EPI-743 for Mitochondrial Respiratory Chain Diseases - Full Text View

Purpose

This study evaluates the safety and efficacy of EPI-743 in patients with severe mitochondrial respiratory chain diseases who are considered to be within 90 days of end-of-life care.

Condition	Intervention	Phase
Mitochondrial Diseases	Drug: EPI-743	Phase 2


Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Emergency Use Protocol for EPI-743 in Acutely Ill Patients With Inherited Mitochondrial Respiratory Chain Disease Within 90 Days of End-of-Life Care

Resource links provided by NLM:

Genetics Home Reference related topics: Friedreich ataxia Leigh syndrome ataxia neuropathy spectrum childhood myocerebrohepatopathy spectrum deoxyguanosine kinase deficiency mitochondrial neurogastrointestinal encephalopathy disease myoclonic epilepsy myopathy sensory ataxia

MedlinePlus related topics: Mitochondrial Diseases

Genetic and Rare Diseases Information Center resources: Friedreich Ataxia Leigh Syndrome

U.S. FDA Resources

Further study details as provided by Edison Pharmaceuticals Inc:

Primary Outcome Measures:

Change in neuromuscular function from baseline to 13 weeks [ Time Frame: Monthly for 13 weeks ] [ Designated as safety issue: No ]
Neurological exams to determine neuro-muscular function, which is typically compromised in patients with inherited mitochondrial diseases. Standard clinical neurological/neuromuscular assessment scales will be used
Number of subjects experiencing adverse events [ Time Frame: Al least monthly for 13 weeks ] [ Designated as safety issue: Yes ]
Standard laboratory tests to evaluate organ function will be used to assess adverse effects on organ systems and function. Electrocardiograms will be recorded to assess any effect on cardiac conduction. Subjects will be monitored for any clinical adverse signs at least monthly, and more frequently if patient condition warrants. In each case of reported adverse events, an assessment will be made if the event is due to EPI-743 administration or to underlying/intercurrent disease.
Change in Newcastle Pediatric Mitochondrial Disease Score from baseline at 13 weeks [ Time Frame: At baseline and at 13 weeks ] [ Designated as safety issue: No ]
The Newcastle Pediatric Mitochondrial Disease Score (NPMDS)is a validated scale to assess the clinical severity of mitochondrial disease. The NPMDS will be scored at baseline and at 13 weeks, and the difference will be assessed as improved, stable or deteriorated.

Secondary Outcome Measures:

Pharmacokinetics of EPI-743 after first dose and at steady state [ Time Frame: At the beginning of the study (baseline) and after 4 weeks of treatment ] [ Designated as safety issue: No ]
Serial blood samples (4-8 samples, 1.5 mL)will be drawn after the first dose of 50 mg and after the first dose escalation to 100 mg. Plasma concentrations ofEPI-743 will be analyzed and pharmacokinetic parameters calculated.


Enrollment:	87
Study Start Date:	February 2010
Estimated Study Completion Date:	December 2017
Estimated Primary Completion Date:	December 2017 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: EPI-743 Treatment Single treatment arm; All enrolled subjects will be treated with EPI-743	Drug: EPI-743 EPI-743 is administered as a dose escalation from 50 mg bid to 100 mg tid

Eligibility


Ages Eligible for Study:	1 Year and older (Child, Adult, Senior)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion criteria:

Patients with genetic diagnosis: Genetically confirmed diagnosis of Inherited mitochondrial respiratory chain disease
Patients with clinical diagnosis: Diagnosis of inherited mitochondrial disease absent genetic confirmation; Specifically, subjects must meet the diagnostic criteria of "definite" or "probable" mitochondrial disease as defined by Bernier et al., 2002
Deemed by principal investigator to be within 90 days of end-of-life hospice/terminal care
Male or female age > one year
Hematocrit within normal range for age group
Agreement to use contraception if within reproductive years
Patient or patient's guardian able to consent and comply with protocol requirements
Presence of caregiver to ensure study compliance
Abstention from use of all pill-form dietary supplements and non-prescribed medications (except as allowed by the investigator)
Abstention from foods or beverages or bars fortified with Coenzyme Q10, vitamin E, super-fortified "functional" foods or beverages
Abstention from use of idebenone
Clinically staged with a Mitochondrial Disease Scale such as the Newcastle Score

Exclusion criteria:

Allergy to EPI-743, vitamin E or sesame oil
Clinical history of bleeding or abnormal PT/PTT (excluding anticoagulation Rx)
Hepatic insufficiency with LFTs greater than two times normal
Renal insufficiency requiring dialysis
Fat malabsorption syndromes precluding drug absorption
Any other concurrent inborn errors of metabolism
Severe end-organ hypo-perfusion syndrome secondary to cardiac failure resulting in lactic acidosis
Pregnancy

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: NCT01370447

Locations


United States, California
Lucille Packard Children's Hospital
Palo Alto, California, United States, 94304

Sponsors and Collaborators

Edison Pharmaceuticals Inc

Investigators


Principal Investigator:	Gregory Enns, MB, ChB	Stanford University

More Information


Responsible Party:	Edison Pharmaceuticals Inc
ClinicalTrials.gov Identifier:	NCT01370447 History of Changes
Other Study ID Numbers:	EPI-2009-1
Study First Received:	June 7, 2011
Last Updated:	March 18, 2016
Health Authority:	United States: Food and Drug Administration

Keywords provided by Edison Pharmaceuticals Inc:


Leigh syndrome MELAS Kearns-Sayre Alper's	Inherited mitochondrial disease Friedreich's ataxia POLG1 deficiency

Additional relevant MeSH terms:


Mitochondrial Diseases Metabolic Diseases Ubiquinone	Micronutrients Growth Substances Physiological Effects of Drugs

ClinicalTrials.gov processed this record on September 27, 2016