Clinical Trial: Cellcept for Treatment of Juvenile Neuronal Ceroid Lipofuscinosis

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Phase II, Randomized, Placebo Controlled Trial of the Safety and Tolerability of Mycophenolate in Children With Juvenile Neuronal Ceroid Lipofuscinosis

Brief Summary:

The primary objective of this trial is to establish the safety and tolerability of short-term (8 weeks) administration of mycophenolate mofetil in ambulatory children with JNCL. The secondary objective is to gather preliminary evidence of the short-term (8 week) impact of mycophenolate mofetil on clinically relevant features of JNCL as measured by the Unified Batten Disease Rating Scale (UBDRS), including motor features, seizures, behavior, cognitive and functional measures.

Funding source-FDA Office of Orphan Product Development (OOPD).


Detailed Summary:

Juvenile Neuronal Ceroid Lipofuscinosis (JNCL) is a fatal disorder. Currently treatment is symptomatic. Thus, there is a real need to intervene and slow the progression of this disease. Preliminary data on genetic knock-down of the ability to mount an immune response in cln3-knockout mice is supportive of a strategy for treating JNCL with an immuno-suppressive agent. Many drugs with the ability to suppress the immune system are steroidal and deemed unsuitable for long-term administration to children. Mycophenolate mofetil (CellCept) is used as an immunosuppressive agent in allogenic transplants in pediatric patients and is therefore approved by the Food and Drug Administration (FDA) for pediatric use.

The study design is a double-blind, randomized, 22-week cross-over study of mycophenolate mofetil vs. placebo. After a 4-week washout period, subjects will undergo blinded crossover from active study drug to placebo or from placebo to active study drug.

Subjects and caregivers will be evaluated in person in the University of Rochester Batten Center (URBC) at screening/baseline, and at weeks 8, 12, and 20. In addition, subjects will be evaluated by their local clinician who is a formalized member of the research team. Such contacts will occur at Weeks 2, 4, 14, 16, and any unscheduled or early termination visits. There will also be regular telephone contact between the URBC and the local clinician.

We have selected the dosage currently FDA approved for use in children being treated for prophylaxis of renal transplant rejection.


Sponsor: University of Rochester

Current Primary Outcome: Tolerability [ Time Frame: 8 weeks ]

The primary outcome measure is tolerability, defined as the completion of 8 weeks on the assigned dosage of study drug.


Original Primary Outcome: Safety and Tolerability as shown by number of subjects with adverse events [ Time Frame: 3 years ]

Establish the safety and tolerability of short-erm (8 weeks) administration of mycophenolate mofetil in ambulatory children with JNCL


Current Secondary Outcome:

  • Preliminary Evidence of Efficacy [ Time Frame: 8 week ]
    To gather preliminary evidence of the short-term (8 week) impact of mycophenolate mofetil on clinically relevant features of Juvenile Neuronal Ceroid Lipofuscinosis as measured by the Unified Batten Disease Rating Scale, including motor features, seizures, behavior, cognitive and functional measures.
  • Feasibility of Clinical Trials in Rare Disorder
    To pilot the feasibility of conducting controlled clinical trials of this rare neurological disorder base on collaboration between a national center of excellence in the disease (URBC), and children's local care-providers (pediatricians and/or local neurologists.


Original Secondary Outcome:

  • Preliminary Evidence of Efficacy [ Time Frame: 3 years ]
    To gather preliminary evidence of the short-term (8 week) impact of mycophenolate mofetil on clinically relevant features of JNCL as measured by the UBDRS, including motor features, seizures, behavior, cognitive and functional measures.
  • Feasibility of Clinical Trials in Rare Disorder [ Time Frame: 3 years ]
    To pilot the feasibility of conducting controlled clinical trials of this rare neurological disorder base on collaboration between a national center of excellence in the disease (URBC), and children's local care-providers (pediatricians and/or local neurologists.


Information By: University of Rochester

Dates:
Date Received: July 5, 2011
Date Started: July 2011
Date Completion:
Last Updated: November 28, 2016
Last Verified: November 2016