Magnesium Supplements In The Treatment Of Pseudoxanthoma Elasticum (PXE)
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Purpose
The purpose of this study is to evaluate the effectiveness of magnesium oxide supplements on the reversal of calcium deposits in the skin, and the yellow bumps and folds of skin in subjects with pseudoxanthoma elasticum (PXE). Magnesium oxide is a dietary supplement that has been shown in some research to reduce these calcium deposits. This study consists of two parts. The first part is a year-long, double-blind, placebo-controlled study. Part two is an open-label, year-long study. In Part 1, qualified subjects will be randomized to receive either magnesium oxide supplements or placebo, in a 1:1 ratio for the first 12 months. The starting dose will be 1000 mg daily, and depending on tolerability, doses may be decreased. Baseline evaluations will be comprised of: blood tests; clinical evaluations; skin biopsy; eye examination; bone density test; and photography of skin lesions. Subjects will be evaluated at week 2, week 6, month 3, and then every 3 months during the first year. Upon completion of the first year, barring any safety concerns, all subjects will be administered magnesium oxide supplements for up to one additional year. Subjects will undergo the same evaluations/ procedures every 3 months. We hypothesize that the magnesium oxide will cause a reduction in calcifications in the subject's soft tissue/skin.
| Condition | Intervention | Phase |
|---|---|---|
|
Pseudoxanthoma Elasticum |
Drug: Magnesium Oxide Drug: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Magnesium Supplements In The Treatment Of Pseudoxanthoma Elasticum (PXE) |
- Reversal of elastic fiber calcification [ Time Frame: Baseline, Month 12, and Month 24 ] [ Designated as safety issue: No ]A blinded dermatopathologist will grade skin biopsies on the density of Von Kossa staining. We will assess changes in the amount of calcification of elastic fibers by assessing von Kossa staining per unit area of dermis
- Reversal of clinical skin lesions [ Time Frame: Screening, Months 6, 12, 18 and 24 ] [ Designated as safety issue: No ]Changes in skin skin lesions observed through investigator evaluations and clinical photographs
- Rate of disease progression [ Time Frame: Baseline, Month 12 and Month 24 ] [ Designated as safety issue: No ]Changes observed through ophthalmologic examinations
- Rate of disease progression [ Time Frame: Month 12 ] [ Designated as safety issue: No ]Observed through ophthalmologic examinations
- Rate of disease progression [ Time Frame: Month 24 ] [ Designated as safety issue: No ]Observed through ophthalmologic examinations
| Estimated Enrollment: | 44 |
| Study Start Date: | August 2012 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Magnesium oxide
1000 mg (one 500 mg capsule two times daily) of magnesium oxide
|
Drug: Magnesium Oxide
1000 mg (one 500 mg capsule two times daily) of magnesium oxide.
|
|
Placebo Comparator: Placebo
1000 mg (one 500 mg capsule two times daily) of placebo.
|
Drug: Placebo
1000 mg (one 500 mg capsule two times daily) of placebo.
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female subject at least 18 years of age
- If female, the subject is not pregnant or nursing
- If female of child bearing potential, the subject has a negative urine pregnancy test at the first visit, and agrees to use an approved method of contraception (hormonal contraceptives [birth control pills, implants [Norplant] or injections [DepoProvera]); intrauterine device (IUD); two forms of barrier methods [condoms and diaphragm]; or abstinence (no sexual activity) throughout the entire study
- Biopsy confirmed diagnosis of pseudoxanthoma elasticum (documenting some calcification of elastic fibers)
- Subject has a clinical disease severity grade of at least "1" (Poorly defined, barely visible macules) at screening.
- Normal kidney function tests
Exclusion Criteria:
- Any subject who is pregnant or becomes pregnant during the study
- Subjects with a serum creatinine greater than 1.6 mg/dL
- Subjects with hypermagnesemia, hypokalemia, or idiopathic hypercalciuria
- Subjects with kidney disease or renal tubular defects (eg. Fanconi's syndrome), or on dialysis
- Subjects with hypothyroidism or hypoparathyroidism or primary hyperparathyroidism
- Subjects with acute gout
- Subjects with malabsorption, or osteomalacia
- Subjects on diuretics, magnesium containing antacids, or anabolic steroids
- Subjects with Cushing's syndrome
- Subjects receiving lithium and those with significant psychiatric disorders that would likely interfere with participation in this study
- Subjects taking anti-seizures medications and anti-arrhythmics medications
- Subjects on tetracycline or metronidazole and ace inhibitors
- Subjects taking cyclosporine or calcineurin inhibitors
Contacts and Locations| Contact: Giselle Singer | 212-241-3288 | giselle.singer@mssm.edu |
| United States, New York | |
| Mount Sinai School of Medicine | Recruiting |
| New York, New York, United States, 10029 | |
| Contact: Giselle Singer 212-241-3288 giselle.singer@mssm.edu | |
| Contact: Mark Lebwohl, MD 212-241-3288 Lebwohl@aol.com | |
| Principal Investigator: Mark Lebwohl, MD | |
| Principal Investigator: | Mark Lebwohl, MD | Mount Sinai School of Medicine |
More Information
Publications:
| Responsible Party: | Mark Lebwohl, Principal Investigator, Mount Sinai School of Medicine |
| ClinicalTrials.gov Identifier: | NCT01525875 History of Changes |
| Other Study ID Numbers: | GCO 09-1157 |
| Study First Received: | February 1, 2012 |
| Last Updated: | November 6, 2012 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Keywords provided by Mount Sinai School of Medicine:
|
pseudoxanthoma elasticum calcification |
Additional relevant MeSH terms:
|
Pseudoxanthoma Elasticum Hemostatic Disorders Vascular Diseases Cardiovascular Diseases Hemorrhagic Disorders Hematologic Diseases Skin Abnormalities Congenital Abnormalities |
Skin Diseases, Genetic Genetic Diseases, Inborn Connective Tissue Diseases Skin Diseases Magnesium Oxide Antacids Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013