European Autism GEnomics Registry (EAGER): Protocol for a multicentre cohort study and registry
Authors: Bloomfield M. , Lautarescu A. , Heraty S. , Douglas S. , Violland P. , Plas R. , Ghosh A. , Van den Bosch K. , Eaton E. , Absoud M. , Battini R. , Blázquez Hinojosa A. , Bolshakova N. , Bolte S. , Bonanni P. , Borg J. , Calderoni S. , Calvo Escalona R. , Castelo-Branco M. , Castro-Fornieles J. , Caro P. , Danieli A. , Delorme R. , Elia M. , Hempel M. , Madeira N. , McAlonan G. , Milone R. , Molloy C. J. , Mouga S. , Montiel V. , Pina Rodrigues A. , Schaaf C. P. , Serrano M. , Tammimies K. , Tye C. , Vigevano F. , Oliveira G. , Mazzone B. , O’Neill C. , Romero V. , Tillmann J. , Oakley B. , Murphy D. , Gallagher L. , Bourgeron T. , Chatham C. , Charman T. 
Published: October 2023

Introduction

Autism is a common neurodevelopmental condition with a complex genetic aetiology that includes contributions from monogenic and polygenic factors. Many autistic people have unmet healthcare needs that could be served by genomics-informed research and clinical trials. The primary aim of the European Autism GEnomics Registry (EAGER) is to establish a registry of participants with a diagnosis of autism or an associated rare genetic condition who have undergone whole-genome sequencing. The registry can facilitate recruitment for future clinical trials and research studies, based on genetic, clinical, and phenotypic profiles, as well as participant preferences. The secondary aim of EAGER is to investigate the association between mental and physical health characteristics and participants’ genetic profiles.

Methods and analysis

EAGER is a European multisite cohort study and registry and is part of the AIMS-2-TRIALS consortium. EAGER was developed with input from the AIMS-2-TRIALS Autism Representatives and representatives from the rare genetic conditions community. 1,500 participants with a diagnosis of autism or an associated rare genetic condition will be recruited at 13 sites across 8 countries. Participants will give a blood or saliva sample for whole-genome sequencing and answer a series of online questionnaires. Participants may also consent for the study to access pre-existing clinical data. Participants will be added to the EAGER registry. Data will be shared via the Autism Sharing Initiative, a new international collaboration aiming to create a federated system for autism data sharing.

Ethics and dissemination

EAGER has received full ethical approval from ethics committees in the UK (REC 23/SC/0022), Germany (S-375/2023), Portugal (CE-085/2023) and Spain (HCB/2023/0038, PIC-164-22). Approvals are in the process of being obtained from committees in Italy, Sweden, Ireland, and France. Findings will be disseminated via scientific publications and conferences, but also beyond to participants and the wider community (e.g., the AIMS-2-TRIALS website, stakeholder meetings, newsletters).

STRENGHTS AND LIMITATIONS OF THIS STUDY

Data from full genotyping through whole-genome sequencing will be combined with mental and physical health data and participant research priorities

The EAGER sample (n=1,500), although relatively small for genetic analyses, will include a substantial proportion (around one third) of participants with a rare genetic condition, ensuring that heterogeneous presentations across the autism spectrum are captured

The EAGER registry will improve the speed, efficiency, and impact of research studies and clinical trials across Europe with a culturally diverse cohort of re-contactable participants, and shared data through the Autism Sharing Initiative

EAGER was developed with input from the AIMS-2-TRIALS Autism Representatives and representatives from the rare genetic conditions community

Phenotypic data are collected only via self/informant-report questionnaires and not direct clinical assessments