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Development of a Prediction Score for the Occurrence of Death or Lung Transplantation in Patients With Emphysema Secondary to Alpha-1-anti-tripsin Deficiency (FLARE)

15. juli 2026 opdateret af: University Hospital, Bordeaux

Emphysema linked to alpha-1-antitrypsin deficiency (DAAT): towards a better prediction of risks Emphysema caused by alpha-1-antitrypsin deficiency (DAAT) is a rare genetic disorder that can lead to serious complications, such as the need for a lung transplant or death, affecting up to 15% of patients. The only specific treatment available is a weekly infusion of alpha-1-antitrypsin (IV-AAT), an expensive and burdensome therapy.

Currently, there is no reliable model to predict the course of the disease in these patients. Our study, conducted in several French hospitals, aims to develop a prediction tool combining clinical, biological, functional data and advanced medical image analysis (lung CT). This model will make it possible to identify the most at-risk patients, in order to better adapt their care, anticipate transplant needs and avoid unnecessary treatments for low-risk patients.

Ultimately, this approach could also improve access to care for patients who need it most, while optimizing health system resources.

Studieoversigt

Status

Rekruttering

Betingelser

Detaljeret beskrivelse

Context. Emphysema secondary to alpha-1-anti-trypsin deficiency (AATD) is a genetic rare disease, but with pejorative events such as death or lung transplantation (LT) which affect up to 15% of patients. Aside from standard medical care for COPD management, the only specific treatment as augmentation therapy for severe AATD, is weekly intravenous alpha-1 antitrypsin (IV-AAT) which is still expensive and restrictive. Several prognostic scores for tobacco-related COPD have been developed but, none of them have been validated in AATD, neither have included quantitative chest CT imaging while they have been associated with mortality in emphysema. Therefore, we aim to develop a prediction model combining clinical, biological, functional and quantitative CT data (including radiomics) for mortality or LT to identify at-risk patients with emphysema secondary to AATD.

Methods: From several French hospitals, we'll conduct a multicenter retrospective study based on data collected in usual care among patients over 18-year-old, with an available chest CT. We'll collect clinical data (BMI, mMRC dyspnea scale), respiratory function parameters and quantitative imaging data (including radiomics) from the initial CT from AATD patients secondary to ZZ, Znull, ZMalton, Z and rare mutations. We'll then validate our results on an independent external database from the European AADT cohort (EARCO), with specific dedicated funding.

Perspectives: To develop a prediction model to identify the AATD patients at risk of clinical deterioration, defined by death or LT allowing for personalized care, in order to: 1. anticipate registration on the transplant list, 2. optimize overall management, including pharmacological (IV-AAT) and non-pharmacological management. 3. to avoid cost-prohibitive and constraining IV-AAT infusion for low risk patients For Health policy, finding a way to target high-risk patients may help a better access for IV-AAT to appropriate individuals.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

230

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Bron, Frankrig, 69677
        • Rekruttering
        • Hospices Civils de Lyon
        • Kontakt:
        • Ledende efterforsker:
          • Jean-Francois MORNEX, MD, PhD
      • Lille, Frankrig, 59000
        • Rekruttering
        • CHU de Lille
        • Kontakt:
        • Ledende efterforsker:
          • Olivier LE ROUZIC, MD, PhD
      • Paris, Frankrig, 75018
        • Rekruttering
        • Hopital Bichat Claude-Bernard
        • Kontakt:
        • Ledende efterforsker:
          • Vincent BUNEL GOURDY, MD
      • Pessac, Frankrig, 33600
        • Rekruttering
        • Bordeaux University Hospital
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Maéva ZYSMAN, MD,PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

The subjects included will be any patients followed and diagnosed between 2010 and 2025 in the pulmonology department for emphysema and COPD secondary to alpha-1 antitrypsin deficiency ZZ, Znull, ZMalton, Z and rare mutations, based on the diagnosis of emphysema made from an initial thoracic CT scan (+/- 12 months after diagnosis).

Beskrivelse

  1. Inclusion criteria:

    • diagnosed between 2010 and 2025
    • in the pulmonology department
    • diagnosis of emphysema and COPD secondary to alpha-1 antitrypsin deficiency ZZ, Znull, ZMalton, Z and rare mutations,
    • emphysema according to the initial thoracic CT scan (+/- 12 months after diagnosis).
  2. Exclusion criteria:

    • Age <18 years
    • Patient opposed to the use of their data for research purposes
    • Patient deprived of liberty by judicial decision
    • Patient not affiliated with a social security scheme
    • no CT scan available
    • no lung function test available the year around CT scan

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Emphysema secondary to alpha-1-anti-trypsin deficiency (AATD)
The subjects included will be any patients followed and diagnosed between 2010 and 2025 in the pulmonology department for emphysema and COPD secondary to alpha-1 antitrypsin deficiency ZZ, Znull, ZMalton, Z and rare mutations, based on the diagnosis of emphysema made from an initial thoracic CT scan (+/- 12 months after diagnosis).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Evaluation of vital status
Tidsramme: 5 years
Death within 5 years of emphysema diagnosis.
5 years
Evaluation of transplantation status
Tidsramme: 5 years
Lung transplantation within 5 years of emphysema diagnosis.
5 years

Samarbejdspartnere og efterforskere

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Sponsor

Publikationer og nyttige links

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Generelle publikationer

Datoer for undersøgelser

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Studer store datoer

Studiestart (Faktiske)

16. februar 2026

Primær færdiggørelse (Anslået)

16. marts 2031

Studieafslutning (Anslået)

16. marts 2031

Datoer for studieregistrering

Først indsendt

15. juli 2026

Først indsendt, der opfyldte QC-kriterier

15. juli 2026

Først opslået (Faktiske)

20. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

15. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • CHUBX 2024/85

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