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Longitudinal Study of Mitochondrial Hepatopathies (MITOHEP)

This study is currently recruiting participants. (see Contacts and Locations)
Verified September 2014 by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Sponsor:
Collaborator:
University of Michigan
Information provided by (Responsible Party):
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
ClinicalTrials.gov Identifier:
NCT01148550
First received: June 18, 2010
Last updated: September 15, 2014
Last verified: September 2014

June 18, 2010
September 15, 2014
July 2010
May 2019   (final data collection date for primary outcome measure)
  • Listing for liver transplant [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Listing for liver transplant
  • Liver transplantation [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Liver transplantation
  • Involvement of other organ systems known to be associated with mitochondrial diseases [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Involvement of other organ systems known to be associated with mitochondrial diseases
  • Death [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Death
Same as current
Complete list of historical versions of study NCT01148550 on ClinicalTrials.gov Archive Site
  • Growth failure [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Growth failure (defined as weight or length Z-score for age < -2)
  • Worsening liver function [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Worsening liver function (defined as PELD >10)
  • Complications of portal hypertension [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Complications of portal hypertension
  • Neurodevelopmental outcome [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Neurodevelopmental outcome
  • Health related Quality of Life [ Time Frame: Measured/assessed at baseline, 6 months, Years 1,2,3,4,5, and at time of liver transplant, liver or muscle biopsy or hospitalization for critical illness if applicable ] [ Designated as safety issue: No ]
    Health related Quality of Life
Same as current
Not Provided
Not Provided
 
Longitudinal Study of Mitochondrial Hepatopathies
Longitudinal Study of Mitochondrial Hepatopathies

The specific aims of this study are (1) to determine the clinical phenotypes and natural history of hepatic RC and FAO disorders, (2) to determine the correlation between genotype and phenotype, (3) to determine if circulating biomarkers reflect diagnosis and predict liver disease progression and survival with the native liver, (4) to determine the clinical outcome of these disorders following liver transplantation, and (5) to develop a repository of serum, plasma, urine, tissue and DNA specimens that will be used in ancillary studies. To accomplish these aims, the ChiLDREN investigators at clinical sites (currently 15 sites) will prospectively collect defined data and specimens in a uniform fashion at fixed intervals in a relatively large number of subjects. Clinical information and DNA samples to be collected from subjects and their parents will enhance the potential for meaningful research in these disorders. A biobank of subject specimens and DNA samples will be established for use in ancillary studies to be performed in addition to this study.

This study will be conducted as part of the NIH-supported Childhood Liver Disease Research and Education Network (ChiLDREN). ChiLDREN is investigating rare cholestatic liver diseases of childhood: alpha-1 antitrypsin deficiency (A1AT), Alagille's Syndrome (AGS), progressive familial intrahepatic cholestasis (PFIC), bile acid synthesis defects and mitochondrial hepatopathies (all previously studied by the Cholestatic Liver Disease Consortium [CLiC]); biliary atresia (previously studied by the Biliary Atresia Research Consortium [BARC]); neonatal hepatitis; and cystic fibrosis liver disease, which is studied by a new branch of ChiLDREN known as the Cystic Fibrosis Liver Disease (CFLD) Network.

In this protocol, mitochondrial hepatopathies in children and young adults will be investigated. The focus will be on respiratory chain defects (RC) and defects of fatty acid oxidation (FAO). There is little known about the full spectrum of severity and long-term natural history of mitochondrial hepatopathies. Moreover, these disorders have not been subject to prospective, rigorous clinicopathological scrutiny.

Observational
Observational Model: Cohort
Time Perspective: Prospective
Not Provided
Retention:   Samples With DNA
Description:

Blood plasma and serum samples with DNA

Non-Probability Sample

A total of 67 children and young adults with suspected or documented hepatic RC defect or FAO defect between birth and 18 years old from both genders and all races and ethnic groups that meet inclusion/exclusion criteria as defined below.

  • Acute Liver Failure,
  • Mitochondrial Diseases
  • End Stage Liver Disease,
  • Respiratory Chain Deficiencies, Mitochondrial
  • Disorder of Fatty Acid Oxidation
Not Provided
  • Group 1
    Mitochondrial Hepatopathy Disease Group
  • Group 2
    Subjects with Suspected Mitochondrial Hepatopathy who do not meet the enrollment criteria for Group 1 Subjects with Suspected Mitochondrial Hepatopathy who do not meet the enrollment criteria for Group 1
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
67
Not Provided
May 2019   (final data collection date for primary outcome measure)

Subjects in Group 1 (Mitochondrial Hepatopathy group) must meet all of the following inclusion criteria:

  1. Children and young adults with suspected or documented hepatic RC defector FAO defect from birth to 18 years old (through 18 years).
  2. Both genders, all races and ethnic groups.
  3. Participants must meet one of the following sets of criteria (A or B):

A. Potential subjects presenting with acute or chronic liver disease or acute liver failure but who have not had a liver transplant must meet one of Clinical Criteria 1 and one of Clinical Criteria 2 listed below:

  1. Clinical Criteria 1 (any one of the following)

    • 1.Acute liver failure,defined as severe liver dysfunction and either 1) INR >1.5 or prothrombin time > 15 seconds with encephalopathy or 2) INR > 2.0 or prothrombin time > 20 seconds with or without encephalopathy; occurring within 8 weeks of onset of illness; with no known underlying chronic liver disease, or
    • 2.Acute liver disease defined as elevated AST or ALT >1.25 ULN and CK <1000u/L or conjugated bilirubin >2.0 mg/dl and >20% of total bilirubin, or
    • 3.Chronic liver disease defined as:

      • elevated ALT or AST (>1.25 ULN) for > 6 months, or
      • conjugated hyperbilirubinemia (conjugated [direct] > 2.0 mg/dl and > 20% of total bilirubin) for > 6 months or
      • clinical stigmata of chronic liver disease, including chronic hepatomegaly, clinical findings or complications of cirrhosis or portal hypertension, impaired liver synthetic function, intractable pruritus explainable only by liver disease or end-stage liver disease, or
      • abnormal liver histology including hepatic fibrosis or cirrhosis, microvesicular steatosis, canalicular cholestasis, ballooned granular red hepatocytes (AKA onocytes), intralobular collapse/regeneration And
  2. Clinical Criteria 2 (any one of the following:

    • 1.Prior history of extra-hepatic organ involvement accompanied by any one or more of the signs and symptoms associated with mitochondrial dysfunction (e.g.

hypotonia, neuro-developmental delay, seizure disorder requiring treatment with valproic acid, nystagmus, cardiomyopathy, renal tubulopathy, bone marrow failure,myopathy, hearing loss), or

  • 2.Lactic acidosis (arterial blood or free-flowing venous blood level >2.5 mmol/L or >22.5 mg/dl at any age and increased lactate:pyruvate ratio [>25.0]) or
  • 3.Hypoglycemia (blood glucose <45 mg/dl on any measurement) and hypoketonuria (<1+ for urine ketones by dipstick on urine specimen obtained within 4 hours after collecting blood with low glucose concentration), or
  • 4.Abnormal acyl carnitine profile, or
  • 5.Documented biochemical (enzymatic) or genetic diagnosis 3b. Potential participants who have undergone a liver transplantation because of acute liver failure or end stage liver disease due to suspected or confirmed mitochondrial hepatopathy; the transplantation may have been performed at a non-ChiLDREN medical center or at a ChiLDREN Clinical Site.

B. Potential subjects who have already had a liver transplant must meet criteria 1 and either criteria 2 or criteria 3 below:

  • 1.Previous liver transplantation, AND
  • 2.Suspected mitochondrial liver disease, based upon meeting one or more of the following criteria:

    • Had a prior history of extra-hepatic organ involvement accompanied by signs and symptoms associated with mitochondrial dysfunction (e.g., hypotonia, neuro-developmental delay, seizure disorder requiring treatment with valproic acid, nystagmus, cardiomyopathy, renal tubulopathy, bone marrow failure, myopathy, hearing loss), OR
    • A prior history of lactic acidosis (arterial blood or free-flowing venous blood level >2.5 mmol/L or >22.5 mg/dl at any age and increased lactate:pyruvate ratio [>25.0]), OR
    • A prior history of hypoglycemia (blood glucose <45 mg/dl on any measurement) and hypoketonuria (≤1+ for urine ketones by dipstick on urine specimen obtained within 4 hours after collecting blood with low glucose concentration), OR
    • A prior history of an abnormal acyl carnitine profile, OR
    • Documented biochemical (enzymatic) or genetic diagnosis of a mitochondrial disorder
  • 3.A documented (confirmed) mitochondrial disorder based upon the confirmation criteria specified in protocol.

Subjects in Group 2 (Suspected Mitochondrial Hepatopathy not meeting Group 1 enrollment criteria) must meet the following inclusion criteria:

  1. Children and young adults with suspected hepatic RC defect or FAO defect between birth through 18 years but who do not meet clinical inclusion criteria listed above for acute or chronic liver disease or acute liver failure.
  2. Both genders, all races and ethnic groups.

Subjects in either Group 1 or 2 must not have any of the following exclusion criteria:

  1. Inability to comply with the longitudinal follow-up described below.
  2. Failure of a family/patient to sign the informed consent/assent document or the HIPAA authorization form.
  3. Known Medium Chain Acyl CoA Dehydrogenase deficiency (MCAD).
  4. Other known causes of liver disease.
Both
up to 18 Years
No
Contact: Joan M Hines, MPH 720-777-2598 joan.hines@childrenscolorado.org
United States,   Canada
 
NCT01148550
MITOHEP 6003
Yes
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
University of Michigan
Study Chair: Ronald J Sokol, MD University of Colorado, Denver
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
September 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP