NCT06370962 Circadian Rhythm Disorders in Children With Cystic Fibrosis Under CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) Modulators
| NCT ID | NCT06370962 |
| Status | Recruiting |
| Phase | — |
| Sponsor | Hospices Civils de Lyon |
| Condition | Cystic Fibrosis |
| Study Type | OBSERVATIONAL |
| Enrollment | 180 participants |
| Start Date | 2024-04-29 |
| Primary Completion | 2025-10-29 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
This is an observational study. You will not receive an experimental treatment; researchers will collect data based on your existing condition or standard treatment.
This trial targets 180 participants in total. It began in 2024-04-29 with a primary completion date of 2025-10-29.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
Cystic fibrosis (CF) is a rare disease affecting one out of 4,500 newborns in France (INSERM 2021). Despite major advances in patient care over the past two decades, with significant improvements in life expectancy, cystic fibrosis remains a pathology that considerably impairs quality of life. Several studies have reported the possibility of respiratory and non-respiratory sleep disorders (SD) in patients with CF. Respiratory disorders are reported to affect 30% of children with CF (Barbosa 2020). Among non-respiratory SD, sleep onset and maintenance insomnia are well known in these patients, while chronotype abnormalities (circadian rhythm disorders) are understudied. Chronotype refers to a person's tendency to be more efficient in the morning or evening. The existence of chronotype abnormalities has been suggested in CF patients, but no precise data are available (Louis 2022). The involvement of CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) protein dysfunction in the central nervous system (CNS) has been hypothesized as a contributory factor. In vivo, in a mouse model of CF, dysregulation of clock genes such as Clock, Cry2 and Per2 was found in the CNS (Barbato 2019). Among them, certain genes such as Rev-erbα could regulate endobronchial inflammation and contribute to the severity of respiratory pathology. All in all, chronotype abnormalities could be at the origin of sleep debt, impaired cognitive functions or metabolic disturbances. In the era of highly effective modulator therapy (HEMT) for the treatment of CF, the impact of these new therapies on chronotype has been understudied. Assuming that chronotype abnormalities are a direct consequence of CFTR protein dysfunction in the retina and anterior hypothalamus, HEMT should improve sleep quality. However, between 20% and 30% of adult and pediatric patients express an increase in chronotype abnormalities following initiation of treatment. Paradoxically, the perceived gain in respiratory quality of life is counterbalanced by the occurrence of these disorders. Some patients would effectively reverse their treatment in order to limit the phenomenon. A single polysomnographic study evaluated the effect of HEMT Kaftrio-Kalydeco on sleep in adults with CF (Welsner 2022). After 3 months of treatment, patients had a significant reduction in respiratory events, with no change in total sleep time, sleep efficiency or sleep architecture. Chronotype was not mentioned. Currently, no studies on chronotype in children or adults with CF have been carried out. Our hypothesis is that CF patients treated with HEMT would develop an abnormal chronotype of late sleep onset. The aim of this study is to evaluate the chronotype of children with CF treated with HEMT. Chronotype abnormalities could have major consequences for quality of life, the immune system, cognitive functions and metabolism. Systematic detection of these disorders via anamnesis, followed by diagnosis by questionnaire, actimetrics and/or urinary melatonin dosage, would enable their early management, starting with the reversal of Kaftrio-Kalydeco intake between morning and evening.
Eligibility Criteria
Inclusion Criteria: * Patients with cystic fibrosis * Aged from 2 to 17 years and 11 months * Treated with CFTR modulator Kaftrio-Kalydeco from at least 2 months * Followed in Lyon, Paris-Trousseau or Nancy Cystic Fibrosis Resource and Skill Centres * Non-opposition from both parents Exclusion Criteria: * Parental refusal * Parents unable to comply with protocol requirements at investigator's discretion * Subject participating in interventional research with an exclusion period still in progress at the time of inclusion
Contact & Investigator
Laurianne COUTIER, MD
PRINCIPAL INVESTIGATOR
Service de pneumologie, allergologie, mucoviscidose, Hôpital Femme Mère Enfant, HCL
Frequently Asked Questions
Who can join the NCT06370962 clinical trial?
This trial is open to participants of all sexes, aged 2 Years or older, up to 17 Years, studying Cystic Fibrosis. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
Is NCT06370962 currently recruiting?
Yes, NCT06370962 is actively recruiting participants. Contact the research team at laurianne.coutie@chu-lyon.fr for enrollment information.
Where is the NCT06370962 trial being conducted?
This trial is being conducted at Bron, France, Nancy, France, Paris, France.
Who is sponsoring the NCT06370962 clinical trial?
NCT06370962 is sponsored by Hospices Civils de Lyon. The principal investigator is Laurianne COUTIER, MD at Service de pneumologie, allergologie, mucoviscidose, Hôpital Femme Mère Enfant, HCL. The trial plans to enroll 180 participants.