SHIELD HD

Estudio de la evolución natural de los portadores de la expansión genética de la enfermedad de Huntington (HDGEC)

Activo, sin reclutamiento

ACTUALIZACIÓN

Este estudio de evolución natural de dos años de duración sobre los HDGEC, patrocinado por Triplet Therapeutics, está recogiendo información longitudinal relacionada con la inestabilidad somática y los genes de respuesta al daño del ADN, junto con evaluaciones establecidas de la progresión de la enfermedad. El estudio ha inscrito a 70 participantes hasta la fecha, y se están realizando evaluaciones de seguimiento en centros de Norteamérica y Europa. Los resultados informarán de las evaluaciones previas a un futuro ensayo de tratamiento.

PATROCINADOR

Triplet Therapeutics, Inc.

PARTICIPANTES

70

SHIELD HD es un estudio internacional que hará un seguimiento a lo largo del tiempo de un grupo de personas que tienen o corren el riesgo de desarrollar la enfermedad de Huntington. SHIELD HD recogerá información sanitaria que incluye el historial médico y muestras de sangre y líquido cefalorraquídeo. Los participantes también se someterán a resonancias magnéticas y a pruebas de función cognitiva y motora. La información se utilizará para evaluar la evolución natural de la EH y los biomarcadores que se asocian a la modulación del número de repeticiones CAG (citosina-adenina-guanina) en el gen mutante de la Huntingtina (HTT). Los resultados de este estudio informarán de las valoraciones para un futuro ensayo de tratamiento de intervención.

Este estudio internacional hará un seguimiento a lo largo del tiempo de un grupo de personas que tienen o están en riesgo de desarrollar la EH. Se recogerá información sobre la salud, incluyendo el historial médico y muestras de sangre y LCR. Los participantes también se someterán a resonancias magnéticas y a pruebas de función cognitiva y motora. La información se utilizará para observar la historia natural de la EH y sus biomarcadores que están relacionados con los cambios en la repetición CAG.

Fecha estimada de finalización del estudio: Diciembre de 2022

Edades elegibles
para el estudio:

18 años o más

(adulto, adulto mayor)

Sexos elegibles
para el estudio:

Todos

Acepta voluntarios sanos:

No

Criterios de inclusión

  • Capacidad para comprender los objetivos y procedimientos del estudio
  • Confirmación de la enfermedad acreditada genéticamente mediante pruebas directas de ADN, definida como una longitud de repetición CAG ≥39 en el gen HTT
  • Capacidad para someterse y tolerar las resonancias magnéticas
  • Capacidad para tolerar las extracciones de sangre y las punciones lumbares

Criterios de exclusión

  • Cualquier condición, incluyendo corea severa y demencia, que impida escribir o realizar tareas con lápiz y papel, tablets u ordenadores, según determine el Investigador
  • Tratamiento con un fármaco en investigación dentro de los 30 días anteriores a la selección o dentro de los 5 ciclos de vida medias del fármaco en investigación, lo que sea más largo
  • Antecedentes de terapia génica o trasplante de células o cualquier otra cirugía cerebral experimental

PAÍSES

Sitios

FRANCIA

LUGAR:
ICM – Institut du Cerveau et de la Moelle épinière

DIRECCIÓN: Paris, France, 75013

ALEMANIA

LUGAR:
George-Huntington-Institut 

DIRECCIÓN: Münster, Germany, 48149.

REINO UNIDO

LUGAR:
University College London – Institute of Neurology & The National Hospital for Neurology and Neurosurgery

DIRECCIÓN: London, 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.