Multi-organ Screening for Asymptomatic Ischaemia in Antiphospholipid Syndrome

NCT03348306 | Completed

• 1 other identifier: 2017-A02345-48
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Introduction AntiPhospholipid antibody Syndrome (APS) is an acquired autoimmune disorder defined by the presence of persistent thrombosis or obstetric manifestations together with the presence of persistent antiphospholipid antibodies (aPL). Patients are young and at high risk of recurrence. The current challenge is the identification of patients at high risk of organ damage that directly impact morbidity and mortality. Small vessels thrombosis can be asymptomatic but detectable by MRI. Apart from APS, it was shown that the detection of asymptomatic ischemic events identify patients at risk for symptomatic ischemic events. Demonstrating this in patients with APS would prevent thrombotic complications. The investigators' hypothesis is that a significant proportion of patients with APS would have asymptomatic organ involvement. Objectives The primary objective is to determine the frequency of asymptomatic target organ (s) (heart, brain, kidney) in APS patients. Secondary objectives are (i) to determine the frequency of each type of MRI abnormality, (ii) to identify the factors associated with asymptomatic target organ lesion, (iii) to describe the parameters of echocardiography associated with cerebral and cardiac MRI, and (iv) to assess the feasibility of a one-time cardiovascular and brain MRI. Methods and analysis This is a prospective interventional, cross-sectional, non-randomized, monocentric clinical study. The investigators expect to include 50 consecutive patients with APS followed in the department of Vascular Medicine at Nancy University Hospital. Within 15 days post-inclusion, a one-time cardiac and cerebral MRI will be performed. For each patient, the number of target organs involvements will be calculated and the frequencies will be compared by Fisher or chi-2 tests.

Conditions

Antiphospholipid Syndrome

Outcome Measures

Primary Outcomes (2)

• A brain or cardiac involvement will be defined by the identification of specific criteria visible by MRI.

  Through study completion, in average of 24 months

• Renal damage will be defined by the identification of a microalbuminuria> 30mg / L.

  Through study completion, in average of 24 months

Study Arms (1)

All patients

EXPERIMENTAL

Device: MRI; Biological: Blood sample collection

Interventions

MRI DEVICE

Brain and cardiac MRI in one time with gadolinium injection.

All patients

Blood sample collection BIOLOGICAL

A blood sampling is also collected for hematocrit measure.

All patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 18 years,
• Patients with documented primary thrombotic and / or obstetrical APS that respond to the revised Sapporo-Sydney classification criteria
• Person affiliated to a social security insurance,
• Person who have received complete information about the organization of the research and have signed informed consent,
• Person who has carried out a suitable clinical examination prior to the research.

You may not qualify if:

• Personal history of myocardial infarction, ischemic stroke or severe renal insufficiency,
• Patients with a contraindication to MRI: in particular implantable cardiac pacemakers or defibrillators, implanted pumps, cochlear implants, neurosurgical clips, intraorbital or brain metallic foreign material,
• Impossibility to perform the MRI examination, especially claustrophobic patients, or with a morphotype that does not allow access to MRI (abdominal diameter too large),
• Patient with a contraindication to Gadolinium injection: severe renal insufficiency, allergy to Gadolinium salts (precautions for use in patients at high risk of convulsions),
• APS associated with autoimmune disease (systemic lupus erythematosus according to American College of Rheumatology criteria),
• Patient with known microalbuminuria \> 30mg/L,
• Women of childbearing age who do not have effective contraception,
• Persons referred to in Articles L. 1121-5 to L. 1121-8, L1122-2 and L. 1122-1-2 of the French Public Health Code :
• Pregnant, parturient or nursing mother
• Person deprived of liberty by judicial or administrative decision
• Person undergoing psychiatric care
• Person admitted to a health or social institution for other purposes than research
• Minor person (not emancipated)
• A major person under a measure of legal protection (guardianship, curator, safeguard of justice)
• Person in an emergency situation

Sponsors & Collaborators

• Central Hospital, Nancy, France: lead

Study Sites (1)

CHRU Nancy Brabois

Nancy, 54000, France

Location

MeSH Terms

Conditions

Antiphospholipid Syndrome

Condition Hierarchy (Ancestors)

Autoimmune Diseases; Immune System Diseases

Study Officials

• Virginie DUFROST

  Nancy Academic Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: August 28, 2017
• First Posted: November 20, 2017
• Study Start: July 20, 2018
• Primary Completion: January 14, 2022
• Study Completion: January 14, 2022
• Last Updated: February 3, 2022

Record last verified: 2022-01

Locations

FR (1)