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An Open-Label Phase II Feasibility Study for the Use of Ublituximab in Adults With Down Syndrome Regression Disorder

4 septembre 2026 mis à jour par: Jonathan Santoro

The goal of this clinical trial is to evaluate whether the monoclonal antibody ublituximab can treat Down Syndrome Regression Disorder (DSRD) by assessing its safety, tolerability, and preliminary efficacy in affected individuals. This study is conducted in adults aged 18-40 years with Down syndrome who have DSRD and have had an inadequate or partial response to first-line therapies.

The main questions it aims to answer are:

  • Does ublituximab demonstrate acceptable safety and tolerability, as measured by treatment-emergent adverse events from baseline through Week 24?
  • Does ublituximab lead to improvement in cognitive, neuropsychiatric, motor, and functional outcomes from baseline to Weeks 12 and 24?

This is a single-arm study, so there is no comparison group.

Participants will:

  • Receive two intravenous infusions of ublituximab (150 mg on Day 1 and 450 mg on Day 15)
  • Attend study visits at Screening, Baseline (Day 1) , Week 2 (Day 15), Week 3, Week 6, Week 12, and Week 24
  • Undergo clinical assessments, including neurological and physical exams and safety monitoring labs throughout the study
  • Complete cognitive, behavioral, and functional evaluations at Baseline, Week 12, and Week 24
  • Provide blood samples for safety monitoring and research biomarker analyses

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Estimé)

20

Phase

  • Phase 2

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

Lieux d'étude

  • États-Unis
    • California
      • Los Angeles, California, États-Unis, 90027
        • Children's Hospital Los Angeles
        • Contact:
        • Contact:
        • Chercheur principal:
          • Jonathan Santoro, MD

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  • Age 18 to 40 years, inclusive at time of consent
  • Diagnosis of Down syndrome (trisomy 21 or translocation type)
  • Diagnosis of possible or probable Down Syndrome Regression Disorder (DSRD) based on 2022 International Consensus Criteria
  • History of partial response or non-response to first-line treatment (e.g., lorazepam, SSRIs, corticosteroids, and/or IVIg). Partial response = 10-50% improvement, Non-response = <10% improvement, Based on BFCRS or NPI-Q after 3 months of treatment.
  • Ability to attend all study visits with a study partner or legally authorized representative
  • Study partner willing to comply with all study procedures
  • Willingness to complete required washout periods for medications that may interfere with the study
  • Highly effective contraception for reproductive participants and partners of childbearing potential.
  • Study partner/LAR sufficiently proficient in English to complete assessments.

Exclusion Criteria:

  • Mosaic Down syndrome
  • Weight < 40 kg at screening
  • Pregnancy or breastfeeding
  • Current or past tobacco smoking
  • Poor venous access or inability to comply with IV procedures
  • Use of IVIg within 8 weeks prior to baseline
  • Use of immunosuppressive drugs within 12 weeks prior to baseline
  • Prior treatment with anti-CD20 or B-cell therapies within required washout unless B-cell recovery criteria are met
  • Other immunosuppressive biologics within 24 months.
  • Any prior use of chemotherapeutic agents (e.g., methotrexate, cyclophosphamide)
  • History of solid organ transplant
  • Recent receipt of blood or plasma products (≤30 days)
  • Clinically significant cardiac disease, clotting disorder, or other serious medical condition
  • Active or chronic infection of clinical significance (including HBV, HCV, TB, HIV per protocol criteria)
  • History of malignancy
  • Abnormal screening labs indicating unacceptable risk
  • Receipt of live or live-attenuated vaccines within 4 weeks prior to treatment
  • Untreated thyroid disease (hypo- or hyperthyroidism)
  • History of moyamoya syndrome or stroke
  • Wards of the state
  • Employees or students of Children's Hospital Los Angeles (CHLA)
  • Prior neurosurgical intervention (exceptions for longstanding shunts)
  • Current investigational therapy/prohibited medications
  • Detailed HBV, HCV, and TB criteria
  • Requirement for B-cell recovery >50 cells/μL after prior anti-CD20 therapy.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Ublituximab
Participants assigned to the Ublituximab arm will receive a fixed two-dose intravenous regimen consisting of 150 mg on Day 1 and 450 mg on Day 15. All participants will be followed for 24 weeks with regular safety monitoring, clinical assessments, and evaluation of cognitive, neuropsychiatric, and functional outcomes.
Médicament: Ublituximab
Participants assigned to the Ublituximab arm will receive a fixed two-dose intravenous regimen consisting of 150 mg on Day 1 and 450 mg on Day 15. All participants will be followed for 24 weeks with regular safety monitoring, clinical assessments, and evaluation of cognitive, neuropsychiatric, and functional outcomes.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Total AEs on Ublituximab
Délai: Baseline through Week 24
Safety will be evaluated by the incidence, type, severity (graded per CTCAE v5.0), and relationship of treatment-emergent adverse events (AEs) occurring after the first dose of ublituximab. Tolerability will be assessed by the proportion of participants completing both doses and follow-up without dose modifications, interruptions, or discontinuation due to AEs.
Baseline through Week 24

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in Scores for Adaptive Behavior using VABS-3 Composite and Domain Survey
Délai: Baseline, Week 12, and Week 24
Change from baseline in adaptive functioning measured by the Vineland Adaptive Behavior Scales, Third Edition (VABS-3), including communication, daily living skills, socialization, and maladaptive behavior domains as reported by caregivers.
Baseline, Week 12, and Week 24
Change in Scores for Catatonia Severity using Bush-Francis Catatonia Rating Scale
Délai: Baseline, Week 12, and Week 24

Change from baseline in catatonia symptoms measured by the Bush-Francis Catatonia Rating Scale (BFCRS), with decreases in total score indicating improvement in symptom severity.

0 (no catatonia) - 45 (Severe Catatonia)
Baseline, Week 12, and Week 24
Change in Score for Neuropsychiatric Symptoms using Neuropsychiatric Inventory Questionnaire (NPI-Q)
Délai: Baseline, Week 12, and Week 24
Change from baseline in neuropsychiatric symptom burden as measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q), a caregiver-reported assessment of symptom frequency and severity across behavioral domains.
Baseline, Week 12, and Week 24
Change in Motor Function (Timed 25-Foot Walk)
Délai: Baseline, Week 12, and Week 24
Change from baseline in time (seconds) required to complete the Timed 25-Foot Walk (T25-FW), reflecting gait speed and motor function, with decreased time indicating improvement.
Baseline, Week 12, and Week 24
Change in Global Clinical Status Using Clinician Global Impression of Change-Down Syndrome (CGIC-DS)
Délai: Baseline, Week 12, and Week 24
Change from baseline in global clinical status assessed using the Clinician Global Impression of Change-Down Syndrome (CGIC-DS), a Down syndrome-adapted clinician-rated instrument. The Baseline version generates a Clinical Global Impression-Severity (CGI-S) rating to assess overall illness severity, and the Follow-up version generates a Clinical Global Impression-Improvement (CGI-I) rating to assess clinical change relative to baseline. CGI-S scores range from 1 (normal, not at all ill) to 7 (among the most extremely ill), while CGI-I scores range from 1 (very much improved) to 7 (very much worse). Assessments will be conducted at Baseline, Week 12, and Week 24.
Baseline, Week 12, and Week 24
Change in Global Clinical Status Using Clinical Global Impression-Severity (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scores Derived from the Clinician Global Impression of Change-Down Syndrome (CGIC-DS)
Délai: Baseline, Week 12, and Week 24
Change from baseline in global clinical status measured using CGI-S and CGI-I ratings derived from the Clinician Global Impression of Change-Down Syndrome (CGIC-DS). CGI-S assesses overall illness severity, and CGI-I assesses improvement or worsening relative to baseline. Assessments will be conducted at Baseline, Week 12, and Week 24. Lower CGI-S scores indicate reduced illness severity, and lower CGI-I scores indicate greater clinical improvement.
Baseline, Week 12, and Week 24
Change in Participant Quality of Life Using Pediatric Quality of Life Inventory (PedsQL) Parent Report
Délai: Baseline, Week 12, and Week 24
Change from baseline in participant quality of life measured by the Pediatric Quality of Life Inventory (PedsQL) Parent Report. This caregiver-reported assessment evaluates health-related quality of life across physical functioning, emotional functioning, social functioning, and work/studies functioning domains. Higher scores indicate better quality of life and functional status. Assessments will be conducted at Baseline, Week 12, and Week 24.
Baseline, Week 12, and Week 24
Change in Caregiver and Family Functioning Using Pediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM)
Délai: Baseline to Week 24
Change from baseline in caregiver and family functioning measured by the Pediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM). This caregiver-reported assessment evaluates the impact of the participant's condition on caregiver well-being and family functioning across physical, emotional, social, cognitive, communication, daily activities, and family relationship domains. Higher scores indicate better caregiver quality of life, improved family functioning, and less negative impact on the family. Assessments will be conducted at Baseline, Week 12, and Week 24.
Baseline to Week 24
Change in Communication Ability Using Observer-Reported Communication Ability (ORCA) Measure
Délai: Baseline, Week 12, and Week 24
Change from baseline in communication abilities measured by the Observer-Reported Communication Ability (ORCA) Measure, a caregiver-reported assessment of expressive and receptive communication skills. The ORCA evaluates verbal communication, use of gestures, social communication, requesting, conversation, comprehension, and functional communication abilities in everyday settings. Higher scores indicate greater communication ability and improved functional communication.
Baseline, Week 12, and Week 24
Change in Caregiver and Family Functioning Using Pediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM)
Délai: Baseline, Week 12, and Week 24
Change from baseline in caregiver and family functioning measured by the Pediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM). This caregiver-reported assessment evaluates the impact of the participant's condition on caregiver well-being and family functioning across physical, emotional, social, cognitive, communication, daily activity, and family relationship domains. Higher scores indicate better caregiver and family functioning and lower family burden.
Baseline, Week 12, and Week 24
Change in Obsessive-Compulsive Symptom Severity Using Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
Délai: Baseline, Week 12, and Week 24
Change from baseline in obsessive-compulsive symptom severity measured by the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), a clinician-administered assessment of obsessions and compulsions. The CY-BOCS evaluates symptom severity across domains including time occupied, interference, distress, resistance, and degree of control. Higher scores indicate greater obsessive-compulsive symptom severity, and decreases in total score indicate improvement.
Baseline, Week 12, and Week 24

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Change in Peripheral B-Cell Counts Following Ublituximab Treatment
Délai: Baseline, Week 2, Week 6, Week 12, and Week 24
Change from baseline in peripheral B-cell populations measured by high-sensitivity flow cytometry, including absolute B-cell counts and percentages of CD19+ and CD20+ B cells. Exploratory analyses will evaluate the extent and duration of B-cell depletion following ublituximab treatment and the association between B-cell depletion and clinical outcomes.
Baseline, Week 2, Week 6, Week 12, and Week 24
Change in Inflammatory Cytokine Profiles
Délai: Baseline and Week 24
Change from baseline in circulating inflammatory cytokine concentrations measured using multiplex immunoassay platforms. Cytokines and related inflammatory biomarkers will be evaluated to characterize immunologic changes associated with ublituximab treatment and Down Syndrome Regression Disorder (DSRD).
Baseline and Week 24
Change in Plasma Proteomic Signatures
Délai: Baseline and Week 24
Change from baseline in plasma proteomic profiles measured using high-throughput proteomic platforms. Exploratory analyses will identify protein expression patterns associated with DSRD and evaluate molecular changes occurring following ublituximab treatment.
Baseline and Week 24
Change in Plasma Metabolomic Profiles
Délai: Baseline and Week 24
Change from baseline in plasma metabolomic signatures measured using mass spectrometry-based metabolomic analyses. Exploratory analyses will evaluate treatment-associated changes in metabolic pathways and identify biomarkers associated with disease activity and therapeutic response.
Baseline and Week 24
Change in Interferon Signaling and Transcriptomic Profiles
Délai: Baseline and Week 24
Change from baseline in whole-blood transcriptomic signatures, including interferon-related gene expression profiles, measured from RNA biospecimens. Exploratory analyses will characterize molecular pathways associated with DSRD and assess the impact of B-cell depletion therapy on interferon signaling and other transcriptional biomarkers.
Baseline and Week 24
Change in Global Autoantibody Profiles
Délai: Baseline and Week 24
Change from baseline in circulating autoantibody profiles measured using high-throughput autoantibody profiling technologies. Exploratory analyses will evaluate changes in autoantibody repertoires following ublituximab treatment and assess associations wi
Baseline and Week 24
Change in Biomarkers of Neurodegeneration and Neuroinflammation
Délai: Baseline and Week 24
Change from baseline in plasma biomarkers of neurodegeneration and neuroinflammation, including neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCHL1), total tau, and other validated biomarkers. Exploratory analyses will evaluate relationships between biomarker changes and clinical outcomes following ublituximab treatment.
Baseline and Week 24

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Jonathan Santoro

Les enquêteurs

  • Chercheur principal: Jonathan Santoro, MD, Children's Hospital Los Angeles

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

1 octobre 2026

Achèvement primaire (Estimé)

1 octobre 2030

Achèvement de l'étude (Estimé)

1 décembre 2030

Dates d'inscription aux études

Première soumission

4 septembre 2026

Première soumission répondant aux critères de contrôle qualité

4 septembre 2026

Première publication (Réel)

10 septembre 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

10 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

4 septembre 2026

Dernière vérification

1 septembre 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • CHLA-26-00158

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Oui

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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