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Special Reports |

Formation and Current Results of a Patient-Organized Registry for α1-Antitrypsin Deficiency*

James K. Stoller, MD, FCCP; Mark Brantly, MD; Lora E. Fleming, MD, PhD, MPH, MSc; Judy A. Bean, PhD; John Walsh for the Alpha One Foundation Research Network Registry Investigators
Author and Funding Information

A complete list of investigators is located in the Appendix.

Correspondence to: James K. Stoller, MD, FCCP, Department of Pulmonary and Critical Care Medicine, A 90, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195; e-mail: stollej@ccf.org



Chest. 2000;118(3):843-848. doi:10.1378/chest.118.3.843
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Background: Significant challenges exist to investigating uncommon illnesses because too few patients are seen at any single clinical center to permit appropriate research studies. Recognizing this impediment to clinical research inα 1-antitrypsin deficiency, the Alpha One Foundation, a patient-organized research foundation, has collaborated with clinician-scientists to organize a voluntary registry of individuals with α1-antitrypsin deficiency.

Purpose: To facilitate clinical research in α1-antitrypsin deficiency by organizing a registry of affected individuals willing to be approached to participate in clinical studies.

Methods: Elements of the Alpha One Foundation Research Network Registry include a Medical and Scientific Advisory Committee, composed of physician-investigators and patient advocates, designated clinical resource centers at medical institutions with expertise in the management of individuals with α1-antitrypsin deficiency, and a data coordinating center with responsibility for database management and analysis. Questionnaires requesting information about demographic features, α1-antitrypsin phenotype, smoking history, and health-care utilization were distributed to prospective registrants through the following channels: mailings from the Alpha One Foundation; mailings from the clinical resource centers; and distribution by home-care and pharmaceutical companies. Information from this questionnaire formed the basis of the initial registry database.

Results: Between May 1997 and June 1999, 7,789 forms were distributed, and forms were returned by 712 unique registrants. Registrants have the following characteristics: mean (± SD) age, 49.3 ± 13.2 years; women, 47.7%; white, 96.2%; PI*ZZ phenotype, 70.7%; ex-smokers, 73.3%; COPD patients, 87.2% (emphysema patients, 54.2%; chronic bronchitis patients, 33%); and self-reported liver disease, 6.4%. The mean number of physician visits reported by registrants in the preceding 12 months was 7.8 ± 9.4, 59% reported currently receiving IV augmentation therapy, and 35% reported using supplemental oxygen at home. Examples of ongoing research studies using this unique database include: (1) a case-control study to evaluate occupational risk factors for obstructive lung disease in individuals with α1-antitrypsin deficiency and (2) a study to evaluate the health-care costs for affected individuals.

Conclusions: A registry currently including 712 individuals with α1-antitrypsin deficiency has been organized through a collaboration between physician-investigators and a patient-organized research foundation. Use of the registry has already facilitated studies that were previously difficult because of the paucity of identifiable study subjects. The registry cohort promises to provide an important resource for future clinical and epidemiologic studies.


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