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Corticobasal syndrome (CBS) is a rapidly progressive neurodegenerative disorder with an average survival time of about 6-8 years after the first clinical manifestation. No potent symptomatic treatment is currently available. A disease-modifying therapy does not exist either. Neuroinflammation is key to the pathogenesis in neurodegenerative diseases with Tau- and/or AD-pathology. There is strong evidence that phenylbutyrate can modulate microglial function by enhancing their phagocytic activity, most likely by epigenetic mechanisms. So the main goal of this clinical trial is to study a potential disease-modifying effect of treatment with glycerol phenylbutyrate (GPB), which is a prodrug of phenylbutyric acid, for 26 weeks assessed by the levels of the biomarker neurofilament light chain (NfL) indicating disease progression in CBS. Given the aggressive nature of CBS, it is feasible to study effects of GPB on plasma NfL levels.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Verum | Experimental | RAVICTI 1.1 g/ml oral liquid (glycerol phenylbutyrate (GPB)) Duration of Treatment: 26 weeks, twice daily |
|
| Placebo | Placebo Comparator | Matching Placebo, oral liquid Duration of Treatment: 26 weeks, twice daily |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| RAVICTI 1.1 g/ml | Drug | Duration of Treatment: 26 weeks, twice daily Dosage:
|
| Measure | Description | Time Frame |
|---|---|---|
| To assess the efficacy of glycerol phenylbutyrate vs. placebo in reducing the levels of neurofilament light chain (NfL) during 26 weeks of exposure to glycerol phenylbutyrate as well as safety and tolerability of glycerol phenylbutyrate in patients with | To assess the efficacy of glycerol phenylbutyrate vs. placebo in reducing the levels of neurofilament light chain (NfL) during 26 weeks of exposure to glyc-erol phenylbutyrate as well as safety and tolerability of glycerol phenylbutyrate in patients with CBS. | 26 weeks (between V1 and V3) |
| Measure | Description | Time Frame |
|---|---|---|
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS Part III), min value 0- max value 132 (worse outcome) | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales |
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Inclusion Criteria:
Age: ≥ 18 years
"clinical possible" or "clinical probable" CBS (Armstrong et al., Neurol-ogy, 2013 80;496-503) and patients with Progressive Supranuclear Palsy-CBS according to Höglinger et al. (Mov Disord. 2017 Jun;32(6):853-864)
No regular consumption of glycerol phenylbutyrate within the last 6 months prior to V1
Capable of thoroughly understanding all information given and giving full informed consent according to GCP
Capability and willingness to comply with the procedures of the clinical trial
Women of childbearing age must be non-lactating and surgically sterile or using a highly effective method of birth control and have a nega-tive pregnancy test. In case of using a hormonal contraception, the method must be supplemented with a barrier method (preferably male condom). Acceptable methods of birth control with a low failure rate i.e. less than 1% per year when used consistently and correct are such as implants, injectables, combined oral contraceptives, hormonal intrauterine devices (IUDs), sexual abstinence (defined as refraining from heterosexual intercourse during the clinical trial) or vasectomized partner. Unacceptable birth control methods are: periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only and lactational amenorrhoea method (LAM). Female condom and male condom should not be used together.
A stable regimen for at least 1 month prior to V1 and no foreseeable need to change the regimen throughout the 26 week treatment period for
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Klinikum der Universität München (KUM), Campus Großhadern, Klinik und Poliklinik für Neurologie & German Center for Neurodegenerative Diseases (DZNE), Department of Neurology | Munich | Bavaria | 81377 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42400090 | Derived | Palleis C, Weidinger E, Maass S, Linke M, Brendel M, Stocklein S, Al Tawil A, Mansmann U, Teupser D, Borst T, Heimke-Brinck R, Hemmer B, Hoglinger GU, Bidner H, Simons M, Levin J. Study protocol: double-blind, randomized, prospective, placebo controlled parallel group phase II study to investigate the effect of glycerol phenylbutyrate (GPB) on neurofilament light chain (NfL) levels in patients with corticobasal syndrome (CBS). Neurol Res Pract. 2026 Jul 3;8(1):54. doi: 10.1186/s42466-026-00504-5. |
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| ID | Term |
|---|---|
| D000088282 | Corticobasal Degeneration |
| ID | Term |
|---|---|
| D024801 | Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| C570223 | glycerol phenylbutyrate |
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|
| Placebo | Drug | Duration of Treatment: 26 weeks, twice daily Dosage:
|
|
To assess longitudinal changes in clinical scale: Progressive Supranuclear Palsy Rating Scale (PSP-RS), min value 0- max value 100 (worse outcome) |
| 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale:Progressive Supranuclear Palsy Clinical Deficits Scale (PSP-CDS), min value 0- max value 21 (worse outcome) | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: Cortical Basal ganglia Functional Scale (CBFS), min value 0- max value 124 (worse outcome) | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: Dementia Apraxia Test (DATE), min value 0 (worse outcome) - max value 60 | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: MONTREAL COGNITIVE ASSESSMENT (MoCA), min value 0 (worse outcome) - max value 30 | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: SCHWAB AND ENGLAND ACTIVITIES OF DAILY LIVING SCALE (SEADL), min value 0 (worse outcome) - max value 100% | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: Clinical Global Impression (CGI-s), min value 1- max value 7 (worse outcome) | 26 weeks (between V1 and V3) |
| To assess longitudinal changes in clinical scales | To assess longitudinal changes in clinical scale: PSP RATING SCALE (PSP-QoL), min value 0- max value 180 (worse outcome) | 26 weeks (between V1 and V3) |
| Klinikum rechts der Isar Technische Universität München Klinik und Poliklinik für Neurologie & German Center for Neurodegenerative Diseases (DZNE), Department of Neurology | Munich | Bavaria | 81377 | Germany |