MR-guided Focused Ultrasound Plus GCase
En fas I/II-studie för bilateral putamenal tillförsel av rekombinant glukocerebrosidas hos patienter med Parkinsons sjukdom med användning av MR-vägledd fokuserat ultraljudsinducerad öppning av blod-hjärnbarriären
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.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
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.
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
Ontario
-
Toronto, Ontario, Kanada
- Sunybrook Research Institute
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: 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 |
|
Experimentell: 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 |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Adverse Events
Tidsram: 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
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Feasibility of MRgFUS BBB opening for GCase brain delivery
Tidsram: 12 Months
|
Using MRI images to measure:
|
12 Months
|
Samarbetspartners och utredare
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- PD016
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