Benefits and Risks of Newborn Screening for Cystic Fibrosis

NCT00014950 | Completed

• 3 other identifiers: Farrell (completed)R01DK034108GCRC
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 2

Brief Summary

Although cystic fibrosis (CF) is the most common, life-threatening autosomal recessive genetic disorder of the white population, there are often delays in diagnosis and hence start of treatment. Advances of the past two decades have made CF screening feasible using routinely collected neonatal blood specimens and measuring an enzyme level followed by CF mutation DNA analysis. Our overall goal of the study is to see if early diagnosis of CF through neonatal screening will be medically beneficial without major risks. ''Medically beneficial'' refers to better nutrition and/or pulmonary status, whereas '' risks'' include laboratory errors, miscommunication or misunderstanding, and adverse psychosocial consequences. Specific aims include assessment of the benefits, risks, costs, quality of life, and cognitive function associated with CF neonatal screening and a better understanding of the epidemiology of CF. A comprehensive, randomized clinical trial emphasizing early diagnosis as the key variable has been underway since 1985. Nutritional status has been assessed using height and weight measurements and biochemical methods. The results have demonstrated significant benefits in the screened (early diagnosis) group. We are now focusing on the effect of early diagnosis of CF on pulmonary outcome. Pulmonary status is measured using chest radiographs, chest scans using high resolution computerized tomography, and pulmonary function tests. Other factors that we are looking at include risk factors for the acquisition of respiratory pathogens such as Pseudomonas aeruginosa, quality of life and cognitive function of children with CF who underwent early versus delayed diagnosis, as well as the cost effectiveness of screening and the costs of diagnosis and treatment of CF throughout childhood. If the questions underlying this study are answered favorably, it is likely that neonatal screening using a combination of enzyme level (immunoreactive trypsinogen) and DNA test will become the routine method for identifying new cases of CF not only in the State of Wisconsin, but throughout the country.

Conditions

Cystic Fibrosis; Lung Disease; Pseudomonas Infections

Keywords

Cystic Fibrosis; Immunoreactive trypsinogen; deltaF508- CFTR gene; newborn screening; Pseudomonas aeruginosa infection; nutrition; pulmonary status; meconium ileus; growth; Genetic counseling; risk communication

Interventions

CF newborn screening PROCEDURE

Eligibility Criteria

• Age: 1 Month - 21 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Must have been born in the State of Wisconsin
• Must have been born between April 15, 1985 and June 30, 1994
• Must have had a valid newborn screening test for cystic fibrosis in the first 28 days of life.
• Must have a sweat chloride test greater or equal to 60 mmol/Liter
• Parental consent

Sponsors & Collaborators

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): lead
• National Center for Research Resources (NCRR): collaborator

Study Sites (2)

University of Wisconsin

Madison, Wisconsin, 53706, United States

Location

Children's Hospital of Wisconsin

Milwaukee, Wisconsin, 53201, United States

Location

Related Publications (6)

• Crossley JR, Elliott RB, Smith PA. Dried-blood spot screening for cystic fibrosis in the newborn. Lancet. 1979 Mar 3;1(8114):472-4. doi: 10.1016/s0140-6736(79)90825-0.

  PMID: 85057 BACKGROUND

• Neonatal screening for cystic fibrosis: position paper. Pediatrics. 1983 Nov;72(5):741-5. No abstract available.

  PMID: 6634283 BACKGROUND

• Fost N, Farrell PM. A prospective randomized trial of early diagnosis and treatment of cystic fibrosis: a unique ethical dilemma. Clin Res. 1989 Sep;37(3):495-500. No abstract available.

  PMID: 2673641 BACKGROUND

• Farrell PM, Kosorok MR, Laxova A, Shen G, Koscik RE, Bruns WT, Splaingard M, Mischler EH. Nutritional benefits of neonatal screening for cystic fibrosis. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. N Engl J Med. 1997 Oct 2;337(14):963-9. doi: 10.1056/NEJM199710023371403.

  PMID: 9395429 BACKGROUND

• Farrell PM. Improving the health of patients with cystic fibrosis through newborn screening. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. Adv Pediatr. 2000;47:79-115. No abstract available.

  PMID: 10959441 BACKGROUND

• Farrell PM, Kosorok MR, Rock MJ, Laxova A, Zeng L, Lai HC, Hoffman G, Laessig RH, Splaingard ML. Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. Pediatrics. 2001 Jan;107(1):1-13. doi: 10.1542/peds.107.1.1.

  PMID: 11134427 BACKGROUND

MeSH Terms

Conditions

Cystic Fibrosis; Lung Diseases; Pseudomonas Infections; Meconium Ileus

Condition Hierarchy (Ancestors)

Pancreatic Diseases; Digestive System Diseases; Respiratory Tract Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Infant, Newborn, Diseases; Gram-Negative Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Infections; Intestinal Obstruction; Intestinal Diseases; Gastrointestinal Diseases

Study Officials

• Philip M. Farrell, MD, PhD

  Dean University of Wisconsin Medical School

  PRINCIPAL INVESTIGATOR

• Michael J. Rock, M.D.

  Dept. Pediatrics, UW Hospital

• Mark Splaingard

  Children's Hospital and Health System Foundation, Wisconsin

• Anita Laxova

  Dept. Pediatrics, UW Madison

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: NIH

Study Record Dates

• First Submitted: April 14, 2001
• First Posted: April 16, 2001
• Last Updated: March 2, 2010

Record last verified: 2010-03

Locations

US (2)