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Extension Study of Intrathecal Enzyme Replacement Therapy for MPS I

This study has been terminated.
(Due to slow enrolment.)
Sponsor:
Collaborator:
The Ryan Foundation for MPS Children
Information provided by (Responsible Party):
Patricia I. Dickson, M.D., Dickson, Patricia I., M.D.
ClinicalTrials.gov Identifier:
NCT00786968
First received: June 17, 2008
Last updated: February 19, 2013
Last verified: February 2013
  Purpose

This is a one-year extension study of the use of laronidase into the spinal fluid to treat spinal cord compression in mucopolysaccharidosis I. Mucopolysaccharidosis I is a rare genetic condition due to deficiency of the enzyme alpha-l-iduronidase. Spinal cord compression occurs in this condition due to accumulation of material called glycosaminoglycans (GAG). Laronidase is the manufactured form of the enzyme alpha-l-iduronidase that is deficient in mucopolysaccharidosis I patients. The aim of this study is to determine whether laronidase is safe and effective when given into the spinal fluid as a potential non-surgical treatment for spinal cord compression due to mucopolysaccharidosis I disease. Funding Source -- FDA OOPD


Condition Intervention Phase
Spinal Cord Compression
Mucopolysaccharidosis I
Hurler-Scheie Syndrome
Scheie Syndrome
Lysosomal Storage Disease
Drug: laronidase
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Extension Study of Intrathecal Enzyme Replacement Therapy for Spinal Cord Compression in Mucopolysaccharidosis I

Resource links provided by NLM:


Further study details as provided by Dickson, Patricia I., M.D.:

Primary Outcome Measures:
  • safety of intrathecal enzyme treatment by blood and spinal fluid tests; improvement or stabilization in neurologic signs and symptoms of spinal cord compression [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Enrollment: 3
Study Start Date: January 2008
Study Completion Date: October 2011
Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: intrathecal laronidase
drug laronidase, dose 1.74 mg, route intrathecal, frequency every 30-90 days, duration 1 year
Drug: laronidase
1.74 mg intrathecally every 1-3 months for 1 year
Other Names:
  • Aldurazyme
  • recombinant human alpha-l-iduronidase

Detailed Description:

Enzyme replacement therapy (ERT) has been developed for mucopolysaccharidosis I (MPS I), a lysosomal storage disorder. ERT helps many physical ailments due to the disease, but does not treat the central nervous system, due to inability to cross the blood brain barrier. Our purpose is to test delivery of ERT to the spinal fluid via intrathecal injection in patients with MPS I. In this pilot study, we will use recombinant human α-L-iduronidase administered intrathecally once per month for four months to individuals with the Hurler-Scheie and Scheie forms of MPS I and spinal cord compression. If successful, intrathecal delivery could represent a practical, straightforward method of treating central nervous system disease due to lysosomal storage.

  Eligibility

Ages Eligible for Study:   8 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Hurler-Scheie, Scheie form of MPS I, or Hurler 2 years after hematopoietic stem cell transplantation

    • Spinal cord compression
    • Has received intrathecal laronidase previously with good response and no significant safety concerns
    • Age greater than 8 years
    • Able to provide legal informed consent
    • Aware of clinical treatment option of observation without treatment or surgical decompression
    • Negative urine pregnancy test at screening (nonsterile females of child-bearing potential who are sexually active only)

Exclusion Criteria:

  • Severe (Hurler) form of MPS I
  • Desires surgical or medical treatment of spinal cord compression
  • Spinal cord compression that warrants immediate surgical intervention
  • Pregnancy or lactation
  • Hematopoietic stem cell transplantation within 2 years of study enrollment
  • Receipt of an investigational drug within 30 days of enrollment
  • Infusion reactions to laronidase that required medical intervention, prophylaxis, or altered enzyme administration
  • Significant anti-iduronidase antibody titer
  • Recent initiation of intravenous laronidase (within past 6 months)
  • Presence of cervical subluxation or similar external pathology as the major cause of cord compression symptoms for which surgical intervention should be immediately undertaken
  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: NCT00786968

Locations
United States, California
Los Angeles Biomedical Research Institute at Harbor-UCLA
Torrance, California, United States, 90502
Finland
Helsinki University Central Hospital
Helsinki, Finland
Sponsors and Collaborators
Patricia I. Dickson, M.D.
The Ryan Foundation for MPS Children
Investigators
Principal Investigator: Patricia I Dickson, MD Los Angeles Biomedical Research Institute at Harbor-UCLA
  More Information

No publications provided

Responsible Party: Patricia I. Dickson, M.D., Associate Professor of Pediatrics, Dickson, Patricia I., M.D.
ClinicalTrials.gov Identifier: NCT00786968     History of Changes
Other Study ID Numbers: MIRC-001-01
Study First Received: June 17, 2008
Last Updated: February 19, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Dickson, Patricia I., M.D.:
mucopolysaccharidosis
Hurler-Scheie
Scheie
laronidase
spinal cord compression
central nervous system
enzyme replacement therapy
intrathecal

Additional relevant MeSH terms:
Mucopolysaccharidosis I
Lysosomal Storage Diseases
Mucopolysaccharidoses
Spinal Cord Compression
Syndrome
Carbohydrate Metabolism, Inborn Errors
Central Nervous System Diseases
Connective Tissue Diseases
Disease
Genetic Diseases, Inborn
Metabolic Diseases
Metabolism, Inborn Errors
Mucinoses
Nervous System Diseases
Pathologic Processes
Spinal Cord Diseases
Spinal Cord Injuries
Wounds and Injuries

ClinicalTrials.gov processed this record on November 25, 2014