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| Name | Class |
|---|---|
| Genome Quebec | OTHER |
| Genome Canada | OTHER |
| ELNA Medical | UNKNOWN |
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The goal of this pragmatic trial is to provide Real World Evidence (RWE) on the impact of the result of a polygenic risk prediction test of cardiorenal complications of T2D, so that more patients at high risk of these complications achieve over an 18 months period, recommended therapeutic targets.
This will be demonstrated as a significant improvement in a composite value including HbA1c or systolic blood pressure (SBP) or albuminuria (UACR), or glomerular filtration rate (GFR) lowering.
Researchers will compare the recommended therapeutic targets of uninformed and informed patients to see if the knowledge of the risk by the patients and their treating physicians improves achievement of these targets.
Participants will:
Have a saliva sampling to determine the genetic risk. Visit the clinic once every 3 months for checkups and tests Answer two questionnaires on quality of life.
Type 2 diabetes (T2D) increases the risk of developing serious cardiovascular and kidney complications that represent a major burden for both patients and our healthcare system. Currently, patients with T2D are treated according to guidelines, with varied results in terms of systolic blood pressure (SBP), blood glucose (HbA1c), urine albumin-creatinine ratio (UACR) and glomerular filtration rate (GFR) target achievement.
OPTITHERA has developed the first genomic test to predict the risk of cardiorenal complications that will allow early and personalized treatment of patients with T2D who are at high risk using Polygenic risk score.
It is proposed that knowledge of the risk of developing complications of diabetes will have a positive effect on the care pathway of diabetic patients: the patient will be able to actively participate in their care and their doctor will be able to adapt his treatment to his personal risk, especially if his patient is at high risk of complications.
Objective: To provide Real World Evidence (RWE) on the impact of the result of a PRS prediction test on the risk of complications of T2D, so that patients at high risk of complications achieve, over an 18-month period, recommended targets for systolic blood pressure (≤130 mmHg) or HbA1c (<7.0%), or decreased albuminuria grade, GFR decline, while avoiding severe hypoglycemia and falls.
This will be demonstrated as a significant improvement in composite value including HbA1c or systolic blood pressure (SBP) or albuminuria (UACR).
Methodology: Multicenter Study: A) Pragmatic trial designed to evaluate the effectiveness of GENOCORDIA PRS testing in real-life routine practice conditions.
B) Randomization of participants into informed and uninformed populations of the PRS test result. C) Adaptive trial for the treatment of subjects initially uninformed of their PRS test result.
Estimated number of participants: 2714 participants randomized into two groups. Estimated study enrollment duration= 9 months. Estimated total study duration = 36 months. 18 months follow-up (7 visits).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Informed | Active Comparator | Intervention group tested and informed of the Polygenic risk score test result at the start of the study |
|
| Not initially informed | No Intervention | Control group: tested but not informed of the Polygenic Risk Score test result at the start of the study. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Polygenic Risk Score | Device | The Polygenic Risk Score (PRS) is a Class II software as a medical device (SaMD) that estimates a person's level of risk of developing a disease or associated complications before clinical signs appear. The device uses the genomic profile of the person in combination with some clinical data (i.e., age, sex, age of onset of diabetes) to compute this risk. This device further provides recommendations for personalized management of T2D for patients based on their risk score. |
| Measure | Description | Time Frame |
|---|---|---|
| Composite endpoint consisting of HbA1c, SBP, albuminuria or GFR | Change of HbA1c, or SBP or albuminuria stage or eGFR decline. Percent of participants at therapeutic targets. | Visit to visit up to 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Medications for blood pressure, blood glucose and lipids | change of class or dosage | Visit to vist up to 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Microvascular and macrovascular endpoints | Macrovascular outcome comprises nonfatal stroke, nonfatal acute coronary syndrome and death from any cardiovascular cause. Microvascular endpoint comprises new or worsening nephropathy defined as the development of macroalbuminuria, doubling of serum creatinine, requirement for renal replacement therapy or death from renal disease. | 18 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marie-Renée Guertin, il,cra | Contact | 514-249-4209 | marie-renee.guertin.chum@ssss.gouv.qc.ca | |
| Johanne Tremblay, PhD | Contact | 514-890-8247 | johanne@optithera.onmicrosoft.com |
| Name | Affiliation | Role |
|---|---|---|
| Pavel Hamet, MD, PhD | CHUM | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHUM | Recruiting | Montreal | Quebec | H2X 0A9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34226943 | Background | Tremblay J, Haloui M, Attaoua R, Tahir R, Hishmih C, Harvey F, Marois-Blanchet FC, Long C, Simon P, Santucci L, Hizel C, Chalmers J, Marre M, Harrap S, Cifkova R, Krajcoviechova A, Matthews DR, Williams B, Poulter N, Zoungas S, Colagiuri S, Mancia G, Grobbee DE, Rodgers A, Liu L, Agbessi M, Bruat V, Fave MJ, Harwood MP, Awadalla P, Woodward M, Hussin JG, Hamet P. Polygenic risk scores predict diabetes complications and their response to intensive blood pressure and glucose control. Diabetologia. 2021 Sep;64(9):2012-2025. doi: 10.1007/s00125-021-05491-7. Epub 2021 Jul 6. |
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De-identified patient data at the end of the study including risk strata.
Six months after study publication.
Contact the PI.
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D002318 | Cardiovascular Diseases |
| D000096442 | Genetic Risk Score |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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A) A pragmatic trial designed to evaluate the effectiveness of GENOCORDIA PRS testing in real-life routine practice conditions.
B) Randomization of participants into informed and uninformed populations of the Polygenic risk score test result.
C) Adaptive trial for the treatment of subjects initially uninformed of their PRS test result after 12 months if positive results.
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|
|
| ELNA Medical | Not yet recruiting | Montreal | Quebec | H3S 1Z5 | Canada |
|
| D004700 | Endocrine System Diseases |
| D020022 | Genetic Predisposition to Disease |
| D004198 | Disease Susceptibility |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |