Epidiolex Trial for Presymptomatic Treatment of Sturge-Weber Syndrome (Epi-Pre)
Epidiolex Pilot Trial for Presymptomatic Treatment of Sturge-Weber Syndrome
Patients with Sturge-Weber syndrome (SWS) are frequently affected by seizures, and seizures are associated with poorer neurological outcomes. To date there is no established means of predicting or preventing seizure onset. Cannabidiol (Epidiolex) was well tolerated in an open label study in this population. This trial will evaluate whether Epidiolex in presymptomatic Sturge-Weber patients may delay the onset of seizures and improve neurological outcome.
研究概览
详细说明
This is an open-label, prospective dose escalation study to determine the safety and tolerability of presymptomatic treatment of SWS patients with Epidiolex. The investigators hypothesize that Epidiolex will be well tolerated and delay seizure onset in SWS patients. The total number of subjects to be consented for this safety study=10 babies with SWS; the initial funded phase will be with 6 subjects. Interim analysis will be completed after 6 subjects; the remaining 4 will be enrolled as warranted for 6 months on Epidiolex. Subjects will be dosed as recommended clinically (starting at 2.5 mg/kg/day divided bid, with weekly increases over the next 4 weeks to a maximum dose of 20 mg/kg/day) as tolerated. Neurologic visits during the trial, the bloodwork, EEGs, and motor assessments will be done as research procedures. Once the first dose of the study drug is administered, a blood draw will be done at 4-hour and 12-hour post study drug administration. A mini-PK will be similarly performed once the maximum maintenance dose is achieved.
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名:Anne Comi, MD
- 电话号码:443-923-9172
- 邮箱:comi@kennedykrieger.org
研究联系人备份
- 姓名:Brenna Keam, BS
- 电话号码:443-923-9127
- 邮箱:keam@kennedykrieger.org
学习地点
-
-
Maryland
-
Baltimore、Maryland、美国、21205
- 招聘中
- Kennedy Krieger Institute
-
接触:
- Anne Comi, MD
- 电话号码:443-923-9172
- 邮箱:comi@kennedykrieger.org
-
接触:
- Brenna Keam, BS
- 电话号码:443-923-9127
- 邮箱:keam@kennedykrieger.org
-
首席研究员:
- Ryan Felling, MD, PhD
-
-
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:
- Clinical diagnosis of Sturge-Weber Syndrome.
- Age 1 to 18 months of age, inclusive.
- Neuroimaging demonstrating involvement of 3 or more lobes, or bilateral involvement.
- No history of seizures.
- Patient's parent or legal guardian provides written informed consent prior to treatment initiation.
Exclusion Criteria:
Any severe and/or uncontrolled medical conditions at randomization including, but not limited to the following:
-
Liver disease such as cirrhosis, decompensated liver disease, and chronic hepatitis (i.e. quantifiable HBVDNA and/or positive HbsAg, quantifiable HCV-RNA). Specifically the patient should not have either AST or ALT more than 1.5 times the upper limit of normal. The Child- Pugh Score must be A (mild) which is a score of 5-6 (minimum/normal score=5). Child-Turcotte-Pugh (CTP) Calculator - Clinical Calculators - Hepatitis C Online (uw.edu)
-
Uncontrolled diabetes as defined by fasting serum glucose > 1.5 ULN
-
Active (acute or chronic) or uncontrolled severe infections
-
Active, bleeding diathesis
- Any other neurological diagnosis that increases the risk of seizure or neurodevelopmental disability.
- Patients who have had a major surgery or significant traumatic injury within 4 weeks of study entry, patients who have not recovered from the side effects of any major surgery (defined as requiring general anesthesia), or patients that may require major surgery during the course of the study.
- Prior treatment with any investigational drug or use of any other cannabis product within the preceding 4 weeks prior to study entry.
- Use of aspirin.
- Allergic reaction/hypersensitivity to Epidiolex or other forms of cannabidiol.
- Concern for non-compliance to medical regimens, or concern that the patient will not be able to complete the entire study, whether due to reliability or logistical barriers. This includes those in foster care, or those unable to keep follow-up appointments, maintain close contact with Principal Investigator, or complete all necessary studies to maintain safety.
- Use of any seizure medication (whether for seizures or any other reason) (e.g. valproate, clobazam).
- Use of chronic medications other than a multi-vitamin and/or vitamin D supplements.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 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:Presymptomatic Epidiolex Treatment
Epidiolex will be started at 2.5 mg/kg/day divided twice daily. The dose will increase weekly as tolerated over the next 5 weeks to a target dose of 20 mg/kg/day. |
Epidiolex is a prescription form of cannabidiol used to treat seizures. Epidiolex will be started at 2.5 mg/kg/day divided twice daily. The dose will increase weekly as tolerated over the next 5 weeks to a target dose of 20 mg/kg/day.
其他名称:
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
Safe completion as assessed by the number of participants with no significant side effects
大体时间:6 months
|
6 months
|
|
Safe completion as assessed by the number of participants with no seizure onset
大体时间:6 months
|
6 months
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Sturge-Weber Syndrome Neuroscore (SWS-NRS)
大体时间:baseline, week 5, week 12, and week 24
|
Neuroscore is a published SWS ordinal score that incorporates domains of visual field cut (0-2), hemiparesis (0-4), seizure frequency (0-4), and cognitive function (0-5). Total score is sum of 4 ratings with a total score from 0-15. Higher score worse impairment. This will be obtained at each study visit. |
baseline, week 5, week 12, and week 24
|
|
Milestone checklist
大体时间:baseline, week 5, week 12, and week 24
|
A publicly available milestone checklist from Pathways.org will be completed at every study visit. The checklist is personalized based on age. Does not use a numerical or point based scoring system. It uses a pass/fail or completed/not-completed checklist tracking format related to Motor, Sensory, Communication, and Feeding abilities. |
baseline, week 5, week 12, and week 24
|
|
Modified Early Motor Questionnaire (EMQ)
大体时间:Baseline, week 24
|
The Modified EMQ will be performed at baseline and at week 24. The EMQ evaluates abilities in three domains: Gross Motor skills, Fine Motor Skills, and Perception-Action Integration. It uses a 5-point scale including -2 = Sure that child does NOT show behavior, -1 = Child probably does NOT show behavior yet, 0 = Unsure whether child could do this or not, 1 = Child probably shows this behavior, and 2 = Sure that child shows this behavior and remember a particular instance. Minimum total score is -200. Maximum total score is 200. Higher score means higher certainty in the child's behaviors. |
Baseline, week 24
|
|
Modified Erhardt Developmental Prehension Assessment (EDPA)
大体时间:Baseline, week 24
|
The Modified EDPA will be performed at baseline and at week 24. The EDPA will evaluate hand skills and arm-hand movements at baseline and in response to the study drug. Both right and left hands are tested. Individual test components are scored by a well-established pattern (+), pattern not yet achieved (-), and temporary pattern to be replaced by a more mature pattern (++). Maximum score would be a well-established pattern (+) for all EDPA items. Higher score better, means a greater number of well-established hand skills and arm-hand movements. |
Baseline, week 24
|
|
Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT)
大体时间:Baseline, week 24
|
The PEDI-CAT will be performed at baseline and at week 24. The PEDI-CAT will evaluate abilities in four functional domains: Daily Activities, Mobility, Social/Cognitive, and Responsibility. The PEDI-CAT uses a 4-point scale including 1 = Unable, 2 = Hard, 3 = A Little Hard, and 4 = Easy. Minimum scaled score is 20. Maximum scaled score is 80. Higher total score means better functional ability. |
Baseline, week 24
|
合作者和调查者
调查人员
- 首席研究员:Ryan Felling, MD, PhD、Johns Hopkins School of Medicine
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
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- IRB00326943
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
Demographics, baseline assessments, completion assessments, adverse events.
IPD 共享时间框架
July 1, 2028 until July 1, 2029
IPD 共享访问标准
Supplemental data with paper when published. Other interested parties can reach out to comi@kennedykrieger.org to discuss other arrangements.
IPD 共享支持信息类型
- 树液
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.