MedPath

A Study of Migalastat in Fabry Disease

Active, not recruiting
Conditions
Fabry Disease
Registration Number
NCT03949920
Lead Sponsor
Manchester University NHS Foundation Trust
Brief Summary

Fabry disease is a rare metabolic condition characterised by the widespread deposition of sphingolipids in multiple organ systems. Cardiac involvement is common, it occurs in fifty percent of patients and it is the leading cause of death. Despite this, heart and blood vessel (cardiovascular system) manifestations of Fabry disease remain poorly characterised, and it remains unclear which patients benefit from therapy, or when therapy should be initiated. Migalastat is increasingly used to treat fabry disease however the impact of Migalastat on the cardiovascular system is poorly understood. Detailed assessment of the impact of Migalastat on heart and blood vessel structure and function is urgently needed. This observational study will use state of the art, non-invasive investigations to provide greater understanding of the cardiovascular manifestations of Fabry disease and the effects of Migalastat. It will provide insight into which patients respond more effectively to Migalastat, which in turn will facilitate personalisation of therapy, optimisation of the timing of therapy initiation and more cost-effective care.

Detailed Description

This is a prospective longitudinal observational study of patients starting Migalastat as part of routine care. Participants will be recruited from outpatient clinics and have a number of investigations before starting therapy and after twelve months of therapy.

Investigations will include a detailed assessment of symptoms and clinical features, blood tests, echocardiography, detailed cardiac MRI scans, heart rhythm monitoring and exercise capacity assessment.

Parameters will be assessed at baseline and at twelve months.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
21
Inclusion Criteria

Confirmed Fabry disease Aged 16 or over Beginning clinical treatment with Migalastat

Exclusion Criteria

Contraindication to cardiac MRI

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Indexed Left Ventricular Mass (grams/m2)12 months

LV mass, indexed to body surface area, assessed using cardiac MRI.

Secondary Outcome Measures
NameTimeMethod
Change in myocardial PCr/ATP ratio, measured using cardiac MRI spectroscopy (ratio)12 months
Change in BSA-indexed LV volumes measured using cardiac MRI, from baseline to 12 months (mls/m2)12 months
Change LV ejection fraction, measured using cardiac MRI (%)12 months
Change in myocardial extracellular volume, measured using cardiac MRI (%)12 months
Change in myocardial tissue T1 and T2 times measured using cardiac MRI (ms)12 months
Change in pulmonary artery systolic pressure, measured using echocardiography (mmHg)12 months
Change in the number of extra heart beats in a 24 hour period, measured using ambulatory heart monitoring. (number)12 months
Change in exercise capacity - Six minute walk test (meters)12 months
20. Change in health status (quality of life), measured using change in SF-36 score. (score)12 months
Change in Lyso-GB3 blood test levels (nmol/L)12 months
Change in NT pro BNP blood test levels (pg/L)12 months
Change in Troponin blood test levels (ng/L)12 months

Trial Locations

Locations (2)

Manchester University Foundation Trust

🇬🇧

Manchester, United Kingdom

Salford Royal NHS Foundation Trust

🇬🇧

Manchester, United Kingdom

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