NCT06081075

Brief Summary

Genomic methods can significantly contribute to all facets of precision medicine, from diagnosis to prevention, therapeutic intervention, and management of acute and chronic illnesses. DNA based methods are already having a considerable impact across healthcare in fields that include: public health, infectious disease monitoring, acute and chronic disease, pharmacogenomics, prenatal testing and diagnosis, and therapeutic development. In this proposal, investigators are focusing on the application of genomic methods in precision medicine - specifically on rapid whole-genome sequencing of parents and children (i.e. a trio) for the identification of diseases that have genetic components. Goals Primary goal: is to provide safe rapid whole genome sequencing to Neonatal Intensive Care Unit/Pediatric Intensive Care Unit patients. Secondary goals: 1) Although several groups globally are implementing rapid sequencing of rare disease, these are predominantly in the research space, with many unanswered questions regarding the best way to implement them into a national healthcare system. Each country and their healthcare systems are unique, and valuable knowledge will be gained by implementing this process within a New Zealand context. As part of this the study will measure the impact on the individuals and families. 2\) to expand the research team's understanding of non-coding disease-causing variants and methylation changes that contribute to severe disease in early life. Primary Aims

  1. 1.To incorporate long-read RNA sequencing data into the diagnostic rapid Whole Genome Sequencing pipeline to provide a direct measure of the functional outcome of the variants of clinical concern.
  2. 2.To measure the clinical utility of analysing non-coding variants in the diagnosis of critically ill children who do not have pathogenic, likely pathogenic, or variants of unknown significance for mendelian disorders.
  3. 3.To identify, in a real-world setting within the New Zealand health-care system, the clinical and economic effects of deploying rapid Whole Genome Sequencing-informed rapid precision medicine for critically ill children.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
500

participants targeted

Target at P75+ for all trials

Timeline
19mo left

Started Jan 2024

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress60%
Jan 2024Dec 2027

First Submitted

Initial submission to the registry

June 29, 2023

Completed
4 months until next milestone

First Posted

Study publicly available on registry

October 12, 2023

Completed
3 months until next milestone

Study Start

First participant enrolled

January 15, 2024

Completed
2.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2026

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2027

Last Updated

May 7, 2025

Status Verified

May 1, 2025

Enrollment Period

2.9 years

First QC Date

June 29, 2023

Last Update Submit

May 4, 2025

Conditions

Outcome Measures

Primary Outcomes (3)

  • To incorporate long-read RNA sequencing data into the diagnostic rapid Whole Genome Sequencing pipeline to provide a direct measure of the functional outcome of the variants of clinical concern

    June 2025

  • To measure the clinical utility of analysing non-coding variants in the diagnosis of critically ill children who do not have pathogenic, likely pathogenic, or variants of unknown significance for mendelian disorders.

    June 2025

  • To identify, in a real-world setting within the New Zealand health-care system, the clinical and economic effects of deploying rapid Whole Genome Sequencing-informed rapid precision medicine for critically ill children.

    June 2025

Study Arms (1)

Acutely ill neonates with suspected genetic condition, without a clear non-genetic aetiology

Other: Genetic testing

Interventions

Rapid whole genome sequencing

Acutely ill neonates with suspected genetic condition, without a clear non-genetic aetiology

Eligibility Criteria

Age0 Hours - 2 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)
Sampling MethodProbability Sample
Study Population

Children with suspected genetic conditions, and their families, will be recruited into the study from within the neonatal and paediatric intensive care units (i.e. NICU and PICU, respectively) from around New Zealand

You may qualify if:

  • Acutely ill inpatient
  • Admitted to NICU or PICU between April 2023 - March 2026
  • Within 1 week of hospitalization or within 1 week of development of abnormal response to standard therapy for an underlying condition
  • Suspected genetic condition, without a clear non-genetic aetiology

You may not qualify if:

  • Patients whose clinical course is entirely explained by
  • Isolated prematurity
  • Isolated unconjugated hyperbilirubinemia
  • Infection or sepsis with expected response to therapy
  • A previously confirmed genetic diagnosis that explains the clinical condition -
  • Isolated transient neonatal tachypnoea
  • Meconium aspiration syndrome
  • Trauma
  • Inability to source blood and buccal samples for DNA extraction from at least the mother and child

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Auckland City Hospital

Auckland, New Zealand

RECRUITING

Related Publications (1)

  • Nyaga DM, Tsai P, Gebbie C, Phua HH, Yap P, Le Quesne Stabej P, Farrow S, Rong J, Toldi G, Thorstensen E, Stark Z, Lunke S, Gamet K, Van Dyk J, Greenslade M, O'Sullivan JM. Benchmarking nanopore sequencing and rapid genomics feasibility: validation at a quaternary hospital in New Zealand. NPJ Genom Med. 2024 Nov 8;9(1):57. doi: 10.1038/s41525-024-00445-5.

MeSH Terms

Conditions

Genetic Diseases, Inborn

Interventions

Genetic Testing

Condition Hierarchy (Ancestors)

Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

Clinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisInvestigative TechniquesGenetic TechniquesGenetic ServicesHealth ServicesHealth Care Facilities Workforce and ServicesDiagnostic ServicesPreventive Health Services

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor, Deputy Director

Study Record Dates

First Submitted

June 29, 2023

First Posted

October 12, 2023

Study Start

January 15, 2024

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2027

Last Updated

May 7, 2025

Record last verified: 2025-05

Data Sharing

IPD Sharing
Will not share

Locations