Exhaled Breath Olfactory Signature of Pulmonary Arterial Hypertension (SNOOPY2)

• ClinicalTrials.gov Identifier: NCT02782026
• Recruitment Status: Completed
• First Posted: May 25, 2016
• Last Update Posted: May 4, 2021
• Sponsor: Assistance Publique - Hôpitaux de Paris
• Collaborators: Technion, Israel Institute of Technology; Bayer
• Information provided by (Responsible Party): Assistance Publique - Hôpitaux de Paris

Tracking Information

• First Submitted Date: February 23, 2016
• First Posted Date: May 25, 2016
• Last Update Posted Date: May 4, 2021
• Actual Study Start Date: March 4, 2016
• Actual Primary Completion Date: August 28, 2018 (Final data collection date for primary outcome measure)

Current Primary Outcome Measures (submitted: May 24, 2016)

Volatile organic compounds in exhaled breath in patients of each group detected using sensor array on the basis of cross-reactive gold-nanoparticles coated with organic ligands. [ Time Frame: Up to 4 hours ]

The primary endpoint will be the ability of the E-nose to discriminate patients with PAH from healthy controls by their olfactory signature from the profile of volatile organic compounds in exhaled breath.

• Original Primary Outcome Measures: Same as current
• 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: Exhaled Breath Olfactory Signature of Pulmonary Arterial Hypertension
• Official Title: Exhaled Breath Olfactory Signature of Pulmonary Arterial Hypertension Detected by an Artificial Nose: A Clinical Validation Study

Brief Summary

In this prospective case-control study, the investigators will evaluate the diagnostic performance of a novel electronic nose (E-nose) for the detection of Pulmonary Arterial Hypertension (PAH). This study is designed to:

1. Assess the performance of the E-nose to discriminate controls from patients with PAH
2. Assess the performance of the E-nose to discriminate between different subtypes of pulmonary hypertension (PH), namely idiopathic PAH, heritable PAH with BMPR2 mutation and chronic thromboembolic PH
3. Assess the performance of the E-nose to discriminate controls from asymptomatic patients with PH who carry BMPR2 mutations.

Detailed Description

Pulmonary arterial hypertension (PAH) is a progressive and rare severe disease (prevalence of 15-50 per million) due to obstruction of small pulmonary arteries, leading to an increase in pulmonary artery pressure with the ultimate consequence right heart failure. Despite recent advances in therapeutic care, there is no cure and most patients die or require lung transplantation within 5 years of diagnosis. Currently, right heart catheterisation is required to diagnose PAH and monitor response to treatment. Right heart catheterisation is an invasive test, and alternatives such as echocardiography have not yielded sufficient accuracy both for early diagnosis and disease monitoring. Currently, PAH is often diagnosed at an advanced stage of the disease. There is often a delay in diagnosis of several years between the first symptoms and the identification of the disease due to the non-specific nature of symptoms. Hence, there is the need to improve the time between the first signs and definitive diagnosis of the disease. Early diagnosis of PAH remains a challenge due to the low sensitivity and specificity of biomarkers available currently.

The main objective is to validate the results obtained in the previous preliminary proof of concept study - that PAH patients display a unique olfactory signature that can be detected by an artificial E- nose.

Secondary objectives are to investigate the ability of the E-nose to:

• Discriminate patients with idiopathic PAH from those with heritable PAH due to BMPR2 mutations
• Discriminate patients with chronic thromboembolic pulmonary hypertension (CTEPH) from healthy controls, and patients with idiopathic and/or heritable PAH.
• Detect development of PAH in BMPR2 mutation carriers
• Determine whether the olfactory signature can stratify subgroups of patients by correlating the olfactory signature to different biological and clinical parameters (hemodynamic measurements, NYHA class, duration of treatment, 6-minute walk distance, response to nitric oxide, BNP levels).

• Study Type: Interventional
• Study Phase: Not Applicable
• Study Design: Allocation: Non-Randomized; Intervention Model: Parallel Assignment; Masking: None (Open Label); Primary Purpose: Diagnostic
• Condition: Pulmonary Hypertension
• Intervention: Device: Exhaled Breath Olfactory Signature (Artificial Nose)

Study Arms

• Experimental: idiopathic PAH
  Exhaled Breath Olfactory Signature Detected by an Artificial Nose
  Intervention: Device: Exhaled Breath Olfactory Signature (Artificial Nose)
• Experimental: heritable PAH with BMPR2 mutation
  Exhaled Breath Olfactory Signature Detected by an Artificial Nose
  Intervention: Device: Exhaled Breath Olfactory Signature (Artificial Nose)
• Experimental: chronic thromboembolic PH
  Exhaled Breath Olfactory Signature Detected by an Artificial Nose
  Intervention: Device: Exhaled Breath Olfactory Signature (Artificial Nose)
• Experimental: Controls
  Exhaled Breath Olfactory Signature Detected by an Artificial Nose
  Intervention: Device: Exhaled Breath Olfactory Signature (Artificial Nose)

• Publications *: Not Provided

Recruitment Information

• Recruitment Status: Completed
• Actual Enrollment (submitted: April 30, 2021): 273
• Original Estimated Enrollment (submitted: May 24, 2016): 350
• Actual Study Completion Date: September 4, 2018
• Actual Primary Completion Date: August 28, 2018 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

Patients group (Group A)

• Age 18 to 65 years inclusive
• Idiopathic or heritable PAH confirmed by right heart catheterization
• Affiliated to a social security (excluding AME)

Healthy control group (Group B)

• Age 18 to 65 years inclusive
• No known allergy
• No history of known pathology
• No chronic disease in active phase
• No history of respiratory illness
• Not genetically linked with the patient
• Affiliated to a social security (excluding AME)

At risk group (Group C)

• Age between 18 and 65 years old inclusive
• Subjects included in the protocol Delphi2 or Subject satisfying the inclusion and non-inclusion criteria of the DELPHI2 study
• Affiliated to a social security (excluding AME)

Patient group (Group D)

• Age between 18 and 65 years old inclusive
• Post-embolic HTP
• Affiliated to a social security scheme (excluding AME)

Exclusion Criteria:

Any patient/subject presenting :

• Connective tissue disease
• HIV infection
• Portal hypertension
• Congenital heart disease
• Asthma and other coexisting lung diseases
• Pregnant or breastfeeding woman
• Alcohol addiction (if consumption >3 glasses/day for men and >2 glasses/day for women)
• Smoking addiction (if consumption >5 cigarettes/day)
• Having had a CT scan in the week prior to the inclusion visit
• Subjects who have consumed coffee, alcohol, or a cigarette in less than 3 hours

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 18 Years to 65 Years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: France

Administrative Information

• NCT Number: NCT02782026
• Other Study ID Numbers: 2014-01321-46
• Has Data Monitoring Committee: No
• U.S. FDA-regulated Product: Not Provided

IPD Sharing Statement

• Plan to Share IPD: No

• Current Responsible Party: Assistance Publique - Hôpitaux de Paris
• Original Responsible Party: Same as current
• Current Study Sponsor: Assistance Publique - Hôpitaux de Paris
• Original Study Sponsor: Same as current

Collaborators

• Technion, Israel Institute of Technology
• Bayer

Investigators

• Principal Investigator: Marc Humbert, MD,PhD; Assistance Publique - Hôpitaux de Paris

• PRS Account: Assistance Publique - Hôpitaux de Paris
• Verification Date: December 2016