GEN-EYE-II: An Observational Study for Evaluation of for the Prevalence of Cerebrotendinous Xanthomatosis (CTX) Disease
Study Details
Study Description
Brief Summary
The prevalence of CTX in our country is estimated to be 1 / 50.000. The aim of this study is to screen more volunteers by conducting a larger screening from neurology and pediatric metabolism clinics in Turkey.
This observational study was designed retrospectively and prospectively in two stages. In the retrospective section, the patient database and / or patient files will be screened in the neurology and pediatric metabolism clinics and the patients aged 40 and below in the neurology clinics with at least two of the following will be enrolled to the study:
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Ataxia and / or spasticity
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Bilateral cataract (except senile cataract)
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Intellectual limitation
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Non-enhancing hyperintensity on T2 sections in MR imaging of dentate nuclei
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Autosomal recessive transition pattern. (Ex: Relative Marriage)
In the pediatric metabolism centers, cases suspected of CTX and planned to apply the Mignarri Index according to the investigator's opinion will be identified.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Outcome Measures
Primary Outcome Measures
- Proportion of patients with CTX possibility in Neurology Clinics [3 years]
- Proportion of patients aged 40 years or younger with at least two of the following (2) in patients with a cholestanol test threshold (3.75 mg / mL) in neurology clinics: Ataxia and / or spasticity Bilateral cataract (except senile cataract) Intellectual limitation Nonintensitive hyperintensity in T2 sections on MRI of the dentate nucleus Forming an autosomal recessive transition pattern. (Ex: Relative Marriage)
- Proportion of patients with CTX possibility in Pediatric Metabolism Clinics [3 years]
- Proportion of cases above the cholestanol test threshold (3.75 mg / mL) in pediatric metabolism centers
Secondary Outcome Measures
- Total of Mignarri Suspicion Index (SI) [3 Years]
Mignarri is a suspicion index, composed of weight-ed scores assigned to indicators such as family history and common systemic and neurological features. The indicators were classified as very strong (score 100), strong (50) or moderate (25). The suspicion index will be applied to study population. Early systemic signs such as catamct, diarrhea and neonatal cholestatic jaundice were considered strong indica- tors, together with neurological features such as intellectual impairment, psychiatric disturbances, ataxia, spastic paraparesis and dentate nuclei abnormalities at MRI. Tendon xanthomas were regarded as very strong indicators, as was an affected sibling. A total score 100 warranted serum cholestanol assessment. Elevated cholestanol or a total score 200, with one very strong or four strong indicators, warranted CYP27Al gene analysis. (Reference: Mignarri et al. J Inherit Metab Dis (2014) 37:421-429) -and physical examination results for patients with high cholestanol levels
- Cholestanol Levels [3 Years]
- Cholestanol levels for patients with high cholestanol levels
- Patient demographics [3 Years]
For all screened patients: • Demographic data
- CTX Family History [3 Years]
For all screened patients: • CTX family history
- Presence of consangunious marriage [3 Years]
For all screened patients: • Presence of consanguineous marriage
- Frequency of the systemic findings [3 Years]
For all screened patients: • Frequency of the following systemic findings: Tendon xanthomas Chronic diarrhea Prolonged neonatal jaundice Early osteoporosis
- Frequency of the neurologic findings [3 Years]
For all screened patients: • Frequency of the following neurological symptoms: Cerebellar ataxia Spastic paraparesis Blateral cataract (except senile cataract) Non-enhancing hyperintensity on T2 sections in MR imaging of dentate nuclei Intellectual disability Psychiatric disorders Epilepsy Parkinson's Polyneuropathy
Eligibility Criteria
Criteria
Inclusion Criteria:
I-1. Giving written informed consent
I-2. Patients in neurology clinics should have been identified with at least two of the following:
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Ataxia and / or spasticity
-
Bilateral cataract (except senile cataract)
-
Intellectual limitation
-
Nonintensitive hyperintensity in T2 sections on MRI of the dentate nucleus
-
Forming an autosomal recessive transition pattern. (Ex: Relative Marriage)
I-3. In the pediatric metabolism centers, cases suspected of CTX and planned to apply the Mignarri Index according to the investigator's opinion.
I-4. On the day the patient signed the Informed Consent Form, the patient did not get older than 41 years of age (subjects aged 40 and under will be included in the study)
Exclusion Criteria:
E-1. The patient's ataxia and / or spasticity, cataract, intellectual limitation, and non-contrasted hyperintensity of T2 sections in MR imaging of dentate nuclei with typical MRI findings are due to a known cause other than CTX or other underlying disease.
E-2. The patient has participated in an interventional clinical study in the last 30 days,
E-3. The patient and / or his / her legal representative does not give consent to participate in the study,
E-4. In the opinion of the investigator, the patient is not able to fulfill the working requirements appropriately,
E-5. Pregnancy and / or lactation
E-6. If the patient was 41 years old when included in the study.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Çukurova University Medical Faculty Deparment of Metabolism | Adana | Turkey | ||
| 2 | Çukurova University Medical Faculty Department of Neurology | Adana | Turkey | ||
| 3 | Ankara Child and Heamatology Hospital Deparment of Metabolism | Ankara | Turkey | ||
| 4 | Ankara City Hospital | Ankara | Turkey | ||
| 5 | Ankara Dışkapı Yıldırım Beyazıt Research and Training Hospital Clinic of Neurology | Ankara | Turkey | ||
| 6 | Gazi University Medical Faculty Department of Pediatric Metabolism | Ankara | Turkey | ||
| 7 | Hacettepe University Medical Faculty Deparment of Metabolism | Ankara | Turkey | ||
| 8 | Hacettepe University Medical Faculty Department of Neurology | Ankara | Turkey | ||
| 9 | Osmangazi University Medical Faculty Department of Neurology | Eskişehir | Turkey | ||
| 10 | Osmangazi University Medical Faculty Department of Pediatric Metabolism | Eskişehir | Turkey | ||
| 11 | Bezmi Alem Vakıf University Medical Faculty Department of Neurology | Istanbul | Turkey | ||
| 12 | Hamidiye Şişli Etfal Research and Training Hospital Clinic of Neurology | Istanbul | Turkey | ||
| 13 | Hamidiye Şişli Etfal Research and Training Hospital Clinic of Pediatric Metabolism | Istanbul | Turkey | ||
| 14 | İstanbul University Cerrahpasa Medical Faculty Department of Pediatric Metabolism | Istanbul | Turkey | ||
| 15 | İstanbul University Cerrahpaşa Medical Faculty Department of Neurology | Istanbul | Turkey | ||
| 16 | İstanbul University İstanbul Medical Faculty Department of Neurology | Istanbul | Turkey | ||
| 17 | İstanbul University İstanbul Medical Faculty Department of Pediatric Metabolism | Istanbul | Turkey | ||
| 18 | Kanuni Sultan Suleyman Research and Training Hospital Clinic of Pediatric Metabolism | Istanbul | Turkey | ||
| 19 | Medeniyet University Göztepe Research and Training Hospital Clinic of Neurology | Istanbul | Turkey | ||
| 20 | Mersin City Hospital Department of Metabolism | Mersin | Turkey | ||
| 21 | Mersin University Medical Faculty Department of Neurology | Mersin | Turkey | ||
| 22 | Cumhuriyet University Medical Faculty Department of Neurology | Sivas | Turkey |
Sponsors and Collaborators
- TRPHARM
- Klinar CRO
- Düzen Laboratories Group
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- TR-CTX-002