Effect of Alemtuzumab on Microglial Activation Positron Emission Tomography (PET) in Multiple Sclerosis
Effect of Alemtuzumab on Microglial Activation Assessed Using Novel [F-18]-Based Positron Emission Tomography (PET) Ligand in Multiple Sclerosis
Specific Aims
The specific aims of the study are:
- Primary Objective: To assess the effect of alemtuzumab on microglial activation in MS patients. The hypothesis is that alemtuzumab reduces microglial activation in MS, which may mediate its effect on reducing conversion of RRMS patients to SPMS, and its effects on cognition, including cognitive fatigue.
- Secondary Objective: To determine the time course of effect of alemtuzumab on microglial activation. The hypothesis is that alemtuzumab reduces microglial activation at 6 months after initiation of treatment and this effect persists and is accentuated at 18 years, i.e. after administration of the second course
調査の概要
詳細な説明
I. Subject Selection
Subjects will be recruited at the Partners MS Center, 60 Fenwood Road, Boston, MA. In addition, referrals for the study will be obtained from MS Center at University of Massachusetts Medical center, Worcester, MA. Subjects will also be recruited through Health and Clinical Research OnCall websites, and from individual physician references.
II. Study Procedures
Initial Visit:
During the first visit, subjects will be adminsitered a screening questionnaire. Subjects will review and eventually sign the consent form. They will be administered standardized questionnaires for cognitive testing and/or other co-morbidities. In addition, a blood sample will be drawn for genotype testing to identify high affinity, medium affinity and low affinity binders.
Genotype Testing Blood sample drawn on the initial screening visit will be used to obtain genomic DNA for genotyping for polymorphism within the TSPO gene on chromosome 22q13.2, using a Taqman assay. High affinity and medium affinity binders will be included in the study while the low affinity binders will be excluded from the study. The blood sample will also be assessed for serum creatinine and estimated GFR because these subjects would need to undergo intravenous gadolinium contrast administration with their 3T MRIs. Blood samples will be stored for future immunophenotyping and/or other blood assays in the future.
PET Visits:
During the PET scan visits, all women subjects of child bearing age will undergo a stat quantitative serum hCG pregnancy test and only women with a negative test will undergo the radiopharmaceutical injection.
PET imaging procedures
PET scanning session will be at BWH PET scanning facility, 75 Francis Street, Boston, MA.
For PET scanning, an intravenous (IV) catheter will be inserted into the radial antecubital or other arm or hand vein for injection of tracer. Radiopharmaceutical will be injected as a bolus (approximately 4mCi for [F-18]PBR06) followed by 5 mL of saline. At the time of imaging, the subjects will be positioned in the gantry of a PET camera. Head alignment will be made, relative to the canthomeatal line, using projected laser lines whose positions are known with respect to the slice positions of the scanner. A head support apparatus will be used to minimize head motion. Brain PET data acquisition will begin at the moment of radiotracer injection. Images will be acquired using a high-resolution PET/CT scanner.
MRI Visit(s):
All subjects will undergo a 3T Brain MRI during an MRI visit that may precede or follow the PET scan visit(s) but will be perfromed within 2 weeks of each other.
MRI imaging procedures MRI scanning session will be performed at BWH MRI facility at 60 Fenwood Road, Boston, MA. MRIs will be performed with and without intravenous gadolinium-based contrast.
Imaging Data
The following data will be collected on all subjects during scanning sessions:
During PET scanning, brain images will be acquired in 3-D mode, and dynamic acquisition scans will continue for 120 minutes. A non-diagnostic CT scan will be performed for attenuation correction of PET transmission data at the time of initiation of scanning. MRI data will be acquired as described above. T2/ FLAIR and other MRI images will be coregistered with PET images
. Non Imaging/Clinical Data
The following non-imaging/clinical data will be obtained:
Expanded Disability Status Scale (EDSS) Timed 25-feet walk (T25W) MS Functional Composite (MSFC) Minimal Assessment of Cognitive Function Scale in MS (MACFIMS) battery Symbol digit modalities test (SDMT) MSQOL-54 scale (QOL) Modified fatigue Impact Scale (MFIS) Pittsburgh Sleep Quality Index (PSQI) Beck's Depression Inventory (BDI) Center for Epidemiological Studies-Depression Scale (CES-D) Hospital Anxiety and Depression Scale (HADS)
研究の種類
入学 (予想される)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究連絡先
- 名前:Tarun Singhal, MD
- 電話番号:203-804-5131
- メール:tsinghal@bwh.harvard.edu
研究場所
-
-
Massachusetts
-
Boston、Massachusetts、アメリカ、02115
- Partners MS Center, 60 Fenwood Road
-
コンタクト:
- Steven Cicero
- 電話番号:617-264-3044
- メール:scicero@bwh.harvard.edu
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Patients with Relapsing Remitting Multiple Sclerosis (RRMS) (defined by International Panel Criteria)
- Age 18-60 years
- Enrolled to start treatment with alemtuzumab
Exclusion Criteria:
- Relapse/Corticosteroid treatment in the past 4 weeks to avoid transient effects on imaging
- Individuals with a known alternate neurologic disorder, previous head injury, or substance abuse.
- Individuals with bipolar disease and schizophrenia
- Concurrent medical conditions that contraindicate study procedures.
- Women who are pregnant or nursing. Also, any woman who is seeking to become pregnant or suspects she is pregnant will be excluded from enrollment.
- Claustrophobia
- Non-MRI compatible implanted devices
- Low affinity binder
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:診断
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:Relapsing Remitting Multiple Sclerosis starting Alemtuzumab
Patients with Relapsing Remitting Multiple Sclerosis (RRMS) (defined by International Panel Criteria), age 18-60 years, enrolled to start treatment with alemtuzumab. Subjects will undergo [F-18]PBR06 PET scans at baseline, 6 months and 18 months. |
PET放射性医薬品
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
PET Uptake/Standardized uptake value ratio (SUVR) change
時間枠:baseline and 18 months
|
PET outcome measure change at 18 months from baseline
|
baseline and 18 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
PET Uptake/Standardized uptake value ratio (SUVR) change
時間枠:baseline and 6 months
|
PET outcome measure change at 6 months from baseline
|
baseline and 6 months
|
T2/FLAIR lesion load change
時間枠:baseline and 18 months
|
MRI outcome measure change at 18 months from baseline
|
baseline and 18 months
|
Whole brain/deep gray matter atrophy change
時間枠:baseline and 18 months
|
MRI outcome measure change at 18 months from baseline
|
baseline and 18 months
|
Expanded Disability Status Scale (EDSS) change
時間枠:baseline and 18 months
|
Clinical outcome measure change at 18 months from baseline; Scale Range: 0-10; Higher values represent worse outcomes
|
baseline and 18 months
|
Timed 25-foot walk (T25FW) change
時間枠:baseline and 18 months
|
Clinical outcome measure change at 18 months from baseline
|
baseline and 18 months
|
Modified Fatigue Impact Scale (MIFS) change
時間枠:baseline and 18 months
|
Clinical outcome measure change at 18 months from baseline; Physical subscale range: 0-36; Cognitive subscale range: 0-40; Psychosocial subscale range: 0-8; Total MFIS Score scale range (Subscales Summed): 0-84; Higher values represent worse outcomes
|
baseline and 18 months
|
Minimal Assessment of Cognitive Function in MS (MACFIMS) change
時間枠:baseline and 18 months
|
Clinical outcome measure change at 18 months from baseline
|
baseline and 18 months
|
協力者と研究者
捜査官
- 主任研究者:Tarun Singhal, MD、Brigham and Women's Hospital
研究記録日
主要日程の研究
研究開始 (予想される)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 2018A019732
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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[F-18]PBR06の臨床試験
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Brigham and Women's HospitalBiohaven Pharmaceuticals, Inc.完了多系統萎縮症 | 多系統萎縮症、パーキンソンバリアント(障害) | 多系統萎縮症、小脳バリアント | 起立性低血圧を伴う多系統萎縮症 (MSA)アメリカ
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Brigham and Women's Hospitalわからない
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Brigham and Women's HospitalU.S. Army Medical Research Acquisition Activity募集
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Brigham and Women's HospitalNovartis募集
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John M. BuattiNational Cancer Institute (NCI); National Institutes of Health (NIH)完了
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Chang Gung Memorial Hospital完了前頭側頭型認知症 | 進行性核上性麻痺 | アルツハイマー病 | 血管性認知障害 | 皮質基底症候群台湾