Rational use of substrate reduction therapy and enzyme replacement therapy in patients with type I Gaucher disease (Uso racional de los tratamientos por inhibición de sustrato y enzimático sustitutivo en pacientes con enfermedad de Gaucher tipo I)

ISRCTN ISRCTN05147495
DOI https://doi.org/10.1186/ISRCTN05147495
Secondary identifying numbers EC-90737
Submission date
31/01/2011
Registration date
18/04/2011
Last edited
18/04/2011
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Pilar Giraldo Castellano
Scientific

Servicio de Hematología
Hospital Universitario Miguel Servet
Paseo Isabel La Católica 1-3
Zaragoza
50009
Spain

Phone +34 670285339
Email giraldo.p@gmail.com

Study information

Study designOpen-label single centre follow-up study
Primary study designInterventional
Secondary study designNon randomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleRational use of substrate reduction therapy and enzyme replacement therapy in patients with type I Gaucher disease: an open-label single-centre follow up study
Study objectivesThe aim of this study is to evaluate the long-term effect of miglustat (substrate reduction therapy) as first-line treatment in mild to moderate Gaucher Disease (GD) and its effectiveness as maintenance therapy either in patients with type I GD who have achieved a stable condition with enzyme replacement therapy or in patients with severe disease who have not reached the objectives of the treatment.

Substrate Reduction Therapy (SRT) is an effective alternative to Enzyme Replacement Therapy (ERT) in type I GD. It is administered orally, therefore it is more comfortable, has lower direct and indirect administration costs. The SRT would have indication and efficacy in patients who have reached treatment goals, for who maintaining response is necessary and in patients with advanced disease who have not reached treatment goals.
Ethics approval(s)Clinical Research Ethics Committee of Aragon (Comité Ético de Investigación Clínica de Aragón (CEICA).
Ref: C.I. EC07/083, 20/05/2008
Health condition(s) or problem(s) studiedType I Gaucher’s disease
InterventionAsymptomatic patients with a severity scale of 0-3 points are not treated but monitored and assessed every 6 months (clinically, laboratory and imaging). New diagnosed symptomatic patients with a severity scale of 0-3 points would be eligible for SRT (100 mg/TID PO) or ERT (30 U/kg IV every 2 weeks) in function of individual characteristics and preferences. New diagnosed symptomatic patients with a severity scale of 4-8 points would be eligible for SRT (100 mg/TID PO) or ERT (60 U/kg IV every 2 weeks) in function of individual characteristics and preferences. New diagnosed symptomatic patients with a severity scale >9 points will receive ERT (60 U/kg IV every 2 weeks). Patients previously treated with ERT and have reached stability for a minimum of 2 years will receive treatment with SRT (100 mg/TID PO). For all treatment arms, the patients will be followed during 24 months. Test that will be run: Magnetic resonance imaging (MRI) spleen and liver volume measurement (basal and every 6 months), MRI femoral and lumbar spinal bone marrow infiltration (basal and months 12 and 24), biomarkers of GD activity such as chitotriosidase, angiotensin-converting enzyme (ACE), tartrate-resistant acid phosphatase (TRAP) and ferritin, and including platelets, hemoglobin and vit B12 (all visits), QLQ SF-36 (basal and months 12 and 24), global improvement scale (patient / investigator, all visits from visit 2), Visual Analog Scale for pain assessment (all visits), neurologic and neuropsychological tests including electroneurography (basal and every 6 months), physical examination and vital signs (basal and months 12 and 24)
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Miglustat
Primary outcome measureThe primary end point is the percentage change in liver volume in baseline visit and every six months upto 24 months measured by MRI
Secondary outcome measures1. The percentage change in spleen volume every six months and bone marrow infiltration measured yearly [baseline visit (visit 1), 12 months (visit 4) and 24 months (visit 6)] by MRI 2. Changes in hAematologic parameters (haemoglobin, platelets)
3. Chitotriosidase activity measured every two years (in baseline visit and visit 6)
Overall study start date01/12/2009
Completion date31/12/2011

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants40
Key inclusion criteria1. Patients ≥ 18 years. Diagnosis of type I GD confirmed by glucocerebrosidase assay or by the presence of mutations in the glucocerebrosidase gene
2. Patients who have received enzyme replacement therapy for at least 3 years with the same dose for at least the last 6 months
3. Stable clinical and biological disease for 2 years confirmed with at least two assessments including the one performed at baseline
Key exclusion criteria1. History of oculomotor palsy, ataxia or other manifestations usually associated with type 3 GD
2. Splenectomy before 18 years due to massive splenomegaly or severe cytopenia
3. Documented peripheral polyneuropathy. Intolerance to lactose
4. Diarrhoea of unknown origin within 6 months prior to visit 1 or history of significant gastrointestinal disorders
5. Cataracts or a known risk of cataract formation
6. Severe renal insufficiency
7. Active intercurrent diseases, such as human immunodeficiency virus (HIV) or hepatitis B or C
8. Dependence or current abuse of drugs or alcohol
9. Suspected hypersensitivity to miglustat or any of the excipients
10. Patients who have previously received miglustat
11. Pregnancy or breast-feeding
12. Patients who refuse to use a reliable contraceptive method throughout the study and during the three months following the discontinuation of miglustat
13. Patients receiving treatment with another investigational product or have received an investigational product in the 3 months prior to baseline
Date of first enrolment01/12/2009
Date of final enrolment31/12/2011

Locations

Countries of recruitment

  • Spain

Study participating centre

Servicio de Hematología
Zaragoza
50009
Spain

Sponsor information

Aragon Institute of Health Sciences [Instituto Aragonés de Ciencias de la Salud] (Spain)
Government

c/o Esteban de Manuel Kenoy
Avenida Gómez Laguna 25
Planta 3
Zaragoza
50009
Spain

Email emlopezh.iacs@aragon.es
Website http://www.aragon.es/
ROR logo "ROR" https://ror.org/05p0enq35

Funders

Funder type

Government

Aragon Institute of Health Sciences [Instituto Aragonés de Ciencias de la Salud] (Spain)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan