EValuation Of poLygenic Scores and CT imAging In Risk Factor Modification in Patients With diabEtes

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age40+
SponsorMonash University

About this trial

This study is a three-arm, parallel-group, randomised controlled trial evaluating the effect of using cardiac CT imaging or polygenic risk score in cardiovascular risk factor modification in patients with diabetes.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age 40 years or older

Established diagnosis of T2DM

Having acceptable imaging quality as deemed by the VHI-AICL

Able to have a PRS calculated

Disqualifiers

Unable to provide written informed consent.

Unwilling to be followed for serial evaluation

Clinically manifest CV disease

Evidence of clinically significant coronary disease on CT that would preclude masking from participant's treating clinician for the duration of the study on the grounds of safety, including but not limited to, equal/greater than 50% in the left main coronary artery or equal/greater than 70% in any epicardial coronary artery

Trial design

Design model

Parallel

Treatments tested in this trial

  • CTCA results

    Other intervention

    Participants who are assigned to CTCA group will receive their CTCA results

  • PRS results

    Other intervention

    Participants who are assigned to PRS group will receive their PRS results

Treatment groups

90 Participants
are divided into 3 treatment groups
Group A: 1. CTCA groupActive comparator 1 intervention
Group B: 2. PRS groupActive comparator 1 intervention
Group C: 3. Control groupNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Change in non-calcified plaque volume, with Bonferroni correction at 12 months

Time frame
From baseline CT to the end of study at 12 months

Secondary outcomes

1

Number of Participants achieving LDL-C <1.8 mmol/L

Time frame
12 months
2

Number of Participants who undergo intensification of lipid-lowering therapy

Intensification of lipid-lowering therapy at 12 months will be defined as the occurrence of any of the following: * an increase in the intensity of statin prescribed, * addition of ezetimibe, or * addition of a PCSK9 inhibitor (PCSK9i). This outcome will be assessed based on medication records at the 12-month follow-up.

Time frame
12 months
3

Number of participants reporting high levels of adherence to their prescribed medications

Medication adherence will be assessed using a participant-reported item from a modified VOILS questionnaire at the 12-month follow-up. Participants are asked: "In the last week, I took my tablet(s):" with response options: * Every day * Almost every day * Less than half * Rarely or not at all Adherence will be defined as selecting "Every day", and the number of participants meeting this criterion will be reported.

Time frame
12 months
4

Change in level of patient activation and engagement in their care, measured by PAM-13 questionnaire

Patient activation and engagement in care will be assessed using the 13-item Patient Activation Measure (PAM-13) at baseline and 12 months. Each item is scored on a 4-point Likert scale (Disagree Strongly to Agree Strongly), with responses converted into a continuous score ranging from 0 to 100. Higher scores indicate greater activation, reflecting better self-management and engagement in health care.

Time frame
12 months

Other outcomes

1

Participant-reported appropriateness of the CTCA intervention

Appropriateness will be assessed using a custom participant survey and focus group interviews. Participants will rate whether they found the CTCA intervention relevant and suitable for their personal health needs. Responses will be summarised using Likert scales and thematic analysis.

Time frame
12 months
2

Participant-reported feasibility of the CTCA intervention

Feasibility will be assessed through participant survey items and focus group discussions addressing clarity of instructions. Responses will be summarised using Likert scales and thematic analysis.

Time frame
12 months
3

Participant-reported acceptability of the CTCA intervention

Acceptability will be measured using participant survey and focus group feedback on comfort, satisfaction, and willingness to undergo CTCA again. Ratings will be reported using Likert scales and thematic analysis.

Time frame
12 months
4

Participant-reported appropriateness of the PRS intervention

Appropriateness will be assessed using a custom participant survey and focus group interviews. Participants will rate whether they found the PRS intervention relevant and suitable for their personal health needs. Responses will be summarised using Likert scales and thematic analysis.

Time frame
12 months

Sponsors and contacts

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