater fatigue (worse outcome).
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Baseline recruitment and repeated once 3-12 months later
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Depression (Patient-Reported Outcomes Measurement Information System [PROMIS] Depression 4a)
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Depression assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression 4a instrument.
Raw scores are converted to T-scores with a mean of 50 and standard deviation of 10 in the reference population.
Higher scores indicate more severe depressive symptoms (worse outcome).
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Baseline recruitment and repeated once 3-12 months later
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Work Productivity Loss (Adapted iMTA Productivity Cost Questionnaire [iPCQ])
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Participant-reported work productivity loss associated with optic neuritis or related diseases, including absenteeism, presenteeism and changes to employment.
Measured using the Adapted iMTA Productivity Cost Questionnaire (iPCQ)
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Baseline recruitment and repeated once 3-12 months later
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Healthcare Resource Utilisation: Appointments, Emergency Department Attendances and Hospital Admissions (Adapted iMTA Medical Consumption Questionnaire [iMCQ])
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Participant-reported utilisation of healthcare services related to optic neuritis or associated diseases, including appointments with healthcare professionals, emergency department attendances, and hospital admissions
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Baseline recruitment and repeated once 3-12 months later
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Healthcare Resource Utilisation: Investigations and Treatment Interventions (Adapted iMTA Medical Consumption Questionnaire [iMCQ])
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Participant-reported utilisation of diagnostic investigations and therapeutic interventions related to optic neuritis or associated diseases, including imaging, laboratory investigations, electrophysiological testing, and treatments received.
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Baseline recruitment and repeated once 3-12 months later
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Informal Care Received (Hours)
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Participant-reported hours of informal care received from family members, friends or acquaintances because of optic neuritis or associated diseases.
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Baseline recruitment and repeated once 3-12 months later
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Out-of-Pocket Costs (Pounds Sterling)
Tidsramme: Baseline recruitment and repeated once 3-12 months later
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Participant-reported personal expenditure related to optic neuritis and associated diseases in the first year after optic neuritis began (e.g.
health insurance, prescription costs, optician/sight tests, low vision aids)
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Baseline recruitment and repeated once 3-12 months later
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Knowledge, Attitudes and Practices/Behaviours Regarding Genetic Risk Prediction (KAP Questionnaire)
Tidsramme: Baseline recruitment and repeated at 3-12 months later
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This will be explored using a knowledge, attitudes and practices/behaviour questionnaire to explore how participants feel about the use of genetic information to predict future health outcome risk including multiple sclerosis.
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Baseline recruitment and repeated at 3-12 months later
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Tasanee Braithwaite, King's College London
Publikationer og nyttige links
Generelle publikationer
- Panthagani J, O'Donovan C, Aiyegbusi OL, Liu X, Bayliss S, Calvert M, Pesudovs K, Denniston AK, Moore DJ, Braithwaite T. Evaluating patient-reported outcome measures (PROMs) for future clinical trials in adult patients with optic neuritis. Eye (Lond). 2023 Oct;37(15):3097-3107. doi: 10.1038/s41433-023-02478-z. Epub 2023 Mar 17.
- Braithwaite T, Wiegerinck N, Petzold A, Denniston A. Vision Loss from Atypical Optic Neuritis: Patient and Physician Perspectives. Ophthalmol Ther. 2020 Jun;9(2):215-220. doi: 10.1007/s40123-020-00247-9. Epub 2020 Mar 21.
- Laviers H, Petzold A, Braithwaite T. How far should I manage acute optic neuritis as an ophthalmologist? A United Kingdom perspective. Eye (Lond). 2024 Aug;38(12):2238-2245. doi: 10.1038/s41433-024-03164-4. Epub 2024 Jun 12.
- Petzold A, Braithwaite T, van Oosten BW, Balk L, Martinez-Lapiscina EH, Wheeler R, Wiegerinck N, Waters C, Plant GT. Case for a new corticosteroid treatment trial in optic neuritis: review of updated evidence. J Neurol Neurosurg Psychiatry. 2020 Jan;91(1):9-14. doi: 10.1136/jnnp-2019-321653. Epub 2019 Nov 18. No abstract available.
- Braithwaite T, Subramanian A, Petzold A, Galloway J, Adderley NJ, Mollan SP, Plant GT, Nirantharakumar K, Denniston AK. Trends in Optic Neuritis Incidence and Prevalence in the UK and Association With Systemic and Neurologic Disease. JAMA Neurol. 2020 Dec 1;77(12):1514-1523. doi: 10.1001/jamaneurol.2020.3502.
- Loginovic P, Wang F, Li J, Ferrat L, Mirshahi UL, Rao HS, Petzold A, Tyrrell J, Green HD, Weedon MN, Ganna A, Tuomi T, Carey DJ; UKBB Eye & Vision Consortium; FinnGen; Geisinger-Regeneron DiscovEHR Collaboration; Oram RA, Braithwaite T. Applying a genetic risk score model to enhance prediction of future multiple sclerosis diagnosis at first presentation with optic neuritis. Nat Commun. 2024 Feb 28;15(1):1415. doi: 10.1038/s41467-024-44917-9.
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Sygdomme i nervesystemet
- Patologiske processer
- Sygdomsegenskaber
- Autoimmune sygdomme
- Sygdomme i immunsystemet
- Øjensygdomme
- Overfølsomhed
- Demyeliniserende autoimmune sygdomme, CNS
- Autoimmune sygdomme i nervesystemet
- Demyeliniserende sygdomme
- Lymfesygdomme
- Lymfoproliferative lidelser
- Myelitis, tværgående
- Synsnervesygdomme
- Sygdomme i kranienerve
- Overfølsomhed, forsinket
- Sygdomsmodtagelighed
- Genetisk disposition for sygdom
- Patologiske tilstande, tegn og symptomer
- Hemiske og lymfatiske sygdomme
- Genetisk risikoscore
- Multipel sclerose
- Neuromyelitis Optica
- Sarcoidose
- Optisk neuritis
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 352834
- 222 (Andet bevillings-/finansieringsnummer: MS Society UK)
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