E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
(1) Severe Congenital Neutropenia type 4 (SNC4) due to a deficiency in G6PC3, a phosphatase of the endoplasmic also known a Ubiquitous glucose-6-phosphatase and (2) the neutropenia in Glycogen Storage Disease type 1b due to a deficiency in the glucose-6-phosphate transporter (G6PT / SLC37A4) of the endoplasmic reticulum. |
(1) Neutropénie Sévère Congénitale de type 4 due à la déficience en G6PC3, une phosphatase du réticulum endoplasmique aussi connu comme la glucose-6-phosphatase ubiquiste et (2) la neutropénie dans la Glycogénose de type 1b due a une déficience dans le transporteur de glucose-6-phosphate (G6PT / SLC37A4) du réticulum endoplasmique. |
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E.1.1.1 | Medical condition in easily understood language |
This study treats the neutropenia of patients deficient in glucose-6-phosphate transporter (GSD1b) and those that are deficient in G6PC3 and thus aims at reducing their number of infectious episodes. |
Cette étude traite la neutropénie des patients déficients en transporteur glucose-6-phosphate (GSD1b) et ceux déficients en G6PC3 et est centrée sur la baisse du nombre de leurs épisodes infectieux.
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Ubiquitous glucose-6-phosphatase deficiency (G6PC3) and glucose-6-phosphate transporter deficiency (G6PT / SLC37A4) both cause neutropenia. The purpose of our trial is to test the effect of the effectiveness of Empagliflozin on the urinary excretion and elimination of 1,5-anhydroglucitol from the blood in patients with G6PT deficiency (GSD Ib) and those who are deficient in G6PC3. This should allow patients to significantly lower the level of the toxic compound 1,5-anhydroglucitol-6-phosphate, that we found to accumulate in their neutrophils, and thereby treat their neutropenia. Empagliflozin (marketed in Belgium as Jardiance®) belongs to the class of drugs known as oral hypoglycemic agents. This project is the outcome of the work from researchers and doctors looking after these patients to translate the results from fundamental research, to be soon published in PNAS (Veiga-da-Cunha et al.), into a clinical trial that will very likely benefit the patients. |
Le déficit en glucose-6-phosphatase (G6PC3) et en transporteur de glucose-6-phosphate (G6PT / SLC37A4) du reticulum endoplasmique entraînent tous deux une neutropénie. Le but de notre essai clinique est de tester l'effet de l'efficacité de l'Empagliflozine sur l'excrétion urinaire et l'élimination du 1,5-anhydroglucitol du sang chez des patients présentant un déficit en G6PT (GSD Ib) ou en G6PC3. Cela devrait permettre aux patients de réduire considérablement le niveau du composé toxique, le 1,5-anhydroglucitol-6-phosphate, que nous avons constaté s’accumule dans leurs neutrophiles, et ainsi guérir leur neutropénie. L'empagliflozine (Jardiance®) appartient à la classe des médicaments appelés agents hypoglycémiants oraux. Ce projet est l'aboutissement de travaux de chercheurs et de médecins s'occupant de ces patients, à paraître dans PNAS (Veiga-da-Cunha et al.), le but est de les traduire en un essai clinique qui bénéficiera très probablement à ces patients. |
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E.2.2 | Secondary objectives of the trial |
Not applicable |
Not applicable |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Glycogenosis type 1b confirmed by biochemical analyzes and / or genetic analysis.
- Alternatively, G6PC3 deficiency confirmed by genetic analysis
- Informed consent signed by the recipient and / or parents / assigns.
- Information and agreement of the referring medical team.
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-Critères d’inclusion
- Glycogénose type 1b confirmée par des analyses biochimiques et/ou analyse génétique.
- Alternativement, déficience en G6PC3 confirmée par analyse génétique
- Consentement informé signé par le receveur et/ ou les parents / ayants droits.
- Information et accord de l’équipe médicale référente. |
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E.4 | Principal exclusion criteria |
- Presence of advanced fibrosis (Metavir F4) or cirrhosis.
- Impossibility of long-term and / or non-compliance monitoring.
- Other medical problems which, in the opinion of the physicians in charge of the patient, would constitute a contraindication to the procedure. |
- Présence d’une fibrose avancée (Metavir F4) ou de cirrhose.
- Impossibilité d’un suivi à long terme et/ou non compliance.
- Autres problèmes médicaux qui, selon l’avis des médecins en charge du patient, constitueraient une contre-indication à la procédure. |
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E.5 End points |
E.5.1 | Primary end point(s) |
-Safety: absence of hypoglycaemia due to gliflozin treatment.
-Efficacy: Increased neutrophil count |
-Sécurité : absence d’hypoglycémies dues au traitement par les gliflozines.
-Efficacité : Augmentation du taux de neutrophiles
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Day 2, day 3, day 5, day 7, day 14, day 21, day 28, day 35, day 42, day 49, day 56 |
Jour 2, jour 3, jour 5, jour 7, jour 14, jour 21, jour 28, jour 35, jour 42, jour 49, jour 56 |
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E.5.2 | Secondary end point(s) |
-Efficacy:
-Decrease in the number of infections
-Decrease in the number of episodes of oral aphtosis (stomatitis)
-Decrease of blood 1,5-anhydroglucitol
-Decrease in the level of 1,5-anhydroglucitol-6-phosphate in neutrophils
-Increased excretion of urinary 1,5-anhydroglucitol
-Improved neutrophilic function
-Improved platelet function |
-Efficacité :
-Diminution du nombre d’infections
-Diminution du nombre d’épisodes d’aphtose buccale (stomatite)
-Diminution du taux de 1,5-anhydroglucitol sanguin
-Diminution du taux de 1,5-anhydroglucitol-6-phosphate dans les neutrophiles
-Augmentation de l’excrétion de 1,5-anhydroglucitol urinaire
-Amélioration de la fonction neutrophilique
-Amélioration de la fonction plaquettaire
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Day 2, day 3, day 5, day 7, day 14, day 21, day 28, day 35, day 42, day 49, day 56 |
Jour 2, jour 3, jour 5, jour 7, jour 14, jour 21, jour 28, jour 35, jour 42, jour 49, jour 56 |
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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 | No |
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 | Yes |
E.6.13.1 | Other scope of the trial description |
Our study concerns the repurposing of a drug already used for another indication (phase 4 equivalent) |
Notre étude concerne le « repurposing » d’un médicament déjà utilisé pour une autre indication (équivalent phase 4) |
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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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
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.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
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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LVLS |
dernier sujet dernière visite |
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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 | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |