PIVOT-HD

Active, Not Recruiting

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SPONSOR

PTC Therapeutics

PARTICIPANTS

162

The PIVOT-HD study is a Phase II trial looking at the safety of Votoplam(PTC518), a new Huntington-Lowering drug, in patients with HD. Votoplam is an oral tablet (taken by mouth every day) that not only tries to lower huntingtin (mHTT) in the brain but also treat HD everywhere in the body (brain, muscle, immune system…). 

This Phase 2 is hoping to enrol 162 participants. 2 doses will be given and also a placebo group over 12 weeks and a follow-up of 12 months.

EHA Webinar on the PTC518 clinical trial updates

October 17th, 2022

Amy-lee Bredlau presents updates on PTC518

September 16th, 2022

Ages Eligible
for Study:

25 Years and older

(Adult, Older Adult)

Sexes Eligible
for Study:

All

Accepts Healthy Volunteers:

No

There has been an amendment to the entry criteria:

  • Length of trial from 12 weeks to 12 months
  • CAG repeat length was previously 42-50 and is now 40-50
  • Number of subjects was previously 162 an is now up to 252
  • We are recruiting Stage II AND Stage 3 now (so TFC and/or Independence scale less than 13/100)
  • Receipt of an experimental agent within 90 days or 5 half-lives prior to Screening or anytime over the duration of this study, ribonucleic acid (RNA)- or deoxyribonucleic acid (DNA)-targeted HD-specific investigational agents such as antisense oligonucleotides, cell transplantation, or any other experimental brain surgery
  • Any history of gene therapy exposure for the treatment of HD
  • Participation in an investigational study or investigational paradigm (such as exercise/physical activity, cognitive therapy, brain stimulation, etc) within 90 days prior to Screening or anytime over the duration of this study
  • Any medical history of brain or spinal disease that would interfere with the lumbar puncture process safety assessments
  • Any medical history or condition that would interfere with the ability to complete the protocol-specified assessments (for example, implanted shunt, conditions precluding magnetic resonance imaging [MRI] scans)
  • Pregnancy, planning on becoming pregnant during the course of the study or within 6 months of end of treatment, or currently breastfeeding

LOCATIONS

COUNTRIES

AUSTRIA
  • Facility: Medizinische Universität Innsbruck
  • Address: Christoph-Probst-Platz 1, Innrain 52 A, Fritz-Pregl-Straße 3, 6020 Innsbruck, Austria
FRANCE
  • Facility: Centre Hospitalier Universitaire d’Angers
  • Address: Angers, France, 49100  
  • Facility: Hôpital Universitaire de Marseille Hôpital de la Timone
  • Address: Marseille, France, 13385
  • Facility: Brain and Spine Institute Paris
  • Address: Paris, France, 75013
GERMANY
  • Facility: Ruhr-Univ. Bochum St. Joseph-Hospital
  • Address: Bochum, Germany, 44791
  • Facility: George-Huntington-Institut
  • Address: Münster, Germany, 48149 
  • Facility: Charite University Medicine Berlin
  • Address: Berlin, Germany, 10117
  • Facility: Ulm University, UKU, Dep. of Neurology
  • Address: Ulm, Germany, 89081 
ITALY
  • Facility: IRCCS Istituto delle Scienze Neurologiche di Bologna
  • Address: Padiglione G, Via Altura, 3, 40139 Bologna BO, Italy
  • Facility: IRCCS Carlo Besta Neurological Institutte
  • Address: Via Giovanni Celoria, 11, 20133 Milano MI, Italy
  • Facility: IRCCS Casa Sollievo della Sofferenza Research Hospital
  • Address: Viale Cappuccini, sn, 71013 San Giovanni Rotondo FG, Italy
NETHERLANDS
  • Facility: Leiden University Medical Center
  • Address: Leiden, Netherlands, 2333 ZA
SPAIN
  • Facility: Hospital Universitario Cruces
  • Address: Cruces Plaza, s/n, 48903 Barakaldo, Bizkaia
  • Facility: Hospital de la Santa Creu i Sant Pau
  • Address: C/ de Sant Quintí, 89, Horta-Guinardó, 08025 Barcelona
  • Facility: Hospital Universitario de Burgos
  • Address: Av. Islas Baleares, 3, 09006 Burgos
  • Facility: Hospital Universitario Ramón y Cajal
  • Address: M-607, 9, 100, Fuencarral-El Pardo, 28034 Madrid
UK
  • Facility: Cardiff University Schools of Medicine and Biosciences
  • Address: Cardiff, United Kingdom, CF10 3AX
  • Facility: UCL Queen Square Institute of Neurology National Hospital for Neurology and Neurosurgery
  • Address: London, United Kingdom, WC1N 3BG
  • Facility: The Barberry National Centre For Mental Health
  • Address: 6 Bullace Croft, Birmingham B15, United Kingdom
  • Facility: Manchester University NHS FT
  • Address: Cobbett House Manchester Royal Infirmary, Oxford Rd, Manchester M13 9WL, United Kingdom
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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.