- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT04089579
hCT-MSC nei bambini con disturbo dello spettro autistico (IMPACT)
Uno studio di fase II su hCT-MSC, un prodotto cellulare stromale mesenchimale derivato dal cordone ombelicale, in bambini con disturbo dello spettro autistico
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
Lo scopo di questo studio di fase II in doppio cieco è determinare l'efficacia delle cellule stromali mesenchimali derivate dal tessuto del cordone ombelicale umano (hCT-MSC), somministrate in due diverse strategie di dosaggio, nei bambini con disturbo dello spettro autistico (ASD).
Questo studio arruolerà bambini con ASD, di età compresa tra 4 e 11 anni. I soggetti idonei saranno sottoposti a valutazione neuropsicologica, test EEG, tracciamento oculare, valutazioni CVA e infusione del prodotto dello studio. I soggetti saranno randomizzati in uno dei due bracci dello studio; 1) una singola infusione di 6,0x106 cellule/Kg al basale, seguita da un'infusione di placebo in cieco a sei mesi o, 2) Infusione di placebo al basale, seguita da una dose endovenosa di 6x106 cellule/Kg a sei mesi.
L'endpoint primario di questo studio è il cambiamento nell'abilità di comunicazione sociale dal basale a sei mesi. I potenziali rischi associati all'infusione di MSC includono una reazione al prodotto (eruzione cutanea, mancanza di respiro, respiro sibilante, difficoltà respiratorie, ipotensione, gonfiore intorno alla bocca, alla gola o agli occhi, tachicardia, sudorazione), trasmissione dell'infezione e sensibilizzazione HLA.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 2
Contatti e Sedi
Luoghi di studio
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North Carolina
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Durham, North Carolina, Stati Uniti, 27705
- Duke University Medical Center
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Descrizione
Criterio di inclusione
- Età da ≥ 4 anni a < 12 anni (11 anni, 364 giorni) al momento del consenso
- Diagnosi clinica confermata dal DSM-5 di disturbo dello spettro autistico utilizzando la lista di controllo del DSM-5 come informata dalla Breve osservazione dei sintomi dell'autismo (BOSA) e dall'Autism Diagnostic Interview-Revised (ADI-R)
- Test X Fragile eseguito e negativo; Sequenziamento dell'APLV e/o dell'intero esoma eseguito e risultati non collegati alla diagnosi di autismo
- Stabile sull'attuale regime di farmaci psichiatrici (dose e programma di dosaggio) per almeno 2 mesi prima dell'infusione del prodotto in studio
- Conta linfocitaria assoluta normale (≥1200/uL per i partecipanti afroamericani e ≥1500/uL per tutti gli altri partecipanti)
- GAI ≥ 65 tramite test cognitivi da parte del personale dello studio
- Il partecipante e il genitore/tutore parlano inglese
- In grado di recarsi alla Duke University due volte (baseline, sei mesi) e il genitore/tutore può partecipare a sondaggi e interviste intermedie
- Consenso del genitore/tutore di almeno un genitore/tutore
Criteri di esclusione
Generale:
- La revisione delle cartelle cliniche e/o le valutazioni di screening indicano che la diagnosi di ASD e/o GAI > 65 non è sicura
- Diagnosi nota di una qualsiasi delle seguenti condizioni psichiatriche coesistenti: depressione, disturbo bipolare, schizofrenia, disturbo ossessivo compulsivo associato a disturbo bipolare, sindrome di Tourette
- I dati di screening suggeriscono che il partecipante non sarebbe in grado di soddisfare i requisiti delle procedure di studio valutate dal gruppo di studio
- La famiglia non vuole o non è in grado di impegnarsi a partecipare a tutte le valutazioni relative allo studio, incluso il follow-up del protocollo
- Il fratello è arruolato in questo studio (Duke IMPACT).
Genetico:
- I registri indicano che il bambino ha una sindrome genetica nota come (ma non limitata a) sindrome dell'X fragile, neurofibromatosi, sindrome di Rett, sclerosi tuberosa, mutazione PTEN, fibrosi cistica, distrofia muscolare o un difetto genetico definitivamente noto per essere associato all'ASD
- Mutazione patogena nota o variazione del numero di copie (CNV) associata a ASD (ad esempio, 16p11.2, 15q13.2, 2q13.3)
Infettivo:
- Infezione attiva nota del sistema nervoso centrale
- Evidenza di infezione incontrollata basata su registrazioni o valutazione clinica
- Positività HIV nota
- Esposizione a COVID-19 nei 14 giorni precedenti o test COVID-19 positivo nei 28 giorni precedenti. I soggetti con una storia passata di infezione da COVID-19 devono essere asintomatici per 14 giorni prima della visita iniziale.
Medico:
- Disturbo metabolico noto
- Disfunzione mitocondriale nota
- Storia di epilessia instabile o disturbo convulsivo incontrollato, spasmi infantili, sindrome di Lennox Gastaut, sindrome di Dravet o altri disturbi convulsivi cronici simili
- Malignità attiva o malignità precedente che è stata trattata con chemioterapia
- Storia di un disturbo da immunodeficienza primaria
- Storia di citopenie autoimmuni (cioè, ITP, AIHA)
- - Condizione medica coesistente che esporrebbe il bambino a un rischio maggiore di complicanze delle procedure dello studio
- Malattie genetiche o acquisite concomitanti o comorbidità che potrebbero richiedere un futuro trapianto di cellule staminali
- Significativa compromissione sensoriale (ad es. cecità, sordità, compromissione dell'udito non corretta) o motoria (ad es. paralisi cerebrale)
- Funzionalità renale o epatica compromessa, determinata dalla creatinina sierica >1,5 mg/dL o dalla bilirubina totale >1,3 mg/dL, tranne nei pazienti con malattia di Gilbert nota
- Anomalie ematologiche significative definite come: Emoglobina <10,0 g/dL, Piastrine <150 x 10e9/uL, WBC <3.000 cellule/mL, ALC <1200/uL per gli afroamericani o <1500/uL per tutti gli altri partecipanti.
- Evidenza di dismorfologia fisica clinicamente rilevante indicativa di una sindrome genetica valutata dagli investigatori privati o da altri ricercatori, inclusi un genetista medico e psichiatri addestrati nell'identificazione delle caratteristiche dismorfiche associate a condizioni di sviluppo neurologico.
Terapia attuale/precedente:
UN. Disponibilità di un'unità di sangue del cordone ombelicale autologa qualificata in banca o utilizzo differito dei genitori di un'unità di sangue del cordone ombelicale autologo qualificata b. Storia di precedente terapia cellulare c. Uso attuale o precedente di IVIG o altri farmaci antinfiammatori ad eccezione dei FANS d. Terapia immunosoppressiva in corso o precedente i. Nessuna terapia steroidea sistemica che sia durata> 2 settimane e nessun steroide sistemico entro 3 mesi prima dell'arruolamento. Sono consentiti steroidi topici e per via inalatoria.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Quadruplicare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: MSC
Una dose di 6x10e6 cellule/kg somministrata per via endovenosa.
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Cellule stromali mesenchimali derivate da tessuto del cordone ombelicale umano (hCT-MSC), isolate ed espanse dal tessuto del cordone ombelicale da donatori allogenici non imparentati.
Una dose di 6x10e6 cellule/kg somministrata per via endovenosa.
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Comparatore placebo: Infusione di placebo
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Infusione comparativa di placebo
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change on the Average Socialization and Communication Subscale Standard Scores on the Vineland Behavior Scales (VABS-3)
Lasso di tempo: Baseline, 6 months
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The primary outcome measure is the mean of the Socialization and Communication Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form.
The primary endpoint is the change in this outcome measure from baseline to six months before the second infusion.
A positive change in the scores indicates an improvement in socialization and communication.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
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Baseline, 6 months
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in VABS-3 (Vineland Adaptive Behavior Scales) Socialization Standard Score
Lasso di tempo: Baseline, 6 months
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The change in the Socialization Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months.
Higher Socialization Standard scores indicate greater socialization.
A positive change in the scores indicates an improvement in socialization.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
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Baseline, 6 months
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Change in VABS-3 Communication Standard Score
Lasso di tempo: Baseline, 6 months
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The change in the Communication Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion.
Higher scores indicate greater communication.
A positive change in the scores indicates an improvement in communication.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
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Baseline, 6 months
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CGI-S (Clinical Global Impression - Severity of Illness) Overall Score
Lasso di tempo: 6 months
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The CGI-S Overall Score is a 7-point scale that requires the clinician to rate the severity of the participant's overall functioning and symptoms of autism at the time of assessment, relative to the clinician's experience with participants who have the same diagnosis.
The clinician rates the severity of autism symptoms - 1, normal, no symptoms; 2, borderline level of symptoms; 3, mild symptoms; 4, moderate symptoms; 5, marked symptoms; 6, severe symptoms; or 7, extremely severe symptoms.
The higher ratings indicate greater severity of overall functioning impairment.
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6 months
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CGI-I (Clinical Global Impression - Improvement) Overall Score
Lasso di tempo: 6 months
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The CGI-I Overall Score is a 7-point scale that requires the clinician to assess how much the participant's autism overall functioning and symptoms have improved or worsened relative to a baseline assessment.
The symptoms are rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.
The lower scores indicate greater improvement.
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6 months
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Change in the Pediatric Quality of Life (PedsQL) Total Scale Score
Lasso di tempo: Baseline, 6 months
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The PedsQL 4.0 Generic Core Scales is a 5-minute parent questionnaire that measures the child's functioning in the dimensions of physical, emotional, social, and school.
The items use a Likert rating scale from 0 (Never) to 4 (Almost Always).
This 0-4 scale is then transformed to 0=100, 1=75, 2=50, 3=25, and 4=0 for a reverse score.
The Total Scale Score is then computed as the sum of all the items over the number of items answered on all the Scales for a total score range of 0 to 100.
Higher scores indicate a better quality of life.
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Baseline, 6 months
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Number of Participants Experiencing an Infusion Reaction
Lasso di tempo: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not what they were randomized.
Patients received the infusion to which they were randomized at baseline and the alternate treatment at 6 months.
Therefore, adverse events are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
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up to 12 months
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Number of Participants Experiencing Product-related Infections
Lasso di tempo: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized.
Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months.
AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
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up to 12 months
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Evidence of Formation of Anti-HLA Antibodies
Lasso di tempo: Baseline, 6 months, 12 months
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Assess for anti-HLA antibodies
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Baseline, 6 months, 12 months
|
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Number of Participants Experiencing Graft Versus Host Disease (GVHD)
Lasso di tempo: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized.
Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months.
AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
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up to 12 months
|
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Number of Participants Experiencing Unexpected Adverse Events Related to the Study Product
Lasso di tempo: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized.
Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months.
AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
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up to 12 months
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Change on the Adaptive Behavior Composite Subscale Standard Score on the Vineland Behavior Scales (VABS-3)
Lasso di tempo: Baseline, 6 months
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The change in the Vineland Adaptive Behavior Scales (VABS-3) Adaptive Behavior Composite Subscale from baseline to 6 months before the second infusion.
Higher Adaptive Behavior Composite Standard scores indicate greater adaptive behavior.
A positive change in the scores indicates an improvement in adaptive behavior.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
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Baseline, 6 months
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Change in VABS-3 (Vineland Adaptive Behavior Scales) Daily Living Skills Standard Score
Lasso di tempo: Baseline, 6 months
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The change in the Daily Living Skills Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months before the second infusion.
Higher Daily Living Skills Standard scores indicate greater daily living skills.
A positive change in the scores indicates an improvement in daily living skills.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
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Baseline, 6 months
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Change in VABS-3 Motor Skills Standard Score
Lasso di tempo: Baseline, 6 months
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The change in the Motor Skills Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion.
Higher scores indicate greater motor skills.
A positive change in the scores indicates an improvement in motor skills.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
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Baseline, 6 months
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Change in Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal
Lasso di tempo: Baseline, 6 months
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The change in the Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal scale from baseline to six months before the second infusion.
Higher scores indicate greater problems with social withdrawal.
A positive change in the scores indicates a worsening in social withdrawal.
This scale has 16 items that are scored on a 4-point Likert scale: 0 = not a problem, 1 = slight problem, 2 = moderately serious problem, 3 = severe problem.
The individual items are added together to calculate the Social Withdrawal scale score.
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Baseline, 6 months
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Change in Pervasive Developmental Disorder Behavior Inventory (PDDBI) Total Score
Lasso di tempo: Baseline, 6 months
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The change in the Pervasive Developmental Disorder Behavior Inventory (PDDBI) from baseline to 6 months before the second infusion.
The PDDBI is a measure of problem behaviors and social, language, and learning or memory skills of children who have been diagnosed with autism spectrum disorder.
Raw scores are converted to T-scores.
The T-score has a mean of 50 with a standard deviation of 10 points with a range of 10-100.
Higher scores indicate greater behavioral issues and a positive change in score indicates worsening.
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Baseline, 6 months
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Change in the Autism Impact Measure (AIM)
Lasso di tempo: Baseline, 6 months
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The change in the Autism Impact Measure (AIM) from baseline to 6 months before second infusion.
AIM is a measure of core Autism Spectrum Disorder Symptoms.
It is a parent-report questionnaire that includes 41 core-symptom items rated on two corresponding 5-point scales: frequency (ranging from "never" to "always") and impact (ranging from "not at all" to "severely") over the previous two weeks.
Frequency and impact ratings are combined, yielding a total score range of 82 to 410.
Higher scores indicate greater symptom severity; a positive change in score indicates worsening of symptoms.
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Baseline, 6 months
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Change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control Subscale
Lasso di tempo: Baseline, 6 months
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The change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control subscale from baseline to month 6 before the second infusion.
BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
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Baseline, 6 months
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Change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory Subscale
Lasso di tempo: Baseline, 6 months
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The change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory subscale from baseline to month 6 before the second infusion.
The BREIF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
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Baseline, 6 months
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Change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit Subscale
Lasso di tempo: Baseline, 6 months
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The change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit subscale from baseline to month 6 before the second infusion.
The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
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Baseline, 6 months
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Change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization Subscale
Lasso di tempo: Baseline, 6 months
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The change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization subscale from baseline to month 6 before the second infusion.
The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
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Baseline, 6 months
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Change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift Subscale
Lasso di tempo: Baseline, 6 months
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The change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift subscale from baseline to month 6 before the second infusion.
The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
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Baseline, 6 months
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Change in the Expressive Vocabulary Test (Third Edition, EVT-3)
Lasso di tempo: Baseline, 6 months
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The change in the Expressive Vocabulary Test (Third Edition, EVT-3) from baseline to 6 months before the second infusion.
The EVT-3 is a measure of a participant's ability to match a spoken word with an image of an object, action, or concept.
The number of words that are retrieved is converted to a Standard Score, where 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
A positive change in EVT-3 score indicates improvement.
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Baseline, 6 months
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Collaboratori e investigatori
Sponsor
Investigatori
- Investigatore principale: Lauren Franz, MBChB, Duke University
- Investigatore principale: Beth Shaz, MD, Duke University
Pubblicazioni e link utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- Pro00113011
- Pro00102894 (Altro identificatore: Duke IRB)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
prodotto fabbricato ed esportato dagli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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