Percorrer por autor "Freiberger, T."
A mostrar 1 - 7 de 7
Resultados por página
Opções de ordenação
- Case-level data sharing makes a difference in variant classificationPublication . Chora, J.R.; Tichý, L.; Lacocca, M.A.; Freiberger, T.; Bourbon, M.The American College of Medical Genetics and Genomics guidelines for variant classification are composed of several evidence criteria that, when combined, lead to a 5-tier pathogenicity variant classification. Several criteria rely on case-level data from patients, relatives, or controls with or without a particular variant of interest. (...)
- Familial hypercholesterolaemia: a global call to armsPublication . Vallejo-Vaz, A.J.; Kondapally Seshasai, S.R.; Cole, D.; Hovingh, G.K.; Kastelein, J.J.; Mata, P.; Raal, F.J.; Santos, R.D.; Soran, H.; Watts, G.F.; Abifadel, M.; Aguilar-Salinas, C.A.; Akram, A.; Alnouri, F.; Alonso, R.; Al-Rasadi, K.; Banach, M.; Bogsrud, M.P.; Bourbon, M.; Bruckert, E.; Car, J.; Corral, P.; Descamps, O.; Dieplinger, H.; Durst, R.; Freiberger, T.; Gaspar, I.M.; Genest, J.; Harada-Shiba, M.; Jiang, L.; Kayikcioglu, M.; Lam, C.S.; Latkovskis, G.; Laufs, U.; Liberopoulos, E.; Nilsson, L.; Nordestgaard, B.G.; O'Donoghue, J.M.; Sahebkar, A.; Schunkert, H.; Shehab, A.; Stoll, M.; Su, TC; Susekov, A.; Widén, E.; Catapano, A.L.; Ray, K.K.Familial Hypercholesterolaemia (FH) is the commonest autosomal co-dominantly inherited condition affecting man. It is caused by mutation in one of three genes, encoding the low-density lipoprotein (LDL) receptor, or the gene for apolipoprotein B (which is the major protein component of the LDL particle), or in the gene coding for PCSK9 (which is involved in the degradation of the LDLreceptor during its cellular recycling). These mutations result in impaired LDL metabolism, leading to life-long elevations in LDLcholesterol (LDL-C) and development of premature atherosclerotic cardiovascular disease (ASCVD) [1e3]. If left untreated, the relative risk of premature coronary artery disease is significantly higher in heterozygous patients than unaffected individuals, with most untreated homozygotes developing ASCVD before the age of 20 and generally not surviving past 30 years [2e5]. Although early detection and treatment with statins and other LDL-C lowering therapies can improve survival, FH remains widely underdiagnosed and undertreated, thereby representing a major global public health challenge.
- A Global Survey Of Genetic Testing Methods For Familial Hypercholesterolemia. A Study From The EAS FHSC RegistryPublication . Karungi, Irene, On behalf of the EAS FHSC Investigators; Chora, Joana Rita; Elshorbagy, A.; Stevens, C.A.T.; Vallejo-Vaz, A. J.; Ray, K. K.; Raal, F. J.; Humphries, S. E.; Freiberger, T.; Bourbon, M.Contexto: A hipercolesterolemia familiar (HF) é causada principalmente por variantes patogénicas nos genes LDLR, APOB ou PCSK9, levando a um LDL-C elevado ao longo da vida e a um aumento do risco de doenças cardiovasculares. Os testes genéticos oferecem um diagnóstico definitivo da HF, no entanto, falta uma abordagem padronizada para os métodos de teste genético da FH a nível global. Métodos: Foi enviado um inquérito estruturado a investigadores nacionais de 68 países ativos no registo da Colaboração de Estudos EAS-FH. Os domínios do inquérito incluíram critérios para encaminhamento para testes genéticos, técnicas de teste, triagem genética e interpretação da patogenicidade variante. Os dados foram analisados descritivamente, e foram feitas comparações entre casos índice e não-índice e países de rendimento elevado versus não elevado. Resultados: Dos 68 países convidados, 55 (81%) responderam. Entre os países com critérios clínicos estabelecidos para adultos (85%) e crianças (76%), a rede holandesa de clínicas de lípidos foi o critério mais utilizado para o encaminhamento de adultos e crianças (72% e 57%, respetivamente) para testes genéticos. Os critérios de Simon-Broome e MedPed foram usados com menor frequência, reportados apenas por países de rendimento elevado para adultos (7% e 2%, respetivamente) e crianças (12% e 2%, respetivamente). Para testes de casos índice, a maioria dos países utilizou painel génico de sequenciação de próxima geração (NGS) (62%), enquanto para casos não indexados, a maioria baseou-se em variantes específicas por sequenciação Sanger (71%). Este padrão era semelhante tanto em países de rendimento elevado como não elevado; no entanto, alguns países usaram a mesma abordagem de teste tanto para casos índice como não indexados (Figura). As variantes de número de cópia (CNVs) foram avaliadas em 65% dos países, dos quais 86% incorporaram análise CNV em plataformas NGS, enquanto 14% utilizaram amplificação de sonda dependente de ligação multiplex (MLPA) e testes de microarray. Todos os países testados para LDLR, 97% para APOB, e 95% para PCSK9. Em 96% dos países, os relatórios de testes incluíram interpretação de patogenicidade variante (com a maioria a seguir as diretrizes do American College of Medical Genetics and Genomics). Conclusões: A variabilidade generalizada nas práticas de testes genéticos destaca a necessidade crítica de padronização para garantir um diagnóstico de FH eficaz, consistente e comparável a nível global.
- Pooling and expanding registries of familial hypercholesterolaemia to assess gaps in care and improve disease management and outcomes: Rationale and design of the global EAS Familial Hypercholesterolaemia Studies CollaborationPublication . EAS Familial Hypercholesterolaemia Studies Collaboration; Vallejo-Vaz, A.J.; Akram, A.; Kondapally Seshasai, S.R.; Cole, D.; Watts, G.F.; Hovingh, G.K.; Kastelein, J.J.; Mata, P.; Raal, F.J.; Santos, R.D.; Soran, H.; Freiberger, T.; Abifadel, M.; Aguilar-Salinas, C.A.; Alnouri, F.; Alonso, R.; Al-Rasadi, K.; Banach, M.; Bogsrud, M.P.; Bourbon, M.; Bruckert, E.; Car, J.; Ceska, R.; Corral, P.; Descamps, O.; Dieplinger, H.; Do, C.T.; Durst, R.; Ezhov, M.V.; Fras, Z.; Gaita, D.; Gaspar, I.M.; Genest, J.; Harada-Shiba, M.; Jiang, L.; Kayikcioglu, M.; Lam, C.S.; Latkovskis, G.; Laufs, U.; Liberopoulos, E.; Lin, J.; Lin, N.; Maher, V.; Majano, N.; Marais, A.D.; März, W.; Mirrakhimov, E.; Miserez, A.R.; Mitchenko, O.; Nawawi, H.; Nilsson, L.; Nordestgaard, B.G.; Paragh, G.; Petrulioniene, Z.; Pojskic, B.; Reiner, Ž.; Sahebkar, A.; Santos, L.E.; Schunkert, H.; Shehab, A.; Slimane, M.N.; Stoll, M.; Su, T.C.; Susekov, A.; Tilney, M.; Tomlinson, B.; Tselepis, A.D.; Vohnout, B.; Widén, E.; Yamashita, S.; Catapano, A.L.; Ray, K.K.BACKGROUND: The potential for global collaborations to better inform public health policy regarding major non-communicable diseases has been successfully demonstrated by several large-scale international consortia. However, the true public health impact of familial hypercholesterolaemia (FH), a common genetic disorder associated with premature cardiovascular disease, is yet to be reliably ascertained using similar approaches. The European Atherosclerosis Society FH Studies Collaboration (EAS FHSC) is a new initiative of international stakeholders which will help establish a global FH registry to generate large-scale, robust data on the burden of FH worldwide. METHODS: The EAS FHSC will maximise the potential exploitation of currently available and future FH data (retrospective and prospective) by bringing together regional/national/international data sources with access to individuals with a clinical and/or genetic diagnosis of heterozygous or homozygous FH. A novel bespoke electronic platform and FH Data Warehouse will be developed to allow secure data sharing, validation, cleaning, pooling, harmonisation and analysis irrespective of the source or format. Standard statistical procedures will allow us to investigate cross-sectional associations, patterns of real-world practice, trends over time, and analyse risk and outcomes (e.g. cardiovascular outcomes, all-cause death), accounting for potential confounders and subgroup effects. CONCLUSIONS: The EAS FHSC represents an excellent opportunity to integrate individual efforts across the world to tackle the global burden of FH. The information garnered from the registry will help reduce gaps in knowledge, inform best practices, assist in clinical trials design, support clinical guidelines and policies development, and ultimately improve the care of FH patients.
- Recommendations for LDLR variant interpretation by the ClinGen’s Familial Hypercholesterolemia Expert PanelPublication . Chora, J.R.; Iacocca, M.; Tichy, L.; Wand, H.; Kurtz, L.C.; Zimmermann, H.; Meredith, A.L.; Williams, M.; Humphries, S.E.; Hooper, A.J.; Brunham, L.; Pereira, A.C.; Chen, M.; Wang, J.; Trinder, M.; Jannes, C.E.; Chonis, J.; Kim, S.; Pesaran, T.; Johnston, T.; Carrie, A.; Leigh, S.; Hegele, R.A.; Sijbrands, E.; Freiberger, T.; Knowles, J.W.; Bourbon, M.Familial Hypercholesterolemia (FH): - Lipid metabolism autosomal dominant condition; - Elevated low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) values since childhood → increased risk of atherosclerotic cardiovascular disease; - High heterozygote prevalence (1/250-1/500); Homozygous rare (1/ 300 000- 1/ 1 000 000); - Caused by pathogenic variants in LDLR (>90%), APOB (5- 10%) and PCSK9 (1-3%) genes; -Marked increase in FH variants submitted to ClinVar; -45% of variants were classified with more than one method and 466 variants submitted with potential clinical significance had conflicting or no classifications.
- Specification of ACMG/AMP guidelines for standardized variant interpretation in familial hypercholesterolemia: On behalf of the ClinGen FH Variant Curation Expert PanelPublication . Iacocca, M.A.; Chora, J.R.; Freiberger, T.; Carrie, A.; Sijbrands, E.J.; Wand, H.; Williams, M.; Kurtz, C.L.; Tichy, L.; Alves, A.C.; Zimmermann, H.; Meredith, A.; Wang, J.; Cuchel, M.; Hooper, A.J.; Humphries, S.E.; Defesche, J.C.; Santos, R.D.; Kullo, I.J.; Brunham, L.R.; Hegele, R.A.; Knowles, J.W.; Bourbon, M.Familial Hypercholesterolemia (FH): Lipid metabolism autosomal dominant condition; Patients present elevated low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) values since childhood → increased risk of atherosclerotic cardiovascular disease; High heterozygote prevalence (1/250); Homozygous rare (1/1 000 000); Caused by pathogenic variants in LDLR (>90%), APOB (5-10%) and PCSK9 (1-3%) genes.
- To Correct or not to Correct (for treatment): Estimating Pre-treatment LDL-C Concentrations in Genetically Characterized Patients with Familial Hypercholesterolaemia on Lipid-lowering MedicationPublication . Stevens, C.A.T.; Elshorbagy, A.; Vallejo-Vaz, A.J.; Dharmayat, K.; Lyons, A.; Bourbon, M.; Chora, J.; Humphries, S.E.; Catapano, A.L.; Hovingh, G.; Mata, P.; Santos, R.; Soran, H.; Watts, G.F.; Raal, F.; Freiberger, T.; Ray, K.K.; on behalf of all the EAS FHSC CollaboratorsBackground and Aims: Pretreatment LDL-C measurements aid familial hypercholesterolaemia (FH) diagnosis, and are crucial in epidemiologic studies investigating FH, but are often unavailable because individuals are already on lipid-lowering medication (LLM). Several formulae have been reported to estimate pre-treatment LDL-C in people on LLM by ‘correcting’ their LDL-C concentrations for LLM type and dosage, based on observational or trial evidence of drug efficacy. We compared 4 published correction factors in estimating pre-treatment LDL-C in patients with FH. Methods: Cross-sectional analysis of adults with pathogenic/likely-pathogenic FH variants in the EAS-FH Studies Collaboration (FHSC) Registry. At the time of LDL-C measurement, N=3012 participants were not on LLM (Untreated group), and N=3226 were on LLM monotherapy, with information on LLM type and dosage allowing estimation of pre-treatment LDL-C (Corrected group) based on correction factors by Ruel 2018, Ellis 2016, Haralambos 2015 and Besseling 2014. We compared the groups for clinical characteristics and LDL-C by gene and variant. Results: The Corrected group was older than the Untreated group (median[IQR]: 50[39,63] vs. 38[28,50]y), with similar proportion of women (54.5% vs. 56.8%;p=0.14) but more comorbidities (all p<0.001). In the Corrected group, 3120 were on statins, 106 on ezetimibe, none on PCSK9-inhibitors. The Corrected group had higher LDL-C vs. Untreated group, with the difference greater at upper percentiles, regardless of correction factor. LDL-C was highest in those with LDLR>APOB>PCSK9 gene variants, but Corrected was still higher than Untreated LDL-C within each gene group. The difference in Corrected vs. Untreated LDL-C varied by variant, from +0.6 to +3.5mmol/L (20 commonest variants). The LDL-C differences persisted after adjusting for age, sex and comorbidities. Conclusions: Application of current LDL-C correction factors appears to overestimate pre-treatment LDL-C in epidemiologic settings, or the Untreated and Corrected groups might have inherently different LDL-C profiles. The accuracy of using LDL-C correction factors in FH therefore warrants further investigation.