Gentamicin for Junctional Epidermolysis Bullosa
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|ClinicalTrials.gov Identifier: NCT03526159|
Recruitment Status : Recruiting
First Posted : May 16, 2018
Last Update Posted : April 7, 2020
|Condition or disease||Intervention/treatment||Phase|
|Junctional Epidermolysis Bullosa||Drug: Gentamicin Sulfate||Phase 1 Phase 2|
Three subjects (adults and children of any age) will receive topical gentamicin to be applied to select skin sites.
Three subjects (adults and children of any age) will receive intravenous (IV) gentamicin infusions.
Patients will be assessed for Primary and Secondary endpoints during follow up visits.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||6 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||A Pilot Study of the Restoration of Functional Laminin 332 in JEB Patients With Nonsense Mutations After Topical and Intravenous Gentamicin Treatment|
|Actual Study Start Date :||June 1, 2018|
|Estimated Primary Completion Date :||July 30, 2020|
|Estimated Study Completion Date :||August 31, 2020|
Experimental: Gentamicin Sulfate
7.5 mg/kg gentamicin once daily for 14 days.
0.5% gentamicin ointment applied twice daily for 14 days to selected skin sites.
Drug: Gentamicin Sulfate
Gentamicin (formulated as gentamicin sulfate) is a well-known, well-characterized antibiotic that has been used for four decades as a treatment against gram negative bacteria. It, like other aminoglycoside antibiotics, has the well documented added potential to facilitate readthrough of premature termination codons in eukaryotic cells and organisms.
Other Name: Gentamicin
- Increased laminin beta 3 / laminin 332 expression as assessed by immunofluorescence. [ Time Frame: 3 months ]New or increased staining of the target protein, laminin 332, in sections of skin biopsies obtained during follow-up visits in comparison with baseline biopsies. Five micron cryosections will be probed with three different antibodies against laminin 332. Patient samples along with normal control samples will be compared. Mean fluorescence intensity will be calculated for each sample and antibody using ImageJ software. Percent expression relative to normal human skin (set to 100%) will be calculated for each patient sample. Any statistically significant increase in (p value < 0.05) over baseline will be considered improvement.
- Incidence of Treatment-Emergent Adverse Events [ Time Frame: 3 months ]The total number of adverse events and serious adverse events will be recorded and enumerated for each study participant. Gentamicin in high doses is associated with ototoxicity and nephrotoxicity. Audiometry and creatinine clearance tests will be performed throughout the study to monitor for the emergence of any treatment-related adverse events. In addition, as this treatment may result in the production of a protein that is hasn't been present in the patient's system, commercial ELISA tests will be performed on serum samples to test for the emergence of circulating anti-laminin 332 antibodies. Adverse events include a decline of >15 dB on pure tone audiometry at 2 consecutive frequencies, creatinine clearance <60ml/min, presence of antibodies to laminin 332, and for IV gentamicin recipients, serum gentamicin peak levels above 40 ug/ml and trough levels above 2 ug/ml.
- Generation of new hemidesmosomes as assessed by electron microscopy. [ Time Frame: 3 months ]Any new hemidesmosomes detected by electron microscopy in post-treatment skin biopsies will be enumerated and compared to baseline.
- Improved wound closure. [ Time Frame: 3 months ]Participants in the Topical arm will treat and monitor specific test sites, along with untreated control sites, selected during their baseline visits. Photographs will be used to assess the size of open erosions. Wound areas (treated and untreated) (cm2) will be measured using computer-assisted planimetry of digital photographs taken throughout the study.
- Reduction in blistering [ Time Frame: 3 months ]Participants in the Topical arm will treat and monitor specific test sites, along with untreated control sites, selected during their baseline visits. Photographs and patient diaries will be used to assess the number of blisters that appear at the test sites as well as whether the wound had closed during treatment.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03526159
|Contact: Mei Chen, Ph.D.||firstname.lastname@example.org|
|Contact: David Woodley, M.D.||email@example.com|