BN40422

Estudio para medir la proteína Huntingtina mutante en el líquido cefalorraquídeo en participantes con enfermedad de Huntington de manifestación temprana en fase I o II

Completado

Acerca de

Patrocinador

Hoffmann-La Roche

PARTICIPANTS

100

El estudio está diseñado como multicéntrico, prospectivo, longitudinal de 15 meses, de cohorte que mide la proteína huntingtina mutante (mHTT) en el líquido cefalorraquídeo (LCR) de los participantes en las primeras fases de la enfermedad de Huntington (EH).

Fecha estimada de finalización del estudio: 1 de enero de 2021

Edades elegibles para el estudio:

De 25 a 65 años (adulto, adulto mayor)

Sexos elegibles para el estudio:

Todos

Acepta voluntarios sanos:

No

Criterios de inclusión

  • Capacidad para expresar su consentimiento para participar en el estudio, evaluada mediante la herramienta de evaluación para firmar el consentimiento y el juicio del investigador
  • Edad de 25 a 65 años, inclusive, en el momento de firmar el formulario de consentimiento informado
  • EH de manifestación temprana, estadio I o estadio II (definida con una puntuación  TFC de 7 a 13, inclusive)
  • Enfermedad confirmada genéticamente (longitud de repetición CAG ≥ 36 en el gen de la huntingtina por prueba directa de ADN)
  • Índice de masa corporal ≥18 y ≤32 kg/m2; peso corporal total >50 kg
  • Capacidad para someterse y tolerar las resonancias magnéticas
  • Capacidad para tolerar las extracciones de sangre y la punción lumbar
  • Capacidad y voluntad de cumplir con todos los aspectos del protocolo, incluida la cumplimentación de las entrevistas y cuestionarios y la utilización de un dispositivo de monitorización digital
  • Estado médico, psiquiátrico y neurológico estable durante al menos 12 semanas antes de la selección y en el momento de la inscripción
  • Consentimiento de participación firmado por el acompañante del estudio, si se dispone de él
  • Para las mujeres en edad fértil: acuerdo de permanecer en abstinencia o utilizar métodos anticonceptivos adecuados durante el período de observación

Criterios de exclusion

  • Cualquier afección, incluida la corea grave, que impida la escritura o la realización de tareas con lápiz y papel o con teléfonos inteligentes
  • Historial de intento de suicidio o de ideación suicida con plan (es decir, ideación suicida activa) que haya requerido una visita al hospital y/o un cambio de nivel de asistencia en los 12 meses anteriores al cribado
  • Psicosis activa actual, estado de confusión o comportamiento violento
  • Cualquier afección médica grave o anormalidades clínicamente significativas de laboratorio, de los signos vitales o del electrocardiograma en el momento del cribado que, a juicio del investigador, impidan la participación segura del participante en el estudio y su finalización
  • Embarazo o encontrarse en periodo de lactancia, o con intención de quedarse embarazada durante el estudio
  • Positivo en anticuerpos del virus de la hepatitis C o antígeno de superficie de la hepatitis B en el cribado
  • Infección conocida por el VIH
  • Uso actual o previo de un oligonucleótido antisentido (incluido el ARN de interferencia pequeño)
  • Uso actual de antipsicóticos recetados para la psicosis, inhibidores de la colinesterasa, memantina, amantadina o riluzol, incluido el uso en las 12 semanas anteriores a la inscripción
  • Tratamiento con un fármaco en investigación dentro de los 30 días anteriores a la selección o 5 ciclos de vida media del fármaco en investigación, lo que sea más largo
  • Terapia antiplaquetaria o anticoagulante dentro de los 14 días anteriores a la selección o el uso previsto durante el estudio, incluyendo, pero sin limitarse, a la aspirina (a menos que sea ≤81mg/día), clopidogrel, dipiridamol, warfarina, dabigatran, rivaroxaban y apixaban.
  • Antecedentes de diátesis hemorrágica o coagulopatía; recuento de plaquetas < límite inferior de la normalidad, a menos que esté estable y el investigador y el monitor médico del patrocinador lo consideren no clínicamente significativo
  • Neoplasia maligna en los 5 años anteriores al cribado, excepto carcinoma de células basales o escamosas de la piel o carcinoma in situ del cuello uterino que haya sido tratado con éxito
  • Antecedentes de terapia génica o trasplante de células o cualquier otra cirugía cerebral experimental
  • Participación simultánea o prevista en cualquier estudio clínico sin la aprobación del monitor médico
  • Presencia de una derivación implantada para el drenaje del LCR o un catéter implantado en el SNC
  • Lesión estructural cerebral preexistente evaluada por una resonancia magnética

PAÍSES

ALEMANIA

TRIAL SITE:
Charité – Universitätsmedizin Berlin, Campus Charité Mitte; Klinik für Psychiatrie und Psychotherapi

Address: Berlin, Germany, 10117

TRIAL SITE: 
St. Josef and St. Elisabeth gGmbH ; St. Josef Hospital Bochum; Neurologisches Forschungszentrum

Address: Bochum, Germany, 44791

TRIAL SITE: 
Universitätsklinikum Ulm

Address: Ulm, Baden-Württemberg, Germany, 89081

REINO UNIDO

TRIAL SITE:
NIHR Welcome Trust Birmingham CRF – University Hospitals Birmingham; Department of Neuropsychiatry

Address: Birmingham, United Kingdom, B15 2FG

TRIAL SITE: 
Cardiff University School of Medicine; Institute of Psychological Medicine Clinical Neurosciences

Address: Cardiff, United Kingdom, CF24 4HQ

TRIAL SITE: 
National Hospital For Neurology and Neurosurgery

Address: London, United Kingdom, WC1N 3BG

TRIAL SITE:
Central Manchester University Hospitals NHS Foundation Trust; Manchester Centre for Genomic Medicine

Address: Manchester, United Kingdom, M13 9WL

new FB feed (19)

dictionary:

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.

 
new FB feed (19)

dictionary:

at risk

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

 
new FB feed (19)

dictionary:

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. 

 
new FB feed (19)

dictionary:

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.

new FB feed (19)

dictionary:

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.

new FB feed (19)

dictionary:

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.

new FB feed (19)

dictionary:

UHDRS- Unified Huntington Disease Rating Scale

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

new FB feed (19)

dictionary:

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

new FB feed (19)

dictionary:

Wild-type

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

new FB feed (19)

dictionary:

Tolerabilty

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

new FB feed (19)

dictionary:

Striatum

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

new FB feed (19)

dictionary:

Randomized allocation

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

new FB feed (19)

dictionary:

Radioligand

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

new FB feed (19)

dictionary:

Protein

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

new FB feed (19)

dictionary:

Premanifest / Prodromal

Prior to onset or diagnosis of movement symptoms.

new FB feed (19)

dictionary:

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.

new FB feed (19)

dictionary:

PK - Pharmacokinetics

The movement of drugs through the body

new FB feed (19)

dictionary:

PD - Pharmacodynamics

The body’s biological response to drugs

new FB feed (19)

dictionary:

PET scan

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

new FB feed (19)

dictionary:

Neuron

Brain cells that store and transmit information

new FB feed (19)

dictionary:

MRI

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

new FB feed (19)

dictionary:

mHTT

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

new FB feed (19)

dictionary:

Manifest

after HD diagnosis, or when symptoms are already showing

new FB feed (19)

dictionary:

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

new FB feed (19)

dictionary:

HTT

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

new FB feed (19)

dictionary:

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

new FB feed (19)

dictionary:

CSF - cerebrospinal fluid

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

new FB feed (19)

dictionary:

Efficacy

A measure of whether a treatment works or not

new FB feed (19)

dictionary:

ASO(Antisense oligonucleotides)

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

new FB feed (19)

dictionary:

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

new FB feed (19)

dictionary:

BDNF

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

new FB feed (19)

dictionary:

Allele

one of the two copies of a gene

new FB feed (19)

dictionary:

Plasma

Liquid component of the blood.

new FB feed (19)

dictionary:

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.

new FB feed (19)

dictionary:

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.