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Severe haemophilia A and B (SHA, SHB) are X - linked inherited bleeding disorders, characterised by factor VIII and IX levels of <1 IU/dL respectively. The mainstay of treatment in SHA and SHB is replacement therapy with intravenous infusions of factor VIII and IX. However, there is significant variability in the bleeding phenotype within severe haemophiliacs with some presenting with minimal bleeding episodes even on less intensive treatment regimens. A significant contributor to inter-individual variability in the bleeding phenotype is the coagulation phenotype, but there are no established assays in routine clinical practice that can be used to quantify this. This study aims to study novel assays and characterise the observed phenotypic heterogeneity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Haemophilia patients | Persons with haemophilia A or B - 240 to be recruited |
| |
| Healthy volunteers | Healthy volunteers - 10 to be recruited |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thrombophilia screen | Diagnostic Test | Thrombophilia screen (including antithrombin activity (AT:Ac), protein S antigen (PS:free), protein C activity (PC:Ac) , genetic analysis for FV Leiden and Prothrombin 3'UTR mutations and screening for lupus anticoagulant. |
| Measure | Description | Time Frame |
|---|---|---|
| Initiation pathway correlation with clinical phenotype | Correlate lab assays that characterise initiation pathway with clinical phenotype. | Within 18 months of consent |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation analysis between FVIII:C/FIX:C levels and whole blood clotting time, thrombin generation in platelet poor plasma. | Within 18 months of consent | |
| Evaluation the sensitivity and specificity of global assays for disease severity and clinical phenotype. |
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Patients
Inclusion Criteria:
Exclusion Criteria:
1. Patients currently enrolled into a clinical trial of investigational medicinal product for haemophilia.
Healthy Volunteers
Inclusion Criteria:
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The study population will include patients severe or moderate haemophilia A or B who are currently attending study sites for routine follow up visits. In addition, 10 healthy volunteers will also be recruited to act as controls
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Thomas Roberts | Contact | 02078302068 | thomas.roberts1@nhs.net |
| Name | Affiliation | Role |
|---|---|---|
| Pratima Chowdary | Royal Free Hospitals NHS Foundation Trust | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal Free Hospital | Recruiting | London | United Kingdom |
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Blood plasma
| Initiation pathway analysis | Diagnostic Test | Evaluation of inter-individual variability in regulation of TF.VIIa.Xa.TFPI complex (tissue factor, activated Factor VII, activated factor X, tissue factor pathway inhibitor) |
|
| Within 18 months of consent |
| Correlation analysis between activation threshold of initiation pathway to thrombin generation and clinical phenotype | Within 18 months of consent |
| ID | Term |
|---|---|
| D006467 | Hemophilia A |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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