Skip to content

Intra-Erythrocyte Dexamethasone Sodium Phosphate in Ataxia Teleangiectasia Patients

Evaluations of Effects of Intra-Erythrocyte Dexamethasone Sodium Phosphate on Neurological Symptoms in Ataxia Teleangiectasia Patients

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01255358
Acronym
IEDAT-01
Enrollment
22
Registered
2010-12-07
Start date
2011-02-28
Completion date
2011-12-31
Last updated
2024-10-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Genetic Syndrome, Nervous System Disorder

Keywords

Ataxia Teleangiectasia, AT, ERY-DEX, Dexamethasone, Dexamethasone sodium phosphate

Brief summary

The study has the aim to evaluate the improvement in CNS symptoms measured by International Co-operative Ataxia Rating Scale (ICARS) in patients with ataxia teleangectasia (AT), during a period of treatment with ERY-DEX (dexamethasone sodium phosphate ex vivo encapsulated into human autologous erythrocytes).

Detailed description

This is a multi-centre, single arm, open label, 6 months, phase II study to evaluate the effect of ERY-DEX in improving Central Nervous System (CNS) symptoms in patients with Ataxia Teleangectasia (AT). The study consists of a screening period (max duration of 30 days) and a treatment period (duration 6 months).

Interventions

DRUGDexamethasone

Dexamethasone sodium phosphate (2 vials, 250 mg/10 ml each) to be administered via encapsulation into autologous erythrocytes (ERY-DEX system). Final amount administered to the patient: about 10-15 mg of dexamethasone sodium phosphate, encapsulated into autologous blood (2 vials of 250 mg each of dexamethasone sodium phosphate will be used in the ex vivo process together with 50 ml of blood previously taken from the same patient). The treatment has to be repeated at intervals of 30 days (±10 days)

Sponsors

Quince Therapeutics S.p.A.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
3 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* neurological signs of AT * patients in autonomous gait or helped by a support * proven molecular diagnosis of AT * Males and females aged \> 3 years * Body weight \>15 kg * Plasma levels of Lymphocytes CD4+/mm3 \> 500 (for patients aged 3-6 years) or \> 200 (older than 6 years) * written IC to participate.

Exclusion criteria

* Current or previous neoplastic disease * History of severe impairment of the immunological system * Chronic conditions representing a contraindication to the use of steroid drugs * Non compliance with the study request * Any previous steroid assumption within 30 days before starting ERY-DEX * Have any other significant disease that in the Investigator's opinion would exclude the patient from the trial * Females of childbearing potential who were pregnant, breast-feeding or were not using adequate contraceptive methods

Design outcomes

Primary

MeasureTime frameDescription
Mean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - ITT PopulationAt visits 2 (day 30), 4 (day 90) and 7 (final visit, day 180)ICARS ia a 100-point semiquantitative scale, which goes from 0 to 100, offering a compartimentalised quantification of 4 subscores: Posture and Gait Disturbances (maximum score = 34), Kinetic Functions (maximum score = 52), Speech Disorders (maximum score = 8), and Oculomotor Disorders (maximum score = 6) for a possible total score of 100 points. The minimum score is 0 (normal), while the maximum score is 100 and corresponds to the worst status of the patient. This means that for each subscale, higher scores indicate higher levels of impairment.
Mean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - PP PopulationAt visits 2 (day 30), 4 (day 90) and 7 (final visit, day 180)ICARS ia a 100-point semiquantitative scale, which goes from 0 to 100, offering a compartimentalised quantification of 4 subscores: Posture and Gait Disturbances (maximum score = 34), Kinetic Functions (maximum score = 52), Speech Disorders (maximum score = 8), and Oculomotor Disorders (maximum score = 6) for a possible total score of 100 points. The minimum score is 0 (normal), while the maximum score is 100 and corresponds to the worst status of the patient. This means that for each subscale, higher scores indicate higher levels of impairment.

Secondary

MeasureTime frameDescription
Mean Change From V4 to V7 in Ocular Motility - ITT PopulationAt visit 7 (final visit, day 180)An evaluation of ocular motility measured by an ad hoc form was performed at V4 and V7. At V4 and V7, ocular motility was assessed through a 5-point qualitative scale: very much improved (1), slightly improved (2), no change (3), slightly worsened (4), very much worsened (5).
Mean Change From V4 to V7 in Ocular Motility - PP PopulationAt visit 7 (final visit, day 180)An evaluation of ocular motility measured by an ad hoc form was performed at V4 and V7. At V4 and V7, ocular motility was assessed through a 5-point qualitative scale: very much improved (1), slightly improved (2), no change (3), slightly worsened (4), very much worsened (5).
Change From V4 to V7 in Investigator Global Assessment (IGA) - ITT PopulationAt visit 7 (final visit, day 180)An evaluation of the global health status of the patients by the IGA was performed. IGA consisted of an evaluation of neurological signs and symptoms as neuromotor disorders, posture and deambulation, disturbances of the oro-pharyngeal apparatus, presence of peripheral neuropathy, neurodevelopmental disturbances, intellectual level, and behavior disturbances based only on a subjective judgment of the Investigator on a single scale: a 5-point qualitative scale as: * very much improved (1), * slightly improved (2), * no change (3), * slightly worsened (4), * very much worsened (5) was used to assess changes from V4 to V7. The higher the score, the worse the outcome.
Change From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - PP PopulationAt visits 4 (90 days) and 7 (180 days, final visit)VABS aggregate scale is used. VABS is divided into 4 adaptive domains and 11 subdomains: 1. Communication: Receptive, Expressive, Written; 2. Daily Living Skills: Personal, Domestic, Community; 3. Socialisation: Interpersonal Relationships, Play & Leisure Time, Coping Skills; 4. Motor Skills: Gross, Fine. For each \*question\* in each of the 11 subdomains, score ranges from 0 to 4 (the higher the value the better the outcome): * 0 = the subject never performs the behaviour without help or reminders; * 1 = rarely performs (as above); * 2 = sometimes performs (as above); * 3 = often performs (as above); * 4 = almost always performs (as above); The total subdomain score is the sum of each \*question\* scores and the total domain score is the sum of each subdomains' scores. Domains min-max interval scores: 0-74 Communication, 0-74 Daily Living Skills, 0-62 Socialization, 0-111 Motor Skills, Sum-of-domains score 0-321(the higher the score, the better the outcome)
Count of Participants on ERY-DEX Showing Treatment Emergent Adverse Events (TEAEs) Including Serious Adverse Events (SAEs)Throughout the study, until the end of 6 months of treatment (day 180)The effect of ERY-DEX on treatment emergent adverse events was expressed as the number of patients showing at least one TEAE or 1 serious AE
Change From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - ITT PopulationAt visits 4 (90 days) and 7 (180 days, final visit)VABS aggregate scale is used. VABS is divided into 4 adaptive domains and 11 subdomains: 1. Communication: Receptive, Expressive, Written; 2. Daily Living Skills: Personal, Domestic, Community; 3. Socialisation: Interpersonal Relationships, Play & Leisure Time, Coping Skills; 4. Motor Skills: Gross, Fine. For each \*question\* in each of the 11 subdomains, score ranges from 0 to 4 (the higher the value the better the outcome): * 0 = the subject never performs the behaviour without help or reminders; * 1 = rarely performs (as above); * 2 = sometimes performs (as above); * 3 = often performs (as above); * 4 = almost always performs (as above); The total subdomain score is the sum of each \*question\* scores and the total domain score is the sum of each subdomains' scores. Domains min-max interval scores: 0-74 Communication, 0-74 Daily Living Skills, 0-62 Socialization, 0-111 Motor Skills, Sum-of-domains score 0-321(the higher the score, the better the outcome)
Change From V4 to V7 in Investigator Global Assessment (IGA) - PP PopulationAt visit 7 (final visit, day 180)An evaluation of the global health status of the patients by the IGA was performed. IGA consisted of an evaluation of neurological signs and symptoms as neuromotor disorders, posture and deambulation, disturbances of the oro-pharyngeal apparatus, presence of peripheral neuropathy, neurodevelopmental disturbances, intellectual level, and behavior disturbances based only on a subjective judgment of the Investigator on a single scale: a 5-point qualitative scale as: * very much improved (1), * slightly improved (2), * no change (3), * slightly worsened (4), * very much worsened (5) was used to assess changes from V4 to V7. The higher the score, the worse the outcome.

Countries

Italy

Participant flow

Recruitment details

Study was carried out in 2 Italian Hospitals. Recruitment started on February 2011 and LPLV was performed on August 2011.

Pre-assignment details

Patients had 30 days of wash-out from steroid assumption before starting the treatment. 26 patients were screened, 4 of them resulted screening failure, due to lymphocytes value below the limit (3) and concomitant disease (1).

Participants by arm

ArmCount
ERY-DEX
Patients treated with monthly treatment of ERY-DEX (dexamethasone sodium phosphate encapsulated in autologous erythrocytes)
22
Total22

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event2
Overall StudyProtocol Violation2

Baseline characteristics

CharacteristicERY-DEX
Age, Categorical
<=18 years
21 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
Age, Continuous11.2 years
STANDARD_DEVIATION 3.5
Region of Enrollment
Italy
22 participants
Sex: Female, Male
Female
11 Participants
Sex: Female, Male
Male
11 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 22
other
Total, other adverse events
15 / 22
serious
Total, serious adverse events
2 / 22

Outcome results

Primary

Mean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - ITT Population

ICARS ia a 100-point semiquantitative scale, which goes from 0 to 100, offering a compartimentalised quantification of 4 subscores: Posture and Gait Disturbances (maximum score = 34), Kinetic Functions (maximum score = 52), Speech Disorders (maximum score = 8), and Oculomotor Disorders (maximum score = 6) for a possible total score of 100 points. The minimum score is 0 (normal), while the maximum score is 100 and corresponds to the worst status of the patient. This means that for each subscale, higher scores indicate higher levels of impairment.

Time frame: At visits 2 (day 30), 4 (day 90) and 7 (final visit, day 180)

Population: Intent to treat population (ITT) patients receiving at least one treatment

ArmMeasureGroupValue (MEAN)Dispersion
ERY-DEXMean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - ITT PopulationV2-2.2 units on a scaleStandard Deviation 5.6
ERY-DEXMean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - ITT PopulationV4-3.4 units on a scaleStandard Deviation 7.3
ERY-DEXMean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - ITT PopulationV7-4.0 units on a scaleStandard Deviation 7.5
Comparison: The primary analysis on ICARS Total score has been conducted on the ITT Population employing carry-forward and carry-backward procedures for missing data imputation, in order to evaluate all enrolled patients.p-value: 0.0295% CI: [-7.1, -0.9]Wilcoxon (Mann-Whitney)
Primary

Mean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - PP Population

ICARS ia a 100-point semiquantitative scale, which goes from 0 to 100, offering a compartimentalised quantification of 4 subscores: Posture and Gait Disturbances (maximum score = 34), Kinetic Functions (maximum score = 52), Speech Disorders (maximum score = 8), and Oculomotor Disorders (maximum score = 6) for a possible total score of 100 points. The minimum score is 0 (normal), while the maximum score is 100 and corresponds to the worst status of the patient. This means that for each subscale, higher scores indicate higher levels of impairment.

Time frame: At visits 2 (day 30), 4 (day 90) and 7 (final visit, day 180)

Population: The PP Population includes 18 patients who have been treated according to protocol and fulfill the following criteria:~* compliance with all entry criteria~* absence of major protocol violations~* adequate compliance with trial medication (at most one missed or out-of-window infusion of the study preparation).

ArmMeasureGroupValue (MEAN)Dispersion
ERY-DEXMean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - PP PopulationV4-3.9 units on a scaleStandard Deviation 7.1
ERY-DEXMean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - PP PopulationV2-2.4 units on a scaleStandard Deviation 4.9
ERY-DEXMean Change From Baseline in Neurological Symptoms Assessed by Using International Cooperative Ataxia Rating Scale (ICARS) Score - PP PopulationV7-5.2 units on a scaleStandard Deviation 7
Comparison: Overall analysis on the PP Populationp-value: 0.003195% CI: [-8.4, -2]Wilcoxon (Mann-Whitney)
Secondary

Change From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - ITT Population

VABS aggregate scale is used. VABS is divided into 4 adaptive domains and 11 subdomains: 1. Communication: Receptive, Expressive, Written; 2. Daily Living Skills: Personal, Domestic, Community; 3. Socialisation: Interpersonal Relationships, Play & Leisure Time, Coping Skills; 4. Motor Skills: Gross, Fine. For each \*question\* in each of the 11 subdomains, score ranges from 0 to 4 (the higher the value the better the outcome): * 0 = the subject never performs the behaviour without help or reminders; * 1 = rarely performs (as above); * 2 = sometimes performs (as above); * 3 = often performs (as above); * 4 = almost always performs (as above); The total subdomain score is the sum of each \*question\* scores and the total domain score is the sum of each subdomains' scores. Domains min-max interval scores: 0-74 Communication, 0-74 Daily Living Skills, 0-62 Socialization, 0-111 Motor Skills, Sum-of-domains score 0-321(the higher the score, the better the outcome)

Time frame: At visits 4 (90 days) and 7 (180 days, final visit)

Population: The ITT Population includes all 22 patients enrolled into the study.

ArmMeasureGroupValue (MEAN)Dispersion
ERY-DEXChange From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - ITT PopulationV41.0 units on a scaleStandard Deviation 0.9
ERY-DEXChange From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - ITT PopulationV71.3 units on a scaleStandard Deviation 1.3
Comparison: VABS total score at V7p-value: <0.000195% CI: [0.8, 1.8]Wilcoxon (Mann-Whitney)
Secondary

Change From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - PP Population

VABS aggregate scale is used. VABS is divided into 4 adaptive domains and 11 subdomains: 1. Communication: Receptive, Expressive, Written; 2. Daily Living Skills: Personal, Domestic, Community; 3. Socialisation: Interpersonal Relationships, Play & Leisure Time, Coping Skills; 4. Motor Skills: Gross, Fine. For each \*question\* in each of the 11 subdomains, score ranges from 0 to 4 (the higher the value the better the outcome): * 0 = the subject never performs the behaviour without help or reminders; * 1 = rarely performs (as above); * 2 = sometimes performs (as above); * 3 = often performs (as above); * 4 = almost always performs (as above); The total subdomain score is the sum of each \*question\* scores and the total domain score is the sum of each subdomains' scores. Domains min-max interval scores: 0-74 Communication, 0-74 Daily Living Skills, 0-62 Socialization, 0-111 Motor Skills, Sum-of-domains score 0-321(the higher the score, the better the outcome)

Time frame: At visits 4 (90 days) and 7 (180 days, final visit)

Population: The PP Population includes 18 patients who have been treated according to protocol and fulfill the following criteria:~* compliance with all entry criteria~* absence of major protocol violations~* adequate compliance with trial medication (at most one missed or out-of-window infusion of the study preparation).

ArmMeasureGroupValue (MEAN)Dispersion
ERY-DEXChange From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - PP PopulationV41.1 units on a scaleStandard Deviation 0.9
ERY-DEXChange From Baseline for Vineland Adaptive Behaviour Scale (VABS) Total Score - PP PopulationV71.5 units on a scaleStandard Deviation 1.1
p-value: <0.000195% CI: [1, 2]Wilcoxon (Mann-Whitney)
Secondary

Change From V4 to V7 in Investigator Global Assessment (IGA) - ITT Population

An evaluation of the global health status of the patients by the IGA was performed. IGA consisted of an evaluation of neurological signs and symptoms as neuromotor disorders, posture and deambulation, disturbances of the oro-pharyngeal apparatus, presence of peripheral neuropathy, neurodevelopmental disturbances, intellectual level, and behavior disturbances based only on a subjective judgment of the Investigator on a single scale: a 5-point qualitative scale as: * very much improved (1), * slightly improved (2), * no change (3), * slightly worsened (4), * very much worsened (5) was used to assess changes from V4 to V7. The higher the score, the worse the outcome.

Time frame: At visit 7 (final visit, day 180)

Population: The ITT Population includes all 22 patients enrolled into the study.

ArmMeasureValue (MEAN)Dispersion
ERY-DEXChange From V4 to V7 in Investigator Global Assessment (IGA) - ITT Population0.2 units on a scaleStandard Deviation 0.6
Secondary

Change From V4 to V7 in Investigator Global Assessment (IGA) - PP Population

An evaluation of the global health status of the patients by the IGA was performed. IGA consisted of an evaluation of neurological signs and symptoms as neuromotor disorders, posture and deambulation, disturbances of the oro-pharyngeal apparatus, presence of peripheral neuropathy, neurodevelopmental disturbances, intellectual level, and behavior disturbances based only on a subjective judgment of the Investigator on a single scale: a 5-point qualitative scale as: * very much improved (1), * slightly improved (2), * no change (3), * slightly worsened (4), * very much worsened (5) was used to assess changes from V4 to V7. The higher the score, the worse the outcome.

Time frame: At visit 7 (final visit, day 180)

Population: The PP Population includes 18 patients who have been treated according to protocol and fulfill the following criteria:~* compliance with all entry criteria~* absence of major protocol violations~* adequate compliance with trial medication (at most one missed or out-of-window infusion of the study preparation).

ArmMeasureValue (MEAN)Dispersion
ERY-DEXChange From V4 to V7 in Investigator Global Assessment (IGA) - PP Population0.2 units on a scaleStandard Deviation 0.6
Secondary

Count of Participants on ERY-DEX Showing Treatment Emergent Adverse Events (TEAEs) Including Serious Adverse Events (SAEs)

The effect of ERY-DEX on treatment emergent adverse events was expressed as the number of patients showing at least one TEAE or 1 serious AE

Time frame: Throughout the study, until the end of 6 months of treatment (day 180)

Population: The SP includes the 22 patients who have received at least one dose of planned trial treatment.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ERY-DEXCount of Participants on ERY-DEX Showing Treatment Emergent Adverse Events (TEAEs) Including Serious Adverse Events (SAEs)Participants with at least 1 TEAE15 Participants
ERY-DEXCount of Participants on ERY-DEX Showing Treatment Emergent Adverse Events (TEAEs) Including Serious Adverse Events (SAEs)Participants with at least 1 serious AE2 Participants
Secondary

Mean Change From V4 to V7 in Ocular Motility - ITT Population

An evaluation of ocular motility measured by an ad hoc form was performed at V4 and V7. At V4 and V7, ocular motility was assessed through a 5-point qualitative scale: very much improved (1), slightly improved (2), no change (3), slightly worsened (4), very much worsened (5).

Time frame: At visit 7 (final visit, day 180)

Population: The ITT Population includes all 22 patients enrolled into the study.

ArmMeasureValue (MEAN)Dispersion
ERY-DEXMean Change From V4 to V7 in Ocular Motility - ITT Population-0.3 units on a scaleStandard Deviation 0.5
Secondary

Mean Change From V4 to V7 in Ocular Motility - PP Population

An evaluation of ocular motility measured by an ad hoc form was performed at V4 and V7. At V4 and V7, ocular motility was assessed through a 5-point qualitative scale: very much improved (1), slightly improved (2), no change (3), slightly worsened (4), very much worsened (5).

Time frame: At visit 7 (final visit, day 180)

Population: The PP Population includes 18 patients who have been treated according to protocol and fulfill the following criteria:~* compliance with all entry criteria~* absence of major protocol violations~* adequate compliance with trial medication (at most one missed or out-of-window infusion of the study preparation).

ArmMeasureValue (MEAN)Dispersion
ERY-DEXMean Change From V4 to V7 in Ocular Motility - PP Population-0.3 units on a scaleStandard Deviation 0.5

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026