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The purpose of this study is to investigate the safety, tolerability and efficacy of a single 6-hour intravenous infusion of AMO-01 to treat adolescents and adults with PMS and co-morbid epilepsy. Phelan-McDermid Syndrome (PMS) is a neurodevelopmental disorder characterized by a chromosomal deletion or mutation at 22q13.3 that contains the SHANK3/ProSAP2 gene. A key co-morbidity in PMS is the presence of epilepsy. Currently there are no approved treatments for PMS. Furthermore, there has been relatively little clinical study of pharmacological interventions for PMS. AMO-01 may provide benefit to PMS patients exhibiting behavioral abnormalities and seizures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AMO-01 | Experimental | Intravenous Infusion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AMO-01 | Drug | Subjects will receive a single 6-hour intravenous infusion for a total dose administration or 120 mg/m2 of AMO-01. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Adverse Events | An adverse event is defined as any untoward medical occurrence in a study subject, temporally associated with the use of the experimental medication, whether or not considered related to the medication. An adverse event can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of the experimental medication. Adverse events will be monitored throughout all 8 weeks of study participation. | 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Weekly Seizure Counts | Seizure frequency was measured by a caregiver-completed seizure diary throughout the duration of the trial. A seizure diary was provided to each family at the screening visit to record each seizure event, its date/time, duration, and type. The study team reviewed the diary at each visit with the caregiver and weekly seizure frequency was calculated. The week 1 seizure count was the number of seizures in the 7 days following the infusion day. Similarly, the week 2 seizure count was the number of seizures in the 7 days between weeks 1 and 2. Lastly, the week 4 seizure count was the sum of seizures in the 14 days between weeks 2 and 4, divided by 2. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alexander Kolevzon, MD | Icahn School of Medicine at Mount Sinai | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seaver Autism Center for Research and Treatment at Mount Sinai | New York | New York | 10029 | United States | ||
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Recruitment began in Feb 2017, with first enrollment in May of 2018. Study was opened for enrollment through Jan 2021 when decision was made to close study due to low enrollment. Participants completed study visits. Last participant seen March 2020.
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| ID | Title | Description |
|---|---|---|
| FG000 | AMO-01 | Subjects received a single 6-hour intravenous infusion for a total dose administration or 120 mg/m2 of AMO-01. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | AMO-01 | Subjects received a single 6-hour intravenous infusion for a total dose administration or 120 mg/m2 of AMO-01. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Adverse Events | An adverse event is defined as any untoward medical occurrence in a study subject, temporally associated with the use of the experimental medication, whether or not considered related to the medication. An adverse event can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of the experimental medication. Adverse events will be monitored throughout all 8 weeks of study participation. | Posted | Number | events | 8 weeks |
|
|
8 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | AMO-01 | Subjects received a single 6-hour intravenous infusion for a total dose administration or 120 mg/m2 of AMO-01. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Constipation | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Christina Layton | Icahn School of Medicine at Mount Sinai | 212-241-6231 | christina.layton@mssm.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 1, 2019 | Mar 29, 2021 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| C536801 | Telomeric 22q13 Monosomy Syndrome |
| D004827 | Epilepsy |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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Single Group, open label
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| 4 weeks |
| Change in CGI - Improvement and Severity Scale | Clinical Global Impressions (CGI) Rating Scales are commonly used to measure symptom severity and global improvement in treatment studies of patients with developmental disorders. There Severity Scale (CGI-S) is a 7-point scale (1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.) that requires the clinician to rate the severity of illness at the time of assessment. The Improvement Scale (CGI-I) is a 7-point scale (1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.) that requires the clinician to assess how much the illness has improved or worsened relative to baseline. | baseline, Week 1, Week 2, and Week 4 |
| Clinician-completed PMS Domain Specific Causes for Concerns Visual Analogue Scale (VAS) | 9 item visual analogue scale completed by the clinician that scores the severity of concerns in domains that are clinically relevant in PMS. For each subject, the clinician is instructed to identify the top 4 or 5 that are of particular concern and that the clinician would most like to see change during the course of treatment with the study medication. The severity of the clinician's concern in each domain is scored by using a 10 cm visual analogue scale, with anchors of 0 "not at all severe" at the left and 100 "very severe" at the right end. | 8 weeks |
| Aberrant Behavior Checklist (ABC) | rating scaled used to monitor an array of behavioral features among patients with intellectual disabilities. It takes 15-30 minutes to complete. 16 items, Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). with total from 0 to 48. | baseline, Week 1, Week 2, and Week 4 |
| Repetitive Behavior Scale-Revised (RBS-R) | 42-item rating scale that is completed by a parent or caregiver. It reports on the severity of repetitive behaviors. each item scored on 4-point scale: 0-Behavior does not occur, 1-Behavior occurs and is a mild problem, 2-Behavior occurs and is a moderate problem, 3-Behavior occurs and is a severe problem. with total score from 0 (mild) to 126 (severe). Subscale ranges: stereotypic behavior (0 - 27);self-injurious behavior (0 - 24); compulsive behavior (0 - 18); ritualistic/Sameness Behavior (0 - 36); restricted Interests (0 - 9). Higher score in all subscales reflect increasing severity. | Baseline, Week 1, Week 2, Week 4 |
| Texas Children's Hospital |
| Houston |
| Texas |
| 77030 |
| United States |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Participants |
|
|
| Secondary | Number of Weekly Seizure Counts | Seizure frequency was measured by a caregiver-completed seizure diary throughout the duration of the trial. A seizure diary was provided to each family at the screening visit to record each seizure event, its date/time, duration, and type. The study team reviewed the diary at each visit with the caregiver and weekly seizure frequency was calculated. The week 1 seizure count was the number of seizures in the 7 days following the infusion day. Similarly, the week 2 seizure count was the number of seizures in the 7 days between weeks 1 and 2. Lastly, the week 4 seizure count was the sum of seizures in the 14 days between weeks 2 and 4, divided by 2. | Posted | Mean | Standard Deviation | seizure event | 4 weeks |
|
|
|
| Secondary | Change in CGI - Improvement and Severity Scale | Clinical Global Impressions (CGI) Rating Scales are commonly used to measure symptom severity and global improvement in treatment studies of patients with developmental disorders. There Severity Scale (CGI-S) is a 7-point scale (1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.) that requires the clinician to rate the severity of illness at the time of assessment. The Improvement Scale (CGI-I) is a 7-point scale (1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.) that requires the clinician to assess how much the illness has improved or worsened relative to baseline. | Posted | Mean | Standard Deviation | score on a scale | baseline, Week 1, Week 2, and Week 4 |
|
|
|
| Secondary | Clinician-completed PMS Domain Specific Causes for Concerns Visual Analogue Scale (VAS) | 9 item visual analogue scale completed by the clinician that scores the severity of concerns in domains that are clinically relevant in PMS. For each subject, the clinician is instructed to identify the top 4 or 5 that are of particular concern and that the clinician would most like to see change during the course of treatment with the study medication. The severity of the clinician's concern in each domain is scored by using a 10 cm visual analogue scale, with anchors of 0 "not at all severe" at the left and 100 "very severe" at the right end. | Posted | Mean | Standard Deviation | score on a scale | 8 weeks |
|
|
|
| Secondary | Aberrant Behavior Checklist (ABC) | rating scaled used to monitor an array of behavioral features among patients with intellectual disabilities. It takes 15-30 minutes to complete. 16 items, Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). with total from 0 to 48. | Posted | Mean | Standard Deviation | score on a scale | baseline, Week 1, Week 2, and Week 4 |
|
|
|
| Secondary | Repetitive Behavior Scale-Revised (RBS-R) | 42-item rating scale that is completed by a parent or caregiver. It reports on the severity of repetitive behaviors. each item scored on 4-point scale: 0-Behavior does not occur, 1-Behavior occurs and is a mild problem, 2-Behavior occurs and is a moderate problem, 3-Behavior occurs and is a severe problem. with total score from 0 (mild) to 126 (severe). Subscale ranges: stereotypic behavior (0 - 27);self-injurious behavior (0 - 24); compulsive behavior (0 - 18); ritualistic/Sameness Behavior (0 - 36); restricted Interests (0 - 9). Higher score in all subscales reflect increasing severity. | Subjects received a single 6-hour intravenous infusion for a total dose administration or 120 mg/m2 of AMO-01. | Posted | Mean | Standard Deviation | score on a scale | Baseline, Week 1, Week 2, Week 4 |
|
|
|
| 0 |
| 6 |
| 0 |
| 6 |
| 4 |
| 6 |
| Sleep Issues | General disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Congestion/Cough | Respiratory, thoracic and mediastinal disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Headache | General disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Cellulitis | Skin and subcutaneous tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Redness on hands | Skin and subcutaneous tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Decreased appetite/weight loss | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Viral Infection | Infections and infestations | CTCAE (Unspecified) | Systematic Assessment |
|
| Rash on nect | Skin and subcutaneous tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Ear Infection | Ear and labyrinth disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Mouth movement, possible tic | Nervous system disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Increased appetite | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Increased rubbing/repetitive behaviors | Psychiatric disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Seizure | Nervous system disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Drowsiness after infusion | Injury, poisoning and procedural complications | CTCAE (Unspecified) | Systematic Assessment |
|
| Flushing in face and hand | Injury, poisoning and procedural complications | CTCAE (Unspecified) | Systematic Assessment |
|
| Motor Stereotypes | Psychiatric disorders | CTCAE (Unspecified) | Systematic Assessment |
|
The Investigators agree not to publish reports, abstracts, or other data compilations concerning the Study before the first multi-site publication by Sponsor. If there is no multi-site publication within 18 months after the Study has been completed or terminated at all Study locations, Principal Investigator shall have the right to publish and or present the results of the Study generated or collected at Study Site(s) (but not the results of any other Study location).
|
| Severity |
|
|
| Thinking and Learning |
|
| Seizures |
|
| Gross Motor |
|
| Repetitive Behavior |
|
| Social Communication |
|
| Sensory |
|
| Activities of Daily Living |
|
| Sleep |
|
| Lethargy |
|
| Stereotypy |
|
| Hyperactivity |
|
| Inappropriate Speech |
|
| Self-Injury |
|
| Compulsive Behavior |
|
| Ritualistic Behavior |
|
| Sameness Behavior |
|
| Restricted Behavior |
|
| Total |
|