ESSAIS INTERVENTIONNELS EN COURS

Avant de participer à une étude, parlez-en à votre médecin et renseignez-vous sur les risques et les avantages potentiels.

Cette étude évalue l’innocuité, les biomarqueurs et les tendances en matière d’efficacité de différents niveaux de dose du médicament expérimental tominersen chez des personnes âgées de 25 à 50 ans présentant des signes prodromiques (signes subtils très précoces de la maladie de Huntington) ou manifestation précoce de la MH. Le tominersen est un médicament expérimental qui a été étudié dans plusieurs essais cliniques depuis 2015, notamment dans une étude de phase III appelée GENERATION HD1 qui a testé deux schémas posologiques différents de tominersen chez des adultes atteints de MH manifeste.

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L’essai portera sur la sécurité et l’efficacité (capacité à produire le résultat souhaité) du BV-101 chez des patients adultes atteints de la maladie de Huntington à un stade précoce. Le BV-101 sera administré (une fois) par des techniques neurochirurgicales guidées par IRM et dirigées vers des tissus cibles dans les structures basales du cerveau. Lors d’études précliniques sur des souris, le BV-101 a montré sa capacité à réparer la voie essentielle du cholestérol (qui est endommagée chez les patients atteints de la maladie de Huntington), à fournir une neuroprotection et à restaurer la fonction neuronale en délivrant une enzyme cruciale dans le cerveau qui est diminuée chez les personnes atteintes de la maladie de Huntington.

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L’étude PIVOT-HD est un essai de phase II visant à évaluer l’innocuité du PTC518, un nouveau médicament qui abaisse le taux de Huntington, chez des patients atteints de MH. Le PTC518 est un comprimé oral (pris par la bouche tous les jours) qui tente non seulement d’abaisser la huntingtine (mHTT) dans le cerveau mais aussi de traiter la MH partout dans le corps (cerveau, muscle, système immunitaire…).

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Résultats de la pridopidine sur la fonction dans la maladie de Huntington (PROOF-HD)

PROOF-HD est une étude clinique de phase 3 qui évalue l’efficacité et la sécurité de la pridopidine chez les patients présentant un stade précoce de la maladie de Huntington. La pridopidine est une petite molécule développée par Prilenia pour le traitement des troubles neurodégénératifs tels que la maladie de Huntington.

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Cette étude interventionnelle est actuellement en phase 1b/2a et évalue l’innocuité et la tolérabilité chez des patients adultes atteints de HD à manifestation précoce.

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L’essai clinique européen de phase Ib/II de l’AMT-130 pour le traitement de la MH explorera l’innocuité, la preuve de concept et la posologie chez 15 patients au total atteints de la maladie de Huntington au stade précoce, répartis en une cohorte ouverte à faible dose (les patients savent ce qu’ils reçoivent) de cinq personnes, suivie d’une cohorte ouverte à dose plus élevée de neuf patients. Tous les patients recevront une dose d’AMT-130. L’objectif thérapeutique est d’inhiber la production du mHTT. Utilisation de vecteurs AAV pour délivrer des micro-ARN directement dans le cerveau. Une injection unique.

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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.