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Primary Objective: To test the hypothesis that 6 months treatment with glatiramer acetate (GA) decreases epileptiform activity in young girls with Rett syndrome.
Primary Safety Objective:To evaluate the safety and tolerability of 6 months treatment with GA in these patients.
Secondary Objectives:
Primary Endpoint:Improvement of epileptiform activity as recorded in a 24-hours EEG.
Primary Safety Endpoint:Frequency and severity of treatment-related AEs (including safety lab parameters).
Secondary Endpoints:
Investigational Product:Glatiramer Acetate (Copaxone® , Teva Pharmaceutical Industries Ltd.) Sample Size Consideration: The planned sample size of 10 patients was considered adequate by the investigator for this phase I exploratory proof-of-concept study. The study is not expected to show statistical significance or statistical power, only a trend for the study endpoints. Each patient will serve as her own control.
Duration of Study: Approximately 8 months per patient (including up to 2 weeks pre-treatment assessment, 6 months initial dose and treatment periods and end-of study visit).
Overall study duration: the study is expected to be completed within 12 months (dependent on rate of recruitment).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Copaxone | Experimental | Glatiramer Acetate (Copaxone® , Teva Pharmaceutical Industries Ltd.) 20 mg daily or in an interval determined in the Dose Setting period. Administration will be subcutaneous to various areas on the body: back of the upper arms (2 areas), front and outside of thighs (2 areas), upper buttocks/rear hips (2 areas), and stomach (the abdomen). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glatiramer Acetate (Copaxone®) | Drug | GA is a potent inducer of Th2-cells and modulates these immune cells to secrete high levels of neurotrophic factors, particularly BDNF. The induced cells cross the blood brain barrier (BBB), accumulate in the CNS and express BDNF and other regulatory substances in situ. |
| Measure | Description | Time Frame |
|---|---|---|
| Improvement of epileptiform activity as recorded in a 24-hours EEG. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| 1.Improvement in the scoring of breath holds and hyperventilation, as measured with non-invasive respiratory inductance plethysmography (NoxT3 device) and parents' diaries. | 8 months | |
| 2. Changes in general behaviour, communication, feeding and motor skills as assessed by the investigator (based on Kerr and Naidu validated severity scores) and recorded in parents' diary. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| BRURIA BEN ZEEV, MD | Contact | +972 3 5302687 | Bruria.BenZeev@sheba.health.gov.il |
| Name | Affiliation | Role |
|---|---|---|
| Bruria Ben Zeev, prof. | Sheba Medical Center | Principal Investigator |
| Andreea Nissenkorn, Dr. | Sheba Medical Center | Principal Investigator |
| Irit Avisar, R.N M.A |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sheba Medical Center | Recruiting | Ramat Gan | Israel |
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| ID | Term |
|---|---|
| D015518 | Rett Syndrome |
| ID | Term |
|---|---|
| D038901 | X-Linked Intellectual Disability |
| D008607 | Intellectual Disability |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
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| ID | Term |
|---|---|
| D000068717 | Glatiramer Acetate |
| ID | Term |
|---|---|
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
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|
| 8 months |
| Decrease in seizure frequency as reported in parents' diary. | 8 months |
| Improvement in sleep schedule as recorded in a sleep diary. | 8 months |
| Change in height and weight | 8 months |
| Sheba Medical Center |
| Study Director |
| D009422 | Nervous System Diseases |
| D040181 | Genetic Diseases, X-Linked |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D020271 | Heredodegenerative Disorders, Nervous System |