4006-776-356 出国就医服务电话

免费获得国外相关药品,最快 1 个工作日回馈药物信息

出境医 / 临床实验 / Micronised Resveratrol as a Treatment for Friedreich Ataxia

Micronised Resveratrol as a Treatment for Friedreich Ataxia

Study Description
Brief Summary:
The aim of this study is to assess the efficacy of micronised resveratrol as a treatment for FRDA, in terms of reducing the severity of ataxia symptoms at 24 weeks, through a randomised blinded, placebo controlled crossover trial.

Condition or disease Intervention/treatment Phase
Friedreich Ataxia Drug: Resveratrol Phase 2

Detailed Description:

Friedreich ataxia (FRDA) is the most common hereditary ataxia, with an estimated prevalence in Caucasians of 1 in 30,000. Neurological features of FRDA are progressive gait and limb ataxia, absent lower limb reflexes, and loss of position and vibration sense. There are currently no treatments proven to alter the natural history of FRDA. Resveratrol is a naturally occurring compound found in red wine, berries, and nuts. It is postulated to have wide-ranging health benefits, including antioxidant, anticarcinogenic, antidiabetic and neuroprotective properties.

The study will be a double-blinded, placebo-controlled randomised 2-period crossover trial of 2g/day of micronised resveratrol in FRDA over 24 weeks. The study will enrol 40 patients with FRDA from 3 sites. The primary outcome measure is the change in modified Friedreich Ataxia Rating Scale (mFARS) score from baseline to 24 weeks.

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Intervention Model Description: Double-blind, randomised, placebo-controlled 2-period crossover trial of 2g/day of micronised resveratrol versus placebo. Participants will be randomised in terms of the order in which they received micronised resveratrol and placebo.
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Participants will be randomised between receiving resveratrol in period 1 and placebo in period 2, or placebo in period 1 and resveratrol in period 2.
Primary Purpose: Treatment
Official Title: A Randomised Placebo-controlled Crossover Trial of Micronised Resveratrol as a Treatment for Friedreich Ataxia
Actual Study Start Date : May 23, 2019
Estimated Primary Completion Date : August 2022
Estimated Study Completion Date : August 2022
Arms and Interventions
Arm Intervention/treatment
Resveratrol followed by placebo
1g micronised resveratrol twice daily for 24 weeks, a wash-out period of 4 weeks, followed by twice daily placebo for 24 weeks.
Drug: Resveratrol
Drug name: Micronised resveratrol. Dosage form: 500mg capsules. Alternate name: 1,3-Benzenediol, 5-[2-(4-hydroxyphenyl)ethenyl]-, (E). Ingredients: 99.50% pure trans-resveratrol. Placebo capsules will be identical in terms of taste, smell, and appearance.

Placebo followed by Resveratrol
Twice daily placebo for 24 weeks, a wash-out period of 4 weeks, followed by 1g micronised resveratrol twice daily for 24 weeks
Drug: Resveratrol
Drug name: Micronised resveratrol. Dosage form: 500mg capsules. Alternate name: 1,3-Benzenediol, 5-[2-(4-hydroxyphenyl)ethenyl]-, (E). Ingredients: 99.50% pure trans-resveratrol. Placebo capsules will be identical in terms of taste, smell, and appearance.

Outcome Measures
Primary Outcome Measures :
  1. Modified Friedreich Ataxia Rating Scale [ Time Frame: 24 weeks ]
    Change in the Modified Friedreich Ataxia Rating Scale score (score range 0-99) at 24 weeks compared with baseline. Higher scores are indicative of more severe disease.


Secondary Outcome Measures :
  1. Nine-Hole Peg Test [ Time Frame: 24 weeks ]
    Change in the Nine-Hole Peg Test at 24 weeks compared with baseline.

  2. Berg Balance Scale [ Time Frame: 24 weeks ]
    Change in the Berg Balance Scale (score range 0-56) at 24 weeks compared with baseline. A higher score indicates lower fall risk.

  3. Ataxia Instrumented Measure-Spoon [ Time Frame: 24 weeks ]
    Change in the Ataxia Instrumented Measure-Spoon at 24 weeks compared with baseline.

  4. Friedreich Ataxia Impact Scale [ Time Frame: 24 weeks ]
    Change in the Friedreich Ataxia Impact Scale at 24 weeks compared with baseline. The Friedreich Ataxia Impact Scale comprises 8 subscales (score range 0-100) that are scored independently. A higher score indicates greater impact of Friedreich ataxia on health and well-being.

  5. Modified Fatigue Impact Scale [ Time Frame: 24 weeks ]
    Change in the Modified Fatigue Impact Scale (score range 0-24) at 24 weeks compared with baseline. Higher scores indicate a greater impact of fatigue on an individual's activities.

  6. Measures of speech [ Time Frame: 24 weeks ]
    Change in measures of speech (reading a paragraph, produce a prolonged vowel sound for 5 seconds, count from one to 20, and produce a 1-minute monologue on a pre-specified topic) at 24 weeks compared with baseline.

  7. Measures of hearing [ Time Frame: 24 weeks ]
    Change in measures of hearing using the Listening in Spatialized Noise Test (LiSN-S) at 24 weeks compared with baseline.

  8. Cardiac parameters measured by echocardiography [ Time Frame: 24 weeks ]
    Change in left ventricular global longitudinal strain at 24 weeks compared to baseline.

  9. Cardiac parameters measured by ECG [ Time Frame: 24 weeks ]
    Change in QRS duration at lead V5 at 24 weeks compared to baseline.

  10. Frataxin levels [ Time Frame: 24 weeks ]
    Change in frataxin levels at 24 weeks compared to baseline.

  11. mRNA levels [ Time Frame: 24 weeks ]
    Change in PGC-1α mRNA levels and Nrf2 mRNA levels at 24 weeks compared to baseline.

  12. Plasma F2-isoprostane levels [ Time Frame: 24 weeks ]
    Change in plasma F2-isoprostane levels at 24 weeks compared to baseline.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   16 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age ≥16 years.
  2. Diagnosis of FRDA, genetically documented to be due to homozygosity for a GAA repeat expansion in intron 1 of FXN.
  3. Functional stage on the Ataxia subscale of the full FARS of 1 or higher (a score of 1 is assigned if the subject has "Minimal signs detected by the physician during screening. Can run or jump without loss of balance. No disability."), and total mFARS score of ≤ 65.
  4. Adequate end organ function defined as follows: (i) total bilirubin <2x upper limit of normal unless attributable to Gilbert disease, (ii) ALT and AST <1.5x upper limit of normal, (iii) Creatinine <2x upper limit of normal, (iv) neutrophils >1.5x10^9/L, (v) platelets >10^6/μL.
  5. Written informed consent provided.

Exclusion Criteria:

  1. Non-elective hospitalisation within the past 60 days that could be of concern in the investigator's judgment. Any hospitalisation in the previous 60 days will be assessed and if in the investigator's judgement it could compromise the individual or the study, that person will not be recruited. Examples include if the individual is hospitalised for management of cardiac morbidity such as uncontrolled arrhythmia or angina or for orthopaedic surgery for a lower limb fracture.
  2. Women who are pregnant or lactating or men and women of childbearing potential who are unwilling to use contraception for the duration of the study.
  3. FRDA due to compound heterozygosity for an expanded GAA repeat and a point mutation/ deletion in the FXN gene.
  4. Current or recent (in last 12 months) arrhythmias including: atrial fibrillation, atrial flutter, sinus tachycardia >120/min, sinus bradycardia <50/min. Symptomatic paroxysmal arrhythmia which is recurring frequently. Cardiac insufficiency (by New York Heart Association >2). Reduced LV ejection fraction (<50%) in the last six months.
  5. Medical illness that in the judgment of the investigator would jeopardise the safe completion of the study. Examples include cancer, chronic inflammatory disease, severe diabetes (type I or II, HbA1c >8%), chronic liver insufficiency, epilepsy, thrombocytosis.
  6. Evidence of end organ dysfunction through failure to meet one or more parameters in inclusion criterion number 4.
  7. Prior invasive cancer (excluding localised basal cell or squamous cell skin cancer).
  8. Known hypersensitivity to resveratrol.
  9. Use of any investigational agent within 30 days of enrolment.
  10. Use of antioxidants such as vitamin E, coenzyme Q10 or idebenone within 30 days prior to enrolment.
  11. Concomitant use of medications with potential for clinically relevant drug interactions. This includes medications with a narrow therapeutic range that are metabolised by the cytochrome P450 3A4, 2D6 or 2C9 systems e.g. warfarin, amiodarone.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Geneieve Tai +61 3 8341 6374 geneieve.tai@mcri.edu.au

Locations
Layout table for location information
Australia, New South Wales
Royal North Shore Hospital Recruiting
St Leonards, New South Wales, Australia, 2065
Contact: Melanie Burk    (02) 9463 1856    Melanie.Burk@health.nsw.gov.au   
Principal Investigator: Christina Liang         
Australia, Queensland
University of Queensland Centre for Clinical Research Recruiting
Herston, Queensland, Australia, 4029
Contact: Elizabeth Arnold    +61 7 3365 5147    elizabeth.arnold@uq.edu.au   
Contact: Lily Tang    +61 7 3646 3111    Lily.Tang@health.qld.gov.au   
Principal Investigator: John O'Sullivan         
Australia, Victoria
Murdoch Children's Research Institute Recruiting
Parkville, Victoria, Australia, 3052
Contact: Geneieve Tai    +61 3 8341 6374    geneieve.tai@mcri.edu.au   
Principal Investigator: Martin Delatycki         
Australia, Western Australia
Royal Perth Hospital Recruiting
Perth, Western Australia, Australia, 6000
Contact: Lee Fyfe    +61 8 9224 3353    Beverly.Fyfe@health.wa.gov.au   
Principal Investigator: Phillipa Lamont         
Sponsors and Collaborators
Murdoch Childrens Research Institute
Investigators
Layout table for investigator information
Principal Investigator: Martin B Delatycki, PhD, MBBS Murdoch Children's Research Institute
Tracking Information
First Submitted Date  ICMJE April 16, 2019
First Posted Date  ICMJE May 1, 2019
Last Update Posted Date February 23, 2021
Actual Study Start Date  ICMJE May 23, 2019
Estimated Primary Completion Date August 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 27, 2019)
Modified Friedreich Ataxia Rating Scale [ Time Frame: 24 weeks ]
Change in the Modified Friedreich Ataxia Rating Scale score (score range 0-99) at 24 weeks compared with baseline. Higher scores are indicative of more severe disease.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: April 27, 2019)
  • Nine-Hole Peg Test [ Time Frame: 24 weeks ]
    Change in the Nine-Hole Peg Test at 24 weeks compared with baseline.
  • Berg Balance Scale [ Time Frame: 24 weeks ]
    Change in the Berg Balance Scale (score range 0-56) at 24 weeks compared with baseline. A higher score indicates lower fall risk.
  • Ataxia Instrumented Measure-Spoon [ Time Frame: 24 weeks ]
    Change in the Ataxia Instrumented Measure-Spoon at 24 weeks compared with baseline.
  • Friedreich Ataxia Impact Scale [ Time Frame: 24 weeks ]
    Change in the Friedreich Ataxia Impact Scale at 24 weeks compared with baseline. The Friedreich Ataxia Impact Scale comprises 8 subscales (score range 0-100) that are scored independently. A higher score indicates greater impact of Friedreich ataxia on health and well-being.
  • Modified Fatigue Impact Scale [ Time Frame: 24 weeks ]
    Change in the Modified Fatigue Impact Scale (score range 0-24) at 24 weeks compared with baseline. Higher scores indicate a greater impact of fatigue on an individual's activities.
  • Measures of speech [ Time Frame: 24 weeks ]
    Change in measures of speech (reading a paragraph, produce a prolonged vowel sound for 5 seconds, count from one to 20, and produce a 1-minute monologue on a pre-specified topic) at 24 weeks compared with baseline.
  • Measures of hearing [ Time Frame: 24 weeks ]
    Change in measures of hearing using the Listening in Spatialized Noise Test (LiSN-S) at 24 weeks compared with baseline.
  • Cardiac parameters measured by echocardiography [ Time Frame: 24 weeks ]
    Change in left ventricular global longitudinal strain at 24 weeks compared to baseline.
  • Cardiac parameters measured by ECG [ Time Frame: 24 weeks ]
    Change in QRS duration at lead V5 at 24 weeks compared to baseline.
  • Frataxin levels [ Time Frame: 24 weeks ]
    Change in frataxin levels at 24 weeks compared to baseline.
  • mRNA levels [ Time Frame: 24 weeks ]
    Change in PGC-1α mRNA levels and Nrf2 mRNA levels at 24 weeks compared to baseline.
  • Plasma F2-isoprostane levels [ Time Frame: 24 weeks ]
    Change in plasma F2-isoprostane levels at 24 weeks compared to baseline.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Micronised Resveratrol as a Treatment for Friedreich Ataxia
Official Title  ICMJE A Randomised Placebo-controlled Crossover Trial of Micronised Resveratrol as a Treatment for Friedreich Ataxia
Brief Summary The aim of this study is to assess the efficacy of micronised resveratrol as a treatment for FRDA, in terms of reducing the severity of ataxia symptoms at 24 weeks, through a randomised blinded, placebo controlled crossover trial.
Detailed Description

Friedreich ataxia (FRDA) is the most common hereditary ataxia, with an estimated prevalence in Caucasians of 1 in 30,000. Neurological features of FRDA are progressive gait and limb ataxia, absent lower limb reflexes, and loss of position and vibration sense. There are currently no treatments proven to alter the natural history of FRDA. Resveratrol is a naturally occurring compound found in red wine, berries, and nuts. It is postulated to have wide-ranging health benefits, including antioxidant, anticarcinogenic, antidiabetic and neuroprotective properties.

The study will be a double-blinded, placebo-controlled randomised 2-period crossover trial of 2g/day of micronised resveratrol in FRDA over 24 weeks. The study will enrol 40 patients with FRDA from 3 sites. The primary outcome measure is the change in modified Friedreich Ataxia Rating Scale (mFARS) score from baseline to 24 weeks.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Crossover Assignment
Intervention Model Description:
Double-blind, randomised, placebo-controlled 2-period crossover trial of 2g/day of micronised resveratrol versus placebo. Participants will be randomised in terms of the order in which they received micronised resveratrol and placebo.
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description:
Participants will be randomised between receiving resveratrol in period 1 and placebo in period 2, or placebo in period 1 and resveratrol in period 2.
Primary Purpose: Treatment
Condition  ICMJE Friedreich Ataxia
Intervention  ICMJE Drug: Resveratrol
Drug name: Micronised resveratrol. Dosage form: 500mg capsules. Alternate name: 1,3-Benzenediol, 5-[2-(4-hydroxyphenyl)ethenyl]-, (E). Ingredients: 99.50% pure trans-resveratrol. Placebo capsules will be identical in terms of taste, smell, and appearance.
Study Arms  ICMJE
  • Resveratrol followed by placebo
    1g micronised resveratrol twice daily for 24 weeks, a wash-out period of 4 weeks, followed by twice daily placebo for 24 weeks.
    Intervention: Drug: Resveratrol
  • Placebo followed by Resveratrol
    Twice daily placebo for 24 weeks, a wash-out period of 4 weeks, followed by 1g micronised resveratrol twice daily for 24 weeks
    Intervention: Drug: Resveratrol
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: April 27, 2019)
40
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE August 2022
Estimated Primary Completion Date August 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Age ≥16 years.
  2. Diagnosis of FRDA, genetically documented to be due to homozygosity for a GAA repeat expansion in intron 1 of FXN.
  3. Functional stage on the Ataxia subscale of the full FARS of 1 or higher (a score of 1 is assigned if the subject has "Minimal signs detected by the physician during screening. Can run or jump without loss of balance. No disability."), and total mFARS score of ≤ 65.
  4. Adequate end organ function defined as follows: (i) total bilirubin <2x upper limit of normal unless attributable to Gilbert disease, (ii) ALT and AST <1.5x upper limit of normal, (iii) Creatinine <2x upper limit of normal, (iv) neutrophils >1.5x10^9/L, (v) platelets >10^6/μL.
  5. Written informed consent provided.

Exclusion Criteria:

  1. Non-elective hospitalisation within the past 60 days that could be of concern in the investigator's judgment. Any hospitalisation in the previous 60 days will be assessed and if in the investigator's judgement it could compromise the individual or the study, that person will not be recruited. Examples include if the individual is hospitalised for management of cardiac morbidity such as uncontrolled arrhythmia or angina or for orthopaedic surgery for a lower limb fracture.
  2. Women who are pregnant or lactating or men and women of childbearing potential who are unwilling to use contraception for the duration of the study.
  3. FRDA due to compound heterozygosity for an expanded GAA repeat and a point mutation/ deletion in the FXN gene.
  4. Current or recent (in last 12 months) arrhythmias including: atrial fibrillation, atrial flutter, sinus tachycardia >120/min, sinus bradycardia <50/min. Symptomatic paroxysmal arrhythmia which is recurring frequently. Cardiac insufficiency (by New York Heart Association >2). Reduced LV ejection fraction (<50%) in the last six months.
  5. Medical illness that in the judgment of the investigator would jeopardise the safe completion of the study. Examples include cancer, chronic inflammatory disease, severe diabetes (type I or II, HbA1c >8%), chronic liver insufficiency, epilepsy, thrombocytosis.
  6. Evidence of end organ dysfunction through failure to meet one or more parameters in inclusion criterion number 4.
  7. Prior invasive cancer (excluding localised basal cell or squamous cell skin cancer).
  8. Known hypersensitivity to resveratrol.
  9. Use of any investigational agent within 30 days of enrolment.
  10. Use of antioxidants such as vitamin E, coenzyme Q10 or idebenone within 30 days prior to enrolment.
  11. Concomitant use of medications with potential for clinically relevant drug interactions. This includes medications with a narrow therapeutic range that are metabolised by the cytochrome P450 3A4, 2D6 or 2C9 systems e.g. warfarin, amiodarone.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 16 Years and older   (Child, Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Geneieve Tai +61 3 8341 6374 geneieve.tai@mcri.edu.au
Listed Location Countries  ICMJE Australia
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03933163
Other Study ID Numbers  ICMJE 36007
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: Yes
IPD Sharing Statement  ICMJE
Plan to Share IPD: Yes
Plan Description:

The de-identified data set collected for analysis of the study will be available six months after publication of the primary outcome.

The study protocol, analysis plan and consent forms will also be available. The data may be obtained from the Murdoch Children's Research Institute by contacting martin.delatycki@vcgs.org.au.

Supporting Materials: Study Protocol
Supporting Materials: Statistical Analysis Plan (SAP)
Supporting Materials: Informed Consent Form (ICF)
Supporting Materials: Clinical Study Report (CSR)
Supporting Materials: Analytic Code
Time Frame: 6 months after publication of primary outcome
Access Criteria: Prior to releasing any data the following are required: a data access agreement must be signed between relevant parties and there must be an agreement around appropriate acknowledgement and any additional costs involved must be covered. Data will only be shared with a recognised research institution which has approved the proposed analysis plan.
Responsible Party Martin Delatycki, Murdoch Childrens Research Institute
Study Sponsor  ICMJE Murdoch Childrens Research Institute
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Martin B Delatycki, PhD, MBBS Murdoch Children's Research Institute
PRS Account Murdoch Childrens Research Institute
Verification Date February 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP