TEMET-HD

Recruiting

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SPONSOR

Instituto de Investigacion Sanitaria La Fe

PARTICIPANTS

60

This is a phase 3 study. Randomized, double-blind, placebo-controlled, parallel group study to assess the efficacy and safety of the drug metformin treatment at a dose of 1700 mg / day in adults with Huntington’s disease.

Placebo-controlled means that one of the groups will be given a substance with no active ingredients (also known as a ‘placebo’). It looks like the drug being tested but does not contain any real medicine. Comparing results from the different groups helps the researchers know whether any changes seen result from the drug or occur by chance.

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.

The drug or placebo will be delivered orally, pill. Up to 60 participants will be recruited. The duration of the trial will be 52 weeks.

 

Contact Information: 

Ages Eligible
for Study:

21 Years to 65 Years (Adult,  Older Adult )

Sexes Eligible
for Study:

All

Accepts Healthy Volunteers:

No

  • Symptomatic positive clinical diagnosis of Huntington disease.
  • Presence of 36 CAG repeats (or more) in the hunting gene based on centralized CAG analysis.
  • Men or women between 21-65 years of age, inclusive, with an onset of HD at 18 years of age or older.
  • Women of childbearing potential (women who are not postmenopausal children or who have not undergone surgical sterilization at times) will need to be using a contraceptive method for 30 days before beginning study treatment, and will have contact with at least two methods of birth control throughout the duration of the study and up to 30 days after taking the last dose of treatment.
  • A sum of > 4 points on the UHDRS-TMS scale and a diagnostic confidence level of 4.
  • Scale of independence ≥ 75%.
  • Score on the UHDRS-TFC scale ≥ 8 at the screening visit.
  • They must be trained and willing to provide written informed consent prior to any procedure related to the study to be performed at the screening visit. Patients with a legal guardian must be determined according to local requirements.
  • They must be trained and will require taking oral medication and will need to be determined to comply with the specific study procedures.
  • They must be able to travel to the study center and, in the judgment of the investigator, demonstrate that it is probable that they can continue traveling during the study.
  • Availability and willingness of a caregiver, informant, or family member to provide information during study visits that evaluate PBA-s. It is recommended that the caregiver be someone who cares for the patient at least 2 to 3 times a week and at least 3 hours per occasion. The suitability of the caregiver must be judged by the investigator.
  • The participant has taken metformin in the last three months before the start of the study.
  • The participant has diabetes of any kind.
  • The participant is pregnant or lactating.
  • The participant has a medical condition other than HD (metabolism, kidney function, liver function, heart problems, etc.), or any contraindication against metformin.
  • The participant has an uncontrolled psychiatric condition.
  • Participant is allergic to metformin or any of the other ingredients of this medicine.
  • The participant has kidney problems [creatinine clearance <60 ml / min calculated using Cockcroft-Gault formula] or liver problems.
  • The participant is dehydrated, from prolonged or severe diarrhea, or has vomited several times.
  • The participant has a serious infection.
  • The participant has been treated for heart failure or has recently had a heart attack, has severe circulation problems, or is having difficulty breathing.
  • The participant drinks> 6 units / day of alcohol (alcoholism).
  • Participants diagnosed with oncological disease.
  • Participants with a suicidal propensity, with an affirmative answer in items 4 or 5 in the C-SSRS at the screening visit.

LOCATIONS

COUNTRIES

SPAIN

TRIAL SITE: Unitat Polivalent Barcelona Nord

Address: Barcelona, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Hospital Universitario Ramón y Cajal

Address: Madrid, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Hospital General Universitario de Elche

Address: Elche, Alicante, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Complejo Hospitalario de Albacete

Address: Albacete, Castilla La Mancha, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Hospital Universitario Burgos

Address: Burgos, Castilla Y León, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Hospital Universitari Son Espases

Address: Palma De Mallorca, Islas Baleares, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Hospital Universitario Central de Asturias

Address: Oviedo, Principado De Asturias, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

TRIAL SITE: Hospital Universitario y Politécnico La Fe

Address: Valencia, València, Spain

Contact: Javier Mateo Lopez

Email: javier_mateo@iislafe.es

Recruiting

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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.