TRAMmoniTTR Study Genetic Screening of an At-risk Population for hATTR and Monitoring of TTR Positive Subjects (TRAMmoniTTR)
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ClinicalTrials.gov Identifier: NCT03237494 |
Recruitment Status :
Recruiting
First Posted : August 2, 2017
Last Update Posted : February 22, 2023
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Condition or disease |
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Transthyretin Amyloidosis Transthyretin-Related (ATTR) Familial Amyloid Polyneuropathy Transthyretin-Related (ATTR) Familial Amyloid Cardiomyopathy Polyneuropathies Cardiomyopathies |
Hereditary TransThyRetin Amyloidosis (hATTR) is a slowly progressive condition, that is transmitted as an autosomal dominant trait and is characterized by abnormal extracellular deposits of fibrillar, misfolded proteins (amyloid fibrils) in the body. Amyloid fibrils can be deposited in different body compartments, such as the nerves, heart, gastrointestinal tract, kidneys and brain, causing severe structural changes. More than 30 proteins can trigger the formation of amyloid fibrils, 5 of which can infiltrate the heart and cause cardiac amyloidosis.
One of these amyloidogenic protein is transthyretin, formerly known as prealbumin. Transthyretin (TTR) is found primarily in the serum (secreted by the liver) and cerebrospinal fluid (secreted by the choroid plexus) and functions as a carrier for the hormone thyroxine (T4) and retinol-binding protein (bound to retinol or vitamin A). The destabilization of the TTR protein and the formation of misfolded TTR.
It is the goal of this study to investigate the prevalence of Hereditary Transthyretin-related Amyloidosis (hATTR) in a cohort of 5.000 subjects are at risk for Hereditary Transthyretin Amyloidosis (hATTR) and subjects diagnosed with hATTR, to monitor the clinical status in TTR positive subjects and to establish hATTR biomarker/s.
Study Type : | Observational |
Estimated Enrollment : | 5000 participants |
Observational Model: | Cohort |
Time Perspective: | Prospective |
Official Title: | Genetic Screening of an At-risk Population for Hereditary TransthyRetin-related AMyloidosis and Longitudinal Monitoring of TTR Positive Subjects- A Multicenter Epidemiological Longitudinal Protocol |
Actual Study Start Date : | July 20, 2017 |
Estimated Primary Completion Date : | April 30, 2025 |
Estimated Study Completion Date : | April 30, 2025 |

Group/Cohort |
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Participants at risk for hATTR and participants diagnosed with hATTR
Participants 18 years of age or older
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- Analysis of prevalance of hATTR mutations among a cohort of participants at risk for hATTR. [ Time Frame: 4 years ]DBS-based genetic analyses of TTR gene will be perfomed via the combination of the Next-Generation Sequencing (the mutation will be confirmed by Sanger sequencing) and the Multiplex ligation-dependent probe amplification.
- To monitor clinical status in TTR positive subjects. [ Time Frame: 4 years ]8 Follow up visits within 24 months
- Establishment of biomarker/s in TTR positive cohort. [ Time Frame: 4 years ]hATTR-positive samples will be analyzed for the identification of potential biomarkers (based on MS/MS-Tandem spectroscopy) and compared with the merged control samples in order establish a HAE specific biomarker.
Biospecimen Retention: Samples With DNA

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Probability Sample |
Inclusion Criteria:
- Informed consent is obtained from the participant
- The participant is 18 years of age or older
- The participant has no diagnosis of alcoholism according to international guidelines
- The participant has not undergone chemotherapy for any carcinoma
AND
The participant is at risk for hATTR due to two or more the factors listed below:
- cardiomyopathy or polyneuropathy with no obvious etiology atypical Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) or Motor Neuron Disease (MND)
- autonomic dysfunction
- hypertrophic cardiomyopathy or heart failure with preserved ejection fraction Left Ventricular Hypertrophy (LVH)
- bilateral carpal tunnel syndrome
- spinal stenosis or spinal radiculopathy
- gait disorders
- ocular changes involving vitreous opacities
- unexplained weight loss >5kg
- renal abnormalities
- family history of hATTR
- based on imaging or biopsy suspected for the wild type TTR (ATTR) and not genetically tested for hATTR
OR • The participant is diagnosed with hATTR
OR
• The participant is a 1st or 2nd degree relative of the TTR positive subject
Exclusion Criteria
- Informed consent is not obtained from the participant
- The participant is younger than 18 years of age
- The participant has a diagnosis of alcoholism according to International guidelines
- The participant has undergone chemotherapy for any carcinoma
- The participant is not at risk for hATTR

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03237494
Contact: Sabine Roesner | +49 381 80113657 | sabine.roesner@centogene.com |

Study Chair: | Peter Bauer, Prof. | Centogene GmbH |
Responsible Party: | CENTOGENE GmbH Rostock |
ClinicalTrials.gov Identifier: | NCT03237494 |
Other Study ID Numbers: |
TRAM2 analysis |
First Posted: | August 2, 2017 Key Record Dates |
Last Update Posted: | February 22, 2023 |
Last Verified: | May 2022 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Peripheral Nervous System Diseases Transthyretin Amyloidosis Transthyretin-related familial amyloid polyneuropathy Transthyretin-related familial amyloid cardiomyopathy |
Polyneuropathies Amyloid Neuropathies, Familial Amyloid Neuropathies Cardiomyopathies Amyloidosis Heart Diseases Cardiovascular Diseases Proteostasis Deficiencies Metabolic Diseases |
Peripheral Nervous System Diseases Neuromuscular Diseases Nervous System Diseases Heredodegenerative Disorders, Nervous System Neurodegenerative Diseases Genetic Diseases, Inborn Amyloidosis, Familial Metabolism, Inborn Errors |