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Study of Zoledronic Acid, Pravastatin, and Lonafarnib for Patients With Progeria

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT00916747
Recruitment Status : Active, not recruiting
First Posted : June 9, 2009
Last Update Posted : February 27, 2023
Merck Sharp & Dohme LLC
Eiger BioPharmaceuticals
Information provided by (Responsible Party):
Monica E. Kleinman, Boston Children's Hospital

Brief Summary:
Hutchinson-Gilford Progeria Syndrome (Progeria) is a rare autosomal disease that results in premature death at a median age of 13 years due to cardiovascular and cerebralvascular compromise. The mutation for this disease has been identified and results in a mutant form of lamin A that cannot be de-farnesylated. This study evaluates the combination of pravastain (a statin), lonafarnib (a farnesyltransferase inhibitor) and zoledronic acid (a bisphosphonate) in an open label phase II efficacy trial in children with Progeria. These agents all target farnesylation pathways at different points. Patients with genetically confirmed progeria will be eligible for this protocol. Treatment will be initiated for 24 months duration. Clinical and biologic parameters will be examined to assess response.

Condition or disease Intervention/treatment Phase
Progeria Drug: Lonafarnib, Zoledronic Acid, and Pravastatin Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 85 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Masking Description: Open Label
Primary Purpose: Treatment
Official Title: An Open Label Phase II Trial of Zoledronic Acid, Pravastatin, and Lonafarnib for Patients With Hutchinson-Gilford Progeria Syndrome(HGPS) and Progeroid Laminopathies
Study Start Date : August 2009
Actual Primary Completion Date : February 2022
Estimated Study Completion Date : December 2023

Arm Intervention/treatment
Experimental: Treatment arm
All patients will receive zoledronic acid, pravastatin and lonafarnib
Drug: Lonafarnib, Zoledronic Acid, and Pravastatin

Lonafarnib: Lonafarnib dosing will begin at 150 mg/m2 by mouth twice daily. Lonafarnib will be orally administered without planned breaks, approximately every 12 hours, for a period of 24 months. For patients unable to swallow capsules, the capsules can be opened and dissolved into Ora Blend SF or Ora-Plus.

Zoledronic Acid: Zoledronic acid will be administered intravenously at week one, and months 6, 12, 18 and 24 of this treatment trial. Treatment will consist of one infusion over a 30 minute period.

Pravastatin: Pravastatin will be orally administered once daily without planned breaks, approximately every 24 hours, for a period of 24 months. The drug may be taken with meals. For patients unable to swallow pills, pills can be crushed into food. Pravastatin will be dosed according to the patient weight. Patients less than 10 kg will receive 5 mg pravastatin orally, once daily. Patients weighing 10 kg or greater will receive 10 mg pravastatin daily.

Primary Outcome Measures :
  1. To evaluate the therapeutic effects of the combination of zoledronic acid, pravastatin and lonafarnib in patients with HGPS. [ Time Frame: 2 years ]

Secondary Outcome Measures :
  1. To describe any acute and chronic toxicities associated with treating progeria patients with the combination of zoledronic acid, pravastatin and lonafarnib. [ Time Frame: 2 years ]
  2. To investigate which clinical and laboratory studies are needed to monitor or alter therapy to prevent unacceptable toxicity. [ Time Frame: 2 years ]
  3. To assess the pharmacokinetics of lonafarnib in patients with progeria. [ Time Frame: 2 years ]
  4. To assay for the inhibition of HDJ-2 farnesylation in Peripheral Blood Leukocytes (PBL). [ Time Frame: 2 years ]
  5. To assay for changes in research-based potential markers of efficacy such as levels of prelamin A, mature lamin A, progerin, and HP1 in protein isolated from PBL. [ Time Frame: 2 years ]
  6. To assess changes in leptin levels, glucose utilization, skeletal abnormalities including bone mineral density and X-ray finding, joint contracture and function, and growth [ Time Frame: 2 years ]
  7. To assess changes in auditory function, dental anomalies, dermatologic changes including hair density, nutrition with calorie analysis and energy expenditure, body composition analysis by DXA scan, and cardiovascular structure and function. [ Time Frame: 2 years ]
  8. To compare and incorporate clinical and laboratory data obtain from this study with that obtained during the single agent lonafarnib trial as well as the pilot combination trial of zoledronic acid, pravastatin and lonafarnib [ Time Frame: 2 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Genetic Diagnosis: All patients must have confirmatory mutational analysis showing mutation in the lamin A gene.
  • Clinical Diagnosis: Patients must display clinical signs of progeria as per the clinical trial team.
  • Travel: Patients must be willing and able to come to Boston for appropriate studies and examinations at initiation of study and at months 6, 12, 18 and 24 on study.
  • Patient must have adequate organ and marrow function as defined by the following parameters:
  • Blood: APC (ANC + bands + monocytes = APC) > 1,000/microliters, Platelets > 75,000/microliters (transfusion independent); Hemoglobin >9g/dl.
  • Renal: creatinine Less than or equal 1.5 times normal for age or GFR > 70 ml/min/1.73m2.
  • Hepatic: bilirubin Less than or equal to 1.5 x upper limit of normal for age; SGPT (ALT) < and SGOT (AST) < 5 x normal range for age.
  • PT/PTT: PT/PTT < 120% upper limit of normal OR PI approval
  • No overt renal, hepatic, pulmonary disease or immune dysfunction.
  • 25-hydroxyvitamin D ≥ 20 ng/ml within 4 weeks of bisphosphonate infusion.
  • Signed informed consent according to institutional guidelines must be obtained and patient must begin therapy within twenty eight (28) days.

Exclusion Criteria:

  • Other than the drugs used in this protocol, drugs targeted to treat Progeria are excluded. Drugs to treat symptoms of Progeria are permitted.
  • Patients must not be taking medications that significantly affect the metabolism of lonafarnib at the time they start lonafarnib
  • Patient must have no uncontrolled infection.
  • Subjects who have known or suspected hypersensitivity to any of the excipients included in the formulation should not be treated.
  • Patients must not be pregnant or breast-feeding. Female patients of childbearing potential must have negative serum or urine pregnancy test. Male and female patients of reproductive potential must agree to use a medically accepted form of birth control while on study and up to 10 weeks after treatment. It is permissible for female patients to take oral contraceptives or other hormonal methods while receiving treatment with lonafarnib.

Information from the National Library of Medicine

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): NCT00916747

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United States, Massachusetts
Children's Hospital Boston
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Boston Children's Hospital
Merck Sharp & Dohme LLC
Eiger BioPharmaceuticals
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Principal Investigator: Mark Kieran, MD, PhD Children's Hospital Boston/ Dana-Farber Cancer Instittue
Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Monica E. Kleinman, Principal Investigator, Boston Children's Hospital
ClinicalTrials.gov Identifier: NCT00916747    
Other Study ID Numbers: Progeria Efficacy
First Posted: June 9, 2009    Key Record Dates
Last Update Posted: February 27, 2023
Last Verified: February 2023
Keywords provided by Monica E. Kleinman, Boston Children's Hospital:
Additional relevant MeSH terms:
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Genetic Diseases, Inborn
Metabolism, Inborn Errors
Metabolic Diseases
Zoledronic Acid
Bone Density Conservation Agents
Physiological Effects of Drugs
Anticholesteremic Agents
Hypolipidemic Agents
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Enzyme Inhibitors