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Clinical Trial in 22q13 Deletion Syndrome(Phelan-McDermid Syndrome)

This study has been completed.
Sponsor:
Collaborator:
National Institute of Mental Health (NIMH)
Information provided by (Responsible Party):
Alexander Kolevzon, Icahn School of Medicine at Mount Sinai
ClinicalTrials.gov Identifier:
NCT01525901
First received: February 1, 2012
Last updated: January 10, 2017
Last verified: October 2016
  Purpose
The purpose of this study is to pilot the use of Insulin-Like Growth Factor-1 (IGF-1) treatment in 22q13 Deletion Syndrome (Phelan-McDermid Syndrome) caused by SHANK3 gene deficiency in order to evaluate safety, tolerability, and efficacy. IGF-1 is an injection under the skin that contains human IGF-1. IGF-1 is approved by the FDA under the brand name Increlex for the treatment of children with short stature due to primary IGF-1 deficiency. It is being used off-label in the current study and is not FDA approved, nor has it yet been studied in humans for the treatment of SHANK3 deficiency.

Condition Intervention Phase
22q13 Deletion Syndrome
Phelan-McDermid Syndrome
Drug: Insulin-Like Growth Factor-1 (IGF-1)
Drug: Normal saline
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Double-Blind Placebo-Controlled Crossover Trial of Insulin-Like Growth Factor-1 (IGF-1) in Children and Adolescents With 22q13 Deletion Syndrome(Phelan-McDermid Syndrome)

Resource links provided by NLM:


Further study details as provided by Icahn School of Medicine at Mount Sinai:

Primary Outcome Measures:
  • Aberrant Behavior Checklist - Social Withdrawal (ABC-SW) subscale [ Time Frame: Week 12 ]

Secondary Outcome Measures:
  • Repetitive Behavior Scale [ Time Frame: Week 12 ]
  • CGI-Improvement and Severity Scales [ Time Frame: Week 12 ]
  • Caregiver Strain Index [ Time Frame: Week 12 ]
  • Exploratory outcomes [ Time Frame: Week 12 ]
    Expressive language, social orienting, and motor skills,


Enrollment: 20
Study Start Date: February 2012
Study Completion Date: September 2016
Primary Completion Date: September 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Insulin-Like Growth Factor-1 (IGF-1)
Injection
Drug: Insulin-Like Growth Factor-1 (IGF-1)
IGF-1 and placebo will each be administered for 3 months with a four-week washout period in between. IGF-1 will be administered for 3 months subcutaneously.
Other Name: Mecasermin; Increlex
Placebo Comparator: Normal saline
Injection
Drug: Normal saline
Saline solution will be administered for three months subcutaneously.
Other Name: Placebo

Detailed Description:

Overall, there will be 1-3 screening visits, a baseline visit where study drug will first be administered, and then 10 follow-up visits. Follow-up visits will occur at week 2, week 4, week 8, and week 12 in each treatment phase (IGF-1 or placebo), and then again 4 weeks after study completion, Parents/guardians will be asked to administer the IGF-1/ placebo by injection at home and will also be responsible for monitoring glucose levels in the child. Parents/guardians will be trained in these methods, and will have scheduled phone calls and appointments where the dose and tolerability will be discussed.

Assessments include the following:

  • Physical and neurological examination
  • Medical and psychiatric history
  • X-ray of long bone (e.g., hand) to ensure your child's growth plates are not closed
  • Electrocardiography
  • Echocardiography
  • Pregnancy test if applicable
  • Lab safety measures (through blood draw)
  • Autism Diagnostic Interview (ADI)
  • Autism Diagnostic Observation Schedule (ADOS)
  • The Mullen Scales of Early Learning or the Leiter International Performance Scale-Revised
  • Vineland Adaptive Behavior Scale (VABS)
  • Clinical Global Impressions (CGI) Rating Scales
  • The Repetitive Behaviors Scale (RBS)
  • Aberrant Behavior Checklist (ABC)
  • The Caregiver Strain Questionnaire (CSI)
  • Language Environment Analysis (LENA)
  • The Macarthur-Bates Communication Inventory (MCDI)
  • Unified Parkinson's Disease Rating Scale (UPDRS)
  • Quick Neurological Screening Test 2nd Edition (QNST-2)
  • Gait Analysis with motion capture video systems and interactive 3-dimensional modeling systems
  Eligibility

Ages Eligible for Study:   5 Years to 12 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • 5 to 12 years old
  • pathogenic deletions or mutations of the SHANK3 gene
  • stable medication regimens for at least three months prior to enrollment

Exclusion Criteria:

  • closed epiphyses
  • active or suspected neoplasia
  • intracranial hypertension
  • hepatic insufficiency
  • renal insufficiency
  • cardiomegaly / valvulopathy
  • history of allergy to IGF-1 or any component of the formulation (mecasermin)
  • history of extreme prematurity (<1000 grams) with associated early neo-natal complications, e.g. intra-cerebral hemorrhage, prolonged hypoxia, prolonged hypoglycemia
  • patients with comorbid conditions deemed too medically compromised to tolerate the risk of experimental treatment with IGF-1
  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: NCT01525901

Locations
United States, New York
Seaver Austin Center, Icahn School of Medicine at Mount Sinai
New York, New York, United States, 10029
Sponsors and Collaborators
Icahn School of Medicine at Mount Sinai
National Institute of Mental Health (NIMH)
Investigators
Principal Investigator: Alexander Kolevzon, MD Icahn School of Medicine at Mount Sinai
  More Information

Additional Information:
Responsible Party: Alexander Kolevzon, Principal Investigator, Icahn School of Medicine at Mount Sinai
ClinicalTrials.gov Identifier: NCT01525901     History of Changes
Other Study ID Numbers: GCO 12-0929
IF# 1358648
1R34MH100276-01 ( US NIH Grant/Contract Award Number )
GCO 11-1555 ( Other Identifier: Icahn School of Medicine at Mount Sinai )
R34MH100276 ( US NIH Grant/Contract Award Number )
Study First Received: February 1, 2012
Last Updated: January 10, 2017

Keywords provided by Icahn School of Medicine at Mount Sinai:
SHANK3
IGF-1
Autism

Additional relevant MeSH terms:
Syndrome
Chromosome Deletion
Chromosome Disorders
Disease
Pathologic Processes
Monosomy
Aneuploidy
Chromosome Aberrations
Congenital Abnormalities
Genetic Diseases, Inborn
Insulin, Globin Zinc
Insulin
Mitogens
Hypoglycemic Agents
Physiological Effects of Drugs
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on May 23, 2017