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The Psoriasis, Atherosclerosis, and Cardiometabolic Disease Initiative (PACI)

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ClinicalTrials.gov Identifier: NCT01778569
Recruitment Status : Recruiting
First Posted : January 29, 2013
Last Update Posted : May 25, 2022
Sponsor:
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) )

Study Description
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Brief Summary:

Background:

- Cardiometabolic diseases are medical disorders that can occur together and affect the heart. They increase the risk of developing heart disease and diabetes. One disorder, psoriasis, is an inflammation that mostly affects the skin but can affect the entire body. Another disorder, atherosclerosis, is a process in which cholesterol is gradually deposited on the wall of arteries. This causes arteries to harden and become less flexible. Many cells that cause psoriasis also cause atherosclerosis. Researchers want to look at the relationship between cardiometabolic diseases and psoriasis.

Objectives:

- To study the relationship between psoriasis and cardiometabolic diseases.

Eligibility:

- Individuals at least 18 years of age who have psoriasis.

Design:

  • Participants will be screened with a physical exam and medical history.
  • Participants will have up to seven outpatient visits over the 4 years. The first visit will be a screening visit. Visits 2 will be12 months after visit 1. Visits 3, 4, and 5, will be scheduled yearly for the next 3 years. If participants have a psoriasis flare with more severe symptoms, they may have an extra visit. Those who leave the study early will have a final visit with the full series of tests.
  • At visits 1, 2,and 5, and any flare visits, participants will have a physical exam and medical history. They will provide blood and urine samples, as well as optional tissue biopsies. They will also have heart function tests. Imaging studies, as well as optional photographs of affected areas, will be performed. These tests will also be performed at the final visit.
  • At visits 3 and 4, participants will have a physical exam and medical history. They will also provide blood and urine samples, and have heart function tests.

Condition or disease
Metabolic Disease Cardiovascular Disease Inflammation Psoriasis

Detailed Description:
Over the past two decades, inflammation has been identified as an important pathogenic process in cardiometabolic diseases (CMD) such atherosclerotic cardiovascular disease (CVD), dyslipidemia, insulin resistance, diabetes and obesity. However, mechanistic links between inflammation and these disease states in humans remain poorly understood. In this study, we propose to utilize psoriasis, a common, chronic inflammatory T-cell skin disease associated with increased CVD and CMD as a model to understand the effect of chronic inflammation on these diseases states. We will conduct a prospective cohort study to understand the effect of chronic inflammation on vascular and metabolic disease at the NIH Clinical Center. Furthermore, we will initiate a large scale collection of blood and skin from extramural sites to facilitate discovery of pathways involved in inflammatory modulation of CVD and CMD.
Study Design
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Study Type : Observational
Estimated Enrollment : 1200 participants
Observational Model: Case-Only
Time Perspective: Prospective
Official Title: Human Translational Studies of Inflammation and Cardiometabolic Diseases: The Psoriasis, Atherosclerosis and Cardiometabolic Disease (PACI) Initiative
Actual Study Start Date : January 22, 2013
Estimated Primary Completion Date : June 30, 2030
Estimated Study Completion Date : June 30, 2030

Resource links provided by the National Library of Medicine


Groups and Cohorts
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Group/Cohort
Group 1
Patient with a diagnosis of chronic plaque psoriasis, psoriatic arthritis, or pustular psoriasis


Outcome Measures
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Primary Outcome Measures :
  1. Our primary outcome of interest is vascular inflammation measured by standard uptake values from PET-CT imaging with FDG. [ Time Frame: 4-6 years ]
    vascular inflammation measured by standard uptake values from PET-CT imaging with FDG.


Secondary Outcome Measures :
  1. Mean Aortic Wall Thickness [ Time Frame: 4-6 years ]
  2. Coronary Artery Calcium Score [ Time Frame: 4-6 years ]
  3. HDL function [ Time Frame: 4-6 years ]
  4. lipoprotein particle size and number [ Time Frame: 4-6 years ]
  5. immune, metabolic & inflammation measure [ Time Frame: 4-6 years ]
  6. Myocardial Flow Reserve (MFR) [ Time Frame: 4-6 years ]

Eligibility Criteria
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Information from the National Library of Medicine

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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:   Non-Probability Sample
Study Population
Any patient with a diagnosis of chronic plaque psoriasis, psoriatic arthritis, or pustular psoriasis will be considered for this protocol.
Criteria
  • INCLUSION CRITERIA
  • 18 years of age or older
  • Diagnosed with psoriasis clinically confirmed by provider, consisting of typical skin findings and associated findings of systemic disease of joints, nails and hair)

EXCLUSION CRITERIA

  • For skin and adipose biopsy, any subject with known bleeding disorder, current fever or on anticoagulation.
  • For imaging studies, pregnant women and lactating women, unless they are willing to discard breast milk for 24 hours after receiving FDG or contrast

  • Subjects with a contraindication to MRI scanning will not receive the optional PET/MRI. These contraindications include subjects with the following devices:

    • Central nervous system aneurysm clips
    • Implanted neural stimulator
    • Implanted cardiac pacemaker or defibrillator
    • Cochlear implant
    • Ocular foreign body (e.g. metal shavings)
    • Implanted Insulin pump
    • Metal shrapnel or bullet
  • Subjects with a BMI >45 will also not receive the PET MRI.
  • Subjects with severe renal excretory dysfunction, estimated glomerular filtration rate < 30 mL/min/1.73m^2 body surface area according to the Modification of Diet in Renal Disease criteria, will not receive the cardiac CT angiography, or gadolinium contrast agent during the PET/MRI.
Contacts and Locations
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Information from the National Library of Medicine

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): NCT01778569


Contacts
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Contact: Tania R Machado (301) 661-1505 tania.machado@nih.gov
Contact: Nehal N Mehta, M.D. (301) 827-0473 mehtann@mail.nih.gov

Locations
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United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Contact: For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)    800-411-1222 ext TTY8664111010    prpl@cc.nih.gov   
Sponsors and Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
Investigators
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Principal Investigator: Nehal N Mehta, M.D. National Heart, Lung, and Blood Institute (NHLBI)
More Information
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Additional Information:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier: NCT01778569    
Other Study ID Numbers: 130065
13-H-0065
First Posted: January 29, 2013    Key Record Dates
Last Update Posted: May 25, 2022
Last Verified: May 6, 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) ):
Imaging
Cardiovascular Risk Factors
Inflammation
 Lipoproteins
Metabolic Dysfunction
Natural History
Additional relevant MeSH terms:
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Cardiovascular Diseases
Atherosclerosis
Psoriasis
Metabolic Diseases
Inflammation
Pathologic Processes
 Skin Diseases, Papulosquamous
Skin Diseases
Arteriosclerosis
Arterial Occlusive Diseases
Vascular Diseases