Amifampridine for the Treatment of Transient Vocal Weakness After OnabotulinumtoxinA Injection for Spasmodic Dysphonia
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 18
- 试验地点
- 1
- 主要终点
- Voice Handicap Index-10
研究概览
简要总结
Botox injections into the thyroarytenoid muscle are a predictable and effective treatment for SD, but typically result in transient symptoms of voice weakness and breathiness during the first 2-3 weeks after injection. Investigators hypothesize that voice weakness and breathiness after Botox treatment can be alleviated using amifampridine.
详细描述
Spasmodic dysphonia (SD) is a dystonia which results in vocal breaks. The mainstay of treatment involves injections using Botox (onabotulinumtoxinA), a neuromuscular blocker which inhibits pre-synaptic release of acetylcholine into the neuromuscular junction. Botox injections into the thyroarytenoid muscle are a predictable and effective treatment for SD, but typically result in transient symptoms of voice weakness and breathiness during the first 2-3 weeks after injection. These symptoms can be present for even longer if Botox is over- dosed.
Investigators hypothesize that these initial, transient symptoms of voice weakness and breathiness after Botox treatment can be alleviated using amifampridine which acts at the neuromuscular junction to increase synaptic presence of the neurotransmitter acetylcholine. In these initial studies, investigators will look at patients who have significant breathiness following an injection.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Male or female ≥18 years of age.
- •Capable of providing informed consent.
- •Confirmed physician diagnosis of spasmodic dysphonia.
- •Receives onabotulinumtoxinA for treatment of their spasmodic dysphonia.
- •Experiences significant breathiness ± 5 days following their injection.
- •If sexually active and of childbearing potential, willing to use an acceptable method of contraception (as noted below) from screening visit until 3 months after the last dose of investigational product.
- •A.NOTE: No adequate clinical data on exposed pregnancies are available for amifampridine. No nonclinical safety data are available regarding the effects of amifampridine on reproductive function. Amifampridine phosphate should not be used during pregnancy. It is unknown whether amifampridine is excreted in human breast milk. The excretion of amifampridine in milk has not been studied in animals. Amifampridine phosphate should not be used during breastfeeding. Acceptable methods of birth control include:
- •Hormonal contraception (e.g., oral contraceptive, transdermal contraceptive, contraceptive implant, or injectable hormonal contraceptive) for at least 3 months prior to study drug administration, throughout the study, and for 3 months after the last dose of study drug.
- •Double-barrier birth control (e.g., a combination of male condom with either cap, diaphragm, or sponge together with spermicide) starting at the Screening visit, throughout the study, and for at least 4 weeks after the last dose of study drug. NOTE: Use of a male and female condom simultaneously is NOT an acceptable method of double-barrier birth control.
- •Intrauterine contraception/device starting at the Screening visit, throughout the study, and for 3 months after the last dose of study drug.
- •Total abstinence from sexual intercourse (only acceptable if it is the preferred and usual lifestyle of the subject) for at least 1 complete menstrual cycle prior to the Screening visit, throughout the study, and for 3 months after the last dose of study drug.
- •Maintenance of a monogamous relationship with a male partner who has been surgically sterilized by vasectomy.
- •B. NOTE: Periodic abstinence (calendar, symptothermal, postovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception.
排除标准
- •History of epilepsy and/or on medication/treatment for seizures (such as but not limited to valproic acid, lamotrigine, topiramate, carbamazepine, and phenytoin); or, on certain medications that may lower seizure threshold, such as:
- •anaesthetic drugs (propofol),
- •antibiotics (penicillins, cephalosporins, imipenem),
- •some antidepressants (clomipramine, bupropion, and maprotiline),
- •antipsychotics (clozapine, chlorpromazine),
- •bronchodilators (aminophylline, theophylline),
- •Immunomodifiers (cyclosporine), and
- •Narcotic analgesics (pethidine, fentanyl).
- •Any SGOT, SGPT that are more than 3x upper limit of normal; and, creatinine that is greater than 2.1
- •Women who are pregnant, expecting to get pregnant, or breastfeeding.
- •Any condition that, in the view of the Principal Investigator, places the subject at risk, or subjects with poor treatment compliance.
研究组 & 干预措施
Treatment Arm
subjects will be given active drug and titrated up in 10mg increments (with max single dose being 30mg) until a change or drug side effect is noticed.
干预措施: Amifampridine (Drug)
结局指标
主要结局
Voice Handicap Index-10
时间窗: over 2 months
VHI-10 is a scale used to assess the severity of problematic symptoms associated with the voice. It is a series of 10 questions. Each questions is answered using numbers 0-4, with 0 meaning the patient never has a problem with that symptom; and, 4 meaning the patient always has a problem with that symptom.
次要结局
未报告次要终点