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NCT Number: NCT05629130

Embolization in Hereditary Coagulopathies

This is a longitudinal, prospective study, which will include 30 subjects with hereditary coagulopathies, with arthropathy, chronic synovitis resulting from hemarthrosis of the elbows, knees and/or ankles followed up at the Centro de Hemofilia HCFMUSP, after approval by the ethics and research committee.

They will undergo imaging tests (X-rays and Magnetic Resonance of knee, elbow, or ankle), physical, pain, quality of life and functional assessments (Hemophilia Joint Health Score, Functional Independence Score in Hemophilia, Perimeter, Test Timed up and Go, 30 second sit and stand test, Haemophilia - Adult - Quality of Life questionnaire (HAEM-A-QoL), Knee Injury and Osteoarthritis Outcome Score, EQ-5D, numerical rating scale for pain and embolization procedure (superselective embolization of target arteries with spherical microparticles Embosphere 100-300 micrometers (Biosphere Medical, Roissy, France), until partial vascular stasis and decharacterization of pathological synovial enhancement.

These evaluations will be performed at baseline, 1, 3, 6, 12, 24, 36, 48 and 60 months after the procedure.

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

São Paulo, 05403-010, Brazil

Location status: Recruiting

Location contact

Fabiane P Farias, PT

CONTACT

[email protected]

55112661-2473

Marcia U Rezende, MD, PhD

CONTACT

[email protected]

551130625531

Marcia U Rezende, MD, PhD

PRINCIPAL_INVESTIGATOR

About this study

Longitudinal, prospective study, which will include 30 subjects with hereditary coagulopathies, with arthropathy, chronic synovitis resulting from hemarthrosis of the elbows, knees and/or ankles followed up at the Centro de Hemophilia do Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, i.e. HC-FMUSP), after approval by the ethics and research committee and registry at the clinical trials.

Patients will be evaluated by imaging (X-rays and Magnetic Resonance of the affected joint, i.e., knee, elbow, and/or ankle); physical and functional assessments (Hemophilia Joint Health Score, Functional Independence Score in Hemophilia, Perimeter of the affected joint(s), Test Timed up and Go, 30 second sit and stand test, Knee Injury and Osteoarthritis Outcome Score (KOOS); quality of life (Haemophilia - adult - quality of life questionnaires (HAEM-A-QoL), Knee Injury and Osteoarthritis Outcome Score (KOOS), EQ-5D; pain measured by numerical rating scale.

Volunteers will be submitted to embolization procedure (superselective embolization of target arteries with spherical microparticles embosphere 100-300 micrometers (Biosphere Medical, Roissy, France) of the affected joint(s), until partial vascular stasis and decharacterization of pathological synovial enhancement.

These evaluations will be performed at baseline, 1, 3, 6, 12, 24, 36, 48 and 60 months after the procedure.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients with hereditary coagulopathies with arthropathy (i.e., chronic synovitis due to hemarthrosis), with X-ray and MRI (documenting synovitis) followed up at the Hemophilia Center HC-FMUSP.

Exclusion criteria

  • Patients who do not complete the planned assessments
  • Patients who do not accept to continue with the study.

Treatment and study plan

embolization with spherical microparticles embosphere

Device

embolization of affected joints with spherical microparticles embosphere

Primary outcomes

  1. Reduction of synovium thickness by embolization

    Time frame: 6 months

    Measure (in milimeters) changes of synovial thickness in patients with hereditary coagulopathies with arthropathy due to hemarthrosis with MRI (measure synovium thickness)

Secondary outcomes

  1. Reduction of synovitis by embolization

    Time frame: 1, 3 12, 24, 36, 48 and 60 months

    Measure (in milimeters) changes on synovial thickness in patients with hereditary coagulopathies with arthropathy due to hemarthrosis with MRI

  2. Inferior limb strength

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure changes in muscle strength by timed up and go (by time of performance, in seconds).

  3. Inferior limb strength

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure changes in muscle strength of lower limbs by 30 seconds sit to stand test (by number of repetitions)

  4. Balance and fall risk

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure (in seconds, period of time to perform the test) changes in balance and risk of falls by Timed up and go test.

  5. Quality of life of the patient

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure, according to the scale of the questionnaire, changes in quality of life with Haemophilia - Adult - Quality of life Questionnaires (HAEM-A-QoL, 10 dimensions, 0 to 100, being 0 the best health related quality of life)

  6. Quality of life of the patient

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure, according to the scale of the questionnaire, changes in quality of life with Knee Injury and Osteoarthritis Outcome Score (KOOS, 0-100, 100 being the best quality of life).

  7. Quality of life of the patient

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure, according to the scale of the questionnaire, changes in quality of life with by EQ-5D, up to 1, being 1 the best quality of life). Please note: "Since 2009, EQ-5D has been available in three versions: the three-level EQ-5D-3L; the five-level EQ-5D-5L; and a 'youth' adaptation, EQ-5D-Y. Although the EQ is in recognition of the EuroQol group name, the D refers to dimensions, the L signifies level, and the Y stands for youth, the name of the instrument should not be spelled out in this manner as this is inaccurate. Therefore, EQ-5D is not an abbreviation and is the correct term to use when referring to the instrument in general." Brooks R, Boye KS, Slaap B. EQ-5D: a plea for accurate nomenclature. J Patient Rep Outcomes. 2020 Jul 3;4(1):52. doi: 10.1186/s41687-020-00222-9. PMID: 32620995; PMCID: PMC7334333.

  8. Functional capacity

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure (according to the scale of the questionnaire) changes in functional capacity with Functional Independence Score in Hemophilia (FISH score, 0 to 32, 32 being the best result)

  9. Functional capacity

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure (according to the scale of the questionnaire) changes in functional capacity with Functional Independence Score by Knee Injury and Osteoarthritis Outcome Score (KOOS, 0-100, 100 being the best result)

  10. Physical capacity

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure changes in physical capacity by Hemophilia Joint Health Score (HJHS), 0 to 124, 0 being the best result.

  11. Pain of the affected joint

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure changes in pain by Hemophilia Joint Health Score (HJHS, 0-12, 0 being the best result)

  12. Pain of the affected joint

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure changes in pain by numerical rating scale (NRS, 0-10, 0 being no pain and 10 being the worst pain possible)

  13. Pain of the affected joint

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure changes in pain by Knee Injury and Osteoarthritis Outcome Score (KOOS, 0 to 100, 100 being the best result)

  14. Stifness

    Time frame: 1, 3, 6, 12, 24, 36, 48, 60 months

    Measure (0 to 100, 100 being the best result) changes in knee stiffness by Knee Injury and Osteoarthritis Outcome Score (KOOS)

Study contacts

Contact information is provided by the study sponsor or research team.

Fabiane E Farias, PT

CONTACT

[email protected]

+ 5511 3062-5531

marcia u rezende, MD PhD

CONTACT

[email protected]

+5511 981226282

Sponsors and collaborators

Lead sponsor

University of Sao Paulo General Hospital

Other

Collaborators

  • Merit Medical Systems, Inc.

Registry information

Acronym: EHCO

Important dates

Study start
2023
Primary completion
2028
Study completion
2029
First posted
Nov 29, 2022
Registry last updated
Nov 29, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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