COMPLETED TRIALS

Here is a list of completed observational and interventional trials in Europe

INTERVENTIONAL

The main purpose of this study is to investigate whether Deep Brain stimulation has a positive effect on the motor and cognitive symptoms in Huntingtons patients. Deep brain stimulation (DBS) is a surgery to implant a device that sends electrical signals to brain areas responsible for body movement. Electrodes are placed deep in the brain and are connected to a stimulator device. Similar to a heart pacemaker, a neurostimulator uses electric pulses to regulate brain activity.  DBS treatment has been used for some people with Parkinsons disease.

Both safety and efficacy will be investigated in this study with 50 participants.  25 participants will be stimulated with the DBS for the first period of 3 months and their performance on a variety of tests, will be compared with the 25 participants who don’t get any stimulation.  After the first 3 months, all participants will be treated with DBS for another 3 months.

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The main objective of DIACCIMEX was to develop and validate an analytical and clinical Non-Invasive Prenatal Diagnosis (NIPD) test for triplet repeat diseases by isolated circulating fetal trophoblastic cells (CFTC) analysis from maternal blood, searching for the familial mutation in families at risk of having one of the following triplet repeat diseases: Huntington’s disease, Steinert Myotonic dystrophy, Fragile X syndrome, spinocerebellar ataxia (SCA) 1, 2 and 3.

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The main purpose of this study is to determine whether a drug called Neflamapimod can improve cognitive functions (planning, memory etc) in patients with early-stage Huntington’s disease (HD). The drug is taken orally.  In the study 16 patients will receive the drug for 10 weeks and then be given placebo for 10 weeks or vice versa.  Neither the doctor nor the patient knows in which period they get the active drug or the placebo.  The effect will be tested with different cognitive tests.

Neflamapimod target an enzyme in the brain called p38 alpha. The aim is to reduce expression of the enzyme in neurons and enable the cells to function better.  The drug has proven promising effect in animal tests and it is also currently being tested on patients with Alzheimers Disease. 

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GEN-EXTEND is the open-label extension study for the Phase 3 trial, GENERATION HD1. Whereas GENERATION HD1 is designed to evaluate the effects of Roche’s HD treatment and help decide if it should be made available to patients, GEN-EXTEND evaluates the long-term safety of the same treatment, to understand long-term side effects. Not everyone is able to be a part of this study, only patients who have been involved in the earlier trials in the programme can join an open-label extension.

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The reason of this study is to look at the movement of the drug, Tominerson into, through, and out of the CSF and plasma and their reaction to the drug. The study will also look at a time line and recovery profile of mHTT in CSF.

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This WAS a phase 3 trial where HD participants were injected in the spine with a drug called Tominersen, an ASO. The drug was believed to lower the amount of mHHT in brain cells. The delivery of the drug was stopped after it was advised by an independent committee. The participants were asked to remain and continue with data collection for the remaining period of the trial. 85% chose to continue.   

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This study is to look at whether so-called radioligands (small radioactive particles) can detect mutant Huntingtin (mHTT) in the brain. The imaging study uses PET scans of the brain to see if when the radioligands are present is related with the expression of mHTT in brain cells.  If the relationship is proven correct then it will a valuable way to measure mHTT and track if huntingtin lowering therapies actually lower mHTT in the brain. 

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The study will to assess the safety, how well the drug is tolerated, the pharmacodynamics(PD- the body’s biological response to drugs) and pharmacokinetics (PK-the movement of drugs through the body)and preliminary efficacy of MBF-015 in HD patients

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The purpose of this trial is to evaluate whether the around 60 participants (with early manifest Huntington’s disease) who commit to the physical activity program, manage to follow up and complete the 12 month intervention. The active intervention group will be supervised and encouraged by a trainer/physiotherapist on a regular basis. The results on both motor and cognitive tests, will be compared with a group of around 60 participants who are only monitored doing their physical activities as usual. 

The aim of the study is to see if Huntington’s disease (HD) patients, when being followed up and encouraged in a specialized program for physical activity, follow the program  and benefit from the training.

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This clinical trial is testing a new drug that selectively lowers the mutant Huntington’s disease (HD) protein, whilst leaving the normal huntingtin protein relatively untouched. In order to be able to identify the gene with the mutant Huntingtin, they use a unique method and identify a so-called snip. Wave has identified two different snips that helps locate the mutant Huntingtin and therefore there are two studies (Presicion HD 1 and Presicion HD 2)  with the same treatment, where the only difference is the targeted snip.

The primary objective is to understand whether the drug is safe in a small number of volunteers, before testing in a larger population and collecting evidence that the drug may work. The total of 60 participants receive either placebo or different dosages of the active drug every 4 weeks.  Both the active drug and the placebo is delivered through a spinal injections. 

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This clinical trial is testing a new drug that selectively lowers the mutant Huntington’s disease (HD) protein, whilst leaving the normal huntingtin protein relatively untouched. In order to be able to identify the gene with the mutant Huntingtin, they use a unique method and identify a so-called snip. Wave has identified two different snips that helps locate the mutant Huntingtin and therefore there are two studies (Presicion HD 1 and Presicion HD 2)  with the same treatment, where the only difference is the targeted snip.

The primary objective is to understand whether the drug is safe in a small number of volunteers, before testing in a larger population and collecting evidence that the drug may work. The total of 60 participants receive either placebo or different dosages of the active drug every 4 weeks.  Both the active drug and the placebo is delivered through a spinal injections. 

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PRidopidine Outcome On Function in Huntington Disease (PROOF-HD)

PROOF-HD is a Phase 3 clinical study that evaluates the efficacy and safety of pridopidine in patients with early stage of Huntington Disease. Pridopidine is a small molecule developed by Prilenia for the treatment of neurodegenerative disorders such as HD

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The main purpose of REVHD was to evaluate the therapeutic potential of Resveratrol on the caudate volume in Huntington’s disease patients, using volumetric MRI. 

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The study is a phase 1/2 and will look at the safety and how participants tolerate a new antisense oligonucleotide(ASO) in early stage disease, with a drug called WVE-003.

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The main purpose of this trial is to study the efficacy and safety of SOM3355 in patients with Huntington’s disease. SOM3355, which has been used for hypertension, will be looked at in this phase 2b trial to establish if it helps with chorea in HD. 2 doses and a placebo group will receive the drug orally twice a day for 12 weeks. 129 participants will be recruited.

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In this trial a compound called Triheptanoin is tested to see if it has a positive impact on Huntington’s disease (HD) patients functions in all areas but with a special emphasis on cognitive functions. Trhiheptanoion is artificially produced and it is a fat.  It is almost tasteless and colorless and is already used as medical food to treat certain diseases related to the bodies energy production, socalled metabolic disorders. We know that the brain cells energy production is negatively affected in HD.

100 participants is included in the trial. 50 will get Triheptanoin each day for 12 months.  The other 50 participants will for the first 6 months receive placebo.  But for the following 6 months they will get Trheptanoin.

Potential effect will be tested with MRS to get an image of whether the energy production has improved or at least not decreased. MRI images will also be taken to see any effect on brain volume.  In addition the participants will be tested with a battery of motor and cognitive tests as well as questionnaires related to general function and psychiatric status.

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This is the first study of the drug branaplam in adults with HD to determine the correct dose required to lower mHTT levels in the CSF to a degree expected to be efficacious over longer periods of time.

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OBSERVATIONAL

BIOHD is studying ‘biomarkers’ that predicts the progression of Huntington’s disease. The study is therefore trying to find markers in the blood, through imaging, and psychological tests. In doing so, clinicians might be better at predicting how Huntington’s disease will progress in people who carry the mutated gene. 

What is a biomarker? It is a measurable indicator of a disease or condition. It can for instance be a level of something in your blood or hormon levels. Biomarkers are often measured and evaluated to examine normal biological processes – like measuring the level of hemoglobin in your blood or your blood pressure. In reference to research on Huntingtons disease, a biomarker is an indicator of disease progression. 

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The study is designed as a multi-site, prospective, 15-month longitudinal, cohort study measuring mutant huntingtin protein (mHTT) in the cerebrospinal fluid (CSF) in participants at the early stages of Huntington’s disease (HD).

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The objectives are to better document the psychosocial status and needs of caregiver of HD patients and understand the dyad functioning, facing the disease at various stages.

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This study is looking at the relationship between caffeine and the course of HD in premanifest participants.

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The main purpose of DOMINO-HD is to look at how sleep, nutrition and physical activity impacts the progression of Huntington´s disease so as to develop new ways to support and manage fundamental aspects of HD patients. The study will also explore how digital technologies, such as wearable fitness trackers, can be used to support people with HD.

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This international study will follow a group of people over time who have or are at risk of developing HD. Health information will be collected including medical history, blood and CSF samples. Participants will also undergo MRIs, cognitive and motor function tests. The information will be used to look at the natural history of HD and its biomarkers that are linked with changes in the CAG repeat

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oxidative seres

an imbalance between unstable molecules called “free radicals” and protective “antioxidants” in your body

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Metabolism & bioenergetics

describe how your body turns food into fuel and uses that energy to live. 

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Small Molecule

a tiny chemical compound, much smaller than big biological structures like proteins, that can easily travel inside our cells to act as medicine (like aspirin or ibuprofen), a building block (like glucose), or a signaling tool in the body, often taken as pills because they’re easy to absorb and distribute

 

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Nucleic acid

(DNA and RNA) are the essential information-carrying molecules in all life, acting like blueprints that store and transmit genetic instructions for building and operating cells, directing everything from growth to protein production, and passing traits from parents to offspring.

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SNP-single nucleotide polymorphisms

a single-letter spelling difference in a gene. SNPs, pronounced ‘snips’, are common and most don’t change the function of the gene.

 
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at risk

You do not know if you carry the genetic mutation for HD gene 

 
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TFC-total functional capacity

A standardized rating scale for function in HD, used to assess capacity to work, handle finances, perform domestic chores and self-care tasks.
Scores range from 0 to 13, with higher scores indicating better functional capacity. 

 
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Double-blinded

 means that neither the participant nor the clinical trial doctor can choose or know the group the participant is in until the trial is over. This approach helps to prevent bias.

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Open label

A trial in which the patient and doctor know what drug is being used. Open label trials are susceptible to bias through placebo effects.

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Gene therapy

a technique that aims to treat or prevent diseases by modifying a person’s genes. It involves introducing, removing, or changing genetic material (DNA or RNA) within a patient’s cells.

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UHDRS- Unified Huntington Disease Rating Scale

A standardized neurological examination that aims to provide a uniform assessment of the clinical features of HD

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CAG repeat

The stretch of DNA at the beginning of the HD gene, which contains the sequence CAG repeated many times, and is abnormally long in people who will develop HD

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Wild-type

the opposite of ‘mutant’. Wild-type huntingtin, for example, is the ‘normal’, ‘healthy’ protein

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Tolerabilty

How well a person can handle a treatment without having serious or uncomfortable side effects.

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Striatum

Part of the brain that  coordinates multiple aspects of cognition, including both motor and action planning, decision-making, motivation, reinforcement, and reward system.

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Randomized allocation

A type of allocation strategy in which participants are assigned to the arms of a clinical trial by chance.

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Radioligand

a radioactive substance that binds to a specific target in the body, allowing visualization of that target’s distribution and activity

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Protein

Protein builds, maintains, and replaces the tissues in your body. The building blocks of life.

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Premanifest / Prodromal

Prior to onset or diagnosis of movement symptoms.

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Placebo

A placebo is a dummy medicine containing no active ingredients. The placebo effect is a psychological effect that causes people to feel better even if they’re taking a pill that doesn’t work.

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PK - Pharmacokinetics

The movement of drugs through the body

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PD - Pharmacodynamics

The body’s biological response to drugs

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PET scan

Positron emission tomography which produces detailed 3-dimensional images of the inside of the body.

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Neuron

Brain cells that store and transmit information

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MRI

Magentic resonance imaging: A technique using powerful magnetic fields to produce detailed images and visualizes the structure of organs, tissues, and bones 

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mHTT

Mutant huntingtin protein. The protein produced by the faulty HD gene.

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Manifest

after HD diagnosis, or when symptoms are already showing

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Longitudinal study

A study where each participant is looked at several times over a time period – unlike a cross-sectional study, where each participant is looked at only once

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HTT

one abbreviation for the gene that causes Huntington’s disease. The same gene is also called HD and IT-15

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fMRI

functional MRI:As with MRI, a technique using powerful magnetic fields  but focusing on brain function by measuring and mapping changes in blood flow, revealing which areas of the brain are active during specific tasks or cognitive processes

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CSF - cerebrospinal fluid

A clear fluid produced by the brain, which surrounds and supports the brain and spinal cord.

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Efficacy

A measure of whether a treatment works or not

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ASO(Antisense oligonucleotides)

A type of gene silencing treatment in which specially designed DNA molecules are used to switch off a gene

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Biomarker

a test of any kind – including blood tests, thinking tests and brain scans – that can measure or predict the progression of a disease like HD. Biomarkers may make clinical trials of new drugs quicker and more reliable

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BDNF

Brain-derived neurotrophic factor: a growth factor that may be able to protect neurons in HD.

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Allele

one of the two copies of a gene

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Plasma

Liquid component of the blood.

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Gene

The basic unit of heredity passed from parent to child. Genes are made up of sequences of DNA and are arranged, one after another, at specific locations on chromosomes in the nucleus of cells.

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Phase

Clinical trial phases are different stages of research that assess the safety and effectiveness of a new medical treatment or intervention in humans.

Each phase has a specific goal and involves a different number of participants. Generally, there are 4 phases (I-IV), with Phase I focusing on safety and dosage, Phase II on efficacy and side effects, Phase III on comparing the new treatment with standard treatments, and Phase IV on long-term safety monitoring.