MR-guidet Focused Ultrasound Plus GCase
Et fase I/II-studie for bilateral putamenal levering af rekombinant glucocerebrosidase hos patienter med Parkinsons sygdom ved brug af MR-guidet fokuseret ultralydsinduceret åbning af blod-hjerne-barrieren
The goal of this study is to establish safety and feasibility of intracerebral delivery of GCase via MRgFUS. This technique may offer potential benefits given the exposure of the putamen to GCase in animal models has been shown to be efficacious in improving Parkinson's disease pathology and phenotype.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
This is a two-arm, open-label, intervention only phase I/II clinical study. One arm of the study will enroll seven (7) GBA PD patients and the other arm seven (7) idiopathic PD patients. During the intervention phase, the first four subjects of each arm will receive three transcranial bilateral putamenal GCase at 30 IU/kg IV every two weeks, followed by 60 IU/kg in the next three subjects. Following three treatments in this study, the subjects will be followed for twelve months.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
Ontario
-
Toronto, Ontario, Canada
- Sunybrook Research Institute
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Men or women between age 35 and 80 years, inclusive.
- Able and willing to give informed consent.
- Diagnosis of PD satisfying MDS Clinical Diagnostic Criteria for PD
- At least 2 years from initial diagnosis
- Hoehn and Yahr Stage 1-3 on PD medication
- Dopaminergic deficit by a positive DAT SPECT scan
- On stable regimen of PD medications for at least 90 days prior to the study
- American Society of Anesthesiologists (ASA) score 1-3
- Harbor at least one GBA mutation if enrolled in the GBA PD arm or two wild-type GBA alleles if enrolled in the idiopathic PD arm
Exclusion Criteria:
- Positive pregnancy test (for pre-menopausal women).
- Contraindication to DEFINITY ultrasound contrast agent or perflutren (e.g. hypersensitivity, known left or bidirectional cardiac shunt)
- Contraindication to MRI or gadolinium-DTPA (e.g. incompatible device, hypersensitivity)
- Insulin-dependent diabetes mellitus that is not well-controlled or that in the Investigator's opinion precludes participation in the study.
- Severely impaired renal function with estimated glomerular filtration rate <30 mL/min/1.73m2 and/or on dialysis.
- Currently participating in another clinical therapeutic trial
- Patient receiving bevacizumab (Avastin) therapy
- Subjects with evidence of cranial or systemic infection.
- Cerebral or systemic vasculopathy.
- Documented cerebral infarction within the past 12 months or TIA in the past 1 month.
- Contraindication to GCase enzyme therapy, specifically previous hypersensitivity reaction to GCase enzyme therapy
- Parkinsonism plus symptoms, secondary parkinsonism
- Previous neurosurgical procedure for PD
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Ikke-randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Idiopathic PD Patients
Idiopathic PD patients receiving 3 cycles of BBBO. There is option to include simultaneous GCase delivery after safety profile review by Data and Safety Monitoring Board (DSMB). |
Delivery of GCase across the BBB to form a disease modifying strategy for patients with Parkinson's Disease |
|
Eksperimentel: GBA PD Patients
GBA PD patients receiving 3 cycles of BBBO. There is option to include simultaneous GCase delivery after safety profile review by Data and Safety Monitoring Board (DSMB). |
Delivery of GCase across the BBB to form a disease modifying strategy for patients with Parkinson's Disease |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Adverse Events
Tidsramme: 12 Months
|
Measure of the adverse events through the intervention phase and follow-up. All adverse events and/or Serious Adverse Events will be documented and reported according to CTCAE criteria. |
12 Months
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Feasibility of MRgFUS BBB opening for GCase brain delivery
Tidsramme: 12 Months
|
Using MRI images to measure:
|
12 Months
|
Samarbejdspartnere og efterforskere
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- PD016
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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Studerer et amerikansk FDA-reguleret enhedsprodukt
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