Stopping TSC Onset and Progression 2: Epilepsy Prevention in TSC Infants
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 5
- 试验地点
- 1
- 主要终点
- Safety - Adverse Events
研究概览
简要总结
This phase I/II clinical trial is an open-label clinical trial design to verify safety and dosing for TAVT-18 (sirolimus) powder for oral solution in TSC infants (N=5).
详细描述
Tuberous Sclerosis Complex (TSC) is caused by genetic mutation in TSC1 or TSC2, resulting in dysregulation of the mechanistic target of rapamycin (mTOR) signaling pathway. Age at time of seizure onset in TSC infants has been linked to long-term neurodevelopmental outcome in this high-risk population. TAVT-18 is a novel formulation of sirolimus, an mTOR inhibitor. This study evaluates TAVT-18 as a targeted, disease-modifying drug therapy for preventing or delaying seizure onset in TSC using a rational, mechanism-based therapeutic approach.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 1 Day 至 6 Months（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •0-6 months of age at the time of enrollment (randomization and treatment initiation must occur before 7 months of age and infants born prematurely must have a corrected age of at least 39 weeks, calculated by subtracting the number of weeks born before 40 weeks gestation from the actual chronological age, in weeks)
- •Has a confirmed diagnosis of TSC based on established clinical or genetic criteria
排除标准
- •Prior history of seizures (clinical or electrographic) at the time of enrollment or identified on baseline EEG
- •Has been treated in the past or is currently being treated at the time of enrollment with conventional anticonvulsant medications (AEDs), systemic (oral) mTOR inhibitors (such as rapamycin, sirolimus, or everolimus), ketogenic-related special diet, or another anti-seizure therapeutic agent, device, or procedure
- •Has taken any other investigational drug as part of another research study, within 30 days prior to the baseline screening visit
- •Has a significant illness or active infection at the time of the baseline screening visit
- •Has a history of significant prematurity, defined as gestational age <30 weeks at the time of delivery, or other significant medical complications at birth or during the neonatal period that other than TSC would convey additional risk of seizures or neurodevelopmental delay (i.e. HIE, severe neonatal infection, major surgery, prolonged ventilatory or other life-saving supportive care or procedures)
- •Abnormal laboratory values at baseline (i.e., renal function, liver function, or bone marrow production) that are in the opinion of the investigator clinically significant and may jeopardize the safety of the study subject
- •Prior, planned or anticipated neurosurgery within 3 months of the baseline visit
- •Has a TSC-associated condition for which mTOR treatment is clinically indicated (i.e. SEGA or AML)
- •Subjects who are, in the opinion of the investigator, unable to comply with the requirements of the study
研究组 & 干预措施
Stage 1 Open Label
Phase I/II, open-label PK and initial safety analysis. TAVT-18 administered orally twice/daily to achieve precision dosing target of 10 ng/ml. Whole blood sirolimus levels are assessed at defined intervals on days 1, 7, and 14. After day 14, participants can elect to continue open-label treatment with TAVT-18 until 12 months of age. Final developmental outcomes are assessed at 24 months of age.
干预措施: TAVT-18 (sirolimus) (Drug)
结局指标
主要结局
Safety - Adverse Events
时间窗: 12 months of age
Percentage of subjects reporting severe (CTCAE v5.0 grade \>= 3) adverse event (AE) or serious adverse event (SAE)
Efficacy - Time to Seizure Onset
时间窗: 12 months of age
Time from treatment initiation to seizure onset
次要结局
- Seizure Type(12 and 24 months of age)
- Treatment Discontinuance Due to Adverse Events(12 months of age)
- Treatment Disruption Due to Adverse Events(12 months of age)
- Precision Dosing Accuracy(12 months of age)
- Age at Seizure Onset(12 and 24 months of age)
- Seizure Frequency(12 and 24 months of age)
- TAND Severity Assessed by the TAND-L Checklist(12 and 24 months of age)
- Adaptive Behavior Assessed by the the VABS(12 and 24 months of age)
- Global Neurodevelopment Assessed by the Bayley Scales of Infant Development(12 and 24 months of age)