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Brief Title: Airway Intervention Registry (AIR): Recurrent Respiratory Papillomatosis (RRP)
Official Title: Airway Intervention Registry (AIR) Extension: Recurrent Respiratory Papillomatosis
Study ID: NCT03465280
Brief Summary: Recurrent Respiratory Papillomatosis (RRP) causes wart-like growths in the airway which can make it difficult to breathe, speak and carry out normal everyday activities. It is a rare condition affecting all ages, but is more common and aggressive in children than in adults, affecting 4 in every 100,000 children. There is no known cure for RRP, but symptoms are checked through regular hospital visits, with multiple therapies or procedures under general anaesthetic needed to remove or shrink the growths which can grow back quickly. The problem is that nobody knows which therapies or procedures work best. Aim: To identify which RRP treatments currently used in National Health Service (NHS) hospitals within the United Kingdom (UK) are the most effective and safest in the short- and long-term. It will also identify which patients respond best to specific treatments, and those who are at higher risk of experiencing a complication after treatment. Method: Collect information from usual patient care and quality of life questionnaire responses in a secure online database. Participation in this study requires patient/parent/guardian consent. This observational study does not require patients to undergo any additional intervention as part of the research.
Detailed Description: Primary aim: The overall goal is to improve the care of patients with Recurrent Respiratory Papillomatosis (RRP) - and the investigators aim to do this by determining the most effective and safe RRP treatments currently being used in patients in National Health Service (NHS) hospitals within the United Kingdom (UK) (information which is currently lacking). By determining the most effective treatments of RRP, the investigators will be able to increase the time interval between surgical interventions to maintain symptomatic control, reduce overall number of RRP interventions, severity and spread of papillomas in the airway, hospital visits, medications and ultimately improve quality of life in those suffering from RRP. By also capturing peri- and post-procedural details the investigators will be able to determine the relative safety of treatments and identify those which slow the progression of disease. From the data collected the investigators intend to identify patient subgroups (based on patient characteristics such as age, gender, human papillomavirus (HPV) type, location of papillomas, RRP severity and spread, comorbidities) who respond better to specific treatments, and also identify patient risk factors which contribute to the complication outcomes (such as tracheostomy). Secondary aims: * build an evidence base of the different RRP treatments used across the UK which will help to formulate hypotheses for future research in RRP and improve quality of life for RRP patients; * inform National Institute for Health and Care Excellence (NICE) interventional procedure guidance on radiofrequency cold ablation (IPG434,2012), which is currently under special arrangements due to lack of safety and efficacy evidence; * identify common symptoms or signs associated with RRP disease profile, to aid future diagnosis of RRP; * determine the geographical spread of RRP patients across the UK, to inform effective use of future NHS resources and inform the Department of Health strategy in its quadrivalent HPV vaccination programme (protecting against four types of HPV including types 6 and 11 commonly associated with RRP) currently offered to 12-13 year old girls within the NHS childhood vaccination programme; * inform future development of national clinical guidance on management of RRP to ensure that everyone receives the best care based on best available current knowledge; * determine impact of COVID on RRP patients including changes to RRP management, RRP symptoms. Objectives: The investigators will make use of an existing secure online database platform (the Airway Intervention Registry, AIR - developed and hosted by The Newcastle upon Tyne Hospitals NHS Foundation Trust, NUTH) and its associated infrastructure and develop it to capture additional observational outcomes from standard clinical practice and quality of life questionnaires from RRP patients. All RRP patients (any age) receiving treatment in any UK NHS hospital will be eligible for inclusion. Data collection will be open for 53 months with no minimum follow-up required for patients. Due to its recurrent nature (requiring regular hospital visits to maintain an open airway), following this patient population will allow the investigators to determine both the short- and long-term relative safety and efficacy of RRP treatments used in the UK. Consent will be required (from patients/parent/guardian) before data are entered into the online database.
Minimum Age:
Eligible Ages: CHILD, ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
NHS Grampian, Aberdeen, , United Kingdom
Betsi Cadwaladr University Health Board,, Bangor, , United Kingdom
Basildon & Thurrock University Hospitals NHS FT, Basildon, , United Kingdom
Belfast Health and Social Care Trust, Belfast, , United Kingdom
University Hospital Birmingham NHS Foundation Trust, Birmingham, , United Kingdom
Birmingham Women's and Children's NHS Foundation Trust, Birmingham, , United Kingdom
Blackpool Teaching Hospital NHS FT, Blackpool, , United Kingdom
Bradford Teaching Hospitals NHS Foundation Trust, Bradford, , United Kingdom
Cambridge University Hospitals NHS Foundation Trust, Cambridge, , United Kingdom
Cardiff and Vale University Local Health Board, Cardiff, , United Kingdom
North Cumbria Univeristy Hospital NHS Trust, Carlisle, , United Kingdom
Hywel Dda University Health Board, Carmarthen, , United Kingdom
County Durham and Darlington NHS Foundation Trust, Darlington, , United Kingdom
University Hospitals of Derby and Burton NHS Foundation Trust, Derby, , United Kingdom
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, , United Kingdom
NHS Tayside, Dundee, , United Kingdom
NHS Lothian, Edinburgh, , United Kingdom
Frimley Health NHS Foundation Trust, Frimley, , United Kingdom
NHS Greater Glasgow & Clyde, Glasgow, , United Kingdom
London North West University Healthcare NHS Trust, Harrow, , United Kingdom
Leeds Teaching Hospitals NHS Trust, Leeds, , United Kingdom
Alder Hey Children's NHS Foundation Trust, Liverpool, , United Kingdom
Liverpool University Hospitals NHS Foundation Trust, Liverpool, , United Kingdom
Barts Health NHS Trust, London, , United Kingdom
University College London Hospitals NHS Foundation Trust, London, , United Kingdom
Guy's and St Thomas' NHS Foundation Trust, London, , United Kingdom
Lewisham and Greenwich NHS Trust, London, , United Kingdom
St George's University Hospitals NHS Foundation Trust, London, , United Kingdom
Imperial College Healthcare NHS Trust, London, , United Kingdom
Great Ormond Street Hospital for Children NHS FT, London, , United Kingdom
Bedfordshire Hospitals NHS Foundation Trust, Luton, , United Kingdom
Manchester University Hospital NHS Foundation Trust, Manchester, , United Kingdom
Pennine Acute Hospitals NHS Trust, Manchester, , United Kingdom
South Tees Hospitals NHS Foundation Trust, Middlesbrough, , United Kingdom
The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, , United Kingdom
Isle of Wight NHS Trust, Newport, , United Kingdom
Nottingham University Hospitals NHS Trust, Nottingham, , United Kingdom
Oxford University Hospitals NHS Foundation Trust, Oxford, , United Kingdom
University Hospital of Plymouth NHS Trust, Plymouth, , United Kingdom
Swansea Bay University Health Board, Port Talbot, , United Kingdom
East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, , United Kingdom
Salford Royal NHS Foundation Trust, Salford, , United Kingdom
Sheffield Children's NHS Foundation Trust, Sheffield, , United Kingdom
The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, , United Kingdom
University Hospital Southampton NHS Foundation Trust, Southampton, , United Kingdom
Stockport NHS Foundation Trust, Stockport, , United Kingdom
South Tyneside and Sunderland NHS Foundation Trust, Sunderland, , United Kingdom
Wirral University Teaching Hospitals NHS Foundation Trust, Wirral, , United Kingdom
Name: Adam Donne
Affiliation: Alder Hey Children's NHS Foundation Trust
Role: PRINCIPAL_INVESTIGATOR