Spinal and Bulbar Muscular Atrophy
Conditions
Brief summary
The purpose of this clinical trial is to evaluate the efficacy and safety of mexiletine hydrochloride in patients with spinal and bulbar muscular atrophy. The main questions it aims to answer are: Does mexiletine hydrochloride improve the ALSFRS-R score in spinal and bulbar muscular atrophy patients? Participants will: Take mexiletine hydrochloride or a placebo every day for 3 months Visit the hospital once every 4 weeks for evaluations.
Interventions
Mexiletine hydrochloride 300 mg is administered orally divided into three times a day after meals for 12 weeks.
OTHERPlacebo
Placebo is administered orally divided into three times a day after meals for 12 weeks.
Sponsors
Masahisa Katsuno
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Male patients with a CAG repeat count of 38 or more for the androgen receptor gene in genetic testing and a confirmed diagnosis of SBMA 2. Patients with muscle weakness (limb weakness and atrophy, or bulbar palsy) due to lower motor neuron lesion 3. Patients with a total ALSFRS-R score of ≥ 24 and ≤ 42 at screening 4. Patients who are at least 18 years old and less than 80 years old at the time of consent 5. Patients who give their voluntary written consent after having received adequate information on this study (However, if the patient is unable to sign the consent form due to the condition of the disease, a person equivalent to a regal representative must be present to provide written explanation, the prospective candidate must verbally consent to participate in the study, and a person equivalent to a regal representative must sign the consent form on behalf of the patient. The person who is to be the regal representative may sign the document on his/her behalf, noting the circumstances and his/her relationship to the subject.)
Exclusion criteria
1. Patients who have participated or are participating in a clinical trial within 12 weeks prior to enrollment 2. Patients with a history of hypersensitivity to any component of this drug product 3. Patients with a conduction disturbance (such as second- or third-degree atrioventricular block without a pacemaker, or left bundle branch block) 4. Patients with Brugada-type ECG 5. Patients with severe heart failure or heart disease (myocardial infarction, valvular disease, cardiomyopathy, etc.) 6. Patients with sinus bradycardia (\<50 beats/minute) 7. Patients with systolic blood pressure of 90 mmHg or less 8. Patients with serum potassium level less than 3.5 mmol/L 9. Patients on antiarrhythmic drugs 10. Patients on antiepileptic drugs that affect to sodium channels 11. Patients on theophylline 12. Patients on narcotics 13. Patients who used Mexiletine within 1 month prior to enrollment or used Mexiletine for expectations of improvement in symptoms of SBMA 14. Patients with serious complications 15. Patients who cannot agree to use contraception during the study period 16. Other Patients deemed inappropriate by the investigator or subinvestigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score | at 4weeks | The ALSFRS-R is a comprehensive severity index comprising 12 items covering bulbar, upper limb, lower limb, and respiratory symptoms to evaluate the ADLs of patients with amyotrophic lateral sclerosis (ALS). Each item is rated on a five-point scale from 0 (worse) to 4 (better), and a total score (miniimum 0point and maximum 48 point) is calculated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) score | up to 12 weeks | The SBMAFRS is a disease-specific motor function assessment scale for Spinal and Bulbar Muscular Atrophy (SBMA).The SBMAFRS is a comprehensive severity index comprising 14 items covering bulbar, upper limb, lower limb, and respiratory symptoms to evaluate the ADLs of patients. Each item is rated on a five-point scale from 0 (worse) to 4 (better), and a total score (miniimum 0point and maximum 56 point) is calculated. |
| Grip strength | up to 12 weeks | Grip strength (kg) is set to evaluate the upper limb motor function of patients with SBMA. |
| Tongue pressure | up to 12 weeks | Tongue pressure (kPa) is set to evaluate the bulbar function of patients with SBMA. |
| ALSFRS-R Score | up to 12 weeks | The ALSFRS-R is a comprehensive severity index comprising 12 items covering bulbar, upper limb, lower limb, and respiratory symptoms to evaluate the ADLs of patients with ALS. Each item is rated on a five-point scale from 0 (worse) to 4 (better), and a total score (miniimum 0point and maximum 48 point) is calculated. |
| 6-minute walk test | up to 12 weeks | The 6-minute walk test is an evaluation index for lower limb muscle weakness and muscle atrophy that measures the walking distance (in meters). |
| Respiratory function test (Forced Vital Capacity (FVC)) | up to 12 weeks | FVC (actual value (L) and predicted rate (%) (%FVC)) is set to evaluate for respiratory function. |
| Respiratory function test (Peak Expiratory Flow (PEF)) | up to 12 weeks | PEF (actual value (L/sec) and predicted rate (%) (%PEF)) is set to evaluate for respiratory function. |
| Timed walk test (4.6 meters) | up to 12 weeks | The timed walk test (4.6 meters) is an evaluation index for muscle weakness and atrophy of the lower limbs that measures the walking time (in seconds). |
Countries
Japan
Contacts
Primary ContactMasahisa Katsuno, PhD, MD
Backup ContactShinobu Shimizu, PhD
Outcome results
None listed