PIVOT-HD

Recrutement

À PROPOS

SPONSOR

PTC Therapeutics

PARTICIPANTS

162

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…).

Cette phase 2 espère recruter 162 participants. Deux doses seront administrées ainsi qu’un groupe placebo pendant 12 semaines et un suivi de 12 mois.

Webinaire de l'EHA sur les mises à jour de l'essai clinique du PTC518

Amy-lee Bredlau présente des mises
à jour sur PTC518

Ages éligibles
pour l'étude:

25 ans et plus

(Adulte, Adulte âgé)

Sexes éligibles
pour l'étude:

Tous

Accepte les volontaires en bonne santé:

Non

Critères d'inclusion

Les critères d'admission ont été modifiés:

  • La durée de l’essai passe de 12 semaines à 12 mois.
  • La longueur des répétitions CAG, qui était auparavant de 42-50, est maintenant de 40-50.
  • Le nombre de sujets était auparavant de 162 et est maintenant de 252.
  • Nous recrutons maintenant des sujets de stade II ET de stade 3 (donc TFC et/ou échelle d’indépendance inférieure à 13/100).

Critères d'exclusion

  • Réception d’un agent expérimental dans les 90 jours ou les 5 demi-vies précédant le dépistage ou à tout moment pendant la durée de l’étude, d’agents expérimentaux ciblant l’acide ribonucléique (ARN) ou l’acide désoxyribonucléique (ADN) pour le traitement de la HD, tels que des oligonucléotides antisens, une transplantation cellulaire ou toute autre chirurgie expérimentale du cerveau.
  • Tout antécédent d’exposition à la thérapie génique pour le traitement de la MH
    Participation à une étude expérimentale ou à un paradigme expérimental (comme l’exercice/activité physique, la thérapie cognitive, la stimulation cérébrale, etc.) dans les 90 jours précédant le dépistage ou à tout moment pendant la durée de l’étude.
  • Tout antécédent médical de maladie du cerveau ou de la colonne vertébrale susceptible d’interférer avec les évaluations de sécurité du processus de ponction lombaire.
  • Tout antécédent ou condition médicale susceptible d’interférer avec la capacité à effectuer les évaluations spécifiées par le protocole (par exemple, shunt implanté, conditions empêchant les examens d’imagerie par résonance magnétique [IRM]).
  • Grossesse, intention de tomber enceinte pendant l’étude ou dans les 6 mois suivant la fin du traitement, ou allaitement.

PAYS

PAYS

ALLEMAGNE

  • Facility: Ruhr-Univ. Bochum St. Joseph-Hospital
  • Address: Bochum, Germany, 44791
  • Principal Investigator: Carsten Saft    
  • Facility: George-Huntington-Institut
  • Address: Münster, Germany, 48149
  • Principal Investigator: Ralf Reilmann  
  • Facility: Ulm University, UKU, Dep. of Neurology
  • Address: Ulm, Germany, 89081
  • Principal Investigator: Bernhard Landwehrmeyer 

Autriche

  • Facility: Medizinische Universität Innsbruck
  • Address: Christoph-Probst-Platz 1, Innrain 52 A, Fritz-Pregl-Straße 3, 6020 Innsbruck, Austria

Espagne

  • 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

FRANCE

  • Facility: Centre Hospitalier Universitaire d’Angers
  • Address: Angers, France, 49100
  • Principal Investigator: Christophe Verny   
  • Facility: Hôpital Universitaire de Marseille Hôpital de la Timone
  • Address: Marseille, France, 13385
  • Principal Investigator: Jean-Philippe Azulay
  • Facility: Brain and Spine Institute Paris
  • Address: Paris, France, 75013
  • Principal Investigator: Alexandra Durr 

Italie

  • 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

PAYS-BAS

  • Facility: Leiden University Medical Center
  • Address: Leiden, Netherlands, 2333 ZA
  • Principal Investigator: Susanne de Bot

UK

  • Facility: Cardiff University Schools of Medicine and Biosciences
  • Address: Cardiff, United Kingdom, CF10 3AX
  • Principal Investigator: Anne Rosser
  • Facility: UCL Queen Square Institute of Neurology National Hospital for Neurology and Neurosurgery
  • Address: London, United Kingdom, WC1N 3BG
  • Principal Investigator: Sarah Tabrizi
  • Facility: The Barberry National Centre For Mental Health
  • Address: 6 Bullace Croft, Birmingham B15, United Kingdom
  • Facility: Chapel Allerton Hospital
  • Address: Chapel Allerton Hospital Chape, Chapeltown Rd, Leeds LS7 4SA, 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.