It's Not JUST Idiopathic Pulmonary Fibrosis Study (INJUSTIS)
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ClinicalTrials.gov Identifier: NCT03670576 |
Recruitment Status :
Recruiting
First Posted : September 13, 2018
Last Update Posted : July 2, 2021
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Condition or disease | Intervention/treatment |
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Interstitial Lung Disease Idiopathic Pulmonary Fibrosis | Procedure: Optional Bronchoscopy Other: Quality of Life Questionnaires Other: Blood Samples for Biomarkers Other: Home Hand Held Spirometry |
The overall aims of this study are
- Identify biomarkers and gene expression profiles that determine progressive fibrotic lung disease regardless of aetiology
- To prospectively assess biomarkers which predict progressive fibrosis in patients with fibrosing lung disease of alternate aetiology, including RA-UIP, Asbestosis, Chronic Hypersensitivity Pneumonitis and Unclassifiable fibrotic lung disease
- Investigate genetic associations and epigenetic modifications which affect fibrotic disease severity and progression
- Prospectively evaluate longitudinal disease behaviour in patients with non IPF-fibrotic lung diseases with a view to developing composite clinical end-points for subsequent use in intervention studies in patients
Study Type : | Observational |
Estimated Enrollment : | 250 participants |
Observational Model: | Cohort |
Time Perspective: | Prospective |
Official Title: | It's Not JUST Idiopathic Pulmonary Fibrosis Study |
Actual Study Start Date : | November 11, 2018 |
Estimated Primary Completion Date : | November 11, 2022 |
Estimated Study Completion Date : | November 11, 2022 |

Group/Cohort | Intervention/treatment |
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Case
A diagnosis of Fibrotic Lung disease classified in 4 categories, RA-UIP, Asbestosis, Chronic HP and Unclassifiable as agreed by an ILD MDT consensus panel.
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Procedure: Optional Bronchoscopy
Patients can decide to have an optional bronchoscopy so that samples can be taken for research up to three months from baseline. Other: Quality of Life Questionnaires MRC Dyspnoea, SPARC, KBILD and EQ-5D-5L will be administered at baseline, 3 months, 12 months and 24 months, Other: Blood Samples for Biomarkers a 40ml research blood sample to be taken at baseline, 3 months, 12 months and 24 months. Other: Home Hand Held Spirometry Patients will download an app and are given a small hand held device to record their own spirometry at home. This is blinded for the first three months of the study and then requested a week before and a week after the three follow up points (3m, 12m, 24m) |
Control
Positive control will be frequency matched to cases of ILD and will be people in secondary care who have an MDT diagnosis of Definite IPF.
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Procedure: Optional Bronchoscopy
Patients can decide to have an optional bronchoscopy so that samples can be taken for research up to three months from baseline. Other: Quality of Life Questionnaires MRC Dyspnoea, SPARC, KBILD and EQ-5D-5L will be administered at baseline, 3 months, 12 months and 24 months, Other: Blood Samples for Biomarkers a 40ml research blood sample to be taken at baseline, 3 months, 12 months and 24 months. Other: Home Hand Held Spirometry Patients will download an app and are given a small hand held device to record their own spirometry at home. This is blinded for the first three months of the study and then requested a week before and a week after the three follow up points (3m, 12m, 24m) |
- Disease Progression [ Time Frame: Within 12 months ]Disease progression defined as >10% relative decline in FVC (using either hospital spirometry or home hand held spirometry) or death within 12 months.
- Overall Survival [ Time Frame: 10 years ]All patients will be tagged at the central NHS registry in order to provide mortality data. For this reason we will need to keep our datasets active for up to 10 years to allow a complete mortality analysis.
- Serum and Plasma Biomarkers [ Time Frame: Baseline, 3 months, 12 months, 24 months ]SPD, MUC16, CA199, Nordic Neoepitopes
- DLco [ Time Frame: Baseline, 3 months, 12 months, 24 months ]Diffusing Capacity of the Lung for Carbon Monoxide
- Quality of Life Questionnaires [ Time Frame: Baseline, 3 months, 12 months, 24 months. ]Assessment of how the patients well-being may be affected over time by their interstitial lung disease
- Domicillary Spirometry [ Time Frame: Daily for the first 3 months of study then at 2 week periods around time of planned follow up ]Change in home handheld spirometry values from baseline to 12 weeks
Biospecimen Retention: Samples With DNA

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Probability Sample |
Inclusion Criteria
- Male or female aged ≥ 18 years old
- Able and willing to give written informed consent
- Recently diagnosed [defined as diagnostic CT scan or surgical lung biopsy (if applicable) >1st May 2017]
- An MDT diagnosis of fibrotic interstitial lung disease (reticulation, traction +/- honeycombing)
Sub Groups
- Rheumatoid arthritis (rheumatologist diagnosed with anti-CCP antibodies and/or Rheumatoid Factor positive)
- Asbestosis (appropriate occupational history and radiological evidence of asbestos exposure)
- Chronic HP in accordance with consensus criteria (appropriate exposure history, radiological features +/- avian and fungal precipitins)
- Unclassifiable fibrotic lung disease (fibrotic lung disease otherwise unclassifiable despite extensive clinical and radiological examination)
- IPF in accordance with consensus criteria (ATS/ERS/JRS/ALAT guidelines) as controls
Exclusion Criteria:
- Participating in an interventional clinic trial
- Asymptomatic Interstitial Lung Abnormalities (ILA) and normal lung function.
- Change in clinical phenotype from initial radiological diagnosis to screening
- Acute Hypersensitivity Pneumonitis.
- Participants who do not possess a smartphone or have a valid email address (necessary for the home FVC readings)

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03670576
Contact: Prof Gisli Jenkins | 0115 8231711 | gisli.jenkins@nottingham.ac.uk | |
Contact: Lucy Howard | 01158231326 | lucy.howard@nottingham.ac.uk |

Responsible Party: | University of Nottingham |
ClinicalTrials.gov Identifier: | NCT03670576 |
Other Study ID Numbers: |
18014 |
First Posted: | September 13, 2018 Key Record Dates |
Last Update Posted: | July 2, 2021 |
Last Verified: | July 2021 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Lung Diseases Pulmonary Fibrosis Idiopathic Pulmonary Fibrosis Lung Diseases, Interstitial |
Fibrosis Pathologic Processes Respiratory Tract Diseases |