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Amyotrophic Lateral Sclerosis (ALS) Gulf War Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT00007722
Recruitment Status : Completed
First Posted : January 1, 2001
Last Update Posted : October 9, 2009
Sponsor:
Collaborators:
United States Department of Defense
Centers for Disease Control and Prevention
Department of Health and Human Services
ALS Association
Information provided by:
VA Office of Research and Development

Tracking Information
First Submitted Date December 29, 2000
First Posted Date January 1, 2001
Last Update Posted Date October 9, 2009
Study Start Date July 2000
Actual Primary Completion Date March 2003   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures
 (submitted: October 7, 2009)
Probability of ALS among veterans both deployed and non-deployed to the Gulf Region(8/2/1990-7/31/1991) [ Time Frame: Ongoing ]
Original Primary Outcome Measures Not Provided
Change History Complete list of historical versions of study NCT00007722 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures Not Provided
Original Secondary Outcome Measures Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title Amyotrophic Lateral Sclerosis (ALS) Gulf War Study
Official Title CSP #500 - An Epidemiological Investigation Into the Occurrence of Amyotrophic Lateral Sclerosis (ALS) Among Gulf War Veterans
Brief Summary Recently, concern has arisen regarding a possible elevated occurrence of ALS among veterans who served in the Persian Gulf during Operations Desert Shield (August 2, 1990 - January 15, 1991), Desert Storm (January 16, 1991 - February 28, 1991) and Clean-up (March 1, 1991 - July 31, 1991). This study involves an epidemiologic investigation into the occurrence of ALS among veterans of the Gulf War. This study will further define the epidemiology of this neurological disease among younger individuals while determining whether there is a higher than expected occurrence. It will also ascertain the etiologic importance of deployment to the Persian Gulf and exposure to specific environmental factors in that geographic area. VA is leading this joint federal government epidemiologic study that also involves DoD, HHS, CDC, and academic centers of excellence in neurology, with advice from the ALS Association.
Detailed Description

Primary Objectives: To develop, through nationwide ascertainment, a comprehensive descriptive epidemiology of amyotrophic lateral sclerosis (ALS) among Gulf War veterans with particular attention to whether there is a higher than expected occurrence of ALS among deployed veterans as compared to non-deployed Gulf War veterans.

Secondary Objectives: To ascertain probable/possible etiologic factors with particular focus on the role of chemical or biologic factors in the Persian Gulf area of deployment.

Primary Outcomes: Incidence of ALS among deployed and non-deployed veterans of the Gulf War.

Intervention: N/A

Study Abstract: Recently, concern has arisen regarding a possible elevated occurrence of ALS among veterans who served in the Persian Gulf during Operations Desert Shield (August 2, 1990 - January 15, 1991), Desert Storm (January 16, 1991 - February 28, 1991) and Clean-up (March 1, 1991 - July 31, 1991). In response to this concern, a nationwide epidemiological investigation was conducted to ascertain all occurrences of ALS between August, 1990 and July, 2000 among all active duty military and mobilized Reserves, including National Guard, who served during the Gulf War period (August 2, 1990-July 31, 1991). A diagnosis of ALS was confirmed by medical record review and, as necessary, neurological examination. Risk was assessed by the age-adjusted, average, annual 10-year cumulative incidence rate. VA led this joint federal government epidemiologic study that also involved DoD, HHS, CDC, and academic centers of excellence in neurology, with advice from the ALS Association.

The study population was defined as all active duty military and mobilized reserves and National Guard who served for at least one month at any time during the Gulf War period. Mobilized reservists and members of the National Guard were those who were activated and called-up, being either deployed to S.W. Asia or "back-filling" positions of military personnel who were deployed. Deployed military personnel were those who served in the S.W. Asian theater during Operations Desert Shield and Desert Storm or the period immediately after Desert Storm or received hazardous duty pay during the Gulf War. All other individuals in the study population were classified as non-deployed, although they may have been stationed outside the U.S.

This study has as its primary component a field epidemiological investigation, involving nationwide ascertainment of ALS cases among deployed and non-deployed veterans of the Gulf War to obtain a census of ALS cases among these populations. Ascertainment of cases occurred through three avenues. The first was a search of extant VA and DoD medical databases. Second, we solicited cases from the ALS Association, other related organizations, and from VA and DoD neurology clinics. And third, we identified cases through self-referrals that resulted from national media announcements. Purported cases were verified via medical record review and, as necessary, a detailed clinical examination. For all living cases, we are collecting a sample of blood and urine for determination of ALS-relevant DNA mutations and heavy metal exposure, respectively. There is also an in-home visit that includes an interview of the patient and family members with emphasis on ascertainment of unique exposures.

Results: In this large epidemiological study, researchers supported by both the Department of VA and DoD have found preliminary evidence that veterans who served in Desert Shield-Desert Storm are nearly twice as likely as their non-deployed counterparts to develop ALS. VA is exploring options for compensating veterans who served in the Gulf and who subsequently develop ALS.

Ongoing Surveillance: The study team has implemented an ongoing surveillance system to detect future cases of ALS that develop in this veteran population. This system involves maintaining the linkages created to detect current cases. New cases will be subject to the same protocols for verification, enrollment and data collection as in the original case ascertainment study.

Study Type Observational
Study Design Observational Model: Case-Only
Time Perspective: Prospective
Target Follow-Up Duration Not Provided
Biospecimen Retention:   Samples With DNA
Description:
DNA samples of blood or mouthwash were collected in veterans' homes by nurses.
Sampling Method Non-Probability Sample
Study Population Living and deceased veterans with an ALS diagnosis who served in the military between 8/2/1990 and 7/31/1991.
Condition Amyotrophic Lateral Sclerosis
Intervention Not Provided
Study Groups/Cohorts 1
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status Completed
Actual Enrollment
 (submitted: October 7, 2009)
135
Original Enrollment
 (submitted: June 23, 2005)
126
Actual Study Completion Date March 2003
Actual Primary Completion Date March 2003   (Final data collection date for primary outcome measure)
Eligibility Criteria

Inclusion Criteria:

Veterans who served in the Persian Gulf during Operations Desert Shield (August 2, 1990 - January 15, 1991), Desert Storm (January 16, 1991 - February 28, 1991) and Clean-up (March 1, 1991 - July 31, 1991)

Exclusion Criteria:

Sex/Gender
Sexes Eligible for Study: All
Ages 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers No
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries United States
Removed Location Countries  
 
Administrative Information
NCT Number NCT00007722
Other Study ID Numbers 500
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement Not Provided
Responsible Party Oddone, Eugene - Study Chair, Department of Veterans Affairs
Study Sponsor US Department of Veterans Affairs
Collaborators
  • United States Department of Defense
  • Centers for Disease Control and Prevention
  • Department of Health and Human Services
  • ALS Association
Investigators
Study Chair: Eugene Z. Oddone, MD MHSc VA Medical Center
PRS Account VA Office of Research and Development
Verification Date October 2009