E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
This therapuetical trial will be conducted in patient with the Allan-Herndon-Dudley Syndrome (AHDS), casued by mutations in the thyroid hormone transporter MCT8. This results in the characteristic clinical phenotype of severe psychomotor retardation due to local hypothyroidism in the brain, in combination with high serum T3 and high normal serum TSH levels that lead to local hyperthyroidism in tissues that do not dependent on MCT8, resulting in tachycardia, low body weight and muscle wasting. |
Deze therapeutische studie zal worden uitgevoerd bij patiënten met het Allan-Herndon-Dudley syndroom (AHDS), wat wordt veroorzaakt door mutaties in de schildklierhormoon transporter MCT8. Dit resulteert in ernstige psychomotore retardatie door lokale hypothyreoidie in het brein, in combinatie met hoge serum T3 en hoog normale serum TSH waardes in het bloed. Dit zorgt voor lokale hyperthyreodie in weefsels waar MCT8 geen belangrijke rol heeft en leidt tot tachycardie, laag gewicht en spierverval. |
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E.1.1.1 | Medical condition in easily understood language |
Patients with a mutation in the thyroid hormone transporter MCT8, resulting in severe psychomotor retardation and abnormal thyroid hormone values in the blood. |
Patiënten met een mutatie in de schildklierhormoon transporter MCT8, wat resulteert in ernstige psychomotore retardatie en abnormale schildklierhormoon waardes in het bloed. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Hormonal diseases [C19] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
(1) To determine the effect of Triac treatment on serum T3 and other TH levels; (2) To determine the effect of Triac on the toxic effects of the hyperthyroid state in peripheral tissues;
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E.2.2 | Secondary objectives of the trial |
(1) To determine the effects of Triac treatment on the neurological phenotype. (2) The registration of adverse events
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
clinical relevant mutation in the MCT8 gene leading to the clinical phenotype of AHDS |
klinisch relevante mutatie in het MCT8 gen, leidend tot het klinische fenotype van AHDS |
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E.4 | Principal exclusion criteria |
- Major illness or recent major surgery (within 4 weeks) unrelated to AHDS - Patients who are participating in ongoing RCTs of therapeutic interventions (including clinical trials of investigational medicinal products); - Patients that have any major contra-indication for Triac treatment (severe cardiac decompensation (NYHA 4), coronary insufficiency, severe cardiac arrhytmias, Galactose intolerance, the Lapp lactose deficiency or glucose-galactose malabsorption) |
- ernstige ziekte of recente grote operatieve ingreep (binnen 4 weken) die niet gerelateerd zijn aan AHDS; - patiënten die deelnemen aan andere RCTs met therapeutische interventies; - patiënten met een harde contra-indicatie voor Triac behandeling (ernstig hartfalen (NYHA 4), coronair lijden, ernstige hartritmestoornis, galactose intollerantie, Lapp lactose deficiëntie, of glucose-galactose malabsorptie) |
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E.5 End points |
E.5.1 | Primary end point(s) |
1) Serum TSH, T4, vrij T4, T3, rT3 and Triac levels
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
These primary endpoints will be evaluated at baseline (t=0) and after 1 year of Triac treatment. To optimize titration of the Triac dose and prevent overtreatment, primary end-points will be evaluated with an expected average of 2 weeks during months 1-3 of the trial. During months 4-12 these parameters will be evaluated with an expected average of 6 weeks. |
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E.5.2 | Secondary end point(s) |
1) Body weight, blood pressure and heart rate 2) Serum levels of markers that reflect peripheral thyroid hormone action: serum steroid hormone binding globuline (SHBG) and lipids (liver), serum beta Ctx and alkalisch phosphatase (bone) and serum kreatine kinase (muscle). 3) Motor function, using the Gross Motor Function Measure 4) Cognitive function using the Bayley Scales of Infant Development III, or Wechsler Preschool and Primary Scale of Intelligence II 5) Adaptive behavior measured by the Vineland adaptive behavior scale 6) Basal Metabolic Rate (BMR) using Doubly labeled Water (DLW) 6) The frequency and nature of adverse events |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
The secundary end points 1-3 will will be evaluated at baseline (t=0) and after 1 year of Triac treatment. To optimize titration of the Triac dose and prevent overtreatment, these end points will also be evaluated with an expected average of 2 weeks during months 1-3 of the trial. During months 4-12 these parameters will be evaluated with an expected average of 6 weeks. End points 3), 4) and 5) will be evaluated at baseline and after 1 year of Triac treatment. Point 6) will be evaluated during the whole study period. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 9 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Canada |
South Africa |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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the end of the trial is defined as the date of the last investigational visit for the last patient undergoing protocol treatment. |
Het einde van de studie is gedefiniëerd als het laatste bezoek van de laatste patiënt die deelneemt aan de studie. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 2 |
E.8.9.2 | In all countries concerned by the trial days | 0 |