A Single Center Observational Study of Biomarkers of Airway Disease, Barrett's and Underdiagnosed Reflux Noninvasively (BADBURN)

Sponsor
NYU Langone Health (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT05216133
Collaborator
National Institute for Occupational Safety and Health (NIOSH/CDC) (U.S. Fed)
200
1
28.9
6.9

Study Details

Study Description

Brief Summary

A majority of Fire Department of New York (FDNY) World Trade Center (WTC) exposed rescue and recovery workers developed gastroesophageal reflux disease (GERD), a risk factor for Barrett's Esophagus (BE) and subsequent esophageal cancer. There is diminished health-related quality of life and productivity associated with aerodigestive diseases such as GERD and BE.

This proposal will leverage the longitudinally phenotyped WTC exposed cohort, validate biomarkers of WTC-aerodigestive disease, and develop novel, noninvasive disease phenotyping of premalignant diseases such as BE, and identify potential targeted therapeutics to improve care.

Condition or Disease Intervention/Treatment Phase

    Study Design

    Study Type:
    Observational
    Anticipated Enrollment :
    200 participants
    Observational Model:
    Cohort
    Time Perspective:
    Prospective
    Official Title:
    AERODIGESTIVE DISEASE IN THE WORLD TRADE CENTER EXPOSED FDNY COHORT: a Single Center Observational Study of Biomarkers of Airway Disease, Barrett's and Underdiagnosed Reflux Noninvasively (BADBURN)
    Anticipated Study Start Date :
    Feb 1, 2022
    Anticipated Primary Completion Date :
    Jun 1, 2023
    Anticipated Study Completion Date :
    Jul 1, 2024

    Outcome Measures

    Primary Outcome Measures

    1. Levels of salivary pepsin [up to Day 365]

      Saliva will be analyzed using the Peptest. The value of >/= 16 ng/mL indicates a positive salivary pepsin.

    2. pH Levels from Exhaled Breath Condensate (EBC) [up to Day 365]

      EBC pH assay will be performed

    3. Histamine Concentration from Exhaled Breath Condensate (EBC) [up to Day 365]

      Histamine concentration will be measured with an enzymatic immunoassay

    4. Score on Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL) Questionnaire [up to Day 365]

      PAGI-QOL asks about how some of the gastrointestinal problems one may be experiencing (such as pain, discomfort, or other problems) may have affected one's overall quality of life and well-being in the past 2 weeks. PAGI-QOL consists of 30 questions, each scored from 0 (none of the time) to 5 (all of the time). The total score range is 0-150; the higher the score, the less the quality of life and well-being.

    5. Score on Patient Assessment of Upper Gastrointestinal Disorders-Symptoms (PAGI-SYM) Questionnaire [up to Day 365]

      PAGI-SYM asks about the severity of symptoms one may have related one's gastrointestinal problem. The questionnaire consists of 20 symptoms, and each symptom is scored from 0 (none) to 5 (very severe). The total score range is 0-100; the higher the score, the more severe the symptoms.

    6. Score on St. George's Respiratory Questionnaire (SGRQ-C) [up to Day 365]

      SGRQ-C is designed to assess how one's breathing is troubling a participant and how it affects one's life. The questionnaire consists of 14 questions. The total score range is 0-54; the higher the score, the worse the chest trouble.

    7. 36-Item Short Form Survey Instrument (SF-36) [up to Day 365]

      SF-36 captures mental health, general health perception, emotional, and social role functioning. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    37 Years to 90 Years
    Sexes Eligible for Study:
    Male
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Age 37-90

    2. FDNY rescue and recovery worker.

    3. Male*

    4. Documented WTC exposure.

    5. Consented/Enrolled in the FDNY WTC Health Program

    6. Subjects are willing and able to consent for themselves to study enrollment

    7. Subjects are willing and able to participate in study procedures

    8. Are able to perform their activities of daily living independently

    9. Are either light duty or retired FDNY Firefighters

    10. Spirometry available within the last 24 months, and at a post-9/11 visit.

    11. Have means to accommodate transportation to/from in-person visit Are able to attend a single visit at the CTSI (462 1st Avenue, C & D 4th Floor)

    12. Pre-9/11 spirometry with FEV1%predicted ≥LLN and if not available 1st -post 9/11 spirometry with an FEV1 >80% predicted.

    13. Exposure at the WTC-site within 2 weeks of the 9/11/2001

    14. Entered WTC-HP before the site closure on 7/24/2002.

    15. Serum from their first post 9/11 WTC-HP visit is available in the FDNY WTC biorepository and may be assayed

    16. Are not currently being treated for malignancy

    17. Subjects will either need to be defined as having WTC-AHR, WTC-GERD, WTC-BE or be designated controls as per the following additional inclusion criteria are specific to the WTC-aerodigestive disease that the subjects have

    18. AHR--A positive methacholine (PC20<16) and/or positive bronchodilator response (ATS/ERS guidelines: improvement of FEV1 by 12% and at least 200mL) at least once post-9/11.[95, 96]No recorded positive AHR testing prior to 9/11

    19. GERD Inclusion Criteria

    • Erosive esophagitis LA grade C or D (as described on endoscopy), OR

    • Stricture or Barrett's esophagus on endoscopy, OR

    • Esophageal acid exposure time >6% on a pH or pH impedance study

    1. BE Inclusion Criteria
    • Columnar epithelium lining ≥1 cm of the distal esophagus. AND

    • Histologic examination of biopsy specimens from that columnar epithelium must reveal intestinal metaplasia characterized with goblet cells.

    Exclusion Criteria:
    1. Unwilling to complete an informed consent.

    2. Not enrolled in the WTC-HP

    3. Do not meet eligibility criteria for AIM 1 or did not have serum available in the biorepository from the first post 9/11 WTC-HP visit.

    4. Have pre-existing and documented conditions or concurrent diagnoses, including (and not necessarily limited to) active cancer, severe heart disease, significant cognitive impairment, eating disorders, significant psychiatric illness, end-stage COPD, severe pulmonary hypertension, or organ transplant.

    5. High dose steroid (>20mg prednisone or equivalent) or other hormonal treatments/chemotherapy use in the last month, including testosterone supplementation.

    6. Life-expectancy < 6 months

    7. Female*

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 NYU Clinical & Translational Science Institute Clinical Research Center (CTSI CRC) New York New York United States 10016

    Sponsors and Collaborators

    • NYU Langone Health
    • National Institute for Occupational Safety and Health (NIOSH/CDC)

    Investigators

    • Principal Investigator: Anna Nolan, MD, NYU Langone Health

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    NYU Langone Health
    ClinicalTrials.gov Identifier:
    NCT05216133
    Other Study ID Numbers:
    • 21-00679
    First Posted:
    Jan 31, 2022
    Last Update Posted:
    Jan 31, 2022
    Last Verified:
    Jan 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Jan 31, 2022