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EVARTIA: Comprehensive Metabolic Genetic Testing

Answers through genetic metabolic testing

OVERVIEW

WHAT IS EVARTIA?

Evartia metabolic test screens for genetic mutations in people suspected of having an inherited metabolic disease. Evartia covers the major categories of inherited metabolic diseases and is offered as a single, detailed panel of 223 genes involved in metabolic pathways. It is based on ‘Target Capture Enrichment Technology’, a technology developed in-house by our team of experts.

Defects in metabolic genes disrupt the actions of the metabolic pathways they are involved in, leading to either toxic accumulation of substances or deficient production of important enzymes and proteins. These can cause a variety of symptoms, that usually manifest shortly after birth or within weeks of birth; but they could also progress slowly over the years and appear in infancy, childhood, adolescence, early or late adulthood. Symptoms and metabolic episodes can also be triggered by specific foods or medications, dehydration, minor illness, sweat or other factors, which would necessitate urgent, appropriate action.

The variability of symptoms and the complexity of detecting metabolic diseases, especially in adult patients, makes identifying a metabolic disorder complicated and time-intensive. Evartia is a comprehensive and reliable test that can help uncover the cause of persistent, debilitating symptoms through genetic testing. Identification of the disease-causing variant can help patients receive the appropriate and essential treatment that can markedly improve or reduce their symptoms, benefiting their quality of life.

WHY GET TESTED?

Being a single, comprehensive panel, Evartia can:
Identify complex diseases with a wide spectrum of symptoms and age of onset faster
Reduce the need for complex and invasive tests
Lead to the most effective or contraindicated therapies
Lead to accurate prognosis
Reduce symptoms and chronic complications, revert disease progression with appropriate therapy
Allow for taking informed decisions on the best clinical management for the affected individual
Lead to early diagnosis of other family members

WHO IS EVARTIA FOR?

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Patients with common symptoms of a metabolic disease

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Patients with a spectrum of overlapping symptoms that vary in age of onset and severity

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Patients with neurological symptoms that haven’t improved with routine therapies

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Individuals with a family history of a metabolic disease

EVARTIA METABOLIC TEST

To facilitate the detection process, Evartia metabolic test covers the major classes of inherited metabolic diseases and is offered as a single, detailed panel of 223 genes involved in metabolic pathways.

The genetic alterations tested in Evartia include single nucleotide variants (SNVs), insertions and deletions (Indels) and copy number alterations (CNAs).

DISORDERS TESTED BY EVARTIA

TECHNOLOGICAL ADVANTAGES

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TARGETED TECHNOLOGY
Evartia is based on a novel, target capture enrichment technology that has been thoroughly validated for its accuracy and precision.

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FULL EXONIC COVERAGE
Evartia screens for all coding regions* on the genes tested, examining single nucleotide variants, small insertions and deletions and copy number variants down to single exon resolution.

*Exceptions apply – see technology section for details

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INNOVATIVE BIOINFORMATICS
Innovative bioinformatics pipelines analyze the sequencing data produced from each sample, increasing the sensitivity and specificity of Evartia.

WHY CONSIDER GENETIC TESTING?

METABOLIC DISORDERS ARE UNDER-RECOGNIZED AND UNDER-DETECTED
Traditionally regarded as ‘childhood diseases’, the prevalence of adults with metabolic disorders who are undetected is unknown. Metabolic diseases have a range of symptoms and age of onset, and no specific phenotype. Also, they may have overlapping symptoms with neurologic, psychiatric or cardiovascular disorders. Without treatment, they can get progressively worse, cause acute pain, and chronic, irreversible complications.

The path towards identifying a metabolic disease hasn’t been straightforward. If a patient with a metabolic disease is not identified through newborn screening, due to the metabolic disease not being a part of the diseases tested or due to technological limitations, detection depends on the time of symptom onset. This can be anytime from infancy, childhood, adolescence or adulthood . Often, patients have to undergo lengthy and complicated biochemical or enzymatic testing which includes a variety of specimen types such as blood, urine or sweat. Additionally, invasive biopsies from muscle or cerebrospinal fluid may be needed.

With Evartia, you are one genetic test away from taking informed, accurate, and early decisions on the best clinical management.

POSSIBLE OUTCOMES OF THE TEST

The Evartia report will have information on the following:
Results on genes tested
Thorough interpretation and clinical significance of mutations detected

Evartia reports on clinically significant and no clinically significant variants, as well as variants of uncertain significance.

HOW CAN I TAKE THE EVARTIA METABOLIC TEST?
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Ask your healthcare provider about Evartia

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Your healthcare provider will collect the sample using a buccal swab

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The sample will be sent to our laboratory

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The sample will be analyzed in our laboratory

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Results will be sent to your healthcare provider within 2-4 weeks from sample receipt

ACCEPTED MATERIAL

Buccal swab collection device, which is provided in theEVARTIA kit

TURNAROUND TIME

2-4 weeks from sample receipt in our laboratory

TECHNOLOGY

gDNA is extracted using a standardized methodology and subjected to mechanical fragmentation prior to DNA library preparation. DNA enrichment for the genomic regions of interest is carried out using a solution-based hybridization method, followed by next generation sequencing (NGS). Single nucleotide variants, small insertions and deletions (≤30bp), and copy number variations (CNVs) are reported. All positive CNVs are confirmed using an orthogonal method. The test aims to detect all coding exons, of MANE and/or Canonical transcripts, and 10bp of adjacent intronic sequence.
Exceptions may include: regions containing repeats, sequences of high homology such as segmental duplications and pseudogenes, as well as regions of extreme GC-content.

Variants are classified according to the criteria set by the American College of Medical Genetics and Genomics. Classification and interpretation of variants is performed using the Varsome Clinical platform, and is according to the published knowledge at the time of testing.

Test Methodology
SEQUENCING

Next generation sequencing (Illumina)

ENRICHMENT

Proprietary Target Capture Enrichment Technology (Click here to see our Publications)

SNV AND CNV DATA ANALYSIS

GATK and Vardict variant callers. Targeted CNV calling using a proprietary bioinformatics pipeline utilizing a circular binary segmentation algorithm

DATA EVALUATION

Varsome Clinical by Saphetor

REFERENCE GENOME

hg19, NCBI GRCh37

QUALITY CRITERIA

>30 (precision 99,9%)
Minimum percentage of bases with RD greater than 20X = 97%

SNV DETECTION SENSITIVITY

Sensitivity: 100% (88-100%)
Specificity: 100% (99.9%-100%)

CLASSIFICATION OF VARIANTS

Richards et al. 2015, Genet Med 17:405; ClinGen Sequence Variant Interpretation Recommendation for PM2-Version 1.0; Tavtigian SV et al. 2020, Hum Mutat 41(10); Fitting a naturally scaled point system to the ACMG/AMP variant classification guidelines; Pejaver V et al. 2022, bioRxiv;

IN SILICO ALGORITHMS

ALoFT, BayesDel, DEOGEN2, Eigen, Eigen-PC, FATHMM, FATHMM-XF, FATHMM-MKL, fitCons, LIST-S2, LRT, M-CAP, MetaLR, MetaRNN, MetaSVM, MPC, MutationAssessor, MutationTaster, MutPred, MVP, Polyphen-2, PrimateAI, PROVEAN, REVEL, SIFT, SIFT4G, dbscSNV

DATABASES

More than 100 datasets including ClinVar, gnomAD, ExAC, ClinGen, DECIPHER, etc

SUPPORTING DOCUMENTS

(click to download)
Evartia Panel Disorders Tested

OUR TESTS

Genes: ABCC8, ABCD1, ABCD4, ACAD8, ACAD9, ACADM, ACADS, ACADSB, ACADVL, ACOX1, ACSF3, AGA, AGL, AGPS, ALDH6A1, ALDOA, ALDOB, ALG1, ALG11, ALG12, ALG13, ALG2, ALG3, ALG6, ALG8, ALG9, AMACR, AMT, ARG1, ARSA, ARSB, ASL, ASPA, ASS1, AUH, B4GALT1, BCKDHA, BCKDHB, BTD, CAD, CCDC115, CD320, CLN3, CLN5, CLN6, CLN8, CLPB, COG1, COG2, COG4, COG5, COG6, COG7, COG8, CPS1, CPT1A, CPT2, CTNS, CTSA, CTSK, DBT, DDOST, DHCR7, DHDDS, DLD, DNAJC12, DNAJC19, DOLK, DPAGT1, DPM1, DPM2, DPM3, ENO3, ETFA, ETFB, ETFDH, FBP1, FUCA1, FUT8, G6PC, GAA, GALC, GALNS, GAMT, GATM, GBA, GBE1, GCDH, GCH1, GCK, GCSH, GLA, GLB1, GLDC, GLUD1, GM2A, GMPPA, GNE, GNPTAB, GNPTG, GNS, GUSB, GYG1, GYS1, GYS2, HADH, HADHA, HADHB, HCFC1, HEXA, HEXB, HGSNAT, HMGCL, HMGCS2, HPD, HRAS, HSD17B10, HSD17B4, HYAL1, IDS, IDUA, INSR, KCNJ11, LAMP2,  LDHA, LIAS, LIPA, LMBRD1, MAN1B1, MAN2B1, MANBA, MCEE, MCOLN1, MFSD8, MGAT2, MLYCD, MMAA, MMAB, MMACHC, MMADHC, MMUT, MOGS, MPDU1, MPI, MTR, MTRR, NAGA, NAGLU, NAGS, NEU1, NGLY1, NPC1, NPC2, NUS1, OPA3, OTC, PAH, PCBD1, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PFKM, PGAM2, PGM1, PHKA1, PHKA2, PHKB, PHKG2, PHYH, PMM2, PPM1K, PPT1, PRKAG2, PSAP, PTS, PYGL, PYGM, QDPR, RFT1, SCP2, SERAC1, SGSH,  SLC16A1, SLC17A5, SLC22A5, SLC25A13, SLC25A15, SLC25A20, SLC2A2, SLC35A1, SLC35A2, SLC35C1, SLC37A4, SLC39A8, SLC6A8, SLC6A9, SMPD1, SRD5A3, SSR4, STT3A, STT3B, SUCLA2, SUCLG1, SUMF1, TAFAZZIN, TIMM50, TMEM165, TMEM199, TMEM70, TPP1, TUSC3, VPS33A

OUR NETWORK