Sterol and Isoprenoid Disease Research Consortium: Smith-Lemli-Opitz Syndrome (STAIR-SLOS)

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. Identifier: NCT01356420
Recruitment Status : Unknown
Verified September 2012 by Robert Steiner, Oregon Health and Science University.
Recruitment status was:  Recruiting
First Posted : May 19, 2011
Last Update Posted : September 20, 2012
Information provided by (Responsible Party):
Robert Steiner, Oregon Health and Science University

Brief Summary:

The purpose of this study is to learn about Smith-Lemli-Opitz Syndrome (SLOS). SLOS is an inherited condition that is caused by the body not making an enzyme as it should. The body needs the enzyme to help make cholesterol. SLOS can cause many health problems including slow growth and development, eating disorders, sleep disorders, behavior disorders, and eye diseases. Severe SLOS leads to birth defects and mental retardation and in many cases early death. The investigators plan to measure cholesterol and other sterol levels, perform clinical observations, whole body testing and imaging (brain MRIs), to learn more about the disease and its progression, differences in the clinical features among individuals with SLOS, and look at the effect of cholesterol supplementation in this condition.

The study is an interventional study to characterize disease progression and correlations between clinical, biochemical and physiological features of the disease. The main hypothesis is that dietary cholesterol supplementation does not improve features of SLOS related to the brain (e.g. IQ, behavior).

Condition or disease Intervention/treatment Phase
Smith-Lemli-Opitz Syndrome Dietary Supplement: Cholesterol supplementation Not Applicable

Detailed Description:
Smith-Lemli-Opitz syndrome (SLOS) is a disorder of cholesterol synthesis, or production. It is caused by mutations in the DHCR7 gene which encodes for 7-dehydrocholesterol- Δ7-reductase, an enzyme necessary for the production of cholesterol in the body. Affected individuals exhibit multiple malformations and mental retardation. The features of SLOS are thought to be primarily related to cholesterol deficiency and accumulation of cholesterol precursors. However, the clinical phenotype is not well characterized, the biochemical pathogenesis is incompletely understood, and there is no proven therapy for this devastating condition. Thus our primary objective is to better define the clinical and biochemical phenotypes of the disease using a natural history study design. The study will contribute to creating a comprehensive SLOS patient registry, identify biomarkers that can be used for diagnostic testing, screening and outcome measures in future therapeutic trials. All patients with SLOS receive dietary cholesterol supplementation with the hope that cholesterol supplementation will improve the clinical manifestation of the disease. However, there is no evidence supporting a clinical benefit of cholesterol supplementation. Thus a secondary objective of the study is to determine if cholesterol intake correlates with changes in whole body cholesterol homeostasis and clinical end-points.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 100 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Smith-Lemli-Opitz Syndrome: A Longitudinal Clinical Study of Patients Receiving Cholesterol Supplementation
Study Start Date : January 2011
Estimated Primary Completion Date : January 2016

Arm Intervention/treatment
Experimental: Cholesterol supplementation
All new subjects will come to their first visit with an least 3 weeks of stable cholesterol intake. Typically and preferably this will include egg yolk as cholesterol supplement, but in some instances e.g. intolerance to egg yolk it may include a new encapsulated cholesterol preparation, Sloesterol.
Dietary Supplement: Cholesterol supplementation
Cholesterol supplementation may be achieved with SLOesterol instead of or in combination with egg yolk. SLOesterol is a powder formulation that contains cholesterol and natural emulsifier. It is considered a medical food developed by Solace Nutrition and available by prescription only.

Primary Outcome Measures :
  1. To define the rate of progression of clinical and biochemical measures in patients with Smith Lemli-Opitz syndrome receiving dietary cholesterol supplementation. [ Time Frame: Once per year at annual study visit ]
    This study will measure changes in whole body cholesterol pool size, 24S, cholesterol absorption and synthesis in relation with cholesterol intake and changes in clincal end-points.

Secondary Outcome Measures :
  1. Correlate biochemical and clinical phenotypes [ Time Frame: Once per year at annual study visit ]
    To correlate biochemical and clinical phenotypes in SLOS subjects given dietary cholesterol with changes in whole body cholesterol pool size, and with its major determinants (cholesterol synthesis, absorption and intake).

  2. Identify clinical or biochemical markers for future therapeutic trials. [ Time Frame: Once per year at annual study visit ]
    To identify clinical or biochemical markers that can be used as outcome measures in a future therapeutic trial.

  3. Identify a biochemical marker that can be used for diagnostic testing or screening. [ Time Frame: Once per year at annual study visit ]
    To identify a biochemical marker that can be used for diagnostic testing or screening

  4. Develop a registry and repository of biomaterials of SLOS patients [ Time Frame: each subject will be enrolled in the registry at the baseline/initial visit, if they choose to participate in this portion of the study ]
    To develop a registry of well characterized SLOS patients and to maintain a repository of biomaterials corresponding to these patients

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 85 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Confirmed diagnosis of Smith-Lemli-Opitz Syndrome (SLOS)
  • Males and females of all ages
  • Willing and able to travel to OHSU or another STAIR site

Exclusion Criteria:

  • Subject does not have Smith-Lemli-Opitz Syndrome (SLOS)

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 identifier (NCT number): NCT01356420

Contact: Sharon Butcher, RN, MSN, CPNP 503-494-6524
Contact: Jennifer Stubbs, BS 503-494-7944

United States, Maryland
Pdgen, Nichd, Nih, Dhhs Recruiting
Bethesda, Maryland, United States, 20892
Contact: FORBES D PORTER, MD, PHD    301-435-4432    FDPORTER@MAIL.NIH.GOV   
Contact: SANDRA K CONLEY, RN, MS, CPNP    301-435-4432    SCONLEY@MAIL.NIH.GOV   
Principal Investigator: FORBES D PORTER, MD, PHD         
United States, Nebraska
University of Nebraska Medical Center Recruiting
Omaha, Nebraska, United States, 68198
Contact: WILLIAM RIZZO, MD    402-559-5698    WRIZZO@UNMC.EDU   
Contact: MACHELLE ZINK, RN    402-559-2560    MAZINK@UNMC.EDU   
Principal Investigator: WILLIAM RIZZO, MD         
United States, Ohio
Cincinnati Children'S Hospital Medical Center Recruiting
Cincinnati, Ohio, United States, 45229
Contact: JAMES E HEUBI, MD    513-636-8046    JAMES.HEUBI@CCHMC.ORG   
Principal Investigator: JAMES E HEUBI, MD         
United States, Oregon
Oregon Health and Science University Recruiting
Portland, Oregon, United States, 97239
Contact: SHARON BUTCHER, RN,MSN,CPNP    503-494-6524    BUTCHER@OHSU.EDU   
Contact: JENNIFER STUBBS, BS    503-494-7944    STUBBSJ@OHSU.EDU   
Principal Investigator: Robert Steiner, MD         
United States, Pennsylvania
Children'S Hospital of Pittsburgh of Upmc Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Contact: GERARD VOCKLEY, MD, PHD    412-692-7746    GERARD.VOCKLEY@CHP.EDU   
Contact: NANCY PERROTT, RD, LDN    412-692-3150    NANCY.PERROTT@CHP.EDU   
Principal Investigator: GERARD VOCKLEY, MD, PHD         
Sponsors and Collaborators
Oregon Health and Science University
Principal Investigator: Robert Steiner, MD Oregon Health and Science University

Responsible Party: Robert Steiner, Vice President of Pediatric Research, Oregon Health and Science University Identifier: NCT01356420     History of Changes
Other Study ID Numbers: STAIR 7001
First Posted: May 19, 2011    Key Record Dates
Last Update Posted: September 20, 2012
Last Verified: September 2012

Keywords provided by Robert Steiner, Oregon Health and Science University:

Additional relevant MeSH terms:
Cleft Palate
Genetic Diseases, X-Linked
Smith-Lemli-Opitz Syndrome
Pathologic Processes
Jaw Abnormalities
Jaw Diseases
Musculoskeletal Diseases
Maxillofacial Abnormalities
Craniofacial Abnormalities
Musculoskeletal Abnormalities
Stomatognathic Diseases
Mouth Abnormalities
Mouth Diseases
Stomatognathic System Abnormalities
Congenital Abnormalities
Craniofacial Dysostosis
Bone Diseases, Developmental
Bone Diseases
Penile Diseases
Genital Diseases, Male
Urogenital Abnormalities
Genetic Diseases, Inborn
Abnormalities, Multiple
Lipid Metabolism, Inborn Errors
Metabolism, Inborn Errors