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SNPMiner SNPMiner Trials (Home Page)


Report for Mutation C282Y

Developed by Shray Alag, 2020-2021.
SNP Clinical Trial Gene

There are 50 clinical trials

Clinical Trials


1 Therapeutic Effect of Erythrocyte Apheresis as Compared to Full Blood Phlebotomy in Patients With Hereditary Hemochromatosis

Primary hemochromatosis is the most frequent hereditary condition in Scandinavia. The condition may result in serious organ damage which can be prevented by therapy, but only few patients develop such organ damage. The optimal treatment, therefore, is still a matter of discussion Prevention of organ damage has traditionally been accomplished by drawing of full blood (phlebotomy), which has to be frequently repeated during the initial phase and then continued indefinitely as a maintenance treatment. The removed amount of iron may be increased two- or threefold for each procedure by using modern equipment for selective removal of red blood cells (red cell apheresis). Possible drawbacks of this technique may be higher costs, prolonged time for each therapeutic procedure, and certain requirements to the patients. The possible advantages are the reduced number of therapeutic procedures and less strain for the patient. No larger, randomized study has been published in order to determine which method should be preferred. This study is a controlled trial in which participating patients are asked to be randomized to red cell apheresis or traditional phlebotomy. Each group will be followed by means of well-defined assessments in order to explore possible advantages and disadvantages of each method in order to establish what type of treatment should be recommended.

NCT00509652
Conditions
  1. Hemochromatosis
Interventions
  1. Procedure: Arm 1: Erythrocyte apheresis
  2. Procedure: Arm 2: Whole blood phlebotomy
MeSH:Hemochromatosis

Inclusion Criteria: 1. Diagnosis - Individuals who art homozygous for C282Y or H63D or "compound heterozygous" for these tow variants and have ferritin levels higher than 300 micrograms/L or transferrin saturation higher than 50%. --- C282Y ---

- Individuals heterozygous for C282Y or H63D if ferritin levels higher than 500 micrograms/L or transferrin saturation higher than 50%. --- C282Y ---

Exclusion Criteria: 1. Contra-indications to either treatment modality 2. Patients who are not able to co-operate 3. Lack of informed consent Inclusion Criteria: 1. Diagnosis - Individuals who art homozygous for C282Y or H63D or "compound heterozygous" for these tow variants and have ferritin levels higher than 300 micrograms/L or transferrin saturation higher than 50%. --- C282Y ---

However, the criteria for ferritin levels have been set at 300 micrograms/L for patients who are homozygous for the C282Y mutation, and also heterozygous individuals will be included if ferritin is higher than 500 micrograms/L. --- C282Y ---

Inclusion criteria 1. Diagnosis 1. Individuals who art homozygous for C282Y or H63D or "compound heterozygous" for these tow variants and have ferritin levels higher than 300 micrograms/L or transferrin saturation higher than 50%. --- C282Y ---

2. Individuals heterozygous for C282Y or H63D if ferritin levels higher than 500 micrograms/L or transferrin saturation higher than 50%. --- C282Y ---

Primary Outcomes

Measure: Decline in ferritin levels and transferrin saturation

Secondary Outcomes

Measure: Decline in hemoglobin levels

Measure: Patient discomfort during therapeutic procedure

Measure: Time consumption

Measure: Costs

2 Effectiveness of Adaptation of the Dose of Iron Supplementation in Pregnancy on Maternal-child Health. Randomized Clinical Trial (ECLIPSES)

Currently, there is no consensus regarding iron supplementation dose that is most beneficial for maternal and offspring health during gestation. This deficit, or excess, of iron prejudices the mother-child wellbeing. Therefore the hypotheses are that an iron supplementation adapted to values of hemoglobin at the start of the pregnancy will would be more effective in preventing iron deficiency, without increasing the risk of hemoconcentration by the end of pregnancy. This would be helped optimize mother-child health status. The aims of the study are to determine the highest level of effectiveness of iron supplementation adapted to hemoglobin (Hb) levels in early pregnancy, which would be optimum for mother-child health. To accomplish this objective a Randomized Clinical Trial (RCT) triple-blinded was designed. The study is structured as a RCT with 2 strata, depending on the Hb levels before week 12 of gestation. Stratum 1: If Hb from 110 to 130 g/L, randomly assigned at week 12 to receive iron supplement of 40 or 80 mg/d. Stratum 2: If Hb >130 g/L, randomly assigned at week 12 to receive iron supplement of 40 or 20 mg/d. This study will be conducted in non-anemic pregnant women at early gestation stage, and their subsequent newborns. The data recollected to mothers will be: socio-economic data, clinical history, food item frequency, lifestyle and emotional state, and adherence to iron supplement prescription. In addition, biochemical measured will be Hemoglobin, serum ferritin, C reactive protein, cortisol, and alterations in the HFE gene (C282Y, H63D). In children, the data collected will be: ultrasound fetal biometry, anthropometric measurements, and temperament development Should conclusive outcomes be reached, the study would indicate the optimal iron supplementation dose required to promote maternal and infant health. These results would contribute towards developing guidelines for good clinical practice.

NCT03196882
Conditions
  1. Anemia Ferropenic
  2. Risk of Hemoconcentration (Iron Levels
  3. Risk of Hemoconcentration (Iron Levels >
  4. Risk of Hemoconcentration (Iron Levels >130g/L)
Interventions
  1. Drug: 40mg/day of iron
  2. Drug: 20mg/day of iron
  3. Drug: 80mg/day of iron
MeSH:Anemia Anemia, Iron-Deficiency
HPO:Anemia Iron deficiency anemia

In addition, biochemical measured will be Hemoglobin, serum ferritin, C reactive protein, cortisol, and alterations in the HFE gene (C282Y, H63D). --- C282Y ---

- Hemoconcentration risk is defined as: Hb >130 g/L in the 2nd and /or3rd trimester (Peña-Rosas y Viteri, 2009).. C282Y polymorphisms of HFE gene. --- C282Y ---

Presence or absence of polymorphisms: C282Y and H63D. --- C282Y ---

Primary Outcomes

Description: - Anemia is defined as Hb <110 g/L in the 1st and 3rd trimester, Hb <110 in 2nd trimester (Centers for Disease Control and Prevention, 1998).

Measure: Anemia

Time: at week 36 of gestation (3rd visit of study)

Description: - Ferropenic anemia is defined as: Hb < the normal limit, and serum ferritin (SF) <15 μg/L (WHO, 2007)

Measure: ferropenic anemia

Time: at week 36 of gestation (3rd visit of study)

Description: - Hemoconcentration risk is defined as: Hb >130 g/L in the 2nd and /or3rd trimester (Peña-Rosas y Viteri, 2009).

Measure: Risk of hemoconcentration

Time: at week 36 of gestation (3rd visit of study)

Secondary Outcomes

Description: Presence or absence of polymorphisms: C282Y and H63D

Measure: C282Y polymorphisms of HFE gene

Time: Blood analysis at 12 weeks of gestation.

Description: weight (g)

Measure: Anthropometric parameters of newborn.

Time: At birth

Description: Units on a scale (score).

Measure: Neurorconductual development of newborn (Bayley Scales)

Time: 40days post-partum

Description: Presence or absence of polymorphisms: C282Y and H63D

Measure: H63D polymorphisms of HFE gene

Time: Blood analysis at 12 weeks of gestation.

3 Effects of S-Adenosyl Methionine (SAMe) on Viral and Cell Signaling Response to Combination Therapy for Chronic Hepatitis C

This study will examine the effectiveness of S-adenosyl methionine (SAMe) in combination with peginterferon and ribavirin for treating hepatitis C virus. One out of three patients with hepatitis C develops cirrhosis of the liver, which can lead to liver failure or liver cancer. SAMe is a nutritional supplement that is made naturally in all cells of the body and acts to improve how the body handles stress. In laboratory experiments with liver cells, SAMe decreases the injury caused by liver toxins and improves the ability of interferon to block hepatitis C virus. Patients 18 years of age and older with hepatitis C infection who did not respond successfully to prior treatment with interferon and ribavirin or peginterferon and ribavirin may be eligible for this study. Participants receive the following treatment: - Peginterferon (given by injection) and ribavirin (taken by mouth) for 2 weeks - Washout period (no medications) for 4 weeks - SAMe (taken by mouth) for 2 weeks - Peginterferon, ribavirin and SAMe for 12-48 weeks, depending on patient response to treatment. Participants have a thorough physical evaluation before beginning treatment and again at the study's end. After starting treatment, patients return for clinic visits and blood tests weekly for the first several weeks, then less frequently (at 2-week, then 4-week and 8-week intervals until up to 72 weeks) to monitor symptoms, drug side effects, hepatitis C virus levels, liver enzyme levels and immune responses to hepatitis C. ...

NCT00475176
Conditions
  1. Chronic Hepatitis C
Interventions
  1. Drug: Peginterferon alfa-2a
  2. Drug: Ribavirin
  3. Drug: S-adenosyl methionine for Chronic Liver Disease
MeSH:Hepatitis A Hepatitis C Hepatitis C, Chronic Hepatitis Hepatitis, Chronic
HPO:Chronic active hepatitis Chronic hepatitis Hepatitis

- Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Patients with iron saturation indices of greater than 45% and serum ferritin levels of greater than 300 ng/ml for men and greater than 250 ng/ml for women will undergo genetic testing for C282Y and H63D. --- C282Y ---

Primary Outcomes

Description: Improvement of slopes of decline in hepatitis C virus Ribonucleic acid in second course compared with first course in days 7 to 14 of therapy

Measure: Improvement in Viral Kinetics During the First 2 Weeks of Therapy

Time: Days 7 to 14 of therapy

Secondary Outcomes

Description: 2-log decline in HCV RNA by week 12 (early virological response) and sustained eradication of HCV RNA (sustained virological response).

Measure: 2-log Decline in HCV RNA by Week 12 (Early Virological Response) and Sustained Eradication of HCV RNA (Sustained Virological Response).

Time: 12 weeks from start of therapy

4 Efficacy and Safety of Ursodesoxycholic Acid in the Management of Non-Alcoholic Steatohepatitis

This is a phase II study with direct individual benefit. It is a randomized, double blind placebo controlled study whose aim is to evaluate the efficacy and tolerance of ursodesoxycholic acid in patients who have been diagnosed with non-alcoholic steatohepatitis. The hepatoprotective effects of ursodesoxycholic acid may ameliorate the hepatic impairment associated with non-alcoholic steatohepatitis leading to subsequent significant decreases in transaminase elevations and non-invasive markers for hepatic fibrosis A positive response is defined as a significantly larger decrease in average ALAT levels between the time of inclusion in the study and the end of the treatment for the ursodesoxycholic acid group as compared to the placebo group. The duration of the study will be 12 months. An end of treatment evaluation (EoT) will take place at the end of the 12th month of treatment.

NCT00470171
Conditions
  1. Serum Levels of ALAT Transaminases
  2. Serum Markers for Fibrosis and Hepatic Inflammation
Interventions
  1. Drug: Ursodesoxycholic acid
MeSH:Fatty Liver Non-alcoholic Fatty Liver Disease Inflammation
HPO:Hepatic steatosis

- Alcohol consumption of >20 g/day for women and > 30 g/day for men - Hepatitis from other causes: chronic viral hepatitis B or C, elevated ferritin levels associated with C282Y homozygosity, primary biliary cirrhosis, primary sclerosing cholangitis, well documented auto-immune hepatitis (specific autoantibodies, hypergammaglobulinemia, consistent histologic changes), alpha1 antitrypsin deficiency, Wilson's disease, HIV infection. --- C282Y ---

Primary Outcomes

Measure: A positive response is defined as a significantly larger decrease in average ALAT levels between the time of inclusion in the study and the end of the treatment for the ursodesoxycholic acid group as compared to the placebo group.

5 Effects of Blood Letting on Insulin Sensitivity and Blood Pressure in Patients With Metabolic Syndrome: A Randomized Controlled Trial

Metabolic syndrome (MS) has an increasing prevalence worldwide and there is an urgent need for improvement of medical treatment. In traditional medicine phlebotomy (blood letting) is a recommended treatment for subjects with obesity and vascular disease. Recent studies showed that blood letting with iron depletion may improve insulin sensitivity in patients with diabetes mellitus. The investigators aimed to test if traditional blood letting has beneficial effects in patients with MS. A randomized trial with a sample size of 64 self-referred MS patients was conducted. Patients in the blood letting group were allocated to blood letting intervention and the control group was offered a later treatment (waiting list). In the intervention group 300-400 ml of venous blood were withdrawn at day 1 and after 4 weeks. Primary outcomes were the change of systolic blood pressure and of insulin sensitivity as measured by HOMA-Index.

NCT01328210
Conditions
  1. Metabolic Syndrome
Interventions
  1. Procedure: blood letting
MeSH:Metabolic Syndrome Syndrome

Inclusion Criteria: - 25-70 years of age - given diagnosis of metabolic syndrome Exclusion Criteria: - clinically significant hepatic, neurological, endocrinologic, or other major systemic or inflammatory disease, including malignancy - known history of hemochromatosis, or presence of the Cys282Tyr mutation - history of drug or alcohol abuse - manifest cardiac disease - history of disturbances in iron balance (e.g., hemosiderosis from any cause, atransferrinemia) - preexisting anemia Inclusion Criteria: - 25-70 years of age - given diagnosis of metabolic syndrome Exclusion Criteria: - clinically significant hepatic, neurological, endocrinologic, or other major systemic or inflammatory disease, including malignancy - known history of hemochromatosis, or presence of the Cys282Tyr mutation - history of drug or alcohol abuse - manifest cardiac disease - history of disturbances in iron balance (e.g., hemosiderosis from any cause, atransferrinemia) - preexisting anemia Metabolic Syndrome Metabolic Syndrome Syndrome null --- Cys282Tyr ---

Inclusion Criteria: - 25-70 years of age - given diagnosis of metabolic syndrome Exclusion Criteria: - clinically significant hepatic, neurological, endocrinologic, or other major systemic or inflammatory disease, including malignancy - known history of hemochromatosis, or presence of the Cys282Tyr mutation - history of drug or alcohol abuse - manifest cardiac disease - history of disturbances in iron balance (e.g., hemosiderosis from any cause, atransferrinemia) - preexisting anemia Inclusion Criteria: - 25-70 years of age - given diagnosis of metabolic syndrome Exclusion Criteria: - clinically significant hepatic, neurological, endocrinologic, or other major systemic or inflammatory disease, including malignancy - known history of hemochromatosis, or presence of the Cys282Tyr mutation - history of drug or alcohol abuse - manifest cardiac disease - history of disturbances in iron balance (e.g., hemosiderosis from any cause, atransferrinemia) - preexisting anemia Metabolic Syndrome Metabolic Syndrome Syndrome null --- Cys282Tyr --- --- Cys282Tyr ---

Primary Outcomes

Description: Glucose and insulin are measured on the basis of overnight fasting blood samples and Insulin sensitivity calculated according to HOMA-Index

Measure: insulin sensitivity

Time: change from baseline at 6 weeks

Description: Blood pressure is measured twice after 5 minutes rest in the sitting position by sphygmomanometry

Measure: systolic blood pressure

Time: change from baseline at 6 weeks

Secondary Outcomes

Measure: diastolic blood pressure

Time: change from baseline at 6 weeks

Measure: HbA1c

Time: change from baseline at 6 weeks

Measure: blood lipids

Time: change from baseline at 6 weeks

Measure: serum ferritin

Time: change from baseline at 6 weeks

Measure: adiponectin

Time: change from baseline at 6 weeks

Measure: blood count

Time: change from baseline at 6 weeks

Measure: serum iron

Time: change from baseline at 6 weeks

Measure: hs-CRP

Time: change from baseline at 6 weeks

Measure: pulse rate

Time: change from baseline at 6 weeks

Measure: serum glucose

Time: change from baseline at 6 weeks

6 A Phase II, Multicenter, Open-label, Randomized Two-year Study to Evaluate the Efficacy and Safety of Deferasirox Film-coated Tablet Versus Phlebotomy in Patients With Hereditary Hemochromatosis.

The purpose of this study is to evaluate the efficacy and safety of deferasirox film coated tablet (FCT) versus phlebotomy for the management of iron overload in adults with HH at risk of iron-related morbidity. This evaluation will provide information on the two treatment options in terms of the rate of response of proportion of patients reaching the study target SF ≤ 100 μg/L and their associated safety profiles. In addition to exploring the safety and efficacy of deferasirox FCT in hereditary hemochromatosis (HH), this study is being conducted to fulfill an FDA post-marketing requirement [PMC 750-10 (Exjade) /PMR 2888-8 (Jadenu)] to provide additional randomized data to confirm the ocular safety profile of deferasirox through detailed ocular assessments in patients treated with deferasirox FCT for 2 years.

NCT03203850
Conditions
  1. Hereditary Hemochromatosis
Interventions
  1. Drug: Deferasirox FCT
  2. Procedure: Phlebotomy
MeSH:Hemochromatosis

Male or female ≥ 18-years-old 2. Documented genotype testing confirming homozygous for the C282Y mutation (C282Y/C282Y) 3. Transferrin saturation ≥ 45% (at either screening visit) 4. Serum ferritin (SF) ≥ 500 μg/L (at either screening visit) - Exclusion Criteria: 1. Medical conditions that preclude inclusion: - Iron overload not due to HH - Condition which might significantly alter the absorption, distribution, metabolism or excretion of oral deferasirox - Systemic disease which prevents taking study treatment or any contraindication to phlebotomy - Inflammatory condition or immunological disease which may interfere with the SF interpretation, such as an active infection, collagen vascular disorders, irritable bowel syndrome, lupus, or immune thrombocytopenia - Significantly impaired gastrointestinal function or disease that may significantly alter the absorption of oral deferasirox, e.g. --- C282Y ---

Male or female ≥ 18-years-old 2. Documented genotype testing confirming homozygous for the C282Y mutation (C282Y/C282Y) 3. Transferrin saturation ≥ 45% (at either screening visit) 4. Serum ferritin (SF) ≥ 500 μg/L (at either screening visit) - Exclusion Criteria: 1. Medical conditions that preclude inclusion: - Iron overload not due to HH - Condition which might significantly alter the absorption, distribution, metabolism or excretion of oral deferasirox - Systemic disease which prevents taking study treatment or any contraindication to phlebotomy - Inflammatory condition or immunological disease which may interfere with the SF interpretation, such as an active infection, collagen vascular disorders, irritable bowel syndrome, lupus, or immune thrombocytopenia - Significantly impaired gastrointestinal function or disease that may significantly alter the absorption of oral deferasirox, e.g. --- C282Y --- --- C282Y ---

Primary Outcomes

Description: Assess the response rate (RR) of deferasirox film coated tablet (FCT) and phlebotomy treatment arms where response is defined by achieving target serum ferritin (SF) ≤ 100 μg/L on or before 24 months. Estimate of the RR and corresponding 95% confidence interval (CI) will be provided for each arm. No formal hypothesis testing is planned in this study.

Measure: Proportion of patients achieving target SF ≤ 100 μg/L for the first time.

Time: Response is defined by achieving target SF ≤ 100 μg/L on or before 24 months.

Secondary Outcomes

Description: To evaluate the ocular safety of deferasirox FCT and phlebotomy over 24 months. To characterize long-term ocular safety by the incidence of treatment-emergent ocular adverse events (AEs) (new or worsening from baseline) summarized categorically by system organ class and/or preferred term.

Measure: Incidence of ocular adverse events (AEs) overall

Time: 24 months

Description: To evaluate the ocular safety of deferasirox FCT and phlebotomy over 24 months. To characterize long-term ocular safety by AE severity (new or worsening from baseline) summarized categorically by system organ class and/or preferred term.

Measure: Incidence of ocular adverse events (AEs) by severity

Time: 24 months

7 Non Alcoholic Fatty Liver Disease and Coronary Heart Disease in Type 2 Diabetes Patients

To assess the feasibility in diabetics in a primary care setting of screening for NAFLD and advanced fibrosis, by using non-invasive magnetic resonance imaging (MRI) to estimate the hepatic proton density fat fraction (MRI-PDFF) and magnetic resonance elastography (MRE) to estimate hepatic stiffness.

NCT04462081
Conditions
  1. Nonalcoholic Steatohepati
  2. Nonalcoholic Steatohepatitis
MeSH:Liver Diseases Fatty Liver Non-alcoholic Fatty Liver Disease Heart Diseases Coronary Disease Coronary Artery Disease Myocardial Ischemia
HPO:Abnormality of the liver Coronary artery atherosclerosis Decreased liver function Elevated hepatic transaminase Hepatic steatosis Myocardial infarction

- Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Primary Outcomes

Description: Evaluation of liver fat fraction and liver stiffness, as determined by magnetic resonance imaging, are associated with subclinical cardiovascular disease, as evaluated by coronary artery calcium scan in diabetics

Measure: Percentage of Liver Fat as Measured by MRI-PDFF

Time: Baseline

8 Aramchol Versus Placebo in the Treatment of HIV-associated Nonalcoholic Fatty Liver Disease and Lipodystrophy: A Randomized, Double-blinded, Allocation-concealed, Placebo-controlled Clinical Trial

A subset of patients with NAFLD that have not been extensively studied are those infected with human immunodeficiency virus (HIV). Currently, there is no FDA approved treatment for NAFLD or NASH. Additionally, there have been no significant clinical trials for HIV patients with NAFLD and there are no approved treatment options. We plan to conduct a randomized, double-blinded, placebo-controlled clinical trial to examine the efficacy of 600 mg of Aramchol daily (including 200 mg tablet and 400 mg tablet) versus identical placebo given over 12 weeks to improve HIV-associated hepatic steatosis as measured by a validated and accurate magnetic resonance imaging (MRI)-based technique.

NCT02684591
Conditions
  1. Nonalcoholic Fatty Liver Disease
  2. HIV
Interventions
  1. Drug: Aramchol
  2. Drug: Placebo
MeSH:Liver Diseases Fatty Liver Non-alcoholic Fatty Liver Disease Lipodystrophy
HPO:Abnormality of the liver Decreased liver function Elevated hepatic transaminase Hepatic steatosis Lipodystrophy

Evidence of another form of liver disease: Hepatitis B as defined as presence of hepatitis B surface antigen (HBsAg), Hepatitis C as defined by presence of hepatitis C virus (HCV) RNA in serum, Autoimmune hepatitis as defined by anti-nuclear antibody (ANA) of 1:160 or greater and liver histology consistent with autoimmune hepatitis or previous response to immunosuppressive therapy, Autoimmune cholestatic liver disorders as defined by elevation of alkaline phosphatase and anti-mitochondrial antibody of greater than 1:80 or liver histology consistent with rimary biliary cirrhosis or elevation of alkaline phosphatase and liver histology consistent with sclerosing cholangitis, Wilsons disease as defined by ceruloplasmin below the limits of normal and liver histology consistent with Wilsons disease Alpha-1-antitrypsin deficiency as defined by alpha-1-antitrypsin level less than normal and liver histology consistent with alpha-1-antitrypsin deficiency hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D, Drug-induced liver disease as defined on the basis of typical exposure and history,Bile duct obstruction as shown by imaging studies. --- C282Y ---

Primary Outcomes

Description: To examine the efficacy of aramchol at 600 mg orally daily versus placebo in improving hepatic steatosis assessed by magnetic resonance imaging in patients with HIV-associated NAFLD

Measure: Efficacy of Aramchol 600 mg vs. Placebo in Improving Hepatic Steatosis Assessed by Magnetic Resonance Imaging in Patients With HIV-associated NAFLD

Time: 12 weeks

Secondary Outcomes

Description: To examine the efficacy of two doses of aramchol: 200 mg/tablet and 400 mg/tablet / day orally daily versus placebo in improving serum alanine aminotransferase (ALT) levels in patients with HIV-associated NAFLD

Measure: Serum Alanine Aminotransferase (ALT)

Time: 12 Weeks

9 Iron Supplement Effect Over Immune System and Neurobehavioral Child Development.

Objective: To evaluate the effect of Iron supplement with two different amounts (one in the higher limit and another in the lower limit of the suggested amount) according to the presence of mutations in the HFE gene in the physical, immune and neurobehavioral development in the 6 to 12 moth toddlers. Methodology: Subjects: 340 toddlers coming from Paediatric Serves of Sant Joan Hospital. Methods: At 6 and 12 months it done clinical history, food registry, biochemist determinations: haemoglobin, iron, transferrin, ferritin, reactive C protein and immune response (IL4, IL10, IL6 IFN, IgA, IgM, IgG, IgE). Mutations in the HFE gene: C282Y, H63D, S65D and hepcidin gene. Mental, psychomotor and behavioual development (Bayley Scales of Infant Development 2on Edition: 1993). We evaluate the level of language and communication (MacArthur), regulation and sensory process (Infant Toddler Symptom Checklist), familiar and environment surroundings (Scale Health General Parental Stress Index).

NCT02690675
Conditions
  1. Neurodevelopmental Disorders
  2. Lactation
Interventions
  1. Dietary Supplement: Iron fortified formula milk
MeSH:Neurodevelopmental Disorders

Mutations in the HFE gene: C282Y, H63D, S65D and hepcidin gene. --- C282Y ---

Primary Outcomes

Measure: Mental and psychomotor development with BSID (Bayley Scale of Infant Development) at 12 months.

Time: 12 months

Secondary Outcomes

Measure: Height at 12 months measured in centimeters

Time: 12 months

Measure: Weight at 12 months measured in grams

Time: 12 months

Measure: Head circumference at 12 months measured in centimeters

Time: 12 months

Measure: Risk of infections at 12 months measured qualitatively from record of presence or not of various infections as bronchitis, rhinitis, otitis etc.

Time: 12 months

10 Natural History of Noncirrhotic Portal Hypertension

Background: - Noncirrhotic Portal Hypertension (NCPH) is caused by liver diseases that increase pressure in the blood vessels of the liver. It seems to start slowly and not have many warning signs. Many people may not even know that they have a liver disease. There are no specific treatments for NCPH. Objectives: - To learn more about how NCPH develops over time. Eligibility: - People age 12 and older who have NCPH or are at risk for getting it. In the past year, they cannot have had other types of liver disease that typically result in cirrhosis, liver cancer, or active substance abuse. Design: - Participants will have 2 screening visits. - Visit 1: to see if they have or may develop NCPH. - Medical history - Physical exam - Urine and stool studies - Abdominal ultrasound - Fibroscan. Sound waves measure liver stiffness. - Visit 2: - Blood tests - Abdominal MRI - Echocardiogram - Questionnaire - Liver blood vessel pressure (hepatic venous portal gradient (HVPG)) measurement. This is done with a small tube inserted in a neck vein. - They may have a liver biopsy. - All participants will visit the clinic every 6 months for a history, physical exam, and blood tests. They will also repeat some of the screening tests yearly. - Participants with NCPH will also have: - Upper endoscopy test. A tube inserted in the mouth goes through the esophagus and stomach. - At least every 2 years: Esophagogastroduodenoscopy. - At least every 4 years: testing including HVPG measurements and liver biopsy. - Participants without NCPH will also have: - Liver biopsy and HVPG measurements to see if they have NCPH. - Every 2 years: abdominal MRI and stool studies. - The study will last indefinitely.

NCT02417740
Conditions
  1. Cystic Fibrosis
  2. Immunologic Deficiency Syndrome
  3. Turner Syndrome
  4. Congenital Hepatic Fibrosis
  5. Idiopathic Non-Cirrhotic Portal Hy
  6. Idiopathic Non-Cirrhotic Portal Hypertension
MeSH:Cystic Fibrosis Hypertension, Portal Turner Syndrome Hyper Hypertension Immunologic Deficiency Syndromes Syndrome Fibrosis
HPO:Hypertension Immunodeficiency Portal hypertension

- Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy or homozygosity for C282Y. --- C282Y ---

Primary Outcomes

Description: natural history study

Measure: To study the natural history of non cirrhotic portal hypertension. It is an ongoing study

Time: Ongoing

11 Study of the Association Between Transferrin Saturation and Asthenia in Hemochromatosis

Observational study.

NCT03356548
Conditions
  1. Hemochromatoses, Genetic
MeSH:Hemochromatosis Asthenia

- Inclusion criteria: - homozygous C282Y ; - in the maintenance phase for at least 6 months ; - follow-up at Rennes University Hospital ; - patient who has not expressed his opposition to participate in the study. --- C282Y ---

Hemochromatoses, Genetic Hemochromatosis Asthenia The linked HFE genetic hemochromatosis (C282Y mutation in the homozygous state) is the most common form of genetic iron overload. --- C282Y ---

Our objective is to evaluate, in patients homozygous C282Y in maintenance phase, the association between quality of life and Transferrin Saturation Coefficient . --- C282Y ---

Primary Outcomes

Measure: Quality of life questionnaire SF 36

Time: Through study completion, an average of 3 months

Measure: Biological markers : Transferrin Saturation Coefficient

Time: Through study completion, an average of 3 months

12 A Phase II Trial of the Safety and Efficacy of Iron Reduction by Phlebotomy in Recipients of Hematopoietic Stem Cell Transplants

Hypothesis: The reduction of total body iron by phlebotomy will be safe and feasible in the post-HSCT setting Iron overload is common after hematopoietic stem cell transplantation. It is associated with chronic liver disease, with increased rates of infection and decreased survival. Eligible, consenting patients will have once monthly phlebotomy procedures (500ml) for 12 months. SAFETY: At each visit, patients will have a comprehensive assessment prior to starting and after completing the phlebotomy. This assessment will include determination of pain at phlebotomy site, local infection and an assessment of symptoms of anemia including presyncope, fatigue and dyspnea. The patient's pulse, blood pressure, respiratory rate and temperature will also be determined before and following the phlebotomy. EFFICACY: Iron stores will be measured serially in each patient. Measurements will be performed prior to the start of phlebotomy, and at 6 months and 12 months following the start of the series of 12 phlebotomies. These evaluations will be undertaken regardless of the number of phlebotomies which the patient actually undergoes. Iron stores will be estimated by measuring serum ferritin and transferrin saturation levels. Total body iron will be estimated from hepatic and cardiac iron concentration as measured by magnetic resonance imaging (MRI). Gandon et al. (12) described a non-invasive technique using MRI to measure hepatic iron stores. Iron is a paramagnetic substance which causes local magnetic field inhomogeneities leading to dephasing and signal loss in MRI. Gradient echo sequences are most susceptible to their effects because they do not use a 180° refocusing pulse, unlike conventional spin-echo sequences. Gandon et al. used multiple gradient echo sequences, compared the signal in liver to adjacent muscle and used this ratio to correlate with hepatic iron levels measured on tissue biopsy samples using spectrophotometric analysis. Multiple sequences were used because the nomogram comparing the L/M signal ratio is linear over only a small concentration of tissue iron.

NCT00689182
Conditions
  1. Iron Overload
Interventions
  1. Procedure: monthly phlebotomy x 12 months
MeSH:Iron Overload

Serum samples will also be collected at baseline to screen for the most common mutations of the HFE gene (C282Y mutation and H63D mutation) as hereditary hemochromatosis is common in the general population and may contribute to iron overload in HSCT recipients. --- C282Y ---

Primary Outcomes

Measure: Iron stores, total body iron

Time: 1 year

13 Effects of Intravenous Injection of Erythropoietin on Hepcidin Pharmacokinetics in Healthy Volunteers

The aim of this study is to measure the variations of serum and urinary hepcidin levels following a single intravenous injection of erythropoietin in healthy volunteers. Hepcidin is a major regulator of iron homeostasis. It acts by binding on ferroportin, and limits cellular efflux of iron through enterocytes and macrophages. Anemia and hypoxia are known to modulate hepcidin synthesis. In these situations, erythropoietin synthesis is increased, so it can be postulated that erythropoietin could modulate hepcidin synthesis.

NCT00687518
Conditions
  1. Iron Metabolism Disorders
Interventions
  1. Drug: Erythropoietin
  2. Drug: Placebo
MeSH:Metabolic Diseases Iron Metabolism Disorders

Inclusion Criteria: - healthy volunteers - male aged 18 - 30 - normal routine laboratory values - normal ECG - normal iron status Exclusion Criteria: - C282Y mutation of the HFE gene - alcohol or tobacco consumption Inclusion Criteria: - healthy volunteers - male aged 18 - 30 - normal routine laboratory values - normal ECG - normal iron status Exclusion Criteria: - C282Y mutation of the HFE gene - alcohol or tobacco consumption Iron Metabolism Disorders Metabolic Diseases Iron Metabolism Disorders null --- C282Y ---

Inclusion Criteria: - healthy volunteers - male aged 18 - 30 - normal routine laboratory values - normal ECG - normal iron status Exclusion Criteria: - C282Y mutation of the HFE gene - alcohol or tobacco consumption Inclusion Criteria: - healthy volunteers - male aged 18 - 30 - normal routine laboratory values - normal ECG - normal iron status Exclusion Criteria: - C282Y mutation of the HFE gene - alcohol or tobacco consumption Iron Metabolism Disorders Metabolic Diseases Iron Metabolism Disorders null --- C282Y --- --- C282Y ---

Primary Outcomes

Measure: serum hepcidin levels

Time: over 24 hours

Secondary Outcomes

Measure: urinary hepcidin levels

Time: over 24 hours

Measure: serum iron and ferritin levels

Time: over 24 hours

14 The Effect of the Dietary Supplement Protandim on Non-Alcoholic Steatohepatitis: A Randomized, Double Blind, Placebo-Controlled Study

The purpose of this study is to evaluate the effect of Protandim on the degree of liver injury after one year of supplementation. Protandim is a nutritional supplement composed of the following 5 botanical extracts: Bacopa Moniera extract, Milk Thistle extract, Ashwagandha powder, Green tea, and Turmeric extract. Protandim is commercially available and can be purchased without a prescription. Our findings could lead to a better understanding of the role of oxidative stress and antioxidant therapy in NASH and may ultimately help improve patient care. Hypothesis #1: Protandim will lead to a significant improvement in NAS compared to placebo. Hypothesis #2: Protandim will lead to a significant decrease in serum markers of oxidative stress and liver chemistry tests. Hypothesis #3: Protandim will lead to decreased levels of TNF- α compared to placebo.

NCT00977730
Conditions
  1. Non-Alcoholic Steatohepatitis
Interventions
  1. Dietary Supplement: Protandim
  2. Dietary Supplement: Placebo
MeSH:Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Hepatic steatosis

7. Iron overload/hemochromatosis, as defined by the following: elevated transferrin saturation (greater than 45 percent) OR serum ferritin (> 300 microg/L in men or >200 microg/L in women), with one of the following: 1) presence of 3+ or 4+ stainable iron on liver biopsy (if obtained); or 2) Hemochromatosis gene testing showing homozygosity for C282Y or compound heterozygosity for C282Y/H63D (if obtained). --- C282Y ---

Primary Outcomes

Measure: Change in NAS at study completion in the Protandim group compared to the placebo group.

Time: 12 months

15 Effects of Polyphenols on Iron Absorption in Iron Overload Disorders.

Dysmetabolic iron overload syndrome and genetic hemochromatosis are frequent causes of iron overload. Polyphenols are efficient iron-chelators. Investigator hypothesize that polyphenol supplementation can reduce iron absorption in iron overload disease. Iron absorption can be studied by the area-under-the-curve of serum iron after iron oral loading. The primary outcome is the decrease of post-prandial serum iron after rich-iron meal, due to polyphenol supplementation.

NCT03453918
Conditions
  1. Dysmetabolic Iron Overload Syndrome
  2. Genetic Hemochromatosis
  3. Iron Absorption
  4. Polyphenols
Interventions
  1. Dietary Supplement: polyphenols
  2. Other: Placebo
MeSH:Hemochromatosis Iron Overload Syndrome

- For Genetic Haemochromatosis type 1 Group: homozygosity mutation C282Y in HFE gene ; patients undergoing therapeutic phlebotomies. --- C282Y ---

Primary Outcomes

Description: decrease of intestinal iron absorption after standardized oral loading dose through rich-iron meal, expressed by area-under-the-curve of serum iron, due to concomitant administration of a single dose of dietary polyphenos (nutrient complement) versus placebo administration. This outcome is a quantitative variable, treated and analysed as such.

Measure: Decrease of post-prandial iron absorption after dietary polyphenol supplementation

Time: at day 3

Secondary Outcomes

Description: comparison of oxylipin levels, through lipidomic analyses by spectrophotometry

Measure: Post-prandial changes of circulating oxylipin in iron overload diseases after iron-rich meal and effects of polyphenols supplementation

Time: at day 1 (fasting versus 3 hours after rich-iron meal, versus 3 hours after rich-iron meal with polyphenol supplementation)

Description: comparison of oxylipin levels, through lipidomic analyses by spectrophotometry. Healthy subjects datas comes from a previous study (MEPHISTO).

Measure: Comparison of oxylipin levels between DIOS, genetic hemochromatosis and healthy subjects after 6 hours of fasting.

Time: at baseline

16 Proton Pump Inhibitors in the Prevention of Iron Reaccumulation in Patient With Hereditary Hemochromatosis

Hereditary Hemochromatosis (HH) is a genetic disorder of iron metabolism, resulting in excessive iron overload causing damage of different important organs like heart, liver, pancreas and joints. Complications and symptoms can regress by intensive treatment reducing the iron overload stores.Different genes have been identified playing a role in the pathophysiology of iron overload. A clinically important HFE gene mutation is the C282Y, located on chromosome 6. Phlebotomy is currently the standard therapy which consists of removal of 500 ml whole blood weekly, representing a loss of 250 mg iron. In naive patients between 20 to 100 phlebotomies are required to reduce the serum ferritine levels to 50 μg/L. Thereafter, a lifelong maintenance therapy of 3 to 6 phlebotomies yearly is needed. For absorption, dietary iron ( 70%) is reduced by gastric acid form the ferric (Fe3+) to the ferrous form (Fe2+). Recently, in an observational open study, Hutchinson et al. found that HH patients treated with proton pump inhibitors (PPI) needed fewer phlebotomies, resulting in a drop of 2.5 (SEM 0.25) to 0.5 (SEM 0.25) liter per year. Research question: The primary objective is to determine the effectiveness and cost effectiveness of PPI's compared to standard phlebotomy therapy in the prevention of iron overload in HH patients. Multi-center trial in two hospitals in the South of Limburg (Atrium medical Center, Maastricht university medical center ) and hospital in Belgium (University Hospital Gasthuisberg). The study will be conducted in randomised double blind manner. The follow up will be one year. Patients are randomized either for the group receiving a PPI or a placebo. Every 2 month the ferritin level is measured and decided if the patient need a phlebotomy (Ferritin >100 µg/L).

NCT01524757
Conditions
  1. Hemochromatosis
Interventions
  1. Drug: Pantoprazole
MeSH:Hemochromatosis

A clinically important HFE gene mutation is the C282Y, located on chromosome 6. --- C282Y ---

Inclusion Criteria: - Patients with hereditary hemochromatosis (HH), homozygous for C282Y, currently treated with phlebotomy as maintenance therapy for at least 12 months with ≥ 3 phlebotomies per year. --- C282Y ---

Primary Outcomes

Measure: the total number of phlebotomies for the group taking PPI treatment compared to the group taking placebo will be the primary endpoint of the study.

Time: 12 months

Secondary Outcomes

Measure: number of participants with side effects

Time: 12 months

17 HEPFER-Evaluation of a New Phenotypic Biological Marker in Genetic Type 1 Hemochromatosis

HFE(High iron FE)-related hereditary hemochromatosis has a highly variable penetrance. No phenotypic or genetic markers can predict the disease. The Iron Reabsorption Index (IRI), recently described by our group, correspond to the daily reabsorbed iron for a subject whose iron stock is stable and less than 50 µg / L. The IRI is constant over time, reflecting the importance of the underlying functional deficit. Hepcidin / ferritin (H / F) ratio may be an independent and constant over time marker of disease stage.No data are available on the validated values of this ratio. The goal of this project is to determine the intra-individual variations of the H / F ratio over time during maintenance therapy and to assess the correlation with the IRI.

NCT01784939
Conditions
  1. Hereditary Hemochromatosis C282Y Homozygous
MeSH:Hemochromatosis

Inclusion Criteria: - Men, at least 18 years old - hereditary hemochromatosis C282Y homozygous diagnosed and followed in the service of Liver Diseases, University Hospital of Rennes - Maintenance therapy with phlebotomy for at least 1 year with stable iron stock on the basis of at least four previous plasma ferritin < 50μg / L, - Written, free and informed consent Exclusion Criteria: - Intercurrent illness unrelated to hemochromatosis causing cytolysis or inflammatory reaction. --- C282Y ---

- Person with a measure of legal protection (guardianship) Inclusion Criteria: - Men, at least 18 years old - hereditary hemochromatosis C282Y homozygous diagnosed and followed in the service of Liver Diseases, University Hospital of Rennes - Maintenance therapy with phlebotomy for at least 1 year with stable iron stock on the basis of at least four previous plasma ferritin < 50μg / L, - Written, free and informed consent Exclusion Criteria: - Intercurrent illness unrelated to hemochromatosis causing cytolysis or inflammatory reaction. --- C282Y ---

- Person with a measure of legal protection (guardianship) Hereditary Hemochromatosis C282Y Homozygous Hemochromatosis HFE-related hereditary hemochromatosis has a highly variable penetrance : 1% of homozygous women and 30% of homozygous men would develop a clinically expressed disease. --- C282Y ---

The study involve 30 C282Y homozygous men, followed in a reference center with phlebotomy maintenance therapy and stabilized at a low level of ferritin (<50 µg / L) for at least 1 year. --- C282Y ---

Primary Outcomes

Description: values of Hepcidin / ferritin plasma ratio

Measure: distribution of values of Hepcidin / ferritin plasma ratio

Time: First dosage on an empty stomach at current time of phlebotomy (Day 0), second dosage at day 14 at the same time, third dosage at day 28 at the same time, fourth dosage at day 42 at the same time, fifth dosage at day 56 at the same time

Secondary Outcomes

Measure: Correlation between Hepcidin / ferritin plasma ratio and IRI.

Time: First dosage on an empty stomach at current time of phlebotomy (Day 0), second dosage at day 14 at the same time, third dosage at day 28 at the same time, fourth dosage at day 42 at the same time, fifth dosage at day 56 at the same time

Measure: Correlation between Hepcidin / Ferritin ratio before and after treatment

Time: First dosage on an empty stomach at current time of phlebotomy (Day 0), second dosage at day 14 at the same time, third dosage at day 28 at the same time, fourth dosage at day 42 at the same time, fifth dosage at day 56 at the same time

Measure: Distribution of inter-individual Hepcidin / Ferritin ratio according to the stage of liver fibrosis

Time: First dosage on an empty stomach at current time of phlebotomy (Day 0), second dosage at day 14 at the same time, third dosage at day 28 at the same time, fourth dosage at day 42 at the same time, fifth dosage at day 56 at the same time

18 Treatment of Refractory Hemochromatosis Rheumatism by Anakinra: a Preliminary Phase II Study

Treatment of refractory hemochromatosis rheumatism by Anakinra. Prospective, multicenter, non-randomised, single-arm, open-label, phase II trial.

NCT02263638
Conditions
  1. Refractory Hemochromatosis Rheumatism
Interventions
  1. Drug: Anakinra
MeSH:Rheumatic Diseases Hemochromatosis Collagen Diseases

Inclusion Criteria: - Patients with age equal to or over 18 years old, - Patients with proved hereditary hemochromatosis with homozygosity for the C282Y mutation of the HFE gene, - Patients with rheumatism related to hemochromatosis, considered by the rheumatologist refractory to usual treatment defined by a persistent painful symptomatology despite a treatment of at least one month with level 2 analgesics (weak opioids) at maximal dose, NSAID, colchicine, steroid injection or a combination of these treatments, - Patients with pain > 40/100mm measured by VAS (pain of the last 48 hours), - Effective contraception to be used during treatment and until 48h after the last administration for women of reproductive age, - Patients who have given written informed consent. --- C282Y ---

Primary Outcomes

Description: Improvement is defined as the minimal clinically important improvement of joint pain and is assessed on a 0-100 mm visual analogue scale (VAS)

Measure: Rate of patients with improvement of joint pain

Time: Day 15

Secondary Outcomes

Description: Assessment of the disease activity by Visual analog scale (VAS)

Measure: Assessment of the disease activity

Time: Day 0, day 15, day 30, day 60, day 90

Description: Assessment of the number of painful joints by a clinical exam

Measure: Assessment of the number of painful joints

Time: Day 0, day 15, day 30, day 60, day 90

Description: Assessment of the number of swollen joints by a clinical exam

Measure: Assessment of the number of swollen joints

Time: Day 0, day 15, day 30, day 60, day 90

Measure: Assessment of analgesics consumption

Time: Day 0, day 15, day 30, day 60, day 90

Measure: Assessment of non-steroidal anti-inflammatory drugs (NSAID) consumption

Time: Day 0, day 15, day 30, day 60, day 90

Measure: Assessment of colchicine consumption

Time: Day 0, day 15, day 30, day 60, day 90

Measure: Assessment of steroids injections consumption

Time: Day 0, day 15, day 30, day 60, day 90

Description: Assessment of the quality of life by the SF36 questionnaire

Measure: Assessment of the quality of life

Time: Day 0, day 15, day 30, day 90

Description: Assessment of the quality of life by the HAQ questionnaire

Measure: Assessment of the quality of life

Time: Day 0, day 15, day 30, day 90

Description: Functional evaluation by WOMAC index for hip and knee

Measure: Functional evaluation

Time: Day 0, day 15, day 30, day 90

Description: Functional evaluation by Dreiser index for hands

Measure: Functional evaluation

Time: Day 0, day 15, day 30, day 90

Description: Assessment of joint damage by X-rays and Doppler ultrasound

Measure: Assessment of joint damage

Time: Day 0, day 90

Description: Puncture if acute joint effusion : cells count

Measure: Synovial fluid analysis

Time: 3 months

Description: Puncture if acute joint effusion : search for crystals presence

Measure: Synovial fluid analysis

Time: 3 months

Description: Puncture if acute joint effusion : iron parameters markers

Measure: Synovial fluid analysis

Time: 3 months

Description: Biological/Vaccine : iron and inflammatory markers

Measure: Biological effects on inflammation and iron metabolism

Time: Day 0, day 15, day 30, day 60, day 90

Description: Pharmacokinetics study

Measure: Time at which Cmax of anakinra was observed (Tmax)

Time: Predose, 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 10, 12, 15, 18, 21, 24 hours post-dose

Description: Pharmacokinetics study

Measure: Maximum observed concentration (Cmax) of anakinra

Time: Predose, 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 10, 12, 15, 18, 21, 24 hours post-dose

Description: Pharmacokinetics study

Measure: Half-life (T1/2) of anakinra

Time: Predose, 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 10, 12, 15, 18, 21, 24 hours post-dose

Description: Pharmacokinetics study

Measure: Area under the concentration-time curve of time 0 to the last detectable concentration (AUC0-last) of anakinra

Time: Predose, 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 10, 12, 15, 18, 21, 24 hours post-dose

Description: Pharmacokinetics study

Measure: Area under the concentration-time curve of time 0 to infinity (AUC0-∞) of anakinra

Time: Predose, 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 10, 12, 15, 18, 21, 24 hours post-dose

Description: Pharmacokinetics study

Measure: Plasma clearance after administration (CL/F) of anakinra

Time: Predose, 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 10, 12, 15, 18, 21, 24 hours post-dose

19 Sitagliptin Versus Placebo in the Treatment of Non-alcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of diseases ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), the progressive form of liver disease that can lead to cirrhosis and liver-related mortality in persons who drink little or no alcohol. NAFLD is defined as the presence of hepatic steatosis with no evidence of hepatocellular injury in the form of ballooning of the hepatocytes. NASH is defined as the presence of hepatic steatosis and inflammation with hepatocyte injury (ballooning) with or without fibrosis. NASH is benign in many affected individuals but can cause progressive liver injury and, indeed, may be the major cause of cryptogenic cirrhosis1. Currently, there is no FDA approved treatment for NAFLD. Weight loss and exercise are the recommended but often difficult maintain these lifestyle changes in the long term and therefore therapeutic agents have been investigated. In this study, we propose to treat 50 patients with NAFLD and diabetes with either sitagliptin or placebo for 24 weeks. After an initial evaluation for insulin sensitivity and MRI liver fat distribution, patients will receive either 100 mg/day of sitagliptin or placebo. Patients will be monitored at regular intervals for symptoms of liver disease, side effects of sitagliptin and serum biochemical and metabolic indices. At the end of 24-weeks, patients will have a repeat medical evaluation, liver MRI and an optional liver biopsy. Pre and post treatment MRI-derived liver fat content and insulin sensitivity will be compared. The primary end point of successful therapy will be improvement in hepatic steatosis measured by MRI. Secondary end points will be improvement in insulin sensitivity and liver biochemistry.

NCT01963845
Conditions
  1. Non-alcoholic Fatty Liver Disease
Interventions
  1. Drug: Sitagliptin
  2. Drug: Placebo
MeSH:Liver Diseases Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Abnormality of the liver Decreased liver function Elevated hepatic transaminase Hepatic steatosis

- Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Primary Outcomes

Description: Participants liver fat was measured at baseline and 24 weeks. This is the percentage change in liver fat assessed by MRI-PDFF and stratified by treatment group.

Measure: Percentage Change in Liver Fat Relative to Baseline Assessed by MRI-PDFF

Time: Baseline and 24 weeks

Secondary Outcomes

Description: AST, measured in IU/L at baseline and 24 weeks

Measure: AST, Aspartate Aminotransferase

Time: Baseline and 24 weeks

Description: ALT, measured in IU/L at baseline and 24 weeks

Measure: ALT, Alanine Aminotransferase

Time: Baseline and 24 weeks

Description: LDL, measured in mg/dL at baseline and 24 weeks

Measure: LDL, Low-density Lipoprotein

Time: Baseline and 24 weeks

Description: HOMA-IR, calculated as [(glucose (mg/dL) X insulin (mg/dL)) / 405 ] at baseline and 24 weeks

Measure: HOMA-IR, Homeostatic Model Assessment of Insulin Resistance

Time: Baseline and 24 weeks

20 A Randomized Controlled Trial to Evaluate the Safety and Efficacy of Twice-Weekly Peginterferon Alpha 2a and Ribavirin Induction Therapy for Chronic Hepatitis C in Patients Who Are Coinfected With HIV-1

This study will evaluate the safety and effectiveness of combination therapy with peginterferon alpha-2a and ribavirin for treating hepatitis C virus (HCV) infection in HIV-infected patients. Peginterferon alpha with ribavirin is the therapy of choice for people with HCV alone. Peginterferon alpha-2a is a compound that results from attaching a polyethylene glycol molecule to interferon alpha-2a. This compound stays in the blood longer than unmodified interferon alpha-2a, causing a higher blood concentration and thus maintaining greater activity against the hepatitis C virus. HIV-infected patients 18 years of age and older with chronic hepatitis C infection and a viral load greater than 2000 copies/mL may be eligible for this 2-1/2 year study. Candidates are screened with a medical history and physical examination, blood and urine tests, eye examination, chest x-ray, electrocardiogram (EKG), liver ultrasound, and pregnancy test in women who are able to become pregnant. If a recent liver biopsy is not available, this test is done to determine the type and severity of liver disease. The patient is given a sedative before the procedure. Then, the skin in the area over the biopsy site is numbed with a local anesthetic and a needle is inserted rapidly into and out of the liver to obtain a small tissue sample. The patient remains in the hospital overnight for monitoring. Participants begin treatment with injections under the skin of peginterferon alpha-2a and ribavirin pills by mouth on study day 0. Peginterferon is given either once or twice a week for 4 weeks and then once a week for 44 weeks. Ribavirin is given daily. In addition, patients continue to take all other medications prescribed by their doctor. Clinic visits are scheduled for the following procedures: - Days 1, 3, 4, 7, 10 and weeks 2, 3, and 4 - Blood tests for safety measures and to measure blood levels of HIV and HCV. - Weeks 6, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44 - Blood and urine tests to determine the side effects of treatment and its effect on the HCV infection. In addition, eye examinations are done every 3 months, and pregnancy and thyroid function tests are done several times during the treatment period. - Week 48 or end of treatment - Treatment stops after 48 weeks. At this time, or earlier for those who do not complete the 48 weeks, patients return to the clinic for a chest x-ray, EKG, blood tests, and abdominal ultrasound. Patients are hospitalized for a repeat liver biopsy. - Weeks 52, 56, 64 and 72 - Blood and urine tests to determine the side effects of treatment and its effect on the HCV infection, and a urine pregnancy test in women.

NCT00085917
Conditions
  1. Hepatitis C
  2. HIV Infecti
  3. HIV Infections
Interventions
  1. Drug: Double dose pegylated interferon with weight based Ribavirin
  2. Drug: standard dose pegylated interferon alfa -2a and ribavirin
MeSH:Hepatitis A Hepatitis C Hepatitis
HPO:Hepatitis

- Hemochromatosis or secondary iron overload as defined by (1) an elevated serum ferritin or an iron saturation (serum iron/IBC X 100%) of greater than 50% and (2) presence of 3+ or more stainable Iron on liver biopsy according to the study pathologist or a history of previous phlebotomy for Iron overload will undergo HFE genetic counseling and those with a positive HFE genetic test demonstrating homozygosity for C282Y and H63D are not eligible. --- C282Y ---

Those who have compound heterozygosity to C282Y and H63D are also not eligible. --- C282Y ---

Primary Outcomes

Description: SVR [ Sustained virological response] SVR was defined as HCV RNA levels below the limit of detection 24 weeks after the end of treatment.

Measure: Number of Participants With Sustained Virologic Response (SVR)

Time: 72 weeks

Secondary Outcomes

Description: normalization of liver enzymes :Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) Alanine aminotransferase (ALT): Normal 6 - 41 U/L Aspartate aminotransferase (AST) : Normal 9 - 34 U/L

Measure: Number of Participants With Normalization of Liver Enzymes

Time: week 24, week 48, week 72

Description: Adverse Events - Anemia, Neutropenia and Psychiatric adverse events

Measure: Number of Participants With Adverse Events

Time: 48 weeks

21 Clinical, Biological, Genetic and Functional Characterization of Rare Iron Overload Phenotypes Associated With Hepcidin Deficiency Except C282Y Homozygosity.

Chronic iron overload is responsible for morbidity and mortality. There are many genetic and acquired causes. One of them is an hepcidin deficiency. Hepcidin is the regulating hormone for iron. The study explores this specific cause, and aim to characterize this iron overload in term of clinical, biological, genetic and functional specificities.

NCT01541813
Conditions
  1. Rare Iron Overloads Except C282Y Homozygosity
MeSH:Iron Overload

Clinical, Biological, Genetic and Functional Characterization of Rare Iron Overload Phenotypes Associated With Hepcidin Deficiency Except C282Y Homozygosity.. Rare Iron Overloads Except C282Y Homozygosity : Description and Characterization. --- C282Y ---

Clinical, Biological, Genetic and Functional Characterization of Rare Iron Overload Phenotypes Associated With Hepcidin Deficiency Except C282Y Homozygosity.. Rare Iron Overloads Except C282Y Homozygosity : Description and Characterization. --- C282Y --- --- C282Y ---

Non inclusion criteria: - HFE hemochromatosis: C282Y/C282Y homozygosity - Treatment by iterative phlebotomies (more than 2 phlebotomies) - Hematological diseases with dyserythropoiesis and/or repeated transfusions - Low haptoglobin level, suggesting chronic hemolysis or myelodysplasia - Long-term iron oral and/or parenteral supplementation Inclusion criteria: - Biological profile suggesting hepcidin deficiency: - high serum iron (> 25μmol / l) checked at least 2 times. --- C282Y ---

Non inclusion criteria: - HFE hemochromatosis: C282Y/C282Y homozygosity - Treatment by iterative phlebotomies (more than 2 phlebotomies) - Hematological diseases with dyserythropoiesis and/or repeated transfusions - Low haptoglobin level, suggesting chronic hemolysis or myelodysplasia - Long-term iron oral and/or parenteral supplementation Rare Iron Overloads Except C282Y Homozygosity Iron Overload One of chronic iron overload profiles is a deficit in hepcidin. --- C282Y ---

Non inclusion criteria: - HFE hemochromatosis: C282Y/C282Y homozygosity - Treatment by iterative phlebotomies (more than 2 phlebotomies) - Hematological diseases with dyserythropoiesis and/or repeated transfusions - Low haptoglobin level, suggesting chronic hemolysis or myelodysplasia - Long-term iron oral and/or parenteral supplementation Rare Iron Overloads Except C282Y Homozygosity Iron Overload One of chronic iron overload profiles is a deficit in hepcidin. --- C282Y --- --- C282Y ---

The main objective of this study is the clinical, biological, genetic and functional characterization of rare iron overload phenotypes associated with hepcidin deficiency except C282Y homozygosity. --- C282Y ---


22 Impact of Bloodletting on Iron Metabolism in Type 1 Hemochromatosis: Pathophysiological and Clinical Implications. Pilot Study.

Hemochromatosis type 1 is one of the most frequent genetic disease since the genetic predisposition (homozygosity for the C282Y mutation of the HFE gene) is encountered in about 3/1000 white subjects (5/1000 in Brittany, France). For the half of these predisposed subjects, the phenotypic expression of the disease needs a treatment. This treatment is based upon repeated bloodletting which is generally considered as simple, safe and effective. Nevertheless, it is still questioned as regard its physiopathological justification and its clinical implications. Indeed, bloodletting could cause an increase of non-transferrin bound iron (NTBI) particularly for its reactive form called labile plasma iron (LPI) This adverse physiopathological effect could have clinical consequences and could be linked with articular consequences which can be aggravated by the treatment.

NCT01810965
Conditions
  1. Hemochromatosis Type 1
Interventions
  1. Procedure: First evaluation phase : no intervention / Second evaluation phase: bloodletting of 7 ml/kg (with a maximum of 500ml)
MeSH:Hemochromatosis

Pilot Study.. Impact of Bloodletting on Iron Metabolism in Type 1 Hemochromatosis Hemochromatosis type 1 is one of the most frequent genetic disease since the genetic predisposition (homozygosity for the C282Y mutation of the HFE gene) is encountered in about 3/1000 white subjects (5/1000 in Brittany, France). --- C282Y ---

Inclusion Criteria: - Men - Age 18 years or older - Homozygosity for the C282Y mutation of the HFE gene - With an indication of treatment by bloodletting (in accordance with the French HAS guidelines) - Ferritinemia ≥ 500µg/L - Transferrin saturation ≥ 75% - Never treated by bloodletting - Written informed consent Exclusion Criteria: - Contraindication to bloodletting - Chronic inflammatory or dysmetabolic or neoplastic disease - Major cardiovascular disease - Excessive consumption of alcohol (≥ 3gr/day) - Treatment by iron chelators, C or E vitamins - Stay in altitude> 1500m in the month preceding the period Day 1 - Patients under guardianship - Blood donation in the 3 past months - Night / shift workers Inclusion Criteria: - Men - Age 18 years or older - Homozygosity for the C282Y mutation of the HFE gene - With an indication of treatment by bloodletting (in accordance with the French HAS guidelines) - Ferritinemia ≥ 500µg/L - Transferrin saturation ≥ 75% - Never treated by bloodletting - Written informed consent Exclusion Criteria: - Contraindication to bloodletting - Chronic inflammatory or dysmetabolic or neoplastic disease - Major cardiovascular disease - Excessive consumption of alcohol (≥ 3gr/day) - Treatment by iron chelators, C or E vitamins - Stay in altitude> 1500m in the month preceding the period Day 1 - Patients under guardianship - Blood donation in the 3 past months - Night / shift workers Hemochromatosis Type 1 Hemochromatosis Hemochromatosis type 1 is one of the most frequent genetic disease since the genetic predisposition (homozygosity for the C282Y mutation of the HFE gene) is encountered in about 3/1000 white subjects (5/1000 in Brittany, France). --- C282Y ---

Inclusion Criteria: - Men - Age 18 years or older - Homozygosity for the C282Y mutation of the HFE gene - With an indication of treatment by bloodletting (in accordance with the French HAS guidelines) - Ferritinemia ≥ 500µg/L - Transferrin saturation ≥ 75% - Never treated by bloodletting - Written informed consent Exclusion Criteria: - Contraindication to bloodletting - Chronic inflammatory or dysmetabolic or neoplastic disease - Major cardiovascular disease - Excessive consumption of alcohol (≥ 3gr/day) - Treatment by iron chelators, C or E vitamins - Stay in altitude> 1500m in the month preceding the period Day 1 - Patients under guardianship - Blood donation in the 3 past months - Night / shift workers Inclusion Criteria: - Men - Age 18 years or older - Homozygosity for the C282Y mutation of the HFE gene - With an indication of treatment by bloodletting (in accordance with the French HAS guidelines) - Ferritinemia ≥ 500µg/L - Transferrin saturation ≥ 75% - Never treated by bloodletting - Written informed consent Exclusion Criteria: - Contraindication to bloodletting - Chronic inflammatory or dysmetabolic or neoplastic disease - Major cardiovascular disease - Excessive consumption of alcohol (≥ 3gr/day) - Treatment by iron chelators, C or E vitamins - Stay in altitude> 1500m in the month preceding the period Day 1 - Patients under guardianship - Blood donation in the 3 past months - Night / shift workers Hemochromatosis Type 1 Hemochromatosis Hemochromatosis type 1 is one of the most frequent genetic disease since the genetic predisposition (homozygosity for the C282Y mutation of the HFE gene) is encountered in about 3/1000 white subjects (5/1000 in Brittany, France). --- C282Y --- --- C282Y ---

Inclusion Criteria: - Men - Age 18 years or older - Homozygosity for the C282Y mutation of the HFE gene - With an indication of treatment by bloodletting (in accordance with the French HAS guidelines) - Ferritinemia ≥ 500µg/L - Transferrin saturation ≥ 75% - Never treated by bloodletting - Written informed consent Exclusion Criteria: - Contraindication to bloodletting - Chronic inflammatory or dysmetabolic or neoplastic disease - Major cardiovascular disease - Excessive consumption of alcohol (≥ 3gr/day) - Treatment by iron chelators, C or E vitamins - Stay in altitude> 1500m in the month preceding the period Day 1 - Patients under guardianship - Blood donation in the 3 past months - Night / shift workers Inclusion Criteria: - Men - Age 18 years or older - Homozygosity for the C282Y mutation of the HFE gene - With an indication of treatment by bloodletting (in accordance with the French HAS guidelines) - Ferritinemia ≥ 500µg/L - Transferrin saturation ≥ 75% - Never treated by bloodletting - Written informed consent Exclusion Criteria: - Contraindication to bloodletting - Chronic inflammatory or dysmetabolic or neoplastic disease - Major cardiovascular disease - Excessive consumption of alcohol (≥ 3gr/day) - Treatment by iron chelators, C or E vitamins - Stay in altitude> 1500m in the month preceding the period Day 1 - Patients under guardianship - Blood donation in the 3 past months - Night / shift workers Hemochromatosis Type 1 Hemochromatosis Hemochromatosis type 1 is one of the most frequent genetic disease since the genetic predisposition (homozygosity for the C282Y mutation of the HFE gene) is encountered in about 3/1000 white subjects (5/1000 in Brittany, France). --- C282Y --- --- C282Y --- --- C282Y ---

Primary Outcomes

Measure: Maximal variation (delta maximum) of NTBI during the 5 days following a bloodletting

Time: Day 5

Secondary Outcomes

Measure: Kinetic of NTBI plasmatic concentration during the 5 days following a bloodletting

Time: Day 5

Measure: Maximal variation (delta maximum) of LPI during the 5 days following a bloodletting

Time: Day 5

Measure: Maximal variation (delta maximum) of hepcidin during the 5 days following a bloodletting

Time: Day 5

Measure: Kinetic of LPI plasmatic concentration during the 5 days following a bloodletting

Time: Day 5

Measure: Kinetic of hepcidin plasmatic concentration during the 5 days following a bloodletting

Time: Day 5

Measure: CRP

Time: Day 9, day 10, day 11 and day 12

Measure: Hemoglobin

Time: Day 9, day 10, day 11 and day 12

Measure: Soluble transferrin receptor

Time: Day 9, day 10, day 11 and day 12

Measure: EPO

Time: Day 9, day 10, day 11 and day 12

Measure: Circadian kinetic of NTBI plasmatic concentration when no bloodletting is performed

Time: Day 1

Measure: Circadian kinetic of API plasmatic concentration when no bloodletting is performed

Time: Day 1

Measure: Circadian kinetic of hepcidine plasmatic concentration when no bloodletting is performed

Time: Day 1

Measure: Maximal variation (delta maximum) of transferrin saturation during the 5 days following a bloodletting

Time: Day 5

Measure: Kinetic of transferrin saturation during the 5 days following a bloodletting

Time: Day 5

23 Iron Depletion Therapy for Patients With Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease

The purpose of this study is to find out whether lowering the amount of iron in the body will result in less resistance to insulin and improved liver function in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease. This may result in better diabetes control and/or a decrease in the amount of liver fat.

NCT00230087
Conditions
  1. Non-Alcoholic Fatty Liver Disease
  2. Diabetes Mellitus
Interventions
  1. Procedure: blood donation
MeSH:Liver Diseases Fatty Liver Non-alcoholic Fatty Liver Disease Diabetes Mellitus
HPO:Abnormality of the liver Decreased liver function Diabetes mellitus Elevated hepatic transaminase Hepatic steatosis

- Hemoglobin HbA1c level ≤ 8 % - Serum ALT levels ≥1.3 x ULN - Between 18-65 years of age Exclusion Criteria - Hereditary hemochromatosis or hepatic iron overload defined as any of the following: - 2+ iron on hepatic iron staining - Hepatic Iron Index ≥ 1.9 - C282Y homozygous or C282Y/H63D compound heterozygous HFE genotype - Use of insulin or thiazolidinediones for the treatment of diabetes - Use of anti-NASH drugs (thiazolidinediones, vitamin E, UDCA, SAM-e, betaine, milk thistle, gemfibrozil, anti-TNF therapies, probiotics) - Serum ferritin <50μg/L - Serum transferrin-iron saturation <10 % - Hemoglobin <10 mg/L - Hematocrit <38 % - Voluntary blood donation or therapeutic phlebotomy within the previous twelve months (except routine lab tests) - Pregnant or lactating women - Prior history of coronary artery disease, myocardial infarction, exertional dyspnea or chronic chest pain at rest. - Evidence of myocardial infarction as determined by an ECG Inclusion Criteria - Histological evidence of NAFLD and enrollment in NASH CRN Database Study - Type 2 DM treated with diet or a stable dose of non-insulin sensitizing oral hypoglycemic agents for > 3 mo. --- C282Y ---

- Hemoglobin HbA1c level ≤ 8 % - Serum ALT levels ≥1.3 x ULN - Between 18-65 years of age Exclusion Criteria - Hereditary hemochromatosis or hepatic iron overload defined as any of the following: - 2+ iron on hepatic iron staining - Hepatic Iron Index ≥ 1.9 - C282Y homozygous or C282Y/H63D compound heterozygous HFE genotype - Use of insulin or thiazolidinediones for the treatment of diabetes - Use of anti-NASH drugs (thiazolidinediones, vitamin E, UDCA, SAM-e, betaine, milk thistle, gemfibrozil, anti-TNF therapies, probiotics) - Serum ferritin <50μg/L - Serum transferrin-iron saturation <10 % - Hemoglobin <10 mg/L - Hematocrit <38 % - Voluntary blood donation or therapeutic phlebotomy within the previous twelve months (except routine lab tests) - Pregnant or lactating women - Prior history of coronary artery disease, myocardial infarction, exertional dyspnea or chronic chest pain at rest. - Evidence of myocardial infarction as determined by an ECG Non-Alcoholic Fatty Liver Disease Diabetes Mellitus Liver Diseases Fatty Liver Non-alcoholic Fatty Liver Disease Diabetes Mellitus Nonalcoholic fatty liver disease (NAFLD) is a common liver disease in the United States. --- C282Y ---

Primary Outcomes

Measure: Improved insulin sensitivity as determined by:(1) hyperinsulinemic euglycemic clamp method

Time: one year

Measure: (2) HOMA model- determined by the OGTT method

Time: one year

Secondary Outcomes

Measure: Change in serum aminotransferase levels Change in levels of serum, plasma and urinary markers of oxidative stress

Time: one year

Measure: Changes in intrahepatic and intraabdominal fat content as determined by CT scan

Time: one year

Measure: Change in serum levels of proinflammatory cytokines (ie IL-6, TnF-αR2)

Time: one year

24 Study of the Effects of Muscular Activity on Iron Metabolism: A Pilot Study on Healthy Volunteers

The aim of this study is to evaluate the effect of muscular exercise on iron metabolism in healthy volunteers. Fourteen healthy male subjects will have to pedal on an ergocycle for 45 minutes, and urine and blood samples will be collected regularly to measure hemojuvelin, hepcidin, iron and transferrin levels.

NCT00378469
Conditions
  1. Iron Overload
  2. Iron Deficiency
Interventions
  1. Behavioral: 45 minute exercise on ergocycle
MeSH:Iron Overload

Inclusion Criteria: - Male individuals aged between 18 and 40 years old - Body mass index (BMI) between 18 and 25 - Normal at clinical examination - Normal biological variables - Written informed consent Exclusion Criteria: - Mutation C282Y of the HFE gene - Iron metabolism abnormality - Inflammatory syndrome - Chronic pathology or ongoing treatment - Tobacco smoking, alcohol consuming more than 30g/day - History of transfusion or blood-giving within 3 months - Positive serology for hepatitis B virus (HBV), hepatitis C virus (HCV) or HIV. --- C282Y ---

Primary Outcomes

Measure: Pharmacokinetics of urinary hepcidin

Measure: Pharmacokinetics of blood hemojuvelin

Secondary Outcomes

Measure: Pharmacokinetics of urine and blood iron, transferrin, interleukin-6 (IL-6) and ferritin

25 Effects of Phlebotomy on Insulin Sensitivity in Insulin Resistance-associated Hepatic Iron Overload Patients

The purpose of this study is to evaluate efficacy of phlebotomy on insulin sensitivity as evaluated by euglycemic-hyperinsulinic clamp in insulin resistance-associated hepatic iron overload patients.

NCT01572818
Conditions
  1. Insulin Resistance
  2. Iron Overload
Interventions
  1. Procedure: phlebotomy
  2. Behavioral: dietary and lifestyle counseling
MeSH:Insulin Resistance Iron Overload
HPO:Insulin resistance

Inclusion Criteria: - Age between 18 and 70 years - Ferritin between 450 and 1000 µg/L - Hepatic iron overload proved by MRI (CHF >36 µmol/g) - Body mass index > 25 kg/m² - Fasting glycemia <1,26 g/L - HbA1c < 6,5% - Signed written and informed consent Exclusion Criteria: - Other causes of hyperferritinemia: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyperferritinemia-cataract syndrome (familial cataract or personal history of cataract before 50 years old) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Haemochromatosis established by the genotype (C282Y homozygous or C282Y/H63D coumpound heterozygous genotypes) - Contraindication of phlebotomy - Haemoglobin <13,5 g/dL (threshold established by the Etablissement Français du Sang) - Heart failure or coronary heart diseases - Hepatic failure, renal (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Viral, immune, genetic, vascular, malignant or toxic chronic hepatic disease - Alcohol consumption more than 21 doses per week during 5 years or more - Type 1 or type 2 diabetes - Oral anti-diabetic, corticoids or immune suppressor drugs - Hepatic severe disease - Claustrophobia, having a pace-maker or intracerebral clips - Subjects deprived of their liberty by judicial or administrative decision, subjects that are not affiliated to social security or topics exclusion period of a previous study Inclusion Criteria: - Age between 18 and 70 years - Ferritin between 450 and 1000 µg/L - Hepatic iron overload proved by MRI (CHF >36 µmol/g) - Body mass index > 25 kg/m² - Fasting glycemia <1,26 g/L - HbA1c < 6,5% - Signed written and informed consent Exclusion Criteria: - Other causes of hyperferritinemia: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyperferritinemia-cataract syndrome (familial cataract or personal history of cataract before 50 years old) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Haemochromatosis established by the genotype (C282Y homozygous or C282Y/H63D coumpound heterozygous genotypes) - Contraindication of phlebotomy - Haemoglobin <13,5 g/dL (threshold established by the Etablissement Français du Sang) - Heart failure or coronary heart diseases - Hepatic failure, renal (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Viral, immune, genetic, vascular, malignant or toxic chronic hepatic disease - Alcohol consumption more than 21 doses per week during 5 years or more - Type 1 or type 2 diabetes - Oral anti-diabetic, corticoids or immune suppressor drugs - Hepatic severe disease - Claustrophobia, having a pace-maker or intracerebral clips - Subjects deprived of their liberty by judicial or administrative decision, subjects that are not affiliated to social security or topics exclusion period of a previous study Insulin Resistance Iron Overload Insulin Resistance Iron Overload The main objective of this study is to evaluate in patients with HSD effects of treatment with phlebotomy rules with lifestyle and dietary rules versus lifestyle modifications alone on peripheral insulin resistance (assessed by hyperinsulinemic clamp). --- C282Y ---

Inclusion Criteria: - Age between 18 and 70 years - Ferritin between 450 and 1000 µg/L - Hepatic iron overload proved by MRI (CHF >36 µmol/g) - Body mass index > 25 kg/m² - Fasting glycemia <1,26 g/L - HbA1c < 6,5% - Signed written and informed consent Exclusion Criteria: - Other causes of hyperferritinemia: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyperferritinemia-cataract syndrome (familial cataract or personal history of cataract before 50 years old) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Haemochromatosis established by the genotype (C282Y homozygous or C282Y/H63D coumpound heterozygous genotypes) - Contraindication of phlebotomy - Haemoglobin <13,5 g/dL (threshold established by the Etablissement Français du Sang) - Heart failure or coronary heart diseases - Hepatic failure, renal (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Viral, immune, genetic, vascular, malignant or toxic chronic hepatic disease - Alcohol consumption more than 21 doses per week during 5 years or more - Type 1 or type 2 diabetes - Oral anti-diabetic, corticoids or immune suppressor drugs - Hepatic severe disease - Claustrophobia, having a pace-maker or intracerebral clips - Subjects deprived of their liberty by judicial or administrative decision, subjects that are not affiliated to social security or topics exclusion period of a previous study Inclusion Criteria: - Age between 18 and 70 years - Ferritin between 450 and 1000 µg/L - Hepatic iron overload proved by MRI (CHF >36 µmol/g) - Body mass index > 25 kg/m² - Fasting glycemia <1,26 g/L - HbA1c < 6,5% - Signed written and informed consent Exclusion Criteria: - Other causes of hyperferritinemia: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyperferritinemia-cataract syndrome (familial cataract or personal history of cataract before 50 years old) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Haemochromatosis established by the genotype (C282Y homozygous or C282Y/H63D coumpound heterozygous genotypes) - Contraindication of phlebotomy - Haemoglobin <13,5 g/dL (threshold established by the Etablissement Français du Sang) - Heart failure or coronary heart diseases - Hepatic failure, renal (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Viral, immune, genetic, vascular, malignant or toxic chronic hepatic disease - Alcohol consumption more than 21 doses per week during 5 years or more - Type 1 or type 2 diabetes - Oral anti-diabetic, corticoids or immune suppressor drugs - Hepatic severe disease - Claustrophobia, having a pace-maker or intracerebral clips - Subjects deprived of their liberty by judicial or administrative decision, subjects that are not affiliated to social security or topics exclusion period of a previous study Insulin Resistance Iron Overload Insulin Resistance Iron Overload The main objective of this study is to evaluate in patients with HSD effects of treatment with phlebotomy rules with lifestyle and dietary rules versus lifestyle modifications alone on peripheral insulin resistance (assessed by hyperinsulinemic clamp). --- C282Y --- --- H63D --- --- C282Y ---

Primary Outcomes

Measure: Glucose Infusion Rate by euglycemic-hyperinsulinic clamp

Time: 6 months

Secondary Outcomes

Measure: hepatic parameters

Time: 6 months

Description: IL-6, TNF alpha, CRP

Measure: inflammation markers

Time: 6 months

Description: adiponectin, PAI1, leptin

Measure: Adipokins markers

Time: 6 months

Measure: SHBG

Time: 6 months

Measure: HOMA-IR

Time: 6 months

Description: transaminase (ALT, AST), gamma GT

Measure: Hepatic iron overload (MRI)

Time: 6 months

Measure: Abdominal and sub-cutaneous fat surface (MRI)

Time: 6 months

Description: serum iron, ferritin, saturation of transferrin

Measure: iron parameters

Time: at 6 months

Description: HDL-c, LDL-c, triglycerides

Measure: lipid profile

Time: at 6 months

26 S-Adenosyl Methionine for Symptomatic Treatment of Primary Biliary Cirrhosis

This study will examine the effect of S-adenosyl methionine (SAMe) on itching and fatigue in patients with primary biliary cirrhosis, a disease of the small bile ducts in the liver. Ursodiol, the only currently available treatment for biliary cirrhosis, does not cure the disease, and many people continue to have symptoms or liver test abnormalities despite treatment. SAMe is a naturally occurring substance found in most cells of the body. The highest levels of the substance are produced by the liver, where it helps to rid the body of toxins and breakdown products of metabolism. Studies in Europe suggest that SAMe may help to: 1) decrease the fatigue and itching that are common in persons with liver problems, and 2) decrease levels of liver enzymes in the blood, suggesting that it may decrease the amount of liver injury. Patients 21 years of age or older with primary biliary cirrhosis who are taking ursodiol and have symptoms of itching or fatigue may be eligible for this study. Candidates are screened with a medical history, physical examination, review of medical records, routine blood tests, and a symptoms rating scale. Participants stop all medications for itching 4 weeks before starting the study, but continue to take ursodiol during the 42-week trial. On entering the study, patients are assigned to take either SAMe or placebo tablets twice a day for 12 weeks. While taking the medications, they are followed in the clinic every 2 weeks for the first month and then every 4 weeks to fill out symptoms questionnaires and have a short medical evaluation and blood tests. At the end of 12 weeks, treatment is interrupted for a 2-week "wash-out" period, after which patients begin a 12-week crossover treatment; that is, patients who were taking SAMe are switched to placebo, and those who were taking placebo are switched to SAMe. After completing the second 12-week treatment course, patients come to the clinic at 4, 8, and 12 weeks to fill out symptoms questionnaires and have a medical evaluation and blood tests. At the last visit, patients are told which type of tablet they received during the two courses of treatment. SAMe is available without prescription in many forms as an over-the-counter medication.

NCT00125281
Conditions
  1. Liver Cirrhosis, Biliary
Interventions
  1. Drug: S-adenosyl-methionine (SAMe) capsules
MeSH:Liver Cirrhosis Liver Cirrhosis, Biliary Fibrosis
HPO:Biliary cirrhosis Cirrhosis Hepatic fibrosis

Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Patients with iron saturation indices of greater than 45% and serum ferritin levels of greater than 300 ng/ml for men and greater than or equal to 250 ng/ml for women will undergo genetic testing for C282Y and H63D. --- C282Y ---

Primary Outcomes

Measure: Improvement in symptoms as assessed by validated questionnaires and visual analogue scales administered at 2 to 4 week intervals during therapy.

Time: 12 weeks of therapy

Secondary Outcomes

Measure: Improvement in serum alanine aminotransferase and alkaline phosphatase.

Time: 12 weeks

27 Treatment of Nonalcoholic Steatohepatitis With Metformin

Nonalcoholic Steatohepatitis (NASH) is associated with progressive liver disease, fibrosis, and cirrhosis. Although the cause of NASH is unknown, it is often associated with obesity, type 2 diabetes, and insulin resistance. At present, there are no approved treatments for NASH patients, but an experimental approach has focused on improving their insulin sensitivity. Metformin is one of the most commonly used medications for the treatment of diabetes. The purpose of this study is to determine whether the medical problems of NASH patients, specifically liver damage, improves when their insulin sensitivity is enhanced with metformin. The study will last 3 to 5 years and will enroll up to 30 patients. Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.

NCT00063232
Conditions
  1. Hepatitis
Interventions
  1. Drug: Metformin
MeSH:Hepatitis Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Hepatic steatosis Hepatitis

7. Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Primary Outcomes

Description: Patients under went liver biopsy, metabolic profiling and imaging studies before and at the end 48 weeks of metformin (2000 mg/day) therapy. The primary endpoint is a three point improvement in the histological NASH activity index with a decrease in at least two of the component scores and no worsening of fibrosis or increase in Mallory bodies.

Measure: Change in the Histological NASH Activity Index at 48 Weeks Compared With Baseline (Number of Participants in Each Change Category)

Time: from baseline to 48 Weeks

Secondary Outcomes

Description: Alanine transaminase <42 U/L is considered normal

Measure: Change in Serum Alanine Aminotransferase (ALT) Levels From Baseline (Number of Participants in Each Change Category)

Time: from baseline to 48 weeks

Description: HOMA-IR is calculated from Fasting Glucose and Fasting Insulin

Measure: Change in Insulin Sensitivity (Glucose Tolerance, Homeostatic Model Assessment of Insulin Resistence (HOMA-IR)) From Baseline

Time: from baseline to 48 weeks

28 Characterization of Cardiac Function in Subjects With Hereditary Hemochromatosis Who Are New York Heart Association Functional Class I

This study will examine the effect of iron buildup in the hearts of patients with hereditary hemochromatosis (HH), a genetic disease that causes the body to accumulate excess amounts of iron. The excess iron can damage the heart, liver, pancreas, skin, and joints. Generally, early treatment with phlebotomy (periodic removal of a unit of blood), and in some cases chelation (using a drug to remove iron from the body) slows down organ damage in HH patients. This study will try to elucidate the effect of iron buildup in the heart and determine if phlebotomy and chelation help keep the heart healthy. Patients with HH and healthy volunteers 21 years of age and older may be eligible for this study. (Normal volunteers will provide normal values of heart function that will be used to verify abnormalities detected in HH patients.) Patients must have a gene abnormality of Hfe gene Cys282Try homozygote. They may or may not be receiving treatment for HH and they must have no heart symptoms or serious organ damage due to HH. Candidates will be screened with a medical history and physical examination, blood tests, electrocardiogram (EKG), Holter EKG (24-hour EKG monitoring, see description below), and chest x-ray. Participants will undergo the following tests and procedures over 2 to 5 days: - Exercise test: The participant exercises on a treadmill while wearing a mouthpiece, which is used to measure how much oxygen is used. Electrodes placed on the chest and arms monitor the heartbeat during the test. - Echocardiography: This ultrasound test uses sound waves to take pictures. A small probe is held against the chest to allow a technician to take pictures of the heart and assess its function. A drug called Optison may be injected in an arm vein if needed to enhance the ultrasound images. - Exercise stress echocardiography: The participant exercises on a stationary bike while heart function is measured with an echocardiogram, EKG, and blood pressure cuff. - 24-hour Holter EKG: The participant wears a small machine that records heart rhythm continuously for 24 hours. The recorder is connected by cables to electrodes placed on the chest. - Magnetic resonance imaging: This test uses a magnetic field and radio waves to obtain detailed images of the heart and blood vessels. The participant lies flat on a table that slides inside the scanner, which is a large hollow tube. All tests are performed once in normal volunteers and in patients who have received standard treatment for HH. Untreated patients repeat the tests 6 months after beginning phlebotomy or chelation. Additional time points for these tests might be added if further evaluation is needed.

NCT00068159
Conditions
  1. Hereditary Hemochromatosis
MeSH:Hemochromatosis

- INCLUSION CRITERIA: HH Patients Group A patients (untreated HH patients) Adults 21 years or older New York Heart Association Functional Classification Class I Documented positive phenotyping for homozygote Cys282Tyr of Hfe gene with documented serum ferritin level above 400 ng/ml or documented % iron saturation more than 60%. --- Cys282Tyr ---

Group B patients (treated HH patients) Adults 21 years or older New York Heart Association Functional Classification Class I Documented positive phenotyping for homozygote Cys282Tyr of Hfe gene with documented serum ferritin level above 400 ng/ml or documented % iron saturation more than 60%. --- Cys282Tyr ---

No symptoms suggestive of heart disease or any other medical conditions, negative Hfe genotyping for Cys282Tyr or His63Asp with normal ferritin and iron saturation. --- Cys282Tyr ---

Homozygosity for the Cys282Tyr mutation, which is the most common known mutation with a predisposition to iron overload, occurs with an estimated frequency of 8 per 1000 in the Caucasians. --- Cys282Tyr ---

Although the pathophysiology remains incompletely understood, a homozygote mutation in Cys282Tyr is present in 84 to 100% of clinically confirmed HH cases. --- Cys282Tyr ---

Primary Outcomes

Description: To assess detailed cardiac function using non-invasive cardiac imaging in Group A; untreated-NYHA Class I HH subjects without conventional therapy for HH, Group B; treated- NYHA Class I HH subjects with conventional phlebotomy and/or iron chelation therapy and compare these results to those from Group C; age-gender matched healthy control volunteers.

Measure: Echocardographic variable early diastolic peak tissue Doppler velocity of septal mitral annulus (Em).

Time: 10 year

Secondary Outcomes

Description: To compare the results of the cardiac functional abnormalities in HH to those from healthy control volunteers

Measure: Exercise testing variable change in ejection fraction in response to exercise

Time: 10 year

29 Long-Term Treatment of Nonalcoholic Steatohepatitis With Pioglitazone

Nonalcoholic steatohepatitis (NASH) is a common liver disease that resembles alcoholic hepatitis but occurs in persons who drink little or no alcohol. The etiology of NASH is unclear, but it is commonly associated with diabetes, obesity, and insulin resistance. Several pilot studies, including a study of pioglitazone at the NIH Clinical Center (01-DK-0130), have shown that the insulin-sensitizing thiazolidinediones lead to decreases in serum alanine aminotransferase (ALT) levels and improved liver histology. Once therapy is stopped, however, ALT levels rapidly return to pre-treatment values. Inaddition we are currently enrolling patients with NASH in a pilot study of metformin therapy for 48-weeks, however our results in 3 patients thus far have not been very encouraging. In the current study, patients who have completed the pilot study of pioglitazone and have been off therapy for 48 weeks will be offered re-treatment for 3 years. We also propose to treat patients who have not had a satisfactory response to metformin with pioglitazone for the same duration. After a repeat medical and metabolic evaluation and liver biopsy, patients with moderate-to-severe NASH (activity score greater than or equal to 4) will restart pioglitazone at a dose of 15 mg daily. If after 48 weeks, ALT levels are not normal or improved to the degree identified during the pilot study, the dose will be increased to 30 mg daily at the end of 3 years, all patients will undergo repeat medical and metabolic evaluation and liver biopsy. The primary end point will be improvement in liver histology. Secondary end points will be improvements in insulin sensitivity, reduction in visceral fat, liver volume, and liver biochemistry. The aim of this study is to evaluate whether long-term pioglitazone therapy can safely achieve and maintain biochemical and histological improvements in NASH. ...

NCT00062764
Conditions
  1. Hepatitis
Interventions
  1. Drug: Actos (Pioglitazone)
MeSH:Hepatitis Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Hepatic steatosis Hepatitis

Hemochromatosis as defined by presence of 3+ or 4 iron on liver biopsy stain and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Primary Outcomes

Description: A histological response was defined as a reduction in the NASH activity index by 3 points or more with improvements of at least 1 point each in steatosis, parenchymal inflammation, and hepatocellular injury.

Measure: Number of Patients With Improvement in Liver Histology

Time: 48 weeks

Secondary Outcomes

Measure: Number of Patients With Impaired Glucose Tolerance After Treatment

Time: 48 weeks

Measure: Mean Increase of Insulin Sensitivity Index

Time: 48 weeks

Measure: Average Increase in Weight After Treatment

Time: 48 weeks

Measure: Mean BMI Change

Time: 48 weeks

30 Cytochrome P450 2E1 and Iron Overload

The aim of the study is to determine, in patients presenting hepatic iron overload (genetic haemochtomatisis or dysmetabolic iron overload syndrome), the effects of venesection therapy on cytochrome P450 2E1 activity by comparing the rates of metabolization of chlorzoxazone before and after venesection.

NCT00138684
Conditions
  1. Insulin Resistance
  2. Iron Overload
Interventions
  1. Procedure: venesection
MeSH:Insulin Resistance Iron Overload
HPO:Insulin resistance

Inclusion Criteria: - Male patients aged from 18 to 70 years - Hepatic iron overload measured by magnetic resonance imaging [MRI] (> 36 µmol/g and < 200 µmol/L) - Homozygosity for the C282Y mutation of the HFE or dysmetabolic iron overload syndrome (DIOS) based on the presence of at least one of these following metabolic abnormalities: - Overweight: BMI > 25 kg/m2 - Waist/hip circumference (cm) > 0.90 - Diabetes mellitus (fasting blood glucose level >1.25g/L or blood glucose level after 2 hours > 2g/L) or glucose intolerance (fasting blood glucose level between 1.10 and 1.25g/L) - Total cholesterolemia > 6.2 mmol/L or HDL-Cholesterol < 0.9 mmol/L - TG>= 1.7 mmol - Written informed consent Non-Inclusion Criteria: - Consumption of alcohol > 50 g/day and of any CYP2E1 inhibitor substances - Smoker > 5 cigarets/day - History of blood donation or venesection - Other causes of iron overload: aceruloplasminaemia, haematological disorder (abnormal blood counting), late cutaneous porphyria (cutaneous bullous disorders and photosensibilisation) , martial treatment, repeated transfusions. --- C282Y ---

- Inflammatory syndrome (CRP > 3ng/ml) Inclusion Criteria: - Male patients aged from 18 to 70 years - Hepatic iron overload measured by magnetic resonance imaging [MRI] (> 36 µmol/g and < 200 µmol/L) - Homozygosity for the C282Y mutation of the HFE or dysmetabolic iron overload syndrome (DIOS) based on the presence of at least one of these following metabolic abnormalities: - Overweight: BMI > 25 kg/m2 - Waist/hip circumference (cm) > 0.90 - Diabetes mellitus (fasting blood glucose level >1.25g/L or blood glucose level after 2 hours > 2g/L) or glucose intolerance (fasting blood glucose level between 1.10 and 1.25g/L) - Total cholesterolemia > 6.2 mmol/L or HDL-Cholesterol < 0.9 mmol/L - TG>= 1.7 mmol - Written informed consent Non-Inclusion Criteria: - Consumption of alcohol > 50 g/day and of any CYP2E1 inhibitor substances - Smoker > 5 cigarets/day - History of blood donation or venesection - Other causes of iron overload: aceruloplasminaemia, haematological disorder (abnormal blood counting), late cutaneous porphyria (cutaneous bullous disorders and photosensibilisation) , martial treatment, repeated transfusions. --- C282Y ---

Primary Outcomes

Measure: variation of chlorzoxazone metabolization rate measured before and after venesection

Time: Baseline and after iron desaturation completion

Secondary Outcomes

Measure: variation of blood Malonedialdehyde rate

Time: Baseline and after iron desaturation completion

Measure: variation of blood 4-hydroxynonenal rate

Time: Baseline and after iron desaturation completion

Measure: variation of blood Glutathion rate

Time: Baseline and after iron desaturation completion

Measure: variation of serum Vitamin E rate

Time: Baseline and after iron desaturation completion

Measure: Variation of serum Vitamin C rate

Time: Baseline and after iron desaturation completion

31 A Phase I/II Open Label, Dose Escalation Trial and a Six Month Extension to Explore the Safety and Efficacy of ICL670 in Patients With Iron Overload Resulting From Hereditary Hemochromatosis.

Brief Summary: This study was designed to explore a safe dose and characterize the preliminary safety and efficacy of ICL670 in adult patients with previously documented history of homozygous C282Y.

NCT00395629
Conditions
  1. Iron Overload
  2. Hereditary Hemochromatosis
Interventions
  1. Drug: Deferasirox (ICL670)
MeSH:Hemochromatosis Iron Overload

A Phase I/II Open Label, Dose Escalation Trial and a Six Month Extension to Explore the Safety and Efficacy of ICL670 in Patients With Iron Overload Resulting From Hereditary Hemochromatosis.. Safety and Efficacy of Deferasirox (ICL670) in Patients With Iron Overload Resulting From Hereditary Hemochromatosis Brief Summary: This study was designed to explore a safe dose and characterize the preliminary safety and efficacy of ICL670 in adult patients with previously documented history of homozygous C282Y. --- C282Y ---

The mean trough concentration at each time point was calculated.. Inclusion Criteria: - Age 18 years of age or older - Male or female patients homozygous for the C282Y mutation. --- C282Y ---

Inclusion Criteria: - Age 18 years of age or older - Male or female patients homozygous for the C282Y mutation. --- C282Y ---

Primary Outcomes

Description: Mean absolute change in serum ferritin from baseline to the end of the extension study.

Measure: Absolute Change of Serum Ferritin From Baseline to the End of Extension, by Dose Cohort (Extension Per-protocol Population)

Time: 0 to 48 weeks

Secondary Outcomes

Description: A blood sample was collected just prior to administration of the next dose of Deferasirox (pre-dose trough level) or approximately 24 hours after the previous dose at weeks 4, 8, 12, 16, 20 and 24. The mean trough concentration at each time point was calculated.

Measure: Trough Concentrations of Deferasirox (ICL670), by Dose Cohort (Per-protocol Population)

Time: 4, 8, 12, 16, 20, and 24 weeks

32 Haemochromatosis and Periodontitis

Periodontitis is a chronic inflammatory disease that affects tissues surrounding the teeth. It is strongly associated with the major pathogenic "red complex", including Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola1 and thus is considered an infection. Recent advances in the pathogenesis of periodontal disease have suggested that polymicrobial synergy and microbiota dysbiosis together with a dysregulated immune response can induce inflammation-mediated damage in periodontal tissues2-4. Interestingly, currently periodontitis is associated with a growing number of systemic diseases, including cardiovascular diseases, adverse pregnancy outcomes, diabetes5-7 and hereditary haemochromatosis8.

NCT04006249
Conditions
  1. to Evaluate the Prevalence of Periodontal Diseases in Patients With Hemochromatosis at the Time of Diagnosis and / or Their Usual Therapeutic
Interventions
  1. Diagnostic Test: dental probes
MeSH:Periodontitis Periodontal Diseases Hemochromatosis
HPO:Periodontitis

Inclusion Criteria: - Patients aged 35 to 64 years with homozygosity hemochromatosis C282Y - Patients regularly enrolled in a health insurance plan - Patients with at least 10 natural teeth - Patients who have given informed written, dated and signed consent Exclusion Criteria: - Diabetic patients - Simultaneous participation in another study - Pregnant or lactating women - The incapacitated persons and persons deprived of their liberty - Patients who do not speak French, both written and spoken - Patients previously included in this trial - Patients with heart valves or endovascular equipment (risk of infective endocarditis ...) - Patients with a history of maxillofacial surgery - Patients whose oral status is considered incompatible with entry into the study, at the discretion of the investigator - Patients on drugs that can cause gingival hypertrophy, such as Hydantoins (phenytoin), Dihydropyridines, Diltiazem or Ciclosporin - Patients on medication that can cause gingival bleeding (anticoagulants, antiplatelet agents and aspirin). --- C282Y ---

Primary Outcomes

Description: To evaluate the prevalence of periodontal diseases in patients with hemochromatosis at the time of diagnosis and / or their usual therapeutic

Measure: prevalence of periodontal diseases

Time: 2 years

33 Testing the Efficacy of a Natural Polyphenol Supplement to Inhibit Dietary Iron Absorption in Subjects With Hereditary Hemochromatosis: a Stable Isotope Study

Polyphenolic compounds are very strong Inhibitors of non-heme iron absorption, as they form insoluble complexes with ferrous iron. Patients with hereditary hemochromatosis (HH) have an increased intestinal non-heme iron absorption due to a genetic mutation in the regulatory pathway, leading to excess iron in the body. This study investigates the inhibitory effect of a natural polyphenol Supplement in participants with HH.

NCT03990181
Conditions
  1. Iron Metabolism Disorders
  2. Iron Overload
  3. Polyphenols
Interventions
  1. Dietary Supplement: meal matrix & NPPS
  2. Dietary Supplement: meal matrix & CS
  3. Dietary Supplement: no-matrix & NPPS
  4. Dietary Supplement: no-matrix & CS
MeSH:Hemochromatosis Iron Overload Metabolic Diseases Iron Metabolism Disorders

Inclusion Criteria: - Homozygous for C282Y mutation in HFE (hemochromatosis) gene - Written informed consent - Age 18-65 y - Not pregnant or lactating - Body weight < 75 kg - Body mass index (BMI) between 18.5 and 25 kg/m2 - No acute illness/infection (self-reported) - No metabolic or gastrointestinal disorders, eating disorders or food allergy to the ingredients of the test meal (self-reported) - No scheduled phlebotomy throughout the study period - The last phlebotomy will be at least 4 weeks prior first test meal administration - No use of medications affecting iron absorption or metabolism during the study - No intake of mineral/vitamin supplements 2 weeks before the first study day and during the study - Participation in any other clinical study within the last 30 days - Expected to comply with study protocol Inclusion Criteria: - Homozygous for C282Y mutation in HFE (hemochromatosis) gene - Written informed consent - Age 18-65 y - Not pregnant or lactating - Body weight < 75 kg - Body mass index (BMI) between 18.5 and 25 kg/m2 - No acute illness/infection (self-reported) - No metabolic or gastrointestinal disorders, eating disorders or food allergy to the ingredients of the test meal (self-reported) - No scheduled phlebotomy throughout the study period - The last phlebotomy will be at least 4 weeks prior first test meal administration - No use of medications affecting iron absorption or metabolism during the study - No intake of mineral/vitamin supplements 2 weeks before the first study day and during the study - Participation in any other clinical study within the last 30 days - Expected to comply with study protocol Iron Metabolism Disorders Iron Overload Polyphenols Hemochromatosis Iron Overload Metabolic Diseases Iron Metabolism Disorders null --- C282Y ---

Inclusion Criteria: - Homozygous for C282Y mutation in HFE (hemochromatosis) gene - Written informed consent - Age 18-65 y - Not pregnant or lactating - Body weight < 75 kg - Body mass index (BMI) between 18.5 and 25 kg/m2 - No acute illness/infection (self-reported) - No metabolic or gastrointestinal disorders, eating disorders or food allergy to the ingredients of the test meal (self-reported) - No scheduled phlebotomy throughout the study period - The last phlebotomy will be at least 4 weeks prior first test meal administration - No use of medications affecting iron absorption or metabolism during the study - No intake of mineral/vitamin supplements 2 weeks before the first study day and during the study - Participation in any other clinical study within the last 30 days - Expected to comply with study protocol Inclusion Criteria: - Homozygous for C282Y mutation in HFE (hemochromatosis) gene - Written informed consent - Age 18-65 y - Not pregnant or lactating - Body weight < 75 kg - Body mass index (BMI) between 18.5 and 25 kg/m2 - No acute illness/infection (self-reported) - No metabolic or gastrointestinal disorders, eating disorders or food allergy to the ingredients of the test meal (self-reported) - No scheduled phlebotomy throughout the study period - The last phlebotomy will be at least 4 weeks prior first test meal administration - No use of medications affecting iron absorption or metabolism during the study - No intake of mineral/vitamin supplements 2 weeks before the first study day and during the study - Participation in any other clinical study within the last 30 days - Expected to comply with study protocol Iron Metabolism Disorders Iron Overload Polyphenols Hemochromatosis Iron Overload Metabolic Diseases Iron Metabolism Disorders null --- C282Y --- --- C282Y ---

Primary Outcomes

Description: The change in the isotopic ratio of iron will be measured after administration of a test meal/drink including iron isotopes

Measure: change from baseline in the isotopic ratio of iron in blood at week 2

Time: baseline, 2 weeks

Description: The change in the isotopic ratio of iron will be measured after administration of a test meal/drink including iron isotopes

Measure: change from baseline in the isotopic ratio of iron in blood at week 4

Time: 2 weeks, 4 weeks

Secondary Outcomes

Description: to assess iron status

Measure: Serum Ferritin concentration (µg/L)

Time: baseline, weeks 2, and 4

Description: to assess iron status

Measure: Serum iron concentration (µg/dL)

Time: baseline, weeks 2, and 4

Description: to assess iron status

Measure: Soluble transferrin receptor (mg/L)

Time: baseline, weeks 2, and 4

Description: to calculate percent of transferrin that has iron bound to it; Plasma iron and transferrin saturation will be combined to calculate transferrin saturation (ratio)

Measure: Transferrin saturation in %

Time: baseline, weeks 2, and 4

Description: to assess blood volume based on weight, height, and Hb.

Measure: Hemoglobin (g/dL)

Time: baseline, weeks 2, and 4

Description: identify acute inflammation

Measure: C-reactive Protein (mg/L)

Time: baseline, weeks 2, and 4

Description: identify chronic inflammation

Measure: alpha-1-glycoprotein (g/L)

Time: baseline, weeks 2, and 4

Description: the major regulator of non-heme iron absorption

Measure: Serum Hepcidin (nM)

Time: baseline, and weeks 2

34 Effect of Curcumin on Iron Metabolism in Healthy Volunteer

The purpose of this study is to determine the impact of curcumin, administrated orally, on iron metabolism in healthy volunteers. Iron metabolism will be describe by hepcidin expression that the investigators observed in vitro and serum hepcidin levels.

NCT01489592
Conditions
  1. Healthy Volunteers
Interventions
  1. Drug: curcuma longa

In vitro: the coculture model that we previously developed to analyze endogenous hepcidin expression, and human hepatic cells line (HepG2) stimulated or not by IL-6 which governs the STAT3 pathway, transfected with gene reporter constructs containing hepcidin promoter.. Inclusion Criteria: - Body mass index between 18 et 25 Kg/m² - Non smoker - No swallowing disorders - Normal clinical exam - Normal ECG - Normal values for routine biological tests : serum iron, transferrin saturation,, hemogram ferritin, C Reactive Protein, AST, ALT, HDL and LDL cholesterol, triglycerides - No C282Y mutation within the HFE gene - Affiliation to social security - Written informed consent obtained Exclusion Criteria: - Chronic or evolutive disease - Infection during the 7 days before each sequence - Drug or alcohol (>30g) abuse - Current treatment - Known food allergy - stay at altitude (> 1500m) in 2 months - Positive serology for hepatitis B or C virus or HIV. - Transfusion or blood donation during the last three months. --- C282Y ---

Inclusion Criteria: - Body mass index between 18 et 25 Kg/m² - Non smoker - No swallowing disorders - Normal clinical exam - Normal ECG - Normal values for routine biological tests : serum iron, transferrin saturation,, hemogram ferritin, C Reactive Protein, AST, ALT, HDL and LDL cholesterol, triglycerides - No C282Y mutation within the HFE gene - Affiliation to social security - Written informed consent obtained Exclusion Criteria: - Chronic or evolutive disease - Infection during the 7 days before each sequence - Drug or alcohol (>30g) abuse - Current treatment - Known food allergy - stay at altitude (> 1500m) in 2 months - Positive serology for hepatitis B or C virus or HIV. - Transfusion or blood donation during the last three months. --- C282Y ---

Primary Outcomes

Measure: Maximal variation of serum hepcidin level after oral administration of curcumin

Time: within 48 hours after administration of curcumin

Secondary Outcomes

Description: Iron, ferritin, transferrin, transferrin saturation

Measure: Plasmatic iron bioavailability

Time: 30min, 1H, 2H, 3H, 4H, 6H, 8H, 12H, 24H et 48H

Description: In vitro: the coculture model that we previously developed to analyze endogenous hepcidin expression, and human hepatic cells line (HepG2) stimulated or not by IL-6 which governs the STAT3 pathway, transfected with gene reporter constructs containing hepcidin promoter.

Measure: Evaluation of the inhibitory activity of volunteers's serum on hepcidin expression by hepatocytes

Time: 30min, 1h, 2h, 3h, 4h, 6h, 8h, 12h, 24h

35 Studies of Phlebotomy Therapy in Hereditary Hemochromatosis

This study will evaluate the effectiveness of a test called MCV in guiding phlebotomy (blood drawing) therapy in patients with hemochromatosis an inherited disorder that causes too much iron to be absorbed by the intestine. The excess damages body tissues, most severely in the liver, heart, pancreas and joints. Because iron is carried in the hemoglobin of red blood cells, removing blood can effectively lower the body s iron stores. Patients with hemochromatosis undergo weekly phlebotomy treatments (1 pint per session) to deplete iron stores. This usually requires 10 to 50 treatments, after which blood is drawn every 8 to 12 weeks to prevent a re-build up of iron. A test that measures ferritin a protein involved in storing iron is commonly used to guide phlebotomy therapy in hemochromatosis patients. This study will compare the usefulness of the ferritin test with that of MCV, which measures red blood cell size, in guiding phlebotomy therapy. In addition, the study will 1) examine whether keeping iron levels low during maintenance therapy can help heal severe liver disease and improve arthritis in affected patients, and 2) design a system for making blood collected from hemochromatosis donors available for transfusion into other patients. Patients 15 years and older with diagnosed hemochromatosis or very high iron levels suggesting possible hemochromatosis may be eligible for this study. Candidates will have a history, physical evaluation, review of medical records and blood tests, and complete a symptoms questionnaire. Participants will have the following procedures: - Phlebotomy therapy every 1 to 2 weeks, depending on iron levels - Blood sample collection for blood cell counts and iron studies at every phlebotomy session - Blood sample collection (about 2 tablespoons) every 1 to 2 weeks after iron stores have been depleted - Phlebotomy every 8 to 12 weeks after iron stores are used up to prevent re-build up of excess iron With each blood donation that will be made available for transfusion to other patients, participants will answer the same health history screening questions and undergo the same blood tests given to all regular volunteer blood donors. These include screening for the HIV and hepatitis viruses and for syphilis. Patients who meet height and weight requirements may be asked to consider "double red cell" donations using apheresis. In this procedure, whole blood is collected through a needle placed in an arm vein, similar to routine phlebotomy. The blood then circulates through a machine that separates it into its components. The red cells are removed and the rest of the blood is returned to the body, either through the same needle or through a second needle in the other arm. Patients who have very high iron levels or an enlarged liver will be offered evaluation by the NIH Liver Service. Those judged to be at increased risk for cirrhosis may be advised to undergo a liver biopsy. If cirrhosis is found, the patient will be asked to consider a repeat biopsy after 3 to 5 years of continuous iron depletion to see if scarring has improved. Patients with arthritis will be offered evaluation by the NIH Arthritis Service and, depending on symptoms, may be advised to have X-ray studies or a joint biopsy.

NCT00007150
Conditions
  1. Hemochromatosis
Interventions
  1. Procedure: Phlebotomy
MeSH:Hemochromatosis

- INCLUSION CRITERIA: Confirmed diagnosis of HH, defined by the following HFE genotypes: C282Y/C282 or C282Y/H63D. --- C282Y ---

Although the molecular pathophysiology remains incompletely understood, a homozygous mutation in the HFE gene (Cys282Tyr) is observed in nearly 100% of clinically confirmed cases. --- Cys282Tyr ---

Primary Outcomes

Description: Response to phlebotomy therapy in HH patients, as evidenced by iron-depletion

Measure: MCV drops 1-3% below baseline

Time: 4 to 12 months after starting phlebotomy therapy

36 Hemochromatosis and Iron Overload Screening Study (HEIRS)

To determine the prevalence, genetic and environmental determinants, and potential clinical, personal, and societal impact of iron overload and hereditary hemochromatosis, in a multi-center, multiethnic, primary care-based sample of 100,000 adults. The study is conducted by the Division of Epidemiology and Clinical Applications of the NHLBI, the Division of Blood Diseases and Resources of the NHLBI, and the Ethical, Legal, and Social Implications (ELSI) Research Program of the NHGRI.

NCT00005541
Conditions
  1. Blood Disease
  2. Hemochromatosis
  3. Iron Overload
MeSH:Hematologic Diseases Hemochromatosis Iron Overload
HPO:Abnormality of blood and blood-forming tissues

Evidence suggests that early diagnosis and treatment can prevent disease manifestations and enable normal life expectancy The discovery of the HFE C282Y and H63D variants in the HLA gene region on chromosome 6 provides an opportunity for early and rapid genetic identification of individuals at risk for development of hereditary hemochromatosis. --- C282Y ---

In order to obtain data on the prevalence of genetic factors in a routine care population, a random subgroup of approximately 20-40 percent of the 101,000 screenees will be genotyped for known variants, such as HFE C282Y and H63D, related to iron metabolism and overload. --- C282Y ---


37 Treatment of Nonalcoholic Steatohepatitis With Pioglitazone

This study will evaluate the effectiveness of pioglitazone, a new diabetes medicine, on decreasing insulin resistance and improving liver disease in patients with nonalcoholic steatohepatitis (NASH). NASH is a chronic liver disease with unknown cause that involves fat accumulation and inflammation in the liver, leading to liver cirrhosis in 10 to 15 percent of patients and significant liver scarring in another 30 percent. Although similar to a condition that affects people who drink excessive amounts of alcohol, NASH occurs in people who drink only minimal or no alcohol. It is most often seen in patients with insulin resistance. Pioglitazone decreases insulin resistance and improves blood lipid (fat) levels, so that it may improve liver disease in NASH. Patients with NASH 18 years of age or older may be eligible for this study. Candidates will be screened with a medical history and physical examination and routine blood tests. They will see a dietitian for counseling on diet and weight reduction, if needed. They will stop taking any medications for liver disease and take a daily multivitamin pill. After 2 months, those eligible for participation will be enrolled in the study. Participants will be admitted to the Clinical Center for 2 to 3 days for a complete medical history, physical examination, blood tests, urinalysis, chest X-ray, electrocardiogram, abdominal ultrasound and a liver biopsy. After the diagnosis of NASH is confirmed, the following procedures will be performed: - Echocardiography - imaging test using sound waves shows the heart structure and function - Resting metabolic rate - measures amount of oxygen (and calories) used to maintain body functions at rest. While lying down, the patient wears a clear plastic hood over the head for 20 minutes while the amount of oxygen used is measured. - Magnetic resonance imaging (MRI) scans - shows the size of the liver and other organs. The patient lies on a table in a metal cylinder that contains a magnetic field (the scanner) for no more than 30 minutes while the organs are imaged. - Dual energy X-ray absorptiometry (DEXA) scan measures whole body composition, including amount of fat. The patient lies under an X-ray scanning machine for about 2 minutes. - Oral glucose tolerance test (OGTT) - measures blood sugar and insulin levels. The patient drinks a very sweet drink containing glucose (sugar), after which blood samples are collected at various intervals during the 3-hour test. The blood is drawn through a catheter (thin plastic tube) placed in the arm before the test begins. - Intravenous glucose tolerance test (IVGTT) - determines how the tissues respond to insulin and glucose. Glucose is injected into a vein, followed by a short infusion of insulin. Blood samples are collected through a catheter at various intervals during the 3-hour test. When the above procedures are completed, patients start taking pioglitazone by mouth once a day for 48 weeks, keeping track of the medication and any side effects. They will be seen at the clinic every 2 weeks for the first month and then every 4 weeks for the rest of the treatment period. The visits will include an interview and examination by a physician and blood draw for laboratory tests. Female patients will have a pregnancy test at each clinic visit. At the end of the treatment period patients will be admitted to the Clinical Center for a repeat medical evaluation that will include the procedures described above.

NCT00013598
Conditions
  1. Fatty Liver
  2. Nonalcoholic Steatohepatitis
Interventions
  1. Drug: Pioglitazone
MeSH:Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Hepatic steatosis

Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---


38 Mi-Iron - Moderately Increased Iron - is Reducing Iron Overload Necessary?

Haemochromatosis is a preventable genetic iron overload disorder. Untreated, it can shorten life due mainly to liver cirrhosis and cancer. It can be prevented by blood donation to maintain normal iron levels. It is unclear, however, whether treatment is necessary when individuals have moderate elevation of iron in the body. This research project will study the effects of treatment in this group by assessing a number of scans, questionnaires and blood tests in treated and untreated individuals.

NCT01631708
Conditions
  1. Hereditary Haemochromatosis
Interventions
  1. Procedure: Erythrocytapheresis
  2. Procedure: Plasmapheresis
MeSH:Hemochromatosis Iron Overload

To assess oxidative stress, we will measure F2-isoprostanes, a validated marker of cellular lipid oxidative damage, in urine and blood.. Inclusion Criteria: 1. HFE C282Y homozygous. --- C282Y ---

Exclusion Criteria: 1. HH due to genotypes other than HFE C282Y homozygosity. --- C282Y ---

Inclusion Criteria: 1. HFE C282Y homozygous. --- C282Y ---

Primary Outcomes

Description: Modified Fatigue Impact Scale (MFIS). The MFIS is a shortened version of the Fatigue Impact Scale. This 21-item scale can be self completed and measures the impact of fatigue on physical, cognitive and psychosocial functioning. Each item is scored from 0 (never) to 4 (almost always) resulting in a score from 0-84. In addition, physical (0-36), cognitive (0-40) and psychosocial (0-8) subscale scores can be derived.

Measure: Fatigue

Time: Clinically and statistically significant change in measures taken at baseline and at the end of treatment will be compared. Patients will have approximately 6 third weekly treatments however this will vary depending on initial SF.

Secondary Outcomes

Description: Liver fibrosis will be assessed using Hepascore and Fibrometer (blood tests) and transient elastography (ultrasound).

Measure: Change in markers of liver fibrosis

Time: Clinically and statistically significant change in measures taken at baseline and at the end of treatment will be compared. Patients will have on average 6 third weekly treatments (15 weeks).

Description: Medical Outcomes Study 36-item short form (SF36). As there are no specific quality of life tools available for HH, we will use this very widely used generic tool that has been used in a number of HH studies. This tool covers eight dimensions of health and wellbeing. One study found that individuals seen in a HH clinic and who had no clinical symptoms had significantly lower scores on a number of dimensions of the SF36 compared to population norms.

Measure: Quality of life

Time: Clinically and statistically significant change in measures taken at baseline and at the end of treatment will be compared. Patients will have on average 6 third weekly treatments (15 weeks).

Description: The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure designed to screen for anxiety symptoms and depression symptoms in a hospital setting. It is composed of two seven-item subscales, the Anxiety (HADS-A) and Depression (HADS-D) subscales, and a 14-item total scale (HADS-T). Participants use a four-point Likert-type scale to rate how they have felt in the past week. It has been found to be valid and reliable in various populations.

Measure: Depression and Anxiety

Time: Clinically and statistically significant change in measures taken at baseline and at the end of treatment will be compared. Patients will have on average 6 third weekly treatments (15 weeks).

Description: The presence and impact of arthritis will be measured by the Arthritis Impact Measurement Scales 2 short form. This is a 24 item validated scale that assesses the impact of arthritis on the individual over the past four weeks. We will also ascertain the use of arthritis medication at baseline and end of erythrocytapheresis/sham erythrocytapheresis.

Measure: Arthritis

Time: Clinically and statistically significant change in measures taken at baseline and at the end of treatment will be compared. Patients will have on average 6 third weekly treatments (15 weeks).

Description: To assess oxidative stress, we will measure F2-isoprostanes, a validated marker of cellular lipid oxidative damage, in urine and blood.

Measure: Markers of oxidative stress

Time: Clinically and statistically significant change in measures taken at baseline and at the end of treatment will be compared. Patients will have on average 6 third weekly treatments (15 weeks).

39 Ezetimibe Versus Placebo in the Treatment of Non-alcoholic Steatohepatitis

The purpose of the study is to see if the drug ezetimibe is a potential treatment for Nonalcoholic Steatohepatitis(NASH).

NCT01766713
Conditions
  1. Non Alcoholic Steatohepatitis
Interventions
  1. Drug: Ezetimibe
MeSH:Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Hepatic steatosis

7. Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D. --- C282Y ---

Primary Outcomes

Measure: Change in Liver Fat as Measured by MRI-PDFF

Time: Baseline, 24 weeks

40 Deferasirox Versus Venesection in Patients With Hemochromatosis and for Treatment of Transfusional Siderosis in Myelodysplastic Syndrome: Diagnostics and New Biomarkers.

Hypothesis: Deferasirox can be used as a therapeutic agent to deplete the liver, heart and bone marrow of excess iron in patients with iron overload caused by myelodysplastic syndrome (MDS) and hemochromatosis (HC. Assess the effect of new serum biomarkers (NTBI and hepcidin) and MRI as indicators of iron overload and their usefulness to monitor iron depletion treatment. Study the effect of iron overload and iron depletion on intracellular signal transduction, trace metals concentrations in serum and urine and markers of oxidative stress in blood cells and urine.

NCT01892644
Conditions
  1. Hemochromatosis
  2. Myelodysplastic Syndromes
Interventions
  1. Drug: Deferasirox
  2. Other: Venesection
  3. Drug: Deferasirox
MeSH:Preleukemia Myelodysplastic Syndromes Hemochromatosis Iron Overload Syndrome
HPO:Myelodysplasia

Inclusion Criteria: - Patients with hemochromatosis, aged > 30 years, C282Y- homozygote, with serum-ferritin =/> 1000 µg/L - Patients aged > 18 years with verified low-risk or intermediate-1 risk of myelodysplastic syndrome, with normal cytogenetics and serum-ferritin > 1500 µg/L, or with a transfusion history of =/> red- blood-cell-transfusions. Exclusion Criteria: - Previous or current venesection - MDS patients eligible for hematopoietic stem cell transplantation - Subject complies with one or more of the following standard exclusion criteria for MRI examination; - If the patient has a pacemaker. --- C282Y ---

The most common are the classic C282Y and H63D point mutations of the hemochromatosis protein HFE, which disturbs its interaction with the transferrin receptor 1, the first step in the hepcidin signal cascade. --- C282Y ---

Homozygosity for C282Y is the strongest risk factor for serious iron overload and disease which develops after a long-lasting, asymptomatic period. --- C282Y ---

The study by Phatak et al (2010) was the first clinical trial to demonstrate the safety and efficacy of deferasirox in patients with C282Y-homzygot hemochromatosis. --- C282Y ---

Primary Outcomes

Measure: Changes from baseline in liver iron concentration (LIC) and heart iron concentration (HIC) determined by Magnetic Resonance Imaging (MRI), and in bone marrow iron content determined by microscopy after treatment with deferasirox.

Time: 0, 6 and 12 months

Secondary Outcomes

Measure: Change of hepcidin concentration in serum

Time: 0, 6 and 12 months

Measure: Change of non-transferrin bound iron (NTBI) concentration in serum

Time: 0, 6 and 12 months

Measure: Change of multiple trace metals in serum

Time: 0, 6 and 12 months

Measure: Change of intracellular signal molecules, mTOR, NFkB and stress sensor p53 in blood cells

Time: 0, 6 and 12 months

Description: Marker of oxidative DNA damage

Measure: Change of 8-oxodG in urine

Time: 0, 6 and 12 months

Description: Cu,Zn-Super Oxid Dismutase (SOD)is an antioxidant enzyme

Measure: Change of Cu,Zn-SOD activity in erythrocyte hemolysate

Time: 0, 6 and 12 months

Description: Serum analysis

Measure: Clinical chemistry: Na, K, Ca, Creatinine, creatinine kinase, CRP, alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GT), lactate dehydrogenase (LD), albumin, bilirubin.

Time: 0, 2,4,6,8 weeks, 3,4,5,6,7,8,9,10,11,12 months, 5 weeks posttreatment

Description: Morning spot urine sample.

Measure: Urine routine test strip for detection of blood, protein, and nitrite

Time: 0,2,4,6,8 weeks and 3,4,5,6,7,8,9,10,11,12 months

Measure: Ferritin concentration in serum

Time: 0,2,4,6,8 weeks, 3,4,5,6,7,8,9,10,11,12 months, 5 weeks post treatment

Measure: Transferrin saturation in serum

Time: 0,2,4,6,8 weeks, 3,4,5,6,7,8,9,10,11,12 months, 5 weeks post treatment

Measure: HbA1c

Time: 0, 2,6,12 months

Measure: INR ( International normalized ratio)

Time: 0,2,6,12 months

Measure: Analysis of hemoglobin, reticulocytes, hematocrit, MCV, leukocyte count (total and differential), and platelets

Time: 0, 2,4,6,8 weeks, 3,4,5,6,7,8,9,10,11,12 months, 5 weeks posttreatment

Measure: Urine trace metals

Time: 0, 6 and 12 months

Measure: Bone marrow sample

Time: 0, 6 and 12 months

Other Outcomes

Measure: Pregnancy urin test (hCG)

Time: 0, 6 and 12 months, 5 weeks posttreatment

41 Erythrocytapheresis Versus Phlebotomy as Maintenance Therapy in Patients With Hereditary Hemochromatosis; a Randomised, Single Blinded Sequential, Cross-over Trial

Hereditary hemochromatosis (HH) is a genetic disorder of iron metabolism, resulting in excessive iron overload. Phlebotomy is currently the standard therapy. More recently Therapeutic Erythrocytapheresis (TE) has become a new therapeutic modality, which potentially offers a more efficient method to remove iron overload with fewer procedures.In the proposed clinical trial the investigators will examine whether TE can keep the ferritin levels in patients requiring maintenance therapy below 50 microg/L, with minimally half the number of treatment procedures when compared to current standard therapy by P.

NCT01398644
Conditions
  1. Hereditary Hemochromatosis
Interventions
  1. Other: Phlebotomy and erythrocytapheresis
MeSH:Hemochromatosis

Inclusion Criteria: - homozygous for C282Y - currently treated with phlebotomy as maintenance therapy for at least 6 month - ferritin level between 30-50 micog/L - age 18 years an older - weight more than 50 kg - signed informed consent - willingness to fill out additional questionnaires at three points in time Exclusion Criteria: - chelating therapy - forced dietary regime - aged below 18 years - excessive overweight ( BMI more than 35) - pregnancy Inclusion Criteria: - homozygous for C282Y - currently treated with phlebotomy as maintenance therapy for at least 6 month - ferritin level between 30-50 micog/L - age 18 years an older - weight more than 50 kg - signed informed consent - willingness to fill out additional questionnaires at three points in time Exclusion Criteria: - chelating therapy - forced dietary regime - aged below 18 years - excessive overweight ( BMI more than 35) - pregnancy Hereditary Hemochromatosis Hemochromatosis The research population exists of patients with HH ( by genetic analysis confirmed as homozygous for C282Y) living in south-east of the Netherlands and currently treated with phlebotomy as maintenance treatment to keep their serum ferritin levels < 50 ug/l. --- C282Y ---

Inclusion Criteria: - homozygous for C282Y - currently treated with phlebotomy as maintenance therapy for at least 6 month - ferritin level between 30-50 micog/L - age 18 years an older - weight more than 50 kg - signed informed consent - willingness to fill out additional questionnaires at three points in time Exclusion Criteria: - chelating therapy - forced dietary regime - aged below 18 years - excessive overweight ( BMI more than 35) - pregnancy Inclusion Criteria: - homozygous for C282Y - currently treated with phlebotomy as maintenance therapy for at least 6 month - ferritin level between 30-50 micog/L - age 18 years an older - weight more than 50 kg - signed informed consent - willingness to fill out additional questionnaires at three points in time Exclusion Criteria: - chelating therapy - forced dietary regime - aged below 18 years - excessive overweight ( BMI more than 35) - pregnancy Hereditary Hemochromatosis Hemochromatosis The research population exists of patients with HH ( by genetic analysis confirmed as homozygous for C282Y) living in south-east of the Netherlands and currently treated with phlebotomy as maintenance treatment to keep their serum ferritin levels < 50 ug/l. --- C282Y --- --- C282Y ---

Inclusion Criteria: - homozygous for C282Y - currently treated with phlebotomy as maintenance therapy for at least 6 month - ferritin level between 30-50 micog/L - age 18 years an older - weight more than 50 kg - signed informed consent - willingness to fill out additional questionnaires at three points in time Exclusion Criteria: - chelating therapy - forced dietary regime - aged below 18 years - excessive overweight ( BMI more than 35) - pregnancy Inclusion Criteria: - homozygous for C282Y - currently treated with phlebotomy as maintenance therapy for at least 6 month - ferritin level between 30-50 micog/L - age 18 years an older - weight more than 50 kg - signed informed consent - willingness to fill out additional questionnaires at three points in time Exclusion Criteria: - chelating therapy - forced dietary regime - aged below 18 years - excessive overweight ( BMI more than 35) - pregnancy Hereditary Hemochromatosis Hemochromatosis The research population exists of patients with HH ( by genetic analysis confirmed as homozygous for C282Y) living in south-east of the Netherlands and currently treated with phlebotomy as maintenance treatment to keep their serum ferritin levels < 50 ug/l. --- C282Y --- --- C282Y --- --- C282Y ---

Primary Outcomes

Measure: The difference in number of required treatments and the interval between treatments per year to keep the serum ferritin levels between 30-50 microg/L

Time: one year after first phlebotomy treatment and one year after first erythrocytapheresis treatment

42 Effect of Iron Depletion by Phlebotomy Plus Lifestyle Changes vs. Lifestyle Changes Alone on Liver Damage in Patients With Nonalcoholic Fatty Liver Disease With Increased Iron Stores

Patients will be randomized to lifestyle changes alone or lifestyle changes associated with iron depletion. Iron depletion will be achieved by removing 350 cc of blood every 10-15 days according to baseline hemoglobin values and venesection tolerance, until ferritin < 30 ng/ml and transferrin saturation < 25%. Weekly phlebotomies will be allowed for carriers of the C282Y HFE mutation. Smaller phlebotomies (250 cc) will be allowed for carriers of beta-thalassaemia trait. Maintenance phlebotomies (as much as required) will then be instituted to keep iron stores depleted (ferritin < 50 ng/ml and transferrin saturation < 25%, MCV <85 fl). Before starting treatment, patients will undergo ECG, and in the presence of hyperglycemia or hypertension also echocardiography (see exclusion criteria). Change in diabetes medication dosage or start of new therapy will be allowed for HbA1C values <6% or ≥ 7%. According to accepted criteria, previously untreated patients should be treated with metformin. If possible, newly diagnosed hypertension should be treated with Ace-inhibitors.

NCT00658164
Conditions
  1. Nonalcoholic Fatty Liver Disease
Interventions
  1. Other: Iron depletion treatment
MeSH:Liver Diseases Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Abnormality of the liver Decreased liver function Elevated hepatic transaminase Hepatic steatosis

Weekly phlebotomies will be allowed for carriers of the C282Y HFE mutation. --- C282Y ---

*Hemochromatosis, as defined by homozygosity for the C282Y HFE mutation or compound heterozygosity for C282Y/H63D mutations or Hepatic Iron Index ≥ 1.9. --- C282Y ---

Primary Outcomes

Measure: To determine in a 24 month controlled study whether iron depletion by phlebotomy improves insulin sensitivity, and thereby reduces hepatic steatosis and inflammation in subjects with nonalcoholic steatohepatitis

Time: 24 months

Secondary Outcomes

Measure: To assess the effect of iron depletion on glucose tolerance status. Glucose tolerance will be determined by OGTT in subjects without type 2 diabetes (T2D), and by HbA1c levels and the change in dosage of pharmacological therapy in those with T2D.

Time: 24 months

43 Prospective Randomized Study Comparing the Effect of Phlebotomy and Lifestyle and Diet Advices vs Lifestyle and Diet Advices Only on Glycemia in Patients With Dysmetabolic Liversiderosis

Insulin resistance-associated hepatic iron overload (IR-HIO), also defined as dysmetabolic iron overload syndrome or dysmetabolic liversiderosis, is a common cause or iron overload in France, mainly in middle-age patients with increased serum ferritin levels associated with normal serum transferrin saturation, and normal serum iron concentration in the absence of other known cause of increased serum ferritin levels. Treatment includes a combination of dietary measures and physical activity to correct metabolic disorders. Phlebotomies seem to be beneficial when serum ferritin level is high. This study aims at comparing the effect of iron depletion (by phlebotomy) plus lifestyle and diet advices versus lifestyle and diet advices alone on blood glucose level and insulin sensitivity in subjects with IR-HIO in order to assess the benefits of phlebotomies on the reduction of risk of diabetes and cardiovascular associated complications.

NCT01045525
Conditions
  1. Liver Cirrhosis
  2. Iron Overload
Interventions
  1. Procedure: Phlebotomy
  2. Behavioral: Lifestyle and diet advices
MeSH:Liver Cirrhosis Iron Overload
HPO:Cirrhosis Hepatic fibrosis

Inclusion Criteria: - Age over 18 - Signed written informed consent - Ferritin ≥ 450 µg/L and ≤ 1500 µg/L - Hepatic iron overload proved by MRI or histological biochemical measurement (Iron hepatic concentration ≥ 50 μmol/g) - At least one of the following criteria : - Body mass index > 25 kg/m² - Systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90 mmHg or antihypertensive treatment - Abdominal obesity (waist measurement ≥ 94 cm for men and ≥ 80 cm for women) - Fasting triglyceridemia ≥ 1.7 mmol/L or triglyceride-lowering treatment - Fasting HDL cholesterol < 1.03 mmol/L for men and < 1.29 mmol/L for women or HDL cholesterol-elevating treatment - Fasting blood glycemia ≥ 5.6 mmol/L Exclusion Criteria: - Subjects deprived of their liberty by judicial or administrative decision - Pregnant women - Other causes of increased serum ferritin levels: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyper-hemolysis - Alcohol consumption more than 210 g for men and 140 g for women per week within the year before inclusion - Haemochromatosis established by the C282Y homozygous genotype - Chronic hepatic cytolysis due to : viral infection (HBV, HCV), alcohol, hyperthyroid disease, celiac disease, drug or immune hepatitis - Increased serum ferritin levels - cataract syndrome (familial cataract or personal history of cataract before 50 years of age) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Contraindication of phlebotomy - Haemoglobin <13 g/dL for men and <12g/dL for women (threshold established by the French Blood Agency) - Congestive heart failure or coronary heart disease - Hepatic failure (TP<60%), renal failure (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Fasting blood glycemia > 7 mmol/L or type 1 or type 2 diabetes, treated or not - Use of drugs known to have anti-steatotic effects : metformin, thiazolidinedione Inclusion Criteria: - Age over 18 - Signed written informed consent - Ferritin ≥ 450 µg/L and ≤ 1500 µg/L - Hepatic iron overload proved by MRI or histological biochemical measurement (Iron hepatic concentration ≥ 50 μmol/g) - At least one of the following criteria : - Body mass index > 25 kg/m² - Systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90 mmHg or antihypertensive treatment - Abdominal obesity (waist measurement ≥ 94 cm for men and ≥ 80 cm for women) - Fasting triglyceridemia ≥ 1.7 mmol/L or triglyceride-lowering treatment - Fasting HDL cholesterol < 1.03 mmol/L for men and < 1.29 mmol/L for women or HDL cholesterol-elevating treatment - Fasting blood glycemia ≥ 5.6 mmol/L Exclusion Criteria: - Subjects deprived of their liberty by judicial or administrative decision - Pregnant women - Other causes of increased serum ferritin levels: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyper-hemolysis - Alcohol consumption more than 210 g for men and 140 g for women per week within the year before inclusion - Haemochromatosis established by the C282Y homozygous genotype - Chronic hepatic cytolysis due to : viral infection (HBV, HCV), alcohol, hyperthyroid disease, celiac disease, drug or immune hepatitis - Increased serum ferritin levels - cataract syndrome (familial cataract or personal history of cataract before 50 years of age) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Contraindication of phlebotomy - Haemoglobin <13 g/dL for men and <12g/dL for women (threshold established by the French Blood Agency) - Congestive heart failure or coronary heart disease - Hepatic failure (TP<60%), renal failure (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Fasting blood glycemia > 7 mmol/L or type 1 or type 2 diabetes, treated or not - Use of drugs known to have anti-steatotic effects : metformin, thiazolidinedione Liver Cirrhosis Iron Overload Liver Cirrhosis Iron Overload Non applicable --- C282Y ---

Inclusion Criteria: - Age over 18 - Signed written informed consent - Ferritin ≥ 450 µg/L and ≤ 1500 µg/L - Hepatic iron overload proved by MRI or histological biochemical measurement (Iron hepatic concentration ≥ 50 μmol/g) - At least one of the following criteria : - Body mass index > 25 kg/m² - Systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90 mmHg or antihypertensive treatment - Abdominal obesity (waist measurement ≥ 94 cm for men and ≥ 80 cm for women) - Fasting triglyceridemia ≥ 1.7 mmol/L or triglyceride-lowering treatment - Fasting HDL cholesterol < 1.03 mmol/L for men and < 1.29 mmol/L for women or HDL cholesterol-elevating treatment - Fasting blood glycemia ≥ 5.6 mmol/L Exclusion Criteria: - Subjects deprived of their liberty by judicial or administrative decision - Pregnant women - Other causes of increased serum ferritin levels: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyper-hemolysis - Alcohol consumption more than 210 g for men and 140 g for women per week within the year before inclusion - Haemochromatosis established by the C282Y homozygous genotype - Chronic hepatic cytolysis due to : viral infection (HBV, HCV), alcohol, hyperthyroid disease, celiac disease, drug or immune hepatitis - Increased serum ferritin levels - cataract syndrome (familial cataract or personal history of cataract before 50 years of age) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Contraindication of phlebotomy - Haemoglobin <13 g/dL for men and <12g/dL for women (threshold established by the French Blood Agency) - Congestive heart failure or coronary heart disease - Hepatic failure (TP<60%), renal failure (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Fasting blood glycemia > 7 mmol/L or type 1 or type 2 diabetes, treated or not - Use of drugs known to have anti-steatotic effects : metformin, thiazolidinedione Inclusion Criteria: - Age over 18 - Signed written informed consent - Ferritin ≥ 450 µg/L and ≤ 1500 µg/L - Hepatic iron overload proved by MRI or histological biochemical measurement (Iron hepatic concentration ≥ 50 μmol/g) - At least one of the following criteria : - Body mass index > 25 kg/m² - Systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90 mmHg or antihypertensive treatment - Abdominal obesity (waist measurement ≥ 94 cm for men and ≥ 80 cm for women) - Fasting triglyceridemia ≥ 1.7 mmol/L or triglyceride-lowering treatment - Fasting HDL cholesterol < 1.03 mmol/L for men and < 1.29 mmol/L for women or HDL cholesterol-elevating treatment - Fasting blood glycemia ≥ 5.6 mmol/L Exclusion Criteria: - Subjects deprived of their liberty by judicial or administrative decision - Pregnant women - Other causes of increased serum ferritin levels: - Inflammatory syndrome (CRP >10 mg/L) or inflammatory, immune or malignant diseases - Hyper-hemolysis - Alcohol consumption more than 210 g for men and 140 g for women per week within the year before inclusion - Haemochromatosis established by the C282Y homozygous genotype - Chronic hepatic cytolysis due to : viral infection (HBV, HCV), alcohol, hyperthyroid disease, celiac disease, drug or immune hepatitis - Increased serum ferritin levels - cataract syndrome (familial cataract or personal history of cataract before 50 years of age) - Low ceruloplasmin level - Porphyria (cutaneous signs) - Contraindication of phlebotomy - Haemoglobin <13 g/dL for men and <12g/dL for women (threshold established by the French Blood Agency) - Congestive heart failure or coronary heart disease - Hepatic failure (TP<60%), renal failure (GFR <50mL/min) or respiratory insufficiency (chronic dyspnea) - Poor venous system - Fasting blood glycemia > 7 mmol/L or type 1 or type 2 diabetes, treated or not - Use of drugs known to have anti-steatotic effects : metformin, thiazolidinedione Liver Cirrhosis Iron Overload Liver Cirrhosis Iron Overload Non applicable --- C282Y --- --- C282Y ---

Primary Outcomes

Measure: Fasting blood glycemia (T0 of Oral Glucose Tolerance Test)

Time: 12 months

Secondary Outcomes

Measure: Rate of Body mass index > 25 kg/m²

Time: 12 months

Measure: Rate of systolic blood pressure ≥ 130mmHg or diastolic blood pressure ≥ 85 mmHg or antihypertensive treatment

Time: 12 months

Measure: Rate of abdominal obesity (waist measurement ≥ 94 cm for men and ≥ 80 cm for women)

Time: 12 months

Measure: Rate of fasting triglyceridemia ≥ 1.7 mmol/L or triglyceride-lowering treatment

Time: 12 months

Measure: Rate of fasting HDL cholesterol < 1.03 mmol/L for men and < 1.29 mmol/L for women or HDL cholesterol-elevating treatment

Time: 12 months

Measure: Rate of fasting glycemia ≥ 5.6 mmol/L

Time: 12 months

Measure: HbA1c value

Time: 12 months

Measure: Quality of life estimated with SF36 form and tolerance to treatment

Time: 12 months

Measure: Insulinoresistance indexes calculated at T0 and T30 min of Oral Glucose Tolerance Test (OGTT)

Time: 12 months

Measure: Biological markers: CRP, hyaluronic acid, fibrometer

Time: 12 months

Description: Two dimensional (2D) speckle tracking echocardiography (STE)

Measure: myocardial deformation

Time: 12 months

44 A Phase III, Randomized Study of the Effects of Parenteral Iron, Oral Iron, or No Iron Supplementation on the Erythropoietic Response to Darbepoetin Alfa for Cancer Patients With Chemotherapy-Associated Anemia

RATIONALE: Darbepoetin alfa may cause the body to make more red blood cells. Red blood cells contain iron that is needed to carry oxygen to the tissues. It is not yet known whether giving darbepoetin alfa (DA) together with intravenous iron or oral iron is more effective than giving darbepoetin alfa together with a placebo in treating anemia caused by chemotherapy. PURPOSE: This randomized phase III trial is studying giving darbepoetin alfa together with iron to see how well it works compared with giving darbepoetin alfa together with a placebo in treating anemia caused by chemotherapy in patients with cancer.

NCT00661999
Conditions
  1. Anemia
  2. Leukemia
  3. Lymphoma
  4. Lymphoproliferative Disorder
  5. Multiple Myeloma and Plasma Cell Neoplasm
  6. Precancerous Condition
  7. Unspecified Adult Solid Tumor, Protocol Specific
Interventions
  1. Biological: darbepoetin alfa
  2. Dietary Supplement: ferrous sulfate
  3. Drug: sodium ferric gluconate complex in sucrose
  4. Other: placebo
MeSH:Lymphoma Leukemia Multiple Myeloma Neoplasms, Plasma Cell Precancerous Conditions Anemia Lymphoproliferative Disorders
HPO:Anemia Leukemia Lymphoma Lymphoproliferative disorder Multiple myeloma

DISEASE CHARACTERISTICS: - Diagnosis of a non-myeloid cancer (other than non-melanomatous skin cancer) - Receiving or scheduled to receive chemotherapy (biological agents, such as small molecules/tyrosine kinase inhibitors and antibody-based therapies, are allowed) - Has chemotherapy-related anemia (hemoglobin < 11 g/dL) - No anemia known to be secondary to gastrointestinal bleeding or hemolysis - No anemia known to be secondary to vitamin B12 or folic acid deficiency + Vitamin B12 and folic acid deficiency must be ruled out if the mean corpuscular volume (MCV) is > 100 fL - No anemia secondary to chemotherapy-induced myelodysplastic syndromes - No primary hematologic disorder causing moderate to severe anemia (e.g., congenital dyserythropoietic anemia, homozygous hemoglobin S disease or compound heterozygous sickling states, or thalassemia major) - Carriers for these disease states are eligible - No first-degree relative with primary hemochromatosis (unless the patient has undergone HFE genotyping and was found to have at least one wild-type allele, while the proband in the family demonstrated to have either the common C282Y or H63D mutation) PATIENT CHARACTERISTICS: - ECOG performance status 0-2 - Ferritin > 20 mcg/L (i.e., not obviously iron deficient) - ALT or AST < 5 times upper limit of normal - Alert, mentally competent, and able to sign informed consent - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception during and for 3 months after completion of study treatment - Willing or able to be randomized and undergo study treatment - Willing or able to fill out quality-of-life forms - No uncontrolled hypertension (i.e., systolic blood pressure [BP] ≥ 180 mm Hg or diastolic BP ≥ 100 mm Hg) - No history of uncontrolled cardiac arrhythmias - No pulmonary embolism or deep venous thrombosis within the past year (unless the patient is on anticoagulation therapy and planning to continue it during study participation) - No known hypersensitivity to darbepoetin alfa, erythropoietin, mammalian cell-derived products, iron, or human albumin - No seizures within the past 3 months - No gastrointestinal conditions expected to cause significant impairment of oral iron, such as untreated celiac disease or amyloidosis involving the gut - Patients with celiac disease who are adhering to a gluten-free diet are eligible PRIOR CONCURRENT THERAPY: - See Disease Characteristics - More than 3 months since prior darbepoetin alfa, epoetin alfa, or any investigational forms of erythropoietin (e.g., gene-activated erythropoietin or novel erythropoiesis-stimulating protein) - More than 1 year since prior peripheral blood stem cell or bone marrow transplantation - More than 2 weeks since prior red blood cell transfusions - More than 14 days since prior major surgery - No prior gastrectomy or resection of > 100 cm of small intestine - Not planning to undergo stem cell or bone marrow transplantation within the next 6 months DISEASE CHARACTERISTICS: - Diagnosis of a non-myeloid cancer (other than non-melanomatous skin cancer) - Receiving or scheduled to receive chemotherapy (biological agents, such as small molecules/tyrosine kinase inhibitors and antibody-based therapies, are allowed) - Has chemotherapy-related anemia (hemoglobin < 11 g/dL) - No anemia known to be secondary to gastrointestinal bleeding or hemolysis - No anemia known to be secondary to vitamin B12 or folic acid deficiency + Vitamin B12 and folic acid deficiency must be ruled out if the mean corpuscular volume (MCV) is > 100 fL - No anemia secondary to chemotherapy-induced myelodysplastic syndromes - No primary hematologic disorder causing moderate to severe anemia (e.g., congenital dyserythropoietic anemia, homozygous hemoglobin S disease or compound heterozygous sickling states, or thalassemia major) - Carriers for these disease states are eligible - No first-degree relative with primary hemochromatosis (unless the patient has undergone HFE genotyping and was found to have at least one wild-type allele, while the proband in the family demonstrated to have either the common C282Y or H63D mutation) PATIENT CHARACTERISTICS: - ECOG performance status 0-2 - Ferritin > 20 mcg/L (i.e., not obviously iron deficient) - ALT or AST < 5 times upper limit of normal - Alert, mentally competent, and able to sign informed consent - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception during and for 3 months after completion of study treatment - Willing or able to be randomized and undergo study treatment - Willing or able to fill out quality-of-life forms - No uncontrolled hypertension (i.e., systolic blood pressure [BP] ≥ 180 mm Hg or diastolic BP ≥ 100 mm Hg) - No history of uncontrolled cardiac arrhythmias - No pulmonary embolism or deep venous thrombosis within the past year (unless the patient is on anticoagulation therapy and planning to continue it during study participation) - No known hypersensitivity to darbepoetin alfa, erythropoietin, mammalian cell-derived products, iron, or human albumin - No seizures within the past 3 months - No gastrointestinal conditions expected to cause significant impairment of oral iron, such as untreated celiac disease or amyloidosis involving the gut - Patients with celiac disease who are adhering to a gluten-free diet are eligible PRIOR CONCURRENT THERAPY: - See Disease Characteristics - More than 3 months since prior darbepoetin alfa, epoetin alfa, or any investigational forms of erythropoietin (e.g., gene-activated erythropoietin or novel erythropoiesis-stimulating protein) - More than 1 year since prior peripheral blood stem cell or bone marrow transplantation - More than 2 weeks since prior red blood cell transfusions - More than 14 days since prior major surgery - No prior gastrectomy or resection of > 100 cm of small intestine - Not planning to undergo stem cell or bone marrow transplantation within the next 6 months Anemia Leukemia Lymphoma Lymphoproliferative Disorder Multiple Myeloma and Plasma Cell Neoplasm Precancerous Condition Unspecified Adult Solid Tumor, Protocol Specific Lymphoma Leukemia Multiple Myeloma Neoplasms, Plasma Cell Precancerous Conditions Anemia Lymphoproliferative Disorders OBJECTIVES: Primary * To compare the effects of IV iron, oral iron, or placebo in combination with darbepoetin alfa on the hematopoietic response rate, defined as a hemoglobin increment of ≥ 2.0 g/dL from baseline or achievement of hemoglobin of ≥ 11 g/dL in the absence of red blood cell transfusions (RBC) in the preceding 28 days of the treatment period, in cancer patients with chemotherapy-associated anemia. --- C282Y ---

DISEASE CHARACTERISTICS: - Diagnosis of a non-myeloid cancer (other than non-melanomatous skin cancer) - Receiving or scheduled to receive chemotherapy (biological agents, such as small molecules/tyrosine kinase inhibitors and antibody-based therapies, are allowed) - Has chemotherapy-related anemia (hemoglobin < 11 g/dL) - No anemia known to be secondary to gastrointestinal bleeding or hemolysis - No anemia known to be secondary to vitamin B12 or folic acid deficiency + Vitamin B12 and folic acid deficiency must be ruled out if the mean corpuscular volume (MCV) is > 100 fL - No anemia secondary to chemotherapy-induced myelodysplastic syndromes - No primary hematologic disorder causing moderate to severe anemia (e.g., congenital dyserythropoietic anemia, homozygous hemoglobin S disease or compound heterozygous sickling states, or thalassemia major) - Carriers for these disease states are eligible - No first-degree relative with primary hemochromatosis (unless the patient has undergone HFE genotyping and was found to have at least one wild-type allele, while the proband in the family demonstrated to have either the common C282Y or H63D mutation) PATIENT CHARACTERISTICS: - ECOG performance status 0-2 - Ferritin > 20 mcg/L (i.e., not obviously iron deficient) - ALT or AST < 5 times upper limit of normal - Alert, mentally competent, and able to sign informed consent - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception during and for 3 months after completion of study treatment - Willing or able to be randomized and undergo study treatment - Willing or able to fill out quality-of-life forms - No uncontrolled hypertension (i.e., systolic blood pressure [BP] ≥ 180 mm Hg or diastolic BP ≥ 100 mm Hg) - No history of uncontrolled cardiac arrhythmias - No pulmonary embolism or deep venous thrombosis within the past year (unless the patient is on anticoagulation therapy and planning to continue it during study participation) - No known hypersensitivity to darbepoetin alfa, erythropoietin, mammalian cell-derived products, iron, or human albumin - No seizures within the past 3 months - No gastrointestinal conditions expected to cause significant impairment of oral iron, such as untreated celiac disease or amyloidosis involving the gut - Patients with celiac disease who are adhering to a gluten-free diet are eligible PRIOR CONCURRENT THERAPY: - See Disease Characteristics - More than 3 months since prior darbepoetin alfa, epoetin alfa, or any investigational forms of erythropoietin (e.g., gene-activated erythropoietin or novel erythropoiesis-stimulating protein) - More than 1 year since prior peripheral blood stem cell or bone marrow transplantation - More than 2 weeks since prior red blood cell transfusions - More than 14 days since prior major surgery - No prior gastrectomy or resection of > 100 cm of small intestine - Not planning to undergo stem cell or bone marrow transplantation within the next 6 months DISEASE CHARACTERISTICS: - Diagnosis of a non-myeloid cancer (other than non-melanomatous skin cancer) - Receiving or scheduled to receive chemotherapy (biological agents, such as small molecules/tyrosine kinase inhibitors and antibody-based therapies, are allowed) - Has chemotherapy-related anemia (hemoglobin < 11 g/dL) - No anemia known to be secondary to gastrointestinal bleeding or hemolysis - No anemia known to be secondary to vitamin B12 or folic acid deficiency + Vitamin B12 and folic acid deficiency must be ruled out if the mean corpuscular volume (MCV) is > 100 fL - No anemia secondary to chemotherapy-induced myelodysplastic syndromes - No primary hematologic disorder causing moderate to severe anemia (e.g., congenital dyserythropoietic anemia, homozygous hemoglobin S disease or compound heterozygous sickling states, or thalassemia major) - Carriers for these disease states are eligible - No first-degree relative with primary hemochromatosis (unless the patient has undergone HFE genotyping and was found to have at least one wild-type allele, while the proband in the family demonstrated to have either the common C282Y or H63D mutation) PATIENT CHARACTERISTICS: - ECOG performance status 0-2 - Ferritin > 20 mcg/L (i.e., not obviously iron deficient) - ALT or AST < 5 times upper limit of normal - Alert, mentally competent, and able to sign informed consent - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception during and for 3 months after completion of study treatment - Willing or able to be randomized and undergo study treatment - Willing or able to fill out quality-of-life forms - No uncontrolled hypertension (i.e., systolic blood pressure [BP] ≥ 180 mm Hg or diastolic BP ≥ 100 mm Hg) - No history of uncontrolled cardiac arrhythmias - No pulmonary embolism or deep venous thrombosis within the past year (unless the patient is on anticoagulation therapy and planning to continue it during study participation) - No known hypersensitivity to darbepoetin alfa, erythropoietin, mammalian cell-derived products, iron, or human albumin - No seizures within the past 3 months - No gastrointestinal conditions expected to cause significant impairment of oral iron, such as untreated celiac disease or amyloidosis involving the gut - Patients with celiac disease who are adhering to a gluten-free diet are eligible PRIOR CONCURRENT THERAPY: - See Disease Characteristics - More than 3 months since prior darbepoetin alfa, epoetin alfa, or any investigational forms of erythropoietin (e.g., gene-activated erythropoietin or novel erythropoiesis-stimulating protein) - More than 1 year since prior peripheral blood stem cell or bone marrow transplantation - More than 2 weeks since prior red blood cell transfusions - More than 14 days since prior major surgery - No prior gastrectomy or resection of > 100 cm of small intestine - Not planning to undergo stem cell or bone marrow transplantation within the next 6 months Anemia Leukemia Lymphoma Lymphoproliferative Disorder Multiple Myeloma and Plasma Cell Neoplasm Precancerous Condition Unspecified Adult Solid Tumor, Protocol Specific Lymphoma Leukemia Multiple Myeloma Neoplasms, Plasma Cell Precancerous Conditions Anemia Lymphoproliferative Disorders OBJECTIVES: Primary * To compare the effects of IV iron, oral iron, or placebo in combination with darbepoetin alfa on the hematopoietic response rate, defined as a hemoglobin increment of ≥ 2.0 g/dL from baseline or achievement of hemoglobin of ≥ 11 g/dL in the absence of red blood cell transfusions (RBC) in the preceding 28 days of the treatment period, in cancer patients with chemotherapy-associated anemia. --- C282Y --- --- H63D --- --- C282Y ---

Primary Outcomes

Description: Hematopoietic response was defined as Hemoglobin (Hb) increment of 2.0 g/dL from baseline or achievement of Hb >= 11 g/dL (whichever occurs first) in the absence of red blood cell transfusions during the preceding 28 days during the treatment period.

Measure: Hematopoietic Response Rate Defined as the Number of Participants Who Exhibit a Hematopoietic Response

Time: 16 Weeks

Secondary Outcomes

Measure: Percentage of Patients Maintaining an Average Hemoglobin Level Within the National Comprehensive Cancer Network (NCCN) Range (11-13 g/dL) Through Week 16, Once Achieving a Hemoglobin of ≥ 11 g/dL

Time: 16 Weeks

Measure: Incidence of Patients Receiving at Least One Red Blood Cell (RBC) Transfusions

Time: Week 1 to Week 16

Description: Value at 7 weeks minus value at baseline.

Measure: Mean Increment in Hemoglobin Level at Week 7

Time: Baseline and 7 weeks

Description: Value at 16 weeks minus value at baseline.

Measure: Mean Increment in Hemoglobin Level at Week 16

Time: Baseline and 16 weeks

Description: Hematopoietic response was defined as Hb increment of 2.0 g/dL from baseline or achievement of Hb >= 11 g/dL (whichever occurs first) in the absence of red blood cell transfusions during the preceding 28 days during the treatment period.

Measure: Time to Hematopoietic Response

Time: 16 weeks

Measure: Time to First Red Blood Cell (RBC) Transfusions

Time: 16 weeks

Description: Overall QOL item score range: 0 (Worst) to 10 (Best), ordinal. Change: score at 16 weeks minus score at baseline.

Measure: Change From Baseline in Overall Quality of Life (QOL) Score as Measured by the Linear Analogue Self Assessment (LASA)

Time: Baseline and 16 weeks

Description: SDS Scale range: 0 (Worst), 100 (Best), ordinal. Change: score at 16 weeks minus score at baseline. A clinically significant result will be defined as a shift of 10 points on a 0-100 point transformed scale between the average QOL scores of the 3 variants of iron therapy.

Measure: Change From Baseline in Quality of Life (QOL) Score as Measured by Symptom Distress Scale (SDS) at End of Study

Time: Baseline and 16 weeks

Description: Fatigue Now Scale range: 0 (No Fatigue) to 10 (Worst), ordinal. Change: score at 16 weeks minus score at baseline.

Measure: Change From Baseline in Quality of Life (QOL) Score as Measured by Brief Fatigue Inventory(BFI) Fatigue Now Scale at End of Study

Time: Baseline and 16 weeks

Description: FACT-AN Scale range: 0 (Worst) to 100 (Best), ordinal. Change: score at 16 weeks minus score at baseline. A clinically significant result will be defined as a shift of 10 points on a 0-100 point transformed scale between the average QOL scores of the 3 variants of iron therapy.

Measure: Change From Baseline in Quality of Life (QOL) Score as Measured by The Functional Assessment of Cancer Therapy-Anemia (FACT-An) at End of Study

Time: Baseline and 16 weeks

Measure: C-reactive Protein (CRP) Level at Week 1, Week 7 and Week 16

Time: 1 Week, 7 Weeks and 16 Weeks

Measure: Soluble Transferrin Receptor (sTfR)Level at Week 1, Week 7 and Week 16

Time: 1 week, 7 weeks and 16 weeks

Measure: Ferritin Level at Baseline, Week 7 and Week 16

Time: Baseline, 7 weeks and 16 weeks

Description: MCV is a measure of the average red blood cell volume.

Measure: Mean Corpuscular Volume (MCV) Level at Baseline, Week 7 and Week 16

Time: Baseline, 7 weeks and 16 weeks

Measure: Transferrin Saturation at Baseline, Week 7 and Week 16

Time: Baseline, 7 weeks and 16 weeks

45 Hepcicor Cohort : Clinical, Biological, Genetic and Fonctional charactérization of Rare Iron Overlaod phénotypes Associated With Hepcidin Deficiency Excluding C282Y Homozygosity

The study explores the hepcidin deficiency causes of rare iron overload (excluding C282Y homozygosity), and aim to characterize this iron overload in term of clinical, biological, genetic and functional spacificities.

NCT02619955
Conditions
  1. Rare Iron Overlaods
Interventions
  1. Other: samples with DNA

Hepcicor Cohort : Clinical, Biological, Genetic and Fonctional charactérization of Rare Iron Overlaod phénotypes Associated With Hepcidin Deficiency Excluding C282Y Homozygosity. --- C282Y ---

Cohort of Patients With Rare Iron Overloads Excluding C282Y Homozygosity The study explores the hepcidin deficiency causes of rare iron overload (excluding C282Y homozygosity), and aim to characterize this iron overload in term of clinical, biological, genetic and functional spacificities. --- C282Y ---

Cohort of Patients With Rare Iron Overloads Excluding C282Y Homozygosity The study explores the hepcidin deficiency causes of rare iron overload (excluding C282Y homozygosity), and aim to characterize this iron overload in term of clinical, biological, genetic and functional spacificities. --- C282Y --- --- C282Y ---

to characterize these iron overloads with phenotype of hepcidin deficiency not related to homozygosity C282Y (clinical, biological and genetic).. comparison of the hepcidin and hepcidin/ferritin ratio in patient with or without in gene known to be associated with iron metabolism. --- C282Y ---

Exclusion Criteria: - HFE hemochromatosis: homozygosity C282Y/C282Y - Treatment with iterative phlebotomy - Hematologic diseases with dyserythropoiesis and/or repeated transfusions - Haptoglobin low, below normal directing towards the diagnosis of chronic hemolysis, myelodysplasia - Prolonged oral or parenteral iron supplementation - Current or past excessive regular drinking - Patient minor or under legal protection measure Inclusion Criteria: - Biological profile suggestive of hepcidin deficiency: - increase of transferrin saturation coefficient (> 50 %) verified on at least 2 times, and calculated from the transferrinemia. --- C282Y ---

Exclusion Criteria: - HFE hemochromatosis: homozygosity C282Y/C282Y - Treatment with iterative phlebotomy - Hematologic diseases with dyserythropoiesis and/or repeated transfusions - Haptoglobin low, below normal directing towards the diagnosis of chronic hemolysis, myelodysplasia - Prolonged oral or parenteral iron supplementation - Current or past excessive regular drinking - Patient minor or under legal protection measure Rare Iron Overlaods Chronic iron overload are responsible for morbidity and mortality. --- C282Y ---

The main objective of this study is to characterize these iron overloads with phenotype of hepcidin deficiency not related to homozygosity C282Y (clinical, biological and genetic). --- C282Y ---

Primary Outcomes

Description: to characterize these iron overloads with phenotype of hepcidin deficiency not related to homozygosity C282Y (clinical, biological and genetic).

Measure: Number of patients presenting with mutation in gene know to be associated with iron metabolism

Time: Inclusion

Secondary Outcomes

Description: To Identificate potential explanatory factors of hepcidino deficiency phenotype

Measure: comparison of the hepcidin and hepcidin/ferritin ratio in patient with or without in gene known to be associated with iron metabolism

Time: inclusion

Description: - Identification of potentially explanatory factors visceral consequences of iron overload in hepcidino deficiency phenotype (overweight, high blood pressure, diabetes)

Measure: Number of patients presenting with associated causes of iron overload

Time: inclusion

Description: To Research correlations genotype-phenotype

Measure: Genotype-Phenotype correlation

Time: Inclusion

Description: Validation of the hepatic iron concentration measurements imaging ( nuclear magnetic resonance (NMR)) in the various centers

Measure: Hepatic and splenic iron concentration measurements by NMR

Time: Inclusion

Description: - Assessment of the clinical value of biomarkers of iron metabolism

Measure: Number of patients with detectable abnormal iron species in blood (non transferrin bound iron, labile pool iron)

Time: Inclusion

46 Impact of Host Iron Status and Iron Supplement Use on Growth and Viability of the Erythrocytic Stage of Plasmodium Falciparum

The purpose of this study is to perform laboratory based studies to determine if the growth and development of the malaria parasite is effected by iron status of its host (the person infected with the malaria parasite). Iron deficiency affects over 500 million people including many pregnant women and children from areas of the world that are plagued by malaria. Some population based studies have suggested that iron deficiency protects people from getting malaria and this has raised questions about the wisdom of public health policies that provide universal iron supplementation in countries where malaria is common. We will use red blood cells and sera from patients with iron deficiency anemia, hereditary hemochromatosis and normal individuals who are taking iron supplements to look at this question in a very systematic way. This study should provide information for or against a possible mechanism by which iron deficiency may affect the malaria parasite. The results will contribute to efforts to develop evidence-based public health policies on iron supplementation policies in malaria-endemic areas. There are three different types of individuals involved in this study (1) people with iron deficiency anemia who will be taking iron supplementation (2) people without iron deficiency anemia who will be taking iron supplementation and (3) people with a condition called hereditary hemochromatosis who have an excess of iron in their bodies.

NCT01027663
Conditions
  1. Iron Deficiency Anemia
  2. Malaria
Interventions
  1. Dietary Supplement: Iron Supplement
MeSH:Malaria Anemia, Iron-Deficiency
HPO:Iron deficiency anemia

From the genotype standpoint, only patients homozygous for the C282Y and H63D mutations and those that are compound heterozygotes for C282Y/H63D will be enrolled. --- C282Y ---


47 Prospective Cohort Assessing the Prevalence and Progress of Non-alcoholic Fatty Liver Disease (NAFLD)/Non-alcoholic Steatohepatitis (NASH) in Chinese

Nonalcoholic fatty liver disease (NAFLD) is a progressive liver disease ranging from simple steatosis to cirrhosis of the liver. Nonalcoholic fatty liver (NAFL) without substantial hepatocellular injury is thought to be relatively benign whereas nonalcoholic steatohepatitis (NASH) is characterized by hepatocyte steatosis, ballooning, inflammation and varying degrees of fibrosis from none to cirrhosis. NASH is strongly associated with insulin resistance and metabolic syndrome and thus is recognized as a major public health concern as the most prevalent liver disease. Liver biopsy is the gold standard for a diagnosis of NASH. However, given the large population of patients at risk for NASH, liver biopsy is not a practical method for determining which patients may benefit from NASH therapy. Non-invasive methods to estimate inflammation and fibrosis are in clinical use, but there remains a dichotomy between gold standard inclusion criteria and end points that are utilized in clinical trials and real world diagnostic methods that are more common in clinical practice. Thus, the investigators would like to conduct an observational study to head-to-head compare the non-invasive methods and liver biopsy in differential liver steatosis and liver biopsy in a real-world setting. Also, by following up patients for a relatively long time (proposed 10 years), the investigators can present the natural history of disease progression.

NCT03282305
Conditions
  1. Nonalcoholic Fatty Liver
  2. Nonalcoholic Steatohepatitis
MeSH:Fatty Liver Non-alcoholic Fatty Liver Disease
HPO:Hepatic steatosis

Exclusion Criteria: - Unable to provide written informed consent (or assent in pediatric subjects) - Alcohol consumption greater than 21 units/week for males or 14 units/week for females (one unit of alcohol is half pint of beer [285 mL; 9.64 oz], 1 glass of spirits [25 mL; 0.85 oz] or 1 glass of wine [125 mL; 4.23 oz] - Enrolled in NASH-related clinical trials - Presence of other forms of chronic liver disease: 1. Chronic hepatitis B (HBsAg positive) 2. Chronic hepatitis C (HCV RNA positive) 3. Iron overload disorders (3-4+ iron on liver biopsy or known hemochromatosis gene (HFE) C282Y homozygous with ferritin > 200 ng/ml; note: an elevated ferritin alone is common in NASH and is not exclusionary) 4. Autoimmune liver disease (biopsy evidence or clinical diagnosis of autoimmune hepatitis or Primary biliary cholangitis (PBC) requiring ongoing treatment, imaging evidence of Primary sclerosing cholangitis (PSC)) 5. Wilson's disease 6. Alpha-1 antitrypsin mutations that in the opinion of the principal investigator is contributing to the patient's liver disease; - Prior bariatric surgery unless the surgery was performed more than one year before the biopsy diagnosis of NASH (i.e., NASH is present despite prior bariatric surgery); - Planned bariatric surgery (e.g. --- C282Y ---

Primary Outcomes

Description: The change in NASH Clinical Research Network (CRN) score based on liver biopsy

Measure: Histological endpoint

Time: 10 years

Secondary Outcomes

Description: Number of all-cause death

Measure: Number of all-cause death

Time: 10 years

Description: Number of liver-related death

Measure: Number of liver-related death

Time: 10 years

Description: Number of liver transplant

Measure: Number of liver transplant

Time: 10 years

Description: Number of hepatocellular carcinoma (HCC)

Measure: Number of hepatocellular carcinoma (HCC)

Time: 10 years

48 A Phase 2,Multicenter,Open-Label Study to Investigate the Efficacy, Safety and Pharmacokinetics of Ritonavir-boosted Danoprevir in Combination With Peg-IFN and RBV in Treatment-Naive Non-Cirrhotic Patients Who Have Chronic Hepatitis GT1

The purpose of this study is to evaluate the Efficacy, Safety and Pharmacokinetics of Ritonavir-boosted Danoprevir (ASC08) in Combination with Peg-IFN and RBV in Treatment-Naive Non-Cirrhotic Patients Who Have Chronic Hepatitis Genotype 1.

NCT03020004
Conditions
  1. Chronic Hepatitis C
Interventions
  1. Drug: Danoprevir
  2. Drug: Ritonavir
  3. Drug: peginterferon alfa-2a
  4. Drug: Ribavirin (RBV)
MeSH:Hepatitis C Hepatitis C, Chronic Hepatitis Hepatitis, Chronic
HPO:Chronic active hepatitis Chronic hepatitis Hepatitis

Patients who have not obtained a liver biopsy or Fibroscan in the last 1 years will have a study related Fibroscan performed in order to confirm the diagnosis - Others as specified in the detailed protocol Exclusion Criteria: - Patients with Fibroscan detection value > 12.9 kPa, or histologic examination for liver cirrhosis patients - Presence or history of non-hepatitis C chronic liver disease, including but not limited to, autoimmune hepatitis, α-1-antitrypsin deficiency, C282Y homozygous hemochromatosis, Wilson's disease, drug- or toxin-induced liver disease, alcohol-related liver disease, primary biliary cirrhosis, sclerosing cholangitis, and porphyria cutanea tarda causing liver pathology or requiring phlebotomy - Patients with a history of liver cell cancer, screening before or screening suspected hepatocellular carcinoma (HCC) patients, or imaging studies found suspicious nodules, or AFP > 50 ng/mL - Positive hepatitis A antibody,positive hepatitis B surface antigen,syphilis antibody or HIV antibody at screening - Others as specified in the detailed protocol Inclusion Criteria: - Willing and able to provide written informed consent - Chronic HCV infection (≥ 6 months) ; - Positive HCV antibody - Serum HCV RNA of ≥ 1 × 104 IU/mL - Hepatitis C virus GT1 - Never received prior-treatment for HCV with interferon, RBV, or other direct-acting or host-targeting antivirals for HCV - The liver biopsy methods in the protocol (non-cirrhosis is defined as: Metavir score ˂ 4), or as determined by Fibroscan defined as: ˂ 14.6 kPa. --- C282Y ---

Patients who have not obtained a liver biopsy or Fibroscan in the last 1 years will have a study related Fibroscan performed in order to confirm the diagnosis - Others as specified in the detailed protocol Exclusion Criteria: - Patients with Fibroscan detection value > 12.9 kPa, or histologic examination for liver cirrhosis patients - Presence or history of non-hepatitis C chronic liver disease, including but not limited to, autoimmune hepatitis, α-1-antitrypsin deficiency, C282Y homozygous hemochromatosis, Wilson's disease, drug- or toxin-induced liver disease, alcohol-related liver disease, primary biliary cirrhosis, sclerosing cholangitis, and porphyria cutanea tarda causing liver pathology or requiring phlebotomy - Patients with a history of liver cell cancer, screening before or screening suspected hepatocellular carcinoma (HCC) patients, or imaging studies found suspicious nodules, or AFP > 50 ng/mL - Positive hepatitis A antibody,positive hepatitis B surface antigen,syphilis antibody or HIV antibody at screening - Others as specified in the detailed protocol Chronic Hepatitis C Hepatitis C Hepatitis C, Chronic Hepatitis Hepatitis, Chronic null --- C282Y ---

Primary Outcomes

Description: SVR12, defined as undetectable HCV RNA 12 weeks after the last day of study drug administration

Measure: Percentage of Subjects With Sustained Virologic Response (SVR12) 12 Weeks Post-treatment

Time: 24 weeks

49 Phase 2 Study To Investigate the Efficacy, Safety And Pharmacokinetics Of Ravidasvir In Combination With Ritonavir-boosted Danoprevir And Ribavirin In Treatment-naive Non-cirrhotic Taiwanese Patients Who Have Chronic Hepatitis C Genotype 1

The purpose of this study is to evaluate the efficacy, safety and tolerability of Ravidasvir (ASC16) in combination with Ritonavir-boosted Danoprevir(ASC08) and Ribavirin in treatment-naive no-cirrhotic Taiwanese patients who have chronic hepatitis C genotype1.

NCT03020095
Conditions
  1. Chronic Hepatitis C
Interventions
  1. Drug: Ravidasvir
  2. Drug: Danoprevir
  3. Drug: Ritonavir
  4. Drug: Ribavirin
MeSH:Hepatitis C Hepatitis C, Chronic Hepatitis Hepatitis, Chronic
HPO:Chronic active hepatitis Chronic hepatitis Hepatitis

- History or presence of decompensated liver disease (history of ascites, hepatic encephalopathy, HCC, or bleeding esophageal varices) - Presence or history of non-hepatitis C chronic liver disease, including but not limited to, autoimmune hepatitis, α-1-antitrypsin deficiency, C282Y homozygous hemochromatosis, Wilson's disease, drug- or toxin-induced liver disease, alcohol-related liver disease, primary biliary cirrhosis, sclerosing cholangitis, and porphyria cutanea tarda causing liver pathology or requiring phlebotomy - Positive hepatitis B surface antigen or HIV antibody at screening - History or presence of liver cirrhosis - History of severe psychiatric disease, including psychosis and/or depression, who is not able to participate or able to give written informed consent and to comply with the study restrictions - History of active malignancy within the last 5 years, with the exception of localized or in situ carcinoma (e.g., basal or squamous cell carcinoma of the skin) - History of severe cardiac disease (e.g., New York Heart Association Functional Class III or IV, myocardial infarction within 6 months, ventricular tachyarrhythmia's requiring ongoing treatment, unstable angina or other unstable, uncontrolled or significant cardiovascular disease within 6 months). --- C282Y ---

Primary Outcomes

Description: SVR12, defined as undetectable HCV RNA 12 weeks after the last day of study drug administration.

Measure: Percentage of Subjects With Sustained Virologic Response (SVR12) 12 Weeks Post-treatment

Time: 12 weeks

50 An Open Label Non-Randomized Trial to Assess Safety and Tolerability of Alb-Interferon Alfa 2b Every Two Weeks With Ribavirin Among HIV/HCV Coinfected Individuals

This study will determine if Albumin-linked interferon (Albinterferon alfa-2b) every 2 weeks is safe and tolerated by patients infected by both hepatitis C virus (HCV) and human immunodeficiency virus (HIV). This is a new medication developed for HCV. It may help the immune system fight infections, especially those caused by viruses. Albinterferon alfa-2b appears quite similar to other interferons, in side effects and action in controlling HCV. Patients ages 18 and older who are infected with HCV genotype 1, are HIV positive, are infected with HCV, and have evidence of HCV-induced liver disease; and who are not pregnant or breast feeding may be eligible for this study. Many visits to NIH over a 76-week period are required. There will be collection of blood and urine, pregnancy test, and tests of HCV in the blood. A liver biopsy is required before start of the study if patients have not had one within 1 year. Another is done at the end of 72 weeks. An eye exam is done before start of the study and repeated later. An optional procedure called automated pheresis is done at the study beginning. Researchers can study patients' immunity to control HCV. Blood is drawn through a needle in an arm vein and spun in a machine to separate the desired blood component. Remaining blood is returned to the patient. Patients will receive Albinterferon alfa-2b at a dose of 900 mcg every 2 weeks for 48 weeks, by injection under the skin. Ribavirin is given at 1,000 mg or 1,200 mg by mouth twice daily, depending on a patient's weight. Side effects of Albinterferon alfa-2b are fatigue, headache, joint and muscle pain, and sleeplessness. The major side effect of ribavirin is anemia. Visits ranging from week 3 to 44 will determine the safety of Albinterferon alfa-2b and ribavirin and to see effects on reducing the HCV viral load. For weeks 48, 52, 56, 64, 72, and 76, patients will return for a clinic visit and blood tests. At week 72, an abdominal ultrasound and liver biopsy are done. Week 76 includes discussion of biopsy results.

NCT00489385
Conditions
  1. HIV Infections
  2. HCV
Interventions
  1. Drug: Albinterferon
  2. Drug: Ribavirin
  3. Drug: Albuferon
MeSH:HIV Infections

Those subjects with, or a history of previous phlebotomy for iron overload will undergo HFE genetic counseling and those with a positive HFE genetic test demonstrating homozygosity for C282Y and H63D are not eligible. --- C282Y ---

Those who have compound heterozygosity to C282Y and H63D are also not eligible. --- C282Y ---

Primary Outcomes

Measure: Safety and tolerability of two doses of Albinterferon alpha 2b with ribavirin.

Secondary Outcomes

Measure: Histologic, virologic responses to Albinterferon alpha 2b and ribavirin


HPO Nodes


HP:0001392: Abnormality of the liver
Genes 1400
TNFSF11 UBR1 TRNK B3GLCT PEX3 NDUFS4 SCYL1 TREX1 CASP8 IARS1 SLC25A13 TRAPPC11 ABCC2 ALG9 GTF2IRD1 CAVIN1 EPB41 CD247 RASA2 APC NHLRC2 PEX3 TSHR NGLY1 ARVCF FANCM UCP2 ND1 ANTXR1 SDHD NELFA RREB1 NLRP3 HPGD CD70 LETM1 KIF3B IFT172 NPHP3 ARSA ASS1 TCF4 WDR35 SHPK RFX6 PSAP PEX11B PEX6 ERCC4 PAX4 SETBP1 HBB APOB RIT1 CEP164 ZAP70 ZIC3 STK11 STN1 GPC1 CYP27A1 GNPTAB DYNC2H1 PEX11B PDGFRL PEX1 PKLR GALK1 AP1S1 TTC7A BRIP1 TREX1 HSD3B7 PLIN1 FDX2 CD81 TNFRSF13B SEC24C POLG2 UROS KLF11 IL36RN PIK3CA CLDN1 SLC37A4 PIGA CD96 CYBA ERCC8 AKT2 FANCG FOXF1 TET2 NDUFV2 GLIS3 DLD PEX2 GNS AKT2 SLC25A20 RRAS2 CASP10 TNPO3 XRCC4 PC NEUROD1 WDR19 NOD2 CEP290 PTRH2 CCDC115 C8ORF37 CPOX SLC13A5 NSMCE2 HAMP VPS45 FBP1 SPTB PRKCD SPECC1L CBS DNAJB11 COG8 HOXD13 RNU4ATAC KMT2E PKD2 TTC21B PKD2 PDX1 NPHP1 AKR1D1 IFT27 CBL PHKG2 PEX19 USB1 NLRP3 SPTB TMEM70 PEX26 CR2 PEX12 SEC63 SPOP ACVRL1 FAH STX11 HNF4A SDHA NEK1 MADD ERCC8 PDGFB FANCL CPLX1 FAS ALDOB PSAP TCIRG1 CALR PEX16 ACADVL RINT1 FAN1 TET2 TKT RFX5 SLC2A1 VPS33A HMGCL MYRF RFT1 SLC4A1 XK NGLY1 DLL4 PCSK1 MSH2 C11ORF95 MVK MCM4 FLI1 AGPAT2 TINF2 ARSA IYD CFTR CR2 CASK ESCO2 LRP5 AGA TRIM37 MET NLRP3 SMPD1 KRT18 FANCF IGF2R NCKAP1L WDPCP GATA6 BBS9 LACC1 ACADVL APPL1 IFT80 CPT1A PEX1 IGF2 KIF20A STAT1 DLL4 PLEKHM1 RMRP KRAS IFT140 UQCRFS1 PEX12 HNF1A PRKCSH TRNN SCO1 BTK SLC25A15 MSH6 PEX13 ERCC8 BSCL2 SLC39A4 NDUFB11 RBCK1 HNRNPA2B1 PALLD RNASEH2B UGT1A1 NDUFAF8 SLC44A1 PSMB9 CCND1 AHCY ATPAF2 SMAD4 SKIV2L SNX10 HMBS TERT ALG8 ABCC8 SC5D TMEM216 NPC1 POMC FANCI FAS SLC22A5 SCARB2 HBB HFE LDLRAP1 HADH MMAA MYBPC3 PEX6 MET NOTCH2 PEX10 CTLA4 RPGRIP1L TRIM28 NPC2 SCYL1 ALMS1 CP VCP TUFM IDUA SBDS COG6 RFXAP GPC3 B9D1 TRHR DHDDS TTC7A PEX14 CYP19A1 INTU SLCO1B3 PTEN NLRP1 TIMMDC1 BBS7 DUOX2 HNF4A COG5 LDLR MMEL1 DNASE1L3 RASGRP1 FANCA DLD COG4 MARS1 PCK2 SOS1 KRT18 IARS1 ENG SCNN1B TYMP HNF1A DHFR GPI LPIN2 TGFB1 MAN2B1 KCNQ1OT1 TTC21B NPM1 NDUFS4 SLC2A1 HNF1A TSHB IL18BP ANK1 CTLA4 MMUT PCSK9 CEP19 KLF1 POLG2 IL21R APC IRF5 IL17RC SAR1B TERT PIGM PEX1 ERBB3 LYZ DYNC2H1 ATAD3A DNAJC21 CTNNB1 MPI PEX14 CFTR PSAP IFT80 RHBDF2 PPARG RTL1 TGFB1 MKS1 DDOST HBA2 TRNE TSFM NDUFB9 NPHP3 EWSR1 GCGR POU6F2 PLPBP PMM2 IDUA SFTPA2 IRAK4 APC HBG2 SLC29A3 RAG2 PEX10 JAK1 GBA MMUT JMJD1C SLC30A10 CPT2 NDUFS6 PALB2 GALT OCLN ETFDH TBX1 WDR19 FLNC NCF4 FASLG COX4I2 IFT172 RFXANK PEX12 PIEZO1 EPB41 BCS1L GBA CORIN ENG SPTA1 PTPN3 PHKB AGA RAG2 TPI1 FECH ALAS2 IL17F MADD MKKS FANCC PYGL LIMK1 PEPD BLK AMACR MCCC1 TWNK MKS1 CNOT1 APC ATP7B NCF1 CD3D NDUFAF1 IL2RB RNU4ATAC CDKN2A NDUFA6 SAA1 FARSA PMS1 IL7R RNASEH2A FAH GAA ABCB11 BRCA2 NDUFS2 TTC37 LMNA SPTA1 PKHD1 ND3 IL17RA KRAS TMEM216 KLF1 IGLL1 BRCA2 DPAGT1 SPTB IGHM PEX16 FASLG PEX10 SOX10 SLC39A8 FAM111B DNAJC19 GDF2 INSR HLA-DRB1 MRPL44 PEX13 NDUFA1 CYBB NEU1 CD3E BSCL2 ATP6AP1 MLH1 PTPRC BCHE TNNI3 GPIHBP1 SNX10 KRT8 PTPN11 CC2D2A FBP1 ACAD9 GNPTAB IDUA CTSK XPR1 ACVRL1 TFAM CYBB TFR2 POLG HADHB MTTP NRAS ARSA LPIN2 CC2D2A CLCN7 DOLK NEU1 ADA SETBP1 FANCB STAT3 ABCB4 PEX6 PEX2 PEX10 ETFB SFTPC SLX4 TSC1 SLC25A13 PGM1 A2ML1 RPGRIP1L PHKG2 HMBS MEFV GABRD ITCH BRCA2 SEMA4A PLAGL1 TRMT5 PALB2 NDUFAF2 ASXL1 ABCG5 DMPK USP18 VPS33B TMEM67 UFD1 HYMAI C1QBP AXIN1 TREX1 HNF1B HNF4A ASAH1 SLC29A3 NOTCH2 UBE2T SRP54 GBA DKC1 JAK2 TSHR TCIRG1 BBS5 POLG2 ERCC6 MMAB HBB NFKB1 IL1RN KCNQ1 TMEM126B ACADM EIF2AK3 ABCB4 DNAJC19 TALDO1 ARL6 PEX12 AP1S1 STEAP3 UNC13D PEX5 HADHA HFE SP110 NFKB2 TRAPPC11 PHKA2 ANK1 IDS CPT1A RNF43 PCCB NDUFAF4 SETD2 KCNN4 ERCC4 CTLA4 INPP5E HMGCS2 DZIP1L NEUROG3 PEX16 JAM2 COG1 POU2AF1 PEX19 DIS3L2 CD28 POLG PEX5 RHAG ADA2 BPGM UROD BCS1L RBPJ WDR19 MRPS7 HNRNPA1 BMPER CPT2 H19-ICR SLC25A13 ADAR TMEM67 MTRR GYPC MLH3 HBA2 GFM1 EFL1 TERC DDRGK1 FOS BOLA3 TF GLB1 MEG3 BBS12 DPM1 AIRE LIG4 PARN HSD3B7 ATP7B PIGS TPO BBS2 PEX11B TRIM37 GLB1 PPARG DCLRE1C SCNN1A UQCRB GPC3 CYP7B1 ALG9 NHP2 IGF2 EXTL3 MAN2B1 COMT PRKCD BLNK MYORG IL2RG OSTM1 IL7R SLC17A5 GCLC ABCG8 SMPD1 APC ETFA RHAG WT1 SPRTN LIPA RAB27A RAG2 SDHC IER3IP1 NR1H4 SMAD4 CYTB BTNL2 ADAMTSL2 INVS GDF2 PSMB4 CLCN7 FGFR2 GNE PEX6 ARHGAP31 JAK2 MS4A1 GNE G6PD BBIP1 DHCR7 MPI TINF2 INSR ERCC6 CAVIN1 ATP6AP2 LBR BBS1 IFNG KIT RRM2B LIPE HNF4A LMNA JAK3 BMP2 ABCG8 PIK3C2A LMBRD1 IFT172 PEX3 NBAS IFT140 BTK AMACR HBG1 CTBP1 LZTFL1 BTNL2 PEPD KCNJ11 GALT GAA SNX14 MFN2 SEC63 MYC ERCC6 DYNC2I1 TP53 CASR NKX2-5 BBS10 RAD51C NAB2 MPV17 TMEM67 GALE PSAP PEX13 REST TGFBR2 PRPS1 PLEKHM1 TTC8 CLIP2 ABCC8 H19 CYBC1 ELN RAG1 PKD1 NPHP1 EPB42 CLEC7A HIRA GP1BB DYNC2LI1 TCIRG1 CYP27A1 SLC26A4 PMM2 FERMT3 HSD17B4 PEX3 ELN FUCA1 EXTL3 HJV TMEM67 MYD88 AGGF1 ARSB MOGS RIPK1 KCNN4 NDUFAF5 HFE NOTCH1 PMS2 DUOXA2 FOXP3 WDR19 USP9X TRMU ND4 SDCCAG8 AP3B1 CBL APOC2 LPL CD28 PKHD1 SON LIPE PPOX TCF3 SUMF1 CA2 HESX1 CC2D2A PDGFRB CEP83 STXBP2 TARS2 GLRX5 HNF1B PCK1 IFT122 TET2 SLC40A1 BBS4 SLC7A7 ARL6 ABHD5 BCS1L STK11 PEX2 PCCA TTC37 DOCK6 DAXX INPPL1 DIS3L2 KRAS TNFRSF13C PRSS1 AP1B1 HSD17B10 SF3B1 SLC25A19 TERT DYNC2I2 TNFRSF1B FANCD2 SLC30A10 IL7R LMNA AGL GPC4 FECH H19-ICR TRNV NAGA RMND1 CIITA KIT GBA G6PC3 CEP290 PEX26 GUCY2D NDUFB10 TRMU TJP2 TMEM67 DNAJC21 PEX26 IL12RB1 SH2D1A XRCC4 SLC25A4 IDUA IL2RA ARG1 PEX19 NDUFA11 NDUFS3 MED25 GBA SLC35C1 HJV IQCB1 MRPL3 SP110 EPB42 VPS13A NAGA SERPINA1 NHP2 SLC4A1 ATP8B1 LIG4 ADK SLC25A20 RAG1 CEP55 RRAS SLC22A5 SKIV2L CLDN1 PSAP TREX1 ZAP70 ALDOB LMNA GATA2 ND2 ND5 IFIH1 IFNGR1 BRCA1 SLC7A7 NDUFS7 FGFRL1 APOE GATA6 JAM3 GCDH UGT1A1 CBS AP3D1 SOS2 ABCA1 NPHP3 TKFC FOXRED1 LIPA PEX3 CSPP1 ACAT1 PCCB CASP10 ALDH7A1 TNFRSF13C FADD BLVRA PPARG GCK KPTN MECP2 LBR AP1B1 PCCA SBDS KCNH1 SLCO1B3 MRAS MRPS28 TNFSF11 CYP7B1 DCDC2 PDGFRA PEX1 SLC25A15 NPHP3 ADA SLC20A2 LIPA PRF1 ND3 TRAF3IP1 ACAD9 GBA SLC4A1 GBA JAK2 TNFRSF11A SUMF1 GUSB CD40LG MSH2 DHCR7 LARS1 MMACHC F5 MIF GUSB ABCC2 NSD2 TRIM32 GBA LBR NCF2 MAN2B1 CEP290 FOXP3 RAC2 PKD1 TNFSF15 RELA SDHA TPP2 SDCCAG8 CIDEC RAG1 STAT6 CDKN1C IFT43 HAVCR2 HMGCL HBB SLC4A1 ACP5 XIAP RNASEH2A IL2RG ATP7A SPTB POLR3A AGPAT2 BTK CARS2 ALG13 ERCC1 ATRX TMEM231 ND1 COG7 IDUA MUC5B COG4 PRKCD NPHP4 LRRC8A RMRP SPINK1 PIEZO1 MPC1 EARS2 ABHD5 NDUFAF3 LCAT PSAP ABCA1 ABCD3 C1S CPA1 KCNJ11 LONP1 CTCF GANAB MSH6 TSC2 PEX14 DGUOK TNFSF12 TMEM107 PEX16 SLCO2A1 COG2 SDHB TRNL1 IDS CHD7 SLC37A4 BSCL2 DPM2 NAGS B2M ARSA CTNNB1 TNNT2 SRP54 CAV1 RPS20 SLCO1B1 DYNC2LI1 LYST PLIN1 CD19 HMOX1 APOA1 ADAMTS13 CCDC47 CYP7A1 ND2 SLC25A1 EIF2AK3 CPOX CPOX CIDEC ITCH APC2 SERPINA1 GPD1 PTRH2 LYRM4 GBA UGT1A1 APOE PFKM POLG TNFRSF1A SPIB CLCN7 YARS2 NSD1 NDUFS8 F5 KCNN3 LMNB2 DYNC2I1 RHAG GNMT HYOU1 TBX1 TNFSF12 EPCAM JAK2 PEX14 ATP8B1 TBL2 MLH1 AKR1D1 TBX19 ATP11C FANCE PDGFRA TGFB1 CTNS NCF2 PNPLA2 TNFRSF1B CEP120 DDRGK1 RFC2 FUCA1 SLCO1B1 PSTPIP1 NPHP3 SLC40A1 CTRC UGT1A1 NDUFS1 TMEM165 RNASEH2C NSD2 TRNW LHX3 FH RRM2B NOP10 PEX5 PEX19 IL12A IL6 FLT1 CD19 SURF1 LTBP3 SMPD1 BBS1 MPV17 B9D2 BRCA1 BSCL2 MPL PSMB8 DCTN4 KRIT1 CLCA4 CTSC LRP5 PROP1 ASL CLCN7 TRIP13 SLC25A19 FCGR2A MST1 ANKS6 ALDOA TRAF3IP2 TBX1 IDS SRSF2 TRIM28 WDPCP ALG8 CD79A PIK3R1 NOP10 TRNS1 TRAF3IP1 ALG2 RAF1 SCNN1G COG6 CD79B HEXB CTSA CPT2 PRDM16 STOX1 ASAH1 SC5D NDUFS7 HK1 TALDO1 NUBPL RPGRIP1 COX15 MAGT1 PAX8 ABCA1 STEAP3 HADHA TERC PHKA2 RTEL1 INS CYBA NDUFB3 PEX12 GPC3 HADH CASR SMAD4 RASGRP1 HBB CASR GBE1 RERE DMPK ICOS FADD MAD2L2 DCDC2 PNPLA6 SKI LMNA ABCB11 EOGT WT1 SEC23B TRNW ICOS RFX5 SLC25A13 ABCB4 GLB1 DCLRE1C ALMS1 NCF1 HBG2 CYBC1 CDAN1 FGA PARS2 LRPPRC RPGRIP1L IL2RG LHX4 KCNH1 TBX19 CDIN1 ACOX1 HBB TMPRSS6 TNFRSF13B LMNA TET2 HAMP NRAS PEX26 TP53 PNPLA2 POU1F1 WRAP53 FAS ABCG8 SAMHD1 WDR35 NDUFV1 ATP7A RFXAP TMEM199 G6PC1 PEX6 CCDC28B KRAS GTF2I DGUOK HGSNAT APOA1 NHP2 TG NEK8 IFIH1 TERT RUNX1 CLPB RNASEH2C ALG1 CIITA HADHA COX14 SLC11A2 RNU4ATAC OFD1 XYLT1 WDR35 EFL1 CD27 BMPR1A PEX2 RBM8A ATP8B1 MKS1 POLD1 NSMCE2 RAD51 POMC MMUT PRKCSH HBA1 CAV1 XRCC2 ITK VHL BICC1 RECQL4 AUH ERCC6 PKLR FARSB RAB27A NAGLU CTC1 PRSS2 PEX5 SLC5A5 LYST GBA JAG1 MYPN C4B LETM1 STX1A RFWD3 APC CFTR CEP290 WHCR GPC4 ICOS RFXANK CDKN1B ERCC8 HPD CA2 ND6 ACADM PRKAR1A MLXIPL VIPAS39 LZTR1 HLA-DRB1 MPL INPP5E PAX8 CD55 HLA-DRB1 MVK DKC1 DLK1 DYNC2I2 APOE KRT8 UGT1A1 POU1F1 SGSH GPR35 BAZ1B ERCC4 NDUFAF1 FBN1 RFT1 HBA1 WT1 TERC PIK3CA GNAS ATP6V1B2 PEX1 CPT2 ATP6 COA8 ACOX1 TCTN2 GANAB TMEM67 KCNAB2 VPS33A GALNS CEL PYGL NEU1 XIAP GALM BTD PRKAR1A FGFR2 MVK
HP:0001903: Anemia
Genes 774
LCAT KMT2D RPS7 TNFSF11 GSS PET100 COL7A1 GATA1 EPB41 TERT NHLRC2 NTRK1 FANCM RPS15A PTF1A NLRP3 MALT1 HPGD FMO3 SHPK PSAP TERT HBB RPL15 STK11 AK1 WAS SDHA TARS1 PKLR TTC7A HBA1 PHGDH RARA ALAS2 BRIP1 RPL26 FDX2 CD81 PNPO UROS SLC19A2 ATRX ERCC8 FANCG TET2 GP1BA TERC RPL35 CFHR1 SURF1 ALAD CASP10 EPHB4 ACTN4 LMBRD1 ABCB7 NOD2 CPOX TRNW VPS45 SPTB PHGDH PRKCD KCNE1 EPO FOXP1 TINF2 ADA2 PHKG2 CFI USB1 AMN NLRP3 SPTB NDUFAF6 STAT2 CR2 ACVRL1 AMMECR1 STX11 MEFV LIG4 THRA TSR2 RPL35 SBDS FANCL FAS TCIRG1 CALR SLC25A10 COX10 HBA1 SLC2A1 VPS33A HMGCL COX15 MDM4 SLC4A1 CTLA4 FLI1 MMADHC HBA2 TINF2 SCO2 CASK TFRC HBA2 EXT2 NLRP3 FANCF MTRR ND4 RPS19 STAT1 PLEKHM1 DGKE RPS28 RMRP IFT140 UQCRFS1 NPHP4 BMPR1A TRNN SLC19A3 BTK PSMB9 STIM1 UMPS SMAD4 ITGB3 FANCC SMAD4 ISCU STAT1 SNX10 TERT FANCI FAS NDUFS2 SCARB2 HBB MMAA GPX1 FARS2 GALNT2 CP ECHS1 SBDS RFXAP TTC7A RAG1 UROS TRNS2 NLRP1 RASGRP1 ATRX FANCA ABCD4 MARS1 RPS19 HBB ENG TYMP DHFR GPI LPIN2 KIF23 RPS24 NPM1 SLC2A1 TACO1 IFNG ANK1 AASS CTLA4 MMUT RPS29 KLF1 CFB UMPS MYSM1 ERBB3 NSUN2 FERMT1 DNAJC21 UROD HBA2 LYRM7 RPS10 ELANE WFS1 RPS26 EWSR1 PIGA ABCB6 HPRT1 FANCF HBG2 SLC29A3 THBD RAG2 SLC46A1 PGM3 MMUT FANCE COL7A1 PALB2 PNP IL12B MYSM1 SPTA1 ATRX FASLG COX4I2 RFXANK PIEZO1 EPB41 GBA ENG SPTA1 MPLKIP PARN LAMC2 RAG2 TPI1 FECH ALAS2 GNA14 FANCC CD59 PEPD RPL5 ZBTB24 IDH1 ATP7B CLCN7 GCLC IL2RB FARSA RPS10 STAT4 SPTA1 MLX KRAS KLF1 HBB TBCE BRCA2 SPTB RNF113A FASLG DNAJC19 GATB PNPO BRCA1 CISD2 GSS GDF2 HAVCR2 CFH STAT3 SRD5A3 NDUFA2 PRKAR1A IDH2 SNX10 COX3 CD3G NDUFV2 CTSK TREX1 ACVRL1 TFR2 MTTP NBN NRAS LPIN2 CLCN7 SLC12A3 ADA NDUFAF3 NDUFAF2 CFH CRIPT FANCB STAT3 HLA-B SLX4 CLCNKB SLC25A13 DNMT3B TCN2 RPL31 YARS2 RPS26 ORAI1 IRF2BP2 ASXL1 SAMD9 RPL5 RPS27 CD247 SURF1 RPS24 RPL35A FTCD TREX1 ASAH1 UBE2T SRP54 GBA DKC1 TCIRG1 ITGA2B LAMB3 MMAB HBB NFKB1 IRAK1 RECQL4 RPL27 DNAJC19 TALDO1 STEAP3 UNC13D LAMB3 NDUFS2 NFKB2 PHKA2 ANK1 HBD LAT HELLS PCCB MTHFD1 KCNN4 ERCC4 LARS2 OCRL DKC1 GATA1 POLG RHAG ADA2 BPGM TSR2 TET2 PML SARS2 MTRR BMPR1A GYPC HBA2 CP COL4A1 TBL1XR1 EFL1 TERC ATRX TF BMPR1A LIG4 PARN ATP7B PFKM REN DCLRE1C WFS1 FANCA ACAD8 NHP2 FANCB PRKCD PLA2G4A IL2RG OSTM1 PTH1R GCLC SMPD1 SLC4A1 RHAG WT1 LIPA RAG2 CLPX SDHC FCGR2A SMAD4 KDM6A BTNL2 IRX5 PSMB4 FANCG UBR1 ND6 MS4A1 G6PD GATA1 NPM1 ZBTB16 ERCC6L2 TINF2 COL7A1 BMPR1A RPS27 PUS1 IFNG KIT RRM2B LAMA3 IKZF1 ABCG8 LMBRD1 TF HBB HBG1 GALT GATA1 CASR RAD51C PRDX1 MUC1 PLEKHM1 MTR IGH CYBC1 ITGB4 FANCD2 RAG1 PRKACG EPB42 TCIRG1 COX1 FERMT3 MYD88 AGGF1 NPHP1 RPL11 NT5C3A RIPK1 KCNN4 MPL SLC40A1 SLX4 FOXP3 RPL27 CBL PPOX CA2 RPL11 GREM1 STAT5B STXBP2 GLRX5 TET2 SLC7A7 STK11 PCCA CD46 SMAD4 DAXX ABCB7 PACS2 RPS15A GLA HBA2 SF3B1 RPL15 TERT FANCD2 PTPN22 IL7R FECH SMARCAL1 HBB KIT G6PC3 TMEM67 DNAJC21 IL2RA CTC1 GSR SLC35C1 PNP SP110 EPB42 SLC4A1 NDUFA12 NBN TRNS1 FCGR2B TRNH RAG1 AGXT ACD TGFB1 ZAP70 C3 IFNGR1 SLC7A7 DNM1L NFKB1 LAMA3 RMRP HBB ND1 ABCA1 SLC19A2 TKFC STING1 RPS14 CASP10 TNFRSF13C RPS17 TBXAS1 RPL18 TRNQ MECOM PGK1 SBDS TNFSF11 PDGFRA CAT KIF15 ADA XRCC4 BCL10 TNFAIP3 PRF1 GBA SLC4A1 NUMA1 PDHA1 JAK2 TNFRSF11A GLA FANCL CD40LG LARS1 MMACHC SLC25A38 CUBN TMPRSS6 GBA MPIG6B SPP1 ELMO2 FOXP3 STIM1 RPL35A KIF1B SDHA TRNF TPP2 RAG1 NDUFV1 HMGCL HBB RPL18 SLC4A1 HBB-LCR ACP5 SPTB NDUFA13 MMP1 NDUFA4 ATRX PCNT PRKCD RPS7 RPL26 COG1 RMRP PIEZO1 PLEC ABCA1 NHEJ1 ABCD3 ANAPC1 SPTA1 FAM111A TNFSF12 DBH NDUFS3 LIPT1 RPS28 RAC2 SLCO2A1 SLC25A21 SDHB CHD7 NABP1 TNFRSF4 CFI PHF21A NPHP4 TRNT1 SRP54 HBB LYST HMOX1 APOA1 ADAMTS13 NDUFA10 GATA1 HSPA9 RPS17 GBA ENG PFKM FAM111A DDX41 CLCN7 YARS2 COL7A1 NDUFB8 RHAG NDUFS7 HYOU1 TNFSF12 TOR1A ZBTB20 SLC4A1 NDUFS8 ATP11C FANCE WIPF1 TGFB1 NDUFAF5 PSTPIP1 BCOR CAD SAMD9L TRNW MAD2L2 NPHP1 CD19 SURF1 TP53 LAMC2 SMARCD2 BRCA1 MPL PSMB8 GATC CCND1 CLCN7 MMACHC KRT14 ALDOA SRSF2 ALG8 NOP10 TRNS1 FOXRED1 OPA1 ETV6 HK1 TALDO1 ERCC2 COX2 COQ2 TEK STEAP3 TERC ALX4 RPS14 RTEL1 RASGRP1 HBB MAD2L2 GATA1 PGM3 CDCA7 PUS1 SEC23B SAMD9L HBA1 SLC46A1 MTFMT ICOS COL17A1 PIGT RFX5 DCLRE1C HBG2 CDAN1 IREB2 CDIN1 HBB TNFRSF13B F8 TET2 HAMP WAS F2 WRAP53 HBG1 NDUFS1 FAS TET2 KCNQ1 STIM1 ADAR PTEN SMARCAL1 SRD5A3 GTF2H5 TERT RUNX1 HPRT1 CIITA SLC11A2 PLEC BIRC3 SPTA1 EFL1 TBXAS1 RBM8A NLRC4 CFHR3 RAD51 PRF1 TRNT1 QRSL1 NDUFA9 HBA1 ALPL XRCC2 CBLIF GATA1 ITK ERCC6 PKLR FARSB TRNL1 CTC1 ANK1 LYST GBA ACVR1 PGK1 FIP1L1 ALAS2 RFWD3 ND5 APC DNASE1 CA2 HLA-B MMP1 NDUFS4 HLA-DRB1 AK2 CD55 DKC1 RPS29 SFXN4 HELLPAR LRBA GTF2E2 ERCC4 HBA1 UBE2T SEC61A1 ERCC3 RTEL1 COA8 CD46 VPS33A ITGB4 MVK
Protein Mutations 4
C282Y C677T H63D V617F
HP:0001871: Abnormality of blood and blood-forming tissues
Genes 1969
RPS7 GCNT2 TREX1 SLFN14 EPB41 TERT NUMA1 CD247 CTPS1 NTRK1 APP ARVCF SLC2A10 RPS15A APP KRT14 ZNF341 NBEAL2 RREB1 PTF1A MALT1 HPGD EGLN1 COG4 PRSS1 PEX11B SPATA5 PAX4 TERT HBB RPL15 STK11 BUB1B MTTP ANKRD11 TARS1 PKLR RAF1 TTC7A SPATA5 SH2B3 ALAS2 BRIP1 FGA VPS13B HSD3B7 PNPO SEC24C TYROBP DSG2 UROS MECOM PIK3CA CLDN1 TCAP RS1 PLEC SLC37A4 TSC1 ATRX FANCG GP1BA INS TERC SRP72 MPL THSD1 EVC2 DLST ATP6V0A2 AK2 ACTN4 DNMT3A THPO ABCB7 NOD2 SRSF2 MYH6 CPOX XYLT1 ANKRD26 VPS45 ACTA2 ERF VPS13B PHGDH PRKCD KCNE1 PALB2 FOXN1 FOXP1 COL1A2 CD79A COL3A1 CBL PHKG2 ATP6V1E1 RUNX1 COL5A1 PEX19 AMN CR2 ACVRL1 AMMECR1 STX11 ADA2 THRA MADD ERCC8 SBDS FANCL ALDOB LYST RINT1 FAN1 SLC25A10 COX10 TET2 RFX5 SLC2A1 VPS33A HMGCL DLL4 KLF1 XK NUP214 MYH11 CCND1 F8 MVK SCO2 PUF60 RYR1 CASK HBA2 MET BEST1 NLRP3 SMPD1 FANCF VWF MLH1 PIK3CA TCIRG1 APPL1 ND4 BLNK RPS19 FLI1 KIF20A DLL4 DGKE MYD88 KRAS IFT140 ERMARD BAP1 APP NPHP4 F12 CALR SMARCB1 TRNN SLC19A3 BTK MSH6 CCBE1 PSMB9 APOE UMPS CDC42 SMAD4 ITGB3 SMAD4 STAT1 SNX10 FKBP14 BRAF GCK SC5D DES FAS MCFD2 SCARB2 NEXN ABCC6 CEP57 GALNT2 ECHS1 RFXAP FLNA PTPN22 TTC7A RAG1 UROS TRNS2 NLRP1 C1R ATRX ABCD4 MARS1 ETHE1 SSR4 SOS1 RPS19 TONSL IL12A-AS1 HBB ENG TNNC1 TYMP CDKN1B LPIN2 RPS24 ACTN1 NPM1 TSC2 SCN11A SLC2A1 TACO1 RB1 IFNG ANK1 AASS CTLA4 KLF1 C1S SAR1B HABP2 MYSM1 DSE ERBB3 NSUN2 FERMT1 GUCY1A1 CTNNB1 RET WIPF1 FGA DDOST HBA2 DYNC2LI1 ELANE WFS1 EWSR1 VHL PMM2 ELN ABCB6 HBG2 SLC29A3 THBD RAG2 RAG2 CAPN5 PGM3 MMUT FANCE MPL TP53 COL7A1 MSN SGCG PNP SRC SPTA1 FLNC GNA11 ATRX NCF4 GBA ENG ETV6 PARN PLN NDP MDM2 AGA LAMC2 NBEAL2 RAG2 DCLRE1C CBL FANCC WAS BLK AMACR GGCX PRLR ATP7B NCF1 CD3D IL2RB MGAT2 SAA1 PMS1 IL7R RNASEH2A TBC1D24 TTC37 SPTA1 MLX HBB PDE11A IDH1 SMAD3 IGLL1 DPAGT1 RYR1 TERT NOS3 GATB SDHB BRCA1 CISD2 GSS BUB1B BAP1 GDF2 CYBB DNMT3A NEU1 PTPRC VWF SRD5A3 NDUFA2 TNNI3 PRKAR1A CYB5R3 IDH2 SNX10 PTPN11 COX3 CARD11 COG8 AGK NDUFV2 TMTC3 CTSK TREX1 XPR1 POT1 ACVRL1 TFAM TFR2 MTTP NBN NRAS BCL11B CLCN7 CHIC2 FBN1 NDUFAF3 NDUFAF2 CRIPT FANCB CD3D STAT3 CARD11 BAG3 CLCNKB SLC25A13 PGM1 JAK2 TCN2 RPL31 F7 YARS2 COL4A1 PIK3CA BCR SAMD9 USP18 CD247 PRLR TREX1 SLC29A3 ARMC5 COLGALT1 JAK2 ITGA2B IL6R NFKB1 IL1RN IRAK1 TGFBR1 MYC FUT8 PEX12 COL4A2 KIF11 GP1BB MDH2 UBE2A LAMB3 NFKB2 PIK3CD ENG ANK1 HBD HELLS MAX RNF43 MTHFD1 SETD2 CTLA4 CCM2 F10 DZIP1L JAM2 DKC1 KRT14 IKZF1 CD28 POLG ADA2 BPGM TSR2 TET2 PML BLOC1S3 TGFB3 GYPC CHD7 CP FH ATRX KIT RBM10 TF BMPR1A DPM1 PARN RHOH NFKB2 HSD3B7 NF1 RFWD3 VHL PFKM TLL1 DCLRE1C NAXD ABL1 WFS1 HAX1 CFHR1 NHP2 TGFBR3 PRPS1 FANCB FOXN1 IL2RG OSTM1 IL7R PTH1R SLC17A5 SDHB SMPD1 COL5A2 SLC4A1 F13B TAL1 LAMTOR2 CLPX SDHC NR1H4 GP1BA SMAD4 IVD KDM6A CLPB F9 IRX5 GDF2 PSMB4 FANCG UBR1 ND6 FGFR2 COL3A1 ARHGAP31 MS4A1 GNE USB1 GATA1 HBG1 GATA2 NDE1 TINF2 F13B BMPR1A HOXA11 ATP6AP2 LBR RPS27 SDHD CYP11B2 PUS1 IL7 IFNG PLAU PROC KCNJ5 RRM2B DTNBP1 HNF4A JAK3 ABCG8 CFTR BAP1 TF NBAS GATA1 ATM CACNA1S VKORC1 SERPINE1 GATA1 CD81 KRT1 PEX13 PLEKHM1 ABCC8 CYBC1 FANCD2 RAG1 BMS1 EPB42 GP1BB TP53 LBR ADAMTS2 TCIRG1 GFI1 PMM2 PICALM FERMT3 IKBKG PTEN FUCA1 GNAS AGGF1 F8 NPHP1 KCNN4 NLRP12 TGFBR1 PRDM5 NUTM1 MPL SIK3 NOTCH1 SLC40A1 PMS2 SLX4 RPL27 CD28 PPOX TCF3 CA2 PDGFRB GREM1 COL1A1 STAT5B STXBP2 CREBBP SLC2A1 NEDD4L SLC7A7 BCS1L CD8A DOCK6 CD46 BCL2 MFAP5 KRAS KNSTRN PRSS1 KIT SF3B1 MYBPC3 FANCD2 PTPN22 IL7R FECH SMARCAL1 CIITA HBB GBA G6PC3 DNAJC21 PDCD10 PEX26 MAP2K2 IL2RA ENPP1 CTC1 IKBKG PNP PRTN3 SP110 EPB42 XYLT2 LIG4 GP1BB TRNS1 FZD4 FCGR2B SDHD CYP2A6 BLM ACD RRAS FANCI TREX1 ZAP70 ALDOB C3 IFIH1 IDH2 USP8 USP8 RMRP APOE HBB AP3D1 BRCC3 ABCA1 PEX3 RPS14 PANK2 TBXAS1 MTAP C4A TRNQ DNAJC21 GCK ZMPSTE24 LBR SBDS PDCD10 CYP7B1 PEX1 MTHFR BCL10 TNFAIP3 PRF1 KRAS MAP1B TGFB2 RAG2 GBA TREM2 JAK2 IRAK4 CD40LG MSH2 NBN MMACHC SLC25A38 CUBN GP1BB BRIP1 SLC35A1 GBA MPIG6B SPP1 NCF2 PTPN11 PTPN22 FOXP3 RAC2 STIM1 RPL35A NPM1 SDHA SDHB TRNF TPP2 RAG1 KANSL1 HAVCR2 HMGCL HBB RPL18 SLC4A1 IL6ST HBB-LCR ACP5 XIAP PLEC TCF3 IL2RG ATP7A CYP11B1 SDHB PCNT PTPN11 GP1BA LRRC8A RPL26 COG1 LRP5 RMRP SPINK1 PIEZO1 TTN PLEC ABHD5 AEBP1 SLC35C1 ANAPC1 CPA1 CD36 SPTA1 TCF4 CTCF MSH6 FAM111A PEX16 FLNA POMP LIPT1 RAC2 SLCO2A1 CD109 A4GALT CHD7 TGFBR2 CFI PHF21A NPHP4 TRNT1 TNNT2 SRP54 COL14A1 CDKN2C KRT5 NDUFA10 FKBP14 RPS17 SLC27A4 APC2 MYH7 ENG PFKM KRT5 TNFRSF1A CBFB CYB5A BCL10 CLCN7 YARS2 NSD1 FOXN1 LMNB2 KIT NDUFS7 PDGFB ATP6V1A TBX1 PROS1 AKT1 KLHDC8B TNFSF12 EPCAM P2RY12 IL10 MLH1 SLC4A1 NDUFS8 PDGFRA TINF2 SDHD NCF2 NDUFAF5 TNFRSF1B PSTPIP1 BCOR RNASEH2C SAMD9L TRNW FH MAD2L2 NOP10 NOTCH3 MPL SMARCE1 F13A1 LAMC2 MPL MYH9 COL1A2 STAT3 CCND1 TMPO TUBB1 KRT14 ARFGEF2 SSR4 ALG8 CD79A PIK3R1 TRNS1 HPS6 ALG2 RIN2 ETV6 LMAN1 SC5D KCNJ11 HK1 PPCS FGB IL23R COX2 COQ2 F8 INS CYBA HADH SCN9A CASR RASGRP1 STT3B ICOS TCF4 FADD AMMECR1 GATA1 COL3A1 TAL2 CDCA7 SEC23B HBA1 SREBF1 COL17A1 ITGA2B PIGT ANO6 F11 HBG2 CDAN1 IREB2 TERT CDIN1 SDHA PLAT SOS1 HAMP NRAS WAS F2 NF2 NDUFS1 FAS SAMHD1 TP53 HPS1 TET2 NSMCE3 PTEN G6PC1 TNFRSF1A VKORC1 JAK2 GNAQ NHP2 SMARCAL1 SRD5A3 IFIH1 TMEM127 CLPB RNASEH2C GNAS JAGN1 F9 CIITA CCR1 SLC11A2 PLEC RNU4ATAC EPOR ITGB2 SPTA1 EFL1 FAS ITGB4 GP1BA RAD51 PRF1 TRNT1 NDUFA9 MMUT HBA1 XRCC2 GATA1 VHL ERAP1 ERCC6 FARSB RAB27A PRKACA ZCCHC8 ANK1 JAK2 LYST GBA VHL PGK1 ELANE RFWD3 CORO1A GNAQ KLRC4 C4A DNASE1 CA2 KIT MMP1 F13A1 LZTR1 HLA-DRB1 MPL ADAMTS2 WDR19 ALG12 AK2 CD55 MVK SFXN4 HELLPAR ELANE GTF2E2 GP9 ABCC9 GPR35 BLOC1S6 CDKN1A UBE2T GP1BA NEBL BRCA2 SH2B3 ERCC3 TGFB3 ANGPTL6 STK4 CEL TET2 PRKAR1A SF3B1 LCAT GFI1B KMT2D MAT2A FIBP LRP5 TNFSF11 GSS PET100 LMNA COL7A1 LCK EPHB2 ABCC2 GATA1 PROC CTRC VWF TGFBR2 RASA2 APC NHLRC2 NGLY1 FANCM NLRP3 GGCX GLI1 CD70 KCNQ1 PIK3CD FMO3 TCF4 CFHR3 SHPK PSAP HLA-DPA1 ERCC4 RIT1 STN1 AK1 UNC119 GPC1 WAS NLRP3 MYD88 THBD TP63 SDHA NF1 HBA1 PHGDH RARA RPL26 GATA2 TREX1 ABCC6 STT3B APOB FDX2 CD81 TNFRSF13B FIG4 TRAF3 LIG4 KLF11 ABL1 IL36RN SLC19A2 COL3A1 ACD MTHFR HLCS CYBA ERCC8 TET2 HLA-DPB1 DLD TERT RPL35 CFHR1 SURF1 ATOH7 SERAC1 GFI1B RRAS2 ALAD CASP10 EPHB4 XRCC4 NIPBL NEUROD1 LMBRD1 PANK2 LACC1 TXNRD2 IL10RA ATP7A MYH9 TRNW GDNF CTLA4 SLC35A1 EPAS1 SPTB ADAMTS3 GLB1 F7 COL5A1 CXCR4 CBS ACP2 EPO EPO LIG4 BLM RNU4ATAC PDX1 CLN3 AKR1D1 TINF2 ADA2 KCNJ1 CST3 RAG1 CFI FKTN USB1 NLRP3 SPTB NDUFAF6 STAT2 SBDS ARL6IP6 FAH LAMTOR2 GALC MEFV RASA1 LIG4 NF1 PDGFB TSR2 DNMT3B RPL35 SDHAF2 FAS SERPINC1 TCIRG1 CALR PIK3R1 HBA1 RFT1 COX15 MDM4 SDHD SLC4A1 SRP54 SLC4A4 MSH2 MCM4 CTLA4 FLI1 MMADHC HBA2 TINF2 CD40 SDHC MPL CR2 COL1A1 FGG TFRC KIT EXT2 ITGA2B KIF1B ITGB3 MTRR CYB5R3 STXBP1 DNM2 NCKAP1L GATA6 SERPINF2 HTRA2 LDB3 FLT3 STAT1 PLEKHM1 RPS28 RMRP UQCRFS1 LMX1B SALL4 MAX BMPR1A PLEC CISD2 IGHM SLC25A15 CXCR4 MEFV RNASEH2B DOCK2 STIM1 CCND1 TICAM1 AHCY FANCC BCL6 SKIV2L ISCU TERT NPC1 FANCI NDUFS2 ALG6 SDHC HBB TNFRSF13B MMAA GPX1 PEX6 CTLA4 FARS2 ATP7A NPC2 TTI2 CP B4GALT1 SBDS CYP26C1 PTEN ETHE1 DNASE1L3 RASGRP1 FANCA DIAPH1 PROC CYCS HNF1A DHFR GPI MAN2B1 KIF23 THPO EPG5 NBN RASGRP2 LBR F13A1 CBL IL18BP ANKRD1 FLNA IL12A ARHGAP26 MMUT RPS29 CFB UMPS SERPIND1 PLOD3 APP PIGM HPS5 COL4A5 PRKG1 ACP5 JAK3 DNAJC21 MPI SH3GL1 UROD CFTR RHBDF2 RBM8A FYB1 LYRM7 RPS10 RPS26 PIGA CD3E POLE CDH23 SCARB2 HPRT1 IRAK4 FANCF PIGL CYP4V2 SLC2A1 PEX10 SLC46A1 JAK1 IL2RG JMJD1C SLC30A10 BUB1 TET2 PALB2 GALT IL12B OCLN MYSM1 LEPR JAK2 TBX1 FGG ZAP70 FASLG COX4I2 RFXANK PEX12 PIEZO1 FLNA EPB41 RUNX1 B2M NOTCH1 CORIN SPTA1 MPLKIP PROS1 TPI1 FECH ALAS2 GNA14 MADD GCDH CD59 PEPD WRAP53 RPL5 ZBTB24 SDHA IDH1 CCM2 ASXL1 CLCN7 SF3B1 GCLC FARSA CDC42 RPS10 ACTC1 ASXL1 STAT4 C2 BCR KRAS KLF1 CD151 EPAS1 TBCE BRCA2 SPTB RNF113A BRAF IGHM RAF1 FASLG DNAJC19 PNPO ATRX HAVCR2 TNXB CFH GATA2 CD3E ATP6AP1 MLH1 STAT3 LOX RNF168 CD3G ESCO2 RAC2 ACAD9 IGH CYBB COL5A2 JAK2 TMEM127 LPIN2 SLC12A3 NTHL1 DOLK NEU1 ADA STAT3 SETBP1 CFH MYH7 MLLT10 HLA-B NUP214 SLX4 CARD9 TSC1 MPDU1 DNMT3B RECQL4 ATR A2ML1 RPS26 FHL2 MEFV ORAI1 ITCH SEMA4A IRF2BP2 ASXL1 RPL5 RPS27 SURF1 RPS24 VPS33B RPL35A RET FTCD UFD1 ASAH1 SERPINF2 UBE2T SRP54 GBA DKC1 RTEL1 TCIRG1 LAMB3 MMAB HBB KANSL1 EIF2AK3 RECQL4 RPL27 DNAJC19 TALDO1 STEAP3 RAG1 UNC13D FZD4 NDUFS2 GFI1 PHKA2 LAT MAP2K1 ABCC8 PCCB KCNN4 ERCC4 ARHGEF1 LARS2 OCRL ARPC1B CALR GATA1 WDR1 TLR3 RHAG DOLK RBPJ MRPS7 CPT2 MYLK ADAR SARS2 MTRR BMPR1A CSF3R TCN2 MLH3 HBA2 JAK2 COL4A1 TBL1XR1 EFL1 TERC BUB3 ITGB3 TRIP13 TINF2 RRAS2 F11 PRDM16 LIG4 MPO ATP7B AMMECR1 GLB1 REN FANCA ACAD8 PRKAR1A PRF1 CYP7B1 VHL EXTL3 KCNE5 RUNX1 MAN2B1 COMT PRKCD BLNK PLA2G4A MYORG FCGR2C GCLC AIP RHAG WT1 TET2 LIPA RAB27A RAG2 KIT ADA FCGR2A WAS PRKAR1A CYTB BTNL2 CSRP3 FN1 CST3 IGH PIEZO1 ACTN2 PSEN1 G6PD COL1A1 NPM1 ATP6V0A2 ZBTB16 ERCC6L2 ERCC6 COL7A1 KIT JAK2 MTOR CDKN2A LAMA3 TBX2 SH2B3 IKZF1 PLOD1 LMNA AKT1 LMBRD1 HBB SH2B3 HBG1 COPA FBN1 GALT SEC63 MYC CASR RAD51C PLOD1 PRDX1 HPS3 MUC1 CYP4F22 TGFBR2 MTR IGH ITGB4 TAZ DNMT3A PRKACG GNAQ HBG2 HIRA FLI1 GNAS NRAS BAP1 MEN1 COX1 EXTL3 MYD88 RPL11 NT5C3A PET100 RIPK1 FOXP3 ELANE TRMU AP3B1 CBL SLC39A13 PKHD1 CD4 RPL11 CHEK2 RANBP2 GLRX5 TET2 DOCK8 FGB ABHD5 F2 STK11 PEX2 PCCA TTC37 SMAD4 DAXX ABCB7 TNFRSF13C KRT14 PACS2 RPS15A GLA F5 HBA2 HSD17B10 RPL15 FGB TERT TNFRSF1B SLC30A10 CHST14 KIT PKLR TBXA2R BACH2 TRAC TMEM67 SH2D1A SLC17A5 KRAS CYP2C9 GBA GSN GSR SLC35C1 CAP2 MPL VPS13A BRD4 ITGA2B NHP2 CLCN7 SLC4A1 NDUFA12 NBN CYSLTR2 TRNH AAGAB RAG1 AGXT TGFB1 PTPN11 MAGT1 GATA2 HMCN1 IFNGR1 SMAD4 SLC7A7 DNM1L PDE4D NFKB1 LAMA3 ZNF469 FGA ND1 CBS DOCK8 SOS2 SLC19A2 LAMA4 SUFU TKFC LIPA ACAT1 STING1 CASP10 SRP54 ZEB2 TNFRSF13C RPS17 RPL18 MECOM PGK1 CCND1 KRT5 MRAS TNFSF11 PDGFRA CAT KIF15 ADA SLC20A2 XRCC4 ACAD9 GBA SLC4A1 NUMA1 PDHA1 TNFRSF11A GLA FANCL FBXL4 LARS1 F5 HRG TMPRSS6 CAPN3 ITGA2 MAN2B1 ELMO2 HLA-DRB1 LRP5 KIF1B APP TAZ TNNT2 NDUFV1 FGG HOXA11 INS TRAF7 RNASEH2A SPTB RBM20 NDUFA13 MMP1 NDUFA4 ATRX STS COG4 ABCC8 GATAD1 PRKCD RPS7 MYPN ABCA1 GP9 NHEJ1 PTEN ABCD3 TNNI3 KCNJ11 GATA2 GNB1 TNXB BCR PDX1 TSC2 PEX14 GFI1 TNFSF12 DBH COL1A2 NDUFS3 TPMT RPS28 C1GALT1C1 SLC25A21 SDHB FOXE3 NLRP3 KCNJ11 NABP1 TNFRSF4 DPM2 NAGS PLVAP HBB RPS20 RPSA HLCS ALPK1 SCN5A LYST SMO CD19 HMOX1 BMPR2 APOA1 ADAMTS13 LEP GATA1 HSPA9 ITCH ATM GBA APOE CRYAB FAM111A CEBPE KIF1B DDX41 PIGL COL7A1 NDUFB8 BAX RHAG HYOU1 AEBP1 RAC2 JAK2 TOR1A VPS13A RARA PRSS2 GINS1 ZBTB20 AKR1D1 EVC ATP11C FANCE WIPF1 TGFB1 FGG CTRC TMEM165 CAD SGPL1 LPP SALL4 KRIT1 NPHP1 FLT1 CD19 SURF1 UNC93B1 TP53 SMPD1 SMARCD2 SERPINC1 BRCA1 SPARC PSMB8 HPS4 CACNA1D ATM CDKN2B KRIT1 GATC SGCD LRP5 CLCN7 HAND2 SAMHD1 FLT3 MST1 TAZ COL5A1 SEMA3E MMACHC ALDOA PROS1 SRSF2 FGB NOP10 FOXRED1 PLG ARF1 RAF1 OPA1 COG6 CD79B BCL11B IVNS1ABP STOX1 ASAH1 CALR SMAD3 TALDO1 CITED2 ERCC2 TAF1A COL4A1 SPINK1 APC TERT TEK STEAP3 TERC ALX4 NF1 PDGFRB RPS14 SPINK5 RTEL1 TGFB2 HBB RNASEH2B TPM1 MAD2L2 PGM3 EOGT VHL PUS1 SAMD9L SLC46A1 MTFMT ICOS TEK F5 RFX5 CHST14 GLB1 DCLRE1C TLR4 NCF1 CYBC1 IL2RG B3GALT6 LMAN1 HBB OTULIN TNFRSF13B F8 TET2 MCFD2 WAS WRAP53 HBG1 ATP7A RFXAP KCNQ1 ABCC6 STIM1 ADAR WARS2 DGUOK HBB STAT4 PTEN SMAD3 GTF2H5 TERT RUNX1 FAT4 CYB5A HPRT1 PSEN2 ITGB3 UBAC2 RIN2 BIRC3 FGA CD27 BMPR1A TBXAS1 MMADHC RBM8A NLRC4 CFHR3 F10 NSMCE2 TDP2 VCL QRSL1 PIK3R1 PRKCSH ALPL CBLIF ITK PKLR TRNL1 CTC1 PRSS2 PEX5 AKT1 MYPN ACVR1 F2 FIP1L1 ALAS2 TBK1 ND5 APC NFIX ACSL4 ICOS RFXANK GP6 HLA-B EP300 NDUFS4 CTNNB1 KLKB1 HLA-DRB1 DKC1 SCN10A RPS29 GGCX LRBA ERCC4 RFT1 HBA1 F5 SEC61A1 TERC SLC25A11 GNAS CEBPA RET IFNG RTEL1 COA8 DMD SLC39A13 CD46 VPS33A KCNJ11 XIAP ITGB4 HLA-B MVK
Protein Mutations 3
C282Y H63D T315I
HP:0000819: Diabetes mellitus
Genes 567
LHX1 BLK MERTK PROK2 UBR1 MTHFR MAGEL2 UBR1 NODAL ND6 NDUFS4 RETN TRNL1 MAGEL2 TRNK POLA1 GTF2IRD1 TRNC SLC7A14 RP1 HNF1A CTRC CAVIN1 BRAF RTL1 BBS1 FGFR1 PDE6A CNGB1 LIPE ZNF408 HNF1B TRNS2 GCK HNF4A SHH CTNNB1 BMP2 HYMAI DCAF17 PTF1A TOPORS CFTR KCNJ11 OCA2 SPINK1 ENPP1 AMACR MTNR1B ND1 TCF4 RBP3 ELMO2 PRSS1 SAG MAPK8IP1 PAX4 TP53 NDN FUZ DLL1 PROKR2 RTL1 PCNT SIM1 CLIP2 ABCC8 ELN KCTD1 PIK3R1 TTC7A IRS2 IGF1R GNAS EDA2R ABCC8 PIK3R1 OFD1 PLIN1 CNBP PEX10 COX1 ELN KLF11 SLC19A2 TULP1 LMNB2 PEX6 AKT2 NDUFV2 NDUFAF5 HFE GLIS3 SNRNP200 INS FOXP3 HMGA1 LIPE TRMT10A XRCC4 NEUROD1 HESX1 PTRH2 MTHFR PDE4D NSMCE2 GLRX5 HAMP HNF1B TRNW NPAP1 PPARG SUFU RP9 IFT88 IRS1 RHO PLAGL1 BLM TDGF1 PRSS1 AKT2 PDX1 TRNW ARL3 RPGR HNF4A GPD2 LMNA PDE6B USB1 MEG3 NDUFB10 SNORD115-1 ZNF513 DNAJC21 WFS1 XRCC4 SOX3 SLC25A4 IL2RA RLBP1 NDUFA11 MKRN3-AS1 PRKAR1A NDUFS3 HJV TKT FAM161A GCK LIG4 ROM1 GJA1 TRNS1 TRNH BLM COX1 SNRPN TTC8 PDE8B AGPAT2 TREX1 TINF2 LMNA AIP DCAF17 ND2 IFIH1 BRCA1 IDH3B DNM1L PDE4D GJB4 USP8 BEST1 PWRN1 GATA6 IPW RP2 ND1 GATA6 ARNT2 SLC19A2 APPL1 ND4 PDX1 FOXRED1 TRNF STAT1 INSR IMPDH1 GATA3 SLC2A2 DHDDS EIF2S3 IL6 CNOT1 HLA-DRB1 GPR101 PPARG TRNQ GCK RPE65 ATP6 SNRPN ZBTB20 CISD2 TRNS1 INS CAT SPATA7 RAC1 NDUFB11 HNF4A PALLD RNASEH2B TRNE XRCC4 NDUFAF8 ARHGEF18 STAT1 CYTB LIPC GCK EDA HBB MMP2 OCA2 ZFYVE26 FOXP3 TRNF KLHL7 ALMS1 CP SEMA4A USH2A FGF8 SBDS HBB CERKL INS CYP19A1 APPL1 RNASEH2A TRNS2 ZFP57 GJA1 CDON TIMMDC1 FGFR1 POLR3A AGPAT2 MAGEL2 HNF4A ZFP57 ND1 FOXH1 PRPF8 IARS1 SPINK1 PAX4 HNF1A NDUFAF3 GAS1 CDHR1 NPM1 STUB1 PWAR1 CPA1 KCNJ11 EYS HNF1A IL18BP DISP1 PDX1 VANGL1 CEP19 POLG2 CARS1 CLRN1 HNF1B NDN MKRN3 KCNJ11 BSCL2 OCA2 ZIC2 SRP54 CAV1 CFTR DHX38 IFT172 PPARG FXN WRN PLIN1 INSR WRN NDUFB9 WFS1 DLK1 MMP14 LEP PTPN1 ARL2BP PRCD EIF2AK3 CIDEC ITCH PRPH2 CDH23 NEK2 ATM PTRH2 TTPA SLC29A3 NDN NKX2-5 PDE11A NDUFS8 REEP6 AGBL5 ZMPSTE24 PROM1 NDUFS6 TRNK AEBP1 PRSS2 LEPR TBL2 BBS2 COL2A1 LRP6 GCK POC1A PDX1 CTNS CORIN PNPLA2 IFT140 PPP1R15B FOXP1 RFC2 CTRC NDUFS1 LMNA PTPN22 SNORD116-1 LEPR RNASEH2C RRM2B LIMK1 BLK NOTCH3 HMGA2 TWNK CNOT1 FLT1 NEUROD1 KCNJ11 ABCA4 IDH3A CDKN2A NDUFA6 KIZ ABCC8 ATM BRCA2 ND6 NDUFS2 LMNA ND3 IMPG2 MST1 TGIF1 PAX4 WFS1 KCNJ11 FXN NOP10 KDSR MEG3 OPA1 TRNQ TUB HYMAI CISD2 DNAJC3 STOX1 IL2RA NDUFS7 NDUFA1 NUBPL BSCL2 PEX1 COX2 SPINK1 PAX4 RTEL1 INS NDUFB3 COX3 CASR SMAD4 GCK ITPR3 SNRPN HBB POLG NDP OTX2 SLC12A3 TRNE PNPLA6 APOA5 LMNA GCK STAT3 POMGNT1 PDE6G WFS1 GLI2 CLCNKB ALMS1 AHI1 LEMD3 HNF1A BBS2 GJB3 ABCC8 TP53 ITCH RP1L1 PLAGL1 LMNA PALB2 NDUFAF2 CRB1 CNGA1 DMPK PPP1R3A PNPLA2 PTCH1 WRAP53 STAT3 SAMHD1 HYMAI NDUFV1 HGSNAT HNF1B HNF4A SLC29A3 ARMC5 CCDC28B KRAS GTF2I MAGEL2 TWNK HNF1A PRPF3 VANGL2 GUCA1B TMEM126B EIF2AK3 TRNV TERT KCNJ11 PTF1A FBN1 IGF2BP2 ARL6 COX2 HFE AIP NR2E3 PCARE MAK KCNJ11 HLA-DQB1 ABCC8 NDN PLCD1 NDUFAF4 POLD1 CEL VANGL2 NSMCE2 PSTPIP1 SOX2 SIX3 ND5 TCF7L2 NEUROG3 MKKS CAV1 SMPD4 SLC16A2 PDX1 FSCN2 PRKACA CA4 MC4R TRNL1 PRKACA CTC1 ADA2 PRSS2 SNRPN RGR AHR DMXL2 PRPF4 KLF11 ADAR SARS2 MOG MEN1 HERC2 CP ND5 INSR LRAT MAFA EFL1 HNF1A TERC FOXC2 SCAPER FOS CRX DLK1 KIAA1549 MAGEL2 MLXIPL DNAJC3 PRPF31 AIRE PRPF6 PARN DKC1 NEUROD1 APOE PPARG WFS1 ABCC8 LRBA AR NRL NHP2 GPR35 BAZ1B RDH12 ERGIC1 ARL6 NDUFAF1 SLC30A8 PDX1 COX3 ABCC8 INS C8ORF37 IER3IP1 PRKAR1A KCNJ11 CEL INS TRNL1
HP:0000822: Hypertension
Genes 424
MAT2A WT1 LMNA HGD FN1 TRNL1 SERPINA6 YY1AP1 TRNK BBIP1 GTF2IRD1 TRNC KCNJ5 CLCN2 MGP TGFBR2 BBS1 CYP11B2 RET ARVCF KCNJ5 EGFR OSGEP SH2B3 TRNS2 SLC2A10 NKX2-5 LMNA RREB1 IFT172 LZTFL1 ND1 FBN1 FMO3 HLA-DPA1 GUCY1A1 APOB SCNN1G CEP164 BBS10 FUZ SDHB MUC1 REST ABCC6 TTC8 CLIP2 H19 ELN FGFR2 GATA5 PKD1 NF1 NPHP1 KCTD1 WNK4 HIRA GP1BB GNAS IRF5 EDA2R LMX1B NFU1 PLIN1 MEN1 SEC24C ELN GNAS COL3A1 NPHP1 SLC37A4 ERCC8 HLA-DPB1 NOTCH1 CFHR1 THSD1 SDCCAG8 DLST PKHD1 PPOX ACTN4 DNMT3A NOD2 SCNN1B C8ORF37 ECE1 XYLT1 ACTA2 GDNF CTLA4 PAM16 EPAS1 BBS4 ARL6 CCR6 DNAJB11 CDH23 ENPP1 WT1 DIS3L2 PKD2 MFAP5 GLA PKD2 NPHP1 TRNW NF1 IFT27 BANF1 CFI LMNA WNK1 WT1 ARHGAP31 SMARCAL1 FGFR2 STAT2 ACVRL1 CEP290 ADA2 NF1 SDHAF2 ENPP1 PRKAR1A IQCB1 PRTN3 TET2 SMAD6 XYLT2 NOD2 SDHD HPSE2 MYH11 SDHD COX1 PDE8B CAV1 C3 SMAD4 SCNN1G ELP1 USP8 EXT2 USP8 KIF1B SLC25A11 FBN1 CBS WDPCP BBS9 BRCC3 ACAT1 SPRY2 TRNF STAT1 SUGCT ELP1 SCNN1A GPR101 PPARG ZMPSTE24 MAX LRIG2 TRNS1 GJA1 ERCC8 BSCL2 CYP11B1 NPHP3 TRNE FIG4 CCND1 CD2AP KCTD1 TRAF3IP1 TRNK GBA TGFB2 CYTB HMBS GLA TRIM32 EDA SDHC TNFRSF11A LDLRAP1 MMP2 XPNPEP3 PKD1 KIF1B ABCC6 TRIM28 SDHB SDCCAG8 ALMS1 MAFB FN1 PTPN22 ACP5 ERCC4 LEMD3 CYP11B1 BBS7 SDHB LDLR SCNN1A NPHP4 KRT18 HSD11B2 CDKN1B CCN2 CUL3 GANAB PDE3A VANGL1 TSC2 ACTA2 PCSK9 CEP19 CFB SMAD4 MTTP COL4A5 LYZ FOXE3 IDS PRKG1 SLC37A4 PHF21A GUCY1A1 B2M RET INVS KCNJ5 PPARG WRN PLIN1 BMPR2 CDKN2C MMP14 VHL POU6F2 ELN COL4A3 CPOX ABCB6 CDH23 LMX1B THBD KIF1B SLC2A10 PDE11A JMJD1C CYP17A1 TRNK TBX1 IL12B COQ7 TBL2 TBX1 WDR19 LRP6 FMR1 SDHD CORIN RFC2 CACNA1H CYP11B1 MKKS ADA2 LIMK1 NOTCH3 MKS1 FLT1 BBS1 CACNA1D YY1AP1 CDKN2B ND6 LMNA MLX VAC14 PKHD1 TRIP13 PDE11A MEF2A IDS TRIM28 NDUFAF6 NOS3 TRNQ SDHB SDHC STOX1 SMAD3 ALX4 APRT LOX OFD1 IDUA TMEM127 COL3A1 AIP FBN1 LMNA CFH WT1 VHL NR3C1 CYP17A1 TSC1 ALMS1 SMAD4 POU3F4 FGA HMBS TP53 HBB ARMC5 BRCA2 SDHA CACNA1D ABCG5 RET UFD1 TREX1 NOTCH2 ABCC6 G6PC1 ARMC5 SCNN1B CCDC28B GTF2I JAK2 KLHL3 BBS5 MYH7 ERCC6 APOA1 TRNV TMEM127 TGFBR1 GNAS FBN1 ARL6 GCH1 COX2 MDH2 NFIX OFD1 AIP COL4A3 WDR35 ENG MAX CFHR3 TMEM70 NSMCE2 LARS2 LEMD3 ND5 CYP21A2 NR3C1 DZIP1L BNC2 VHL BICC1 ERCC6 PRKACA MC4R PRKACA ADA2 CYP11B1 INF2 HLA-DRB1 MYLK TGFB3 MTRR MYMK POR COL4A4 JAK2 SDHD SCN2B CEP290 ITGA8 FH DYRK1B TRPC6 HLA-B PRKAR1A MLXIPL BBS12 MDM2 MPL TMEM237 VHL BBS2 PDE3A NR3C2 KRT8 GPC3 PRKAR1A BAZ1B ERCC4 VHL TGFBR3 CDKN1A COMT WT1 SLC25A11 RET COX3 AIP ABCG8 HSD11B2 GANAB TMEM67 CD46 ADAMTSL4 TNFRSF11B ANGPTL6 INVS TRNL1
HP:0002721: Immunodeficiency
Genes 269
CHD7 ACP5 JAK3 TNFRSF4 NFE2L2 NFKB2 SRP54 MS4A1 LCK STAT1 EPG5 PRPS1 CUL4B CD19 MEIS2 CCDC47 GATA1 CD3E CTPS1 POLE ARVCF CDH23 ATM IRAK4 PRKDC RREB1 RAG2 RAG2 SLC46A1 PGM3 FOXN1 IL2RG LMNB2 CTBP1 JMJD1C PIK3CD CREBBP HYOU1 FCGR3A TBX1 PNP SPATA5 UNG TNFSF12 TERT PTEN MALT1 TBX1 CD81 UNC119 WIPF1 TNFRSF1B PARN NSD2 TTC7A HIRA SPATA5 GP1BB GATA2 ZBTB24 IRF7 CD19 CD81 UNC93B1 EP300 TNFRSF13B SEC24C IL2RB TRAF3 CRKL DCLRE1C CDC42 IL7R DCTN4 CLCA4 ATRX SIK3 IGLL1 SEC23B CHD1 AK2 XRCC4 TCF3 IGHM CD79A PIK3R1 NOP10 MS4A1 CD79B BCL11B BUB1B AGL IVNS1ABP TTC37 PTPRC FOXN1 TNFRSF13C KNSTRN TYK2 TINF2 BCL10 RAG1 RNF168 RTEL1 CYBA IL7R USB1 CD3G PKP1 RAC2 USF3 CR2 CARD11 LAMTOR2 CYBB POLE ICOS DNAJC21 SH2D1A DNMT3B IL21 ADA CPLX1 IL2RA PIK3CA PGM3 LYST CD3D CDCA7 PIK3R1 ICOS FRAS1 LIG4 CARD9 SDHC DCLRE1C DNMT3B NCF1 RAG1 ORAI1 ACD SKIV2L IL2RG ZBTB24 TINF2 MAGT1 CD40 IKBKG TNFRSF13B WAS CR2 TFRC NFKB1 FGFRL1 USP8 CD247 RMRP WRAP53 UFD1 IKBKG AP3D1 DKC1 IL12RB1 IL12B RTEL1 SHANK3 ISG15 STAT1 MBTPS2 IRF8 RMRP TNFRSF13C NFKB1 SMARCAL1 IRF8 TERT MYC RAG1 BTK RNF168 SP110 NFKB2 PIK3CD IKBKB RBCK1 LAT ADA HELLS XRCC4 DOCK2 CDC42 TICAM1 MTHFD1 SKIV2L RAG2 STAT1 ANTXR2 IRAK4 CD40LG IFNGR1 AICDA DKC1 SDHB IKZF1 RAB27A CD28 CREBBP MYD88 TLR3 CTC1 ADA2 NCF2 STIM1 LYST IRF2BP2 AKT1 CTLA4 LETM1 STX1A TNFRSF13C TBK1 CORO1A CFTR SBDS WHCR ICOS EFL1 TERC XIAP TTC7A RAG1 UROS LIG4 PARN AK2 BCR DKC1 SDHD LRRC8A KLLN HBB LRBA TGFB1 MAN2B1 NHP2 NHEJ1 NPM1 EXTL3 EPG5 MAN2B1 COMT PRKCD BLNK CR2 TBCE IL2RG CTLA4 RTEL1 MMUT LAMTOR2 TNFSF12 IFNGR2 MAPK1 IL21R ACTB CHD1 CD19 STK4 XIAP
SNP 0