CROWD: Cohort Research on Wilson's Disease
Study Details
Study Description
Brief Summary
Wilson's disease (WD) is an inherited disorder that causes abnormal copper accumulation in the brain and/or liver. Some people develop neurological or psychiatric symptoms whereas other develop liver disease. The reasons for this are unclear but genetic factors are likely to contribute. Current treatment, using copper-binding medications, is required lifelong. Some respond well but others suffer debilitating side-effects or deteriorate despite treatment, leading to disability or the need for liver transplantation.
In the first part of this study the main aim is to identify genetic factors that determine whether someone with a diagnosis of WD will develop neurological involvement or not. The investigators will invite 500 adults with WD across the UK to take part. Participants will be asked to complete an online questionnaire and provide a saliva sample for genetic testing using a collection kit sent via post. Identifying these genetic factors would significantly advance our understanding of the disease and may provide new targets for drug discovery or help guide more personalised approaches to treatment.
In the second part of this study the main aim is to develop new ways to monitor the effect of WD on the brain using tests. Copper levels in blood and urine, currently used to monitor the disease, are unreliable and do not necessarily reflect ongoing brain damage. The role of MRI scans, cerebrospinal fluid tests or other measures of brain damage, commonly used in other neurological disorders, is unclear. The investigators will therefore follow a group of 40 patients using clinical assessments and a combination of neurological tests, including novel imaging and laboratory techniques, over 24 months. Developing new approaches to monitoring the effect of WD on the brain will enable better prevention of neurological disability and be essential for demonstrating the effectiveness of new treatments, such as gene therapy, in clinical trials in the future.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Part 1 Genetic determinants (n=500) |
Genetic: Next generation sequencing
Saliva samples
|
| Part 2 Biomarker discovery (n=40) |
Diagnostic Test: Imaging and fluid biomarkers
Magnetic resonance imaging of the brain and urine, blood and cerebrospinal fluid sampling
|
Outcome Measures
Primary Outcome Measures
- Clinical phenotype [Questionnaire responses will be collected over two years.]
Responses to online questionnaires for the first part of the study will be used to the determine the presence or absence of neurological symptoms.
- Unified Wilson's Disease Rating Scale (UWDRS) [This assessment will be performed at two research visits 12-18 months apart.]
Participants in the second part of the study will be assessed at research visits using this scale (0-320)
Eligibility Criteria
Criteria
Inclusion Criteria (part 1 and part 2):
-
Diagnosed with Wilson's disease
-
Age 16 years or over
-
Living in the UK
Exclusion Criteria (part 2):
-
Participant has another medical or psychiatric illness that would interfere in completing assessments
-
Participant is pregnant
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Birmingham Women's and Children's NHS Foundation Trust | Birmingham | United Kingdom | ||
| 2 | University Hospitals Birmingham NHS Foundation Trust | Birmingham | United Kingdom | ||
| 3 | Cambridge University Hospitals NHS Foundation Trust | Cambridge | United Kingdom | ||
| 4 | Cardiff and Vale University Health Board | Cardiff | United Kingdom | ||
| 5 | King's College Hospital NHS Foundation Trust | London | United Kingdom | ||
| 6 | National Hospital for Neurology and Neurosurgery | London | United Kingdom | ||
| 7 | Royal Free London NHS Foundation Trust | London | United Kingdom | ||
| 8 | Manchester University NHS Foundation Trust | Manchester | United Kingdom | ||
| 9 | Newcastle upon Tyne Hospitals NHS Foundation Trust | Newcastle | United Kingdom | ||
| 10 | Salford Royal NHS Foundation Trust | Salford | United Kingdom | ||
| 11 | Sheffield Teaching Hospitals NHS Foundation Trust | Sheffield | United Kingdom |
Sponsors and Collaborators
- University College, London
Investigators
- Principal Investigator: Thomas Warner, UCL Queen Square Institute of Neurology
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 18/0200