Dose Response Study of Nitisinone in Alkaptonuria (SONIA1)
An International, Multicentre, Randomised, Open-label, No-treatment Controlled, Parallel-group, Dose-response Study to Investigate the Effect of Once Daily Nitisinone on 24-hour Urinary Homogentisic Acid Excretion in Patients With Alkaptonuria After 4 Weeks Treatment.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Merseyside
-
Liverpool, Merseyside, United Kingdom, L7 8XP
- Royal Liverpool Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria
A subject must fulfil the following criteria in order to be included in the study:
- Diagnosis of alkaptonuria verified by documented elevated urinary homogentisic acid excretion.
- Age ≥18 years.
- Willing and able to visit the investigational site for study visits.
- Signed written informed consent obtained.
Exclusion criteria
The presence of any of the following will exclude a subject from inclusion in the study:
- Non-alkaptonuria causes of ochronosis.
- Currently pregnant or lactating.
- Known allergy to nitisinone or any of the constituents of the investigational product.
- Use of a protein-restricted diet
- Dietary habits or use of homeopathic therapies that interfere with tyrosine catabolism.
- Current keratopathy, contact lens use or uncontrolled glaucoma.
- Current malignancy.
- Uncontrolled hypertension (blood pressure greater than 180 systolic or greater than 95 diastolic).
- Electrocardiogram changes indicative of myocardial infarction, arrhythmia, tachycardia, bradycardia, left bundle branch block.
- Chest radiographic abnormalities, including an infiltrative, mass, congestive heart failure, embolism, atelectasis.
- Serum potassium < 3.0 mmol/L.
- eGFR < 60 mL/min.
- Any hepatic enzymes greater than 3 x upper limit of normal.
- Haemoglobin < 10.0 g/dL.
- Platelets less than 100 x 109/L.
- WBC less than 3.0 x 109/L.
- ESR greater than 100 mm/h.
- History of alcohol or drug abuse.
- Participation in another clinical trial within 3 months of randomisation.
- Treatment with nitisinone within 3 months of randomisation
- Psychiatric illness or neurological disease that interferes with compliance or communication with health care personnel.
- Any other medical condition which in the opinion of the investigator makes the subject unsuitable for inclusion.
- Foreseeable inability to cooperate with given instructions or study procedures.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: no treatment
comparrator
|
|
|
Experimental: Nitisinone 1mg
interventional
|
doses 1, 2, 4 & 8 mg plus no treatment arm
|
|
Experimental: Nitisinone 2mg
interventional
|
doses 1, 2, 4 & 8 mg plus no treatment arm
|
|
Experimental: Nitisinone 4mg
interventional
|
doses 1, 2, 4 & 8 mg plus no treatment arm
|
|
Experimental: Nitisinone 8mg
interventional
|
doses 1, 2, 4 & 8 mg plus no treatment arm
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
dose of nitisinone that decreases urinary homogentisic acid to near normal
Time Frame: 4 weeks
|
4 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: L Ranganath, Royal Liverpool & Broadgreen University Hospitals NHS Truts
Publications and helpful links
General Publications
- Milan AM, Hughes AT, Davison AS, Khedr M, Rovensky J, Psarelli EE, Cox TF, Rhodes NP, Gallagher JA, Ranganath LR. Quantification of the flux of tyrosine pathway metabolites during nitisinone treatment of Alkaptonuria. Sci Rep. 2019 Jul 11;9(1):10024. doi: 10.1038/s41598-019-46033-x.
- Ranganath LR, Milan AM, Hughes AT, Dutton JJ, Fitzgerald R, Briggs MC, Bygott H, Psarelli EE, Cox TF, Gallagher JA, Jarvis JC, van Kan C, Hall AK, Laan D, Olsson B, Szamosi J, Rudebeck M, Kullenberg T, Cronlund A, Svensson L, Junestrand C, Ayoob H, Timmis OG, Sireau N, Le Quan Sang KH, Genovese F, Braconi D, Santucci A, Nemethova M, Zatkova A, McCaffrey J, Christensen P, Ross G, Imrich R, Rovensky J. Suitability Of Nitisinone In Alkaptonuria 1 (SONIA 1): an international, multicentre, randomised, open-label, no-treatment controlled, parallel-group, dose-response study to investigate the effect of once daily nitisinone on 24-h urinary homogentisic acid excretion in patients with alkaptonuria after 4 weeks of treatment. Ann Rheum Dis. 2016 Feb;75(2):362-7. doi: 10.1136/annrheumdis-2014-206033. Epub 2014 Dec 4.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- UoL000928
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