Clinical trial NCT05927467: Eurbio-Alport (RaDiCo Cohort) (RaDiCo Eurbio-Alport)
Official title: Study of the Natural History of Alport Syndrome by Establishment of an International Database
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Alport Syndrome
Keywords: Alport Syndrome
Rare disease
European database
Quality of life
Kidney disease
Molecular diagnostics
Predictive biomarkers
Lead sponsor: Institut National de la Santé Et de la Recherche Médicale, France
Sponsor class: OTHER_GOV
First posted: 2023-07-03
Enrollment: 700
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The countries that are potentially interested in joining the project have identified in their local records about 100 (Germany), 200 (Spain), 100 (United Kingdom), 785 (Italy), 100 (Belgium) patients. The database ASTOR in USA have included 800 patients. For France, the CEMARA database contains currently 680 Alport Syndrome patients while there are 950 identified patients in France. These patients are followed in nephrology and paediatric nephrology services belonging to the French network for rare renal diseases. Prevalent cases will include cases already registered in the different existing databases in the different countries, after monitoring that the inclusion criteria are respected. There is no known estimated incident rate, but according to the available information and the estimated prevalence rate (1/5,000), it is expected to enrol roughly between 100 and 200 incident patients/year in the study.

Brief summary: Alport syndrome is a rare, inherited condition characterized by a combination of glomerular nephropathy progressing to kidney failure, deafness, and eye involvement. This disease is associated with mutations in the genes encoding one of the three IV collagen chains expressed in the glomerular basement membrane. Significant progress has been made in understanding the molecular mechanisms responsible for the disease, but relatively little in understanding the progression of renal failure and in the area of therapeutics. We have shown in a retrospective European study that blockers of the renin angiotensin system may slow disease progression, but no controlled studies have been performed. Finally, innovative therapies (anti-micro-RNA, stem cells) have recently shown their effectiveness in animal models of the disease, and industrials are planning to quickly carry out phase 1 trials to test molecules. Carrying out therapeutic trials in humans will require full knowledge of the natural history of the disease (isolated hematuria, microalbuminuria, macroalbuminuria, renal failure and its progression) and gathering a sufficient number of patients, especially in the early stages. These trials and the indications for treatments would be greatly facilitated by the discovery of biomarkers that make it possible to predict the progression to renal failure earlier than the onset of proteinuria.

The study aims to:

* Establish a European database on Alport syndrome to assess the natural history of the disease.
* To investigate the impact of the disease on the educational and professional life of patients and their families, and on the adherence and tolerance to renin-angiotensin system blockers prescribed to proteinuric patients.
* Investigate access to molecular diagnostics and genetic counseling, as well as identify biomarkers that can predict progression of kidney disease.

This project will be carried out at a French level with the support and participation of the very active renal rare disease sector, in collaboration with various countries wishing to participate.


Eligibility criteria: Inclusion Criteria:

* Diagnosis of AS based on electron microscopic examination of the renal biopsy and/or molecular studies and/or abnormal expression of type IV collagen chains on skin and/or glomerular basement membranes.
* Signed informed consent

Exclusion Criteria:

- No exclusion criteria

Primary outcomes:
measure: Renal function: eGFR, age at ESRD, requirement of Renal Replacement Therapy (RRT) and type of RRT
timeFrame: Through study completion, at 1 year, 2 year, 3 year
measure: Urine bio-analysis results: Presence or not and quantification of hematuria, microalbuminuria and proteinuria
timeFrame: Through study completion, at 1 year, 2 year, 3 year
measure: Presence or not of hypertension
timeFrame: Through study completion, at 1 year, 2 year, 3 year
measure: Level of Hearing loss
timeFrame: Through study completion, at 1 year, 2 year, 3 year
measure: Ocular symptoms (presence or not of lenticonus, cataract, retina and cornea impairment)
timeFrame: Through study completion, at 1 year, 2 year, 3 year
Secondary outcomes:
measure: Adverse events for the long-term safety of RAAS blockers treatment
timeFrame: Through study completion, at 1 year, 2 year, 3 year
measure: Quality of life questionnaires
timeFrame: Through study completion, at 1 year, 2 year, 3 year
measure: Compliance
timeFrame: Throughout the follow-up
Other outcomes:
measure: Disease stage
timeFrame: Throughout the follow-up
measure: Urinal concentration of specific molecules
timeFrame: Through study completion, at 1 year, 2 year, 3 year
Locations:
city: Paris
country: France
facility: RaDiCo Eurbio-Alport
state: Île-de-France
Study officials:
affiliation: INSERM U933
name: Laurence Heidet, PHD
role: PRINCIPAL_INVESTIGATOR
References: