A Safety Study of NNZ-2566 in Patients With Rett Syndrome

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
Baylor College of Medicine
Texas Children's Hospital
International Rett Syndrome Foundation
Information provided by (Responsible Party):
Neuren Pharmaceuticals Limited
ClinicalTrials.gov Identifier:
NCT01703533
First received: October 4, 2012
Last updated: July 13, 2014
Last verified: July 2014
  Purpose

The purpose of this study is to determine whether NNZ-2566 is safe and well tolerated in the treatment of Rett Syndrome in adolescent and adult females.


Condition Intervention Phase
Rett Syndrome
Drug: NNZ-2566
Drug: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase II Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Dose-Escalation Study of NNZ-2566 in Rett Syndrome

Resource links provided by NLM:


Further study details as provided by Neuren Pharmaceuticals Limited:

Primary Outcome Measures:
  • Adverse events [ Time Frame: Through to Day 40 ] [ Designated as safety issue: Yes ]
    Incidence of adverse events (AE), including Serious adverse events (SAE), will be evaluated between the two NNZ-2566 doses and placebo. SAEs will be examined from randomization through to Day 40. AEs will be examined from dosing through to Day 40.


Secondary Outcome Measures:
  • Change in EEG activity [ Time Frame: Baseline through to Day 40 ] [ Designated as safety issue: No ]

    Absolute change in the number of spikes in the EEG per hour during the awake state will be calculated for each subject between baseline (pre-treatment), during treatment (Days 1 thru 4, 14 and 26) and after treatment (Day 40).

    Absolute change in the power of frequency bands in the EEG over an hour in the awake state as determined by the Fast Fourier method will be calculated for each subject between baseline (pre-treatment), during treatment (Days 1 thru 4, 14 and 26) and after treatment (Day 40).

    Changes in the frequency of the characteristic repetitive stereotypic hand movements during wakefulness will be calculated for each subject between baseline (pre-treatment), during treatment (Days 1 thru 4, 14 and 26) and after treatment (Day 40).


  • Behavior [ Time Frame: Baseline through to Day 40 ] [ Designated as safety issue: No ]

    The following measures will be assessed at baseline and Day 26 and the changes compared between active and placebo groups:

    Symptom severity according to the Rett Syndrome Natural History Motor Behavior Assessment (MBA), Clinical Severity Scale (CSS), Aberrant Behavior Checklist (ABC), Vineland Adaptive Behavior Scale (VABS), and Clinical Global Impression of Severity (CGI-S).

    The following assessments will be undertaken at the additional time points specified: CGI-S (screening, baseline, Days 5, 14, 26, and 40), CGI-I (Days 5, 14, 26, and 40), MBA (Baseline, Days 26 and 40), CSS (screening, baseline, Days 26, and 40).


  • Physiological changes [ Time Frame: Baseline through to Day 40 ] [ Designated as safety issue: No ]
    Changes in autonomic function, i.e. respiratory rhythm, hyperventilation, apneas, oxygen desaturation, and heart rate variation will be calculated between baseline (pre-treatment), during treatment (Days 1 thru 4, 14 and 26) and after treatment (Day 40).

  • Global and Functional outcome Measures [ Time Frame: Baseline through to Day 40 ] [ Designated as safety issue: No ]

    Global outcome as measured by the change in scores on the Rett Syndrome Clinical Severity Score (CSS), The Rett Syndrome Motor-Behavior Assessment Scale (MBA), and the Clinical Global Impression - Severity and Improvement scales (CGI-S and -I) from baseline, during treatment, and post treatment.

    Changes in caregiver assessment of the top three causes for concern as assessed via a Visual Analogue Scale (VAS) will be evaluated for each subject between baseline (pre-treatment), during treatment (Day 26) and after treatment (Day 40).

    Changes in the Aberrant Behavior Checklist (ABC) and Vineland Adaptive Behavior Scales (VABS) will be calculated for each subject between baseline (pre-treatment), and during treatment (Day 26).



Other Outcome Measures:
  • Pharmacokinetics [ Time Frame: Baseline through to Day 40 ] [ Designated as safety issue: No ]
    The following pharmacokinetic measures will be calculated from NNZ-2566 concentrations in whole blood: Tmax, Cmax (peak), Cmin (trough), CAV at steady state, T1/2 and AUC.


Estimated Enrollment: 60
Study Start Date: March 2013
Estimated Study Completion Date: October 2014
Estimated Primary Completion Date: September 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: NNZ-2566
Glycyl-L-2-Methylpropyl-L-Glutamic Acid
Drug: NNZ-2566
Glycyl-L-2-Methylpropyl-L-Glutamic Acid (NNZ-2566) supplied as a lyophilized powder (2g in 50mL vials) for reconstitution with strawberry flavored solution 0.5% v/v in Water for Injection.
Other Name: NNZ-2566
Placebo Comparator: Placebo (strawberry flavored solution)
Strawberry flavored solution and Water for Injection
Drug: Placebo
Strawberry flavored solution and Water for Injection
Other Name: Strawberry flavored solution 0.5% v/v in Water for Injection

Detailed Description:

Rett Syndrome is a developmental disorder primarily if not exclusively affecting females. The disorder is characterized by apparent normal development in early infancy (6-18 months), followed by a period of regression with onset of systemic and neurological signs. The CNS symptoms of Rett Syndrome include learning disability, autism and epilepsy and these can be severe and highly debilitating. Affected individuals also show signs of autonomic dysfunction, reflected in cardiovascular and respiratory abnormalities. There is no currently effective treatment for Rett Syndrome.

This study will investigate the safety and tolerability of treatment with oral administration of NNZ-2566 at 35 mg/kg or 70 mg/kg BID in adolescent or adult females with Rett Syndrome. The study also will also investigate measures of efficacy during treatment.

  Eligibility

Ages Eligible for Study:   16 Years to 45 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of Rett Syndrome with proven mutation of the MeCP2 gene
  • Age 16 to 45 years
  • Severity rating of between 10 and 36 (Rett Syndrome Natural History/Clinical Severity Scale)
  • Concomitant medications must be stable for >4 weeks prior to enrollment. The following concomitant medications are permitted: anticonvulsants which do not have liver inducing effects; beta-blockers; medications for the treatment of gastroesophageal reflux disease (GERD); medications for the treatment of chronic respiratory conditions such as asthma; medications for the treatment of anxiety, of depression and of psychosis, hormonal contraceptives. Melatonin for difficulties with sleep onset.
  • Ability to swallow study medication provided as a liquid solution, or via gastrostomy tube

Exclusion Criteria:

  • No detectable abnormality of the EEG during screening period
  • Actively undergoing regression
  • QTcF exclusions (any of the following): baseline/screening QT/QTcF interval of 450 msec; history of risk factors for torsade de pointes (e.g. heart failure, hypokalemia (serum potassium at screening < 3.0 mmol/L) or family history of long QT syndrome; QT/QTcF prolongation previously or currently controlled with medication
  • Current treatment with insulin
  • Hgb A1C values outside the normal reference range at screening
  • Current or past treatment with IGF-1
  • Current or past treatment with growth hormone
  • Current treatment with N-methyl-D-aspartate (NMDA) antagonists
  • Current or planned use of non-medication based interventional therapy during the period of the study (defined as 4-6 week screening period followed by 4 week dosing and 2 week follow-up period)
  • Current clinically significant cardiovascular, renal, hepatic or respiratory disease
  • Gastrointestinal disease which may interfere with the absorption, distribution, metabolism or excretion of the the study medication
  • History of, or current cerebrovascular disease or brain trauma
  • History of, or current significant endocrine disorder e.g. hypo or hyperthyroidism or diabetes mellitus
  • History of, or current malignancy
  • Clinically significant abnormalities in safety laboratory tests, vital signs or ECG, as measured at screening or baseline
  • Confirmed pregnancy
  • Significant hearing and/or visual impairment that may affect ability to complete the test procedures
  • Enrollment in another clinical trial within the previous 30 days
  • Previously randomized in this clinical trial
  • Allergy to strawberries
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01703533

Locations
United States, Alabama
University of Alabama
Birmingham, Alabama, United States, 35294-0113
United States, Minnesota
Gillette Children's Specialty Healthcare
St. Paul, Minnesota, United States, 55101
United States, Texas
Baylor School of Medicine
Houston, Texas, United States, 77030
Sponsors and Collaborators
Neuren Pharmaceuticals Limited
Baylor College of Medicine
Texas Children's Hospital
International Rett Syndrome Foundation
Investigators
Principal Investigator: Daniel G Glaze, M.D. Baylor College of Medicine
Principal Investigator: Jeffrey L Neul, M.D., Ph.D. Baylor College of Medicine
Principal Investigator: Alan Percy, MD University of Alabama at Birmingham
Principal Investigator: Timothy Feyma, MD Gillette Children's Specialty Healthcare
Principal Investigator: Arthur Beisang, MD Gillette Children's Specialty Healthcare
  More Information

No publications provided

Responsible Party: Neuren Pharmaceuticals Limited
ClinicalTrials.gov Identifier: NCT01703533     History of Changes
Other Study ID Numbers: Neu-2566-RETT-001
Study First Received: October 4, 2012
Last Updated: July 13, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Neuren Pharmaceuticals Limited:
Autism
Rett's Syndrome
Rett Disorder
Rett's Disorder
Ataxia

Additional relevant MeSH terms:
Rett Syndrome
Heredodegenerative Disorders, Nervous System
Neurodegenerative Diseases
Nervous System Diseases
Mental Retardation, X-Linked
Mental Retardation
Neurobehavioral Manifestations
Neurologic Manifestations
Genetic Diseases, X-Linked
Genetic Diseases, Inborn

ClinicalTrials.gov processed this record on July 26, 2014