MR 引导聚焦超声加 GCase
使用 MR 引导聚焦超声诱导血脑屏障打开的帕金森氏病患者重组葡糖脑苷脂酶双侧壳核递送的 I/II 期研究
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.
研究概览
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习地点
-
-
Ontario
-
Toronto、Ontario、加拿大
- Sunybrook Research Institute
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的: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 |
|
实验性的: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 |
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Adverse Events
大体时间: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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Feasibility of MRgFUS BBB opening for GCase brain delivery
大体时间:12 Months
|
Using MRI images to measure:
|
12 Months
|
合作者和调查者
赞助
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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