Gaucher Disease Clinical Trial
— CIMIOfficial title:
Study of Intra-monocytic Imiglucerase Kinetic and Its Correlation With Clinical and Biological Gaucher Disease
Rational: Imiglucerase has been used to treat Gaucher disease since 1997 but data about its
pharmacokinetics have been partial; investigators know that imiglucerase undergoes a quick
clearance from plasma compartment following the infusion (1/2 life: 1-6 min, from tissue:
<24h), an observation apparently contradictory with usual infusion rhythm (one infusion
every two weeks). Furthermore, by going by GD response, the rhythm of Infusion is sometimes
diminished (for example, every 3 or 4 wks) without pharmacological rational ; In parallel,
investigators demonstrated that monocytes represent a satisfactory surrogate of GD target
cells and that enzyme activity into monocytes varies between individuals.
Our hypothesis is that enzyme activity into monocyte compartment could be different and
could be related to GD response.
Primary purpose: to evaluate the pharmacokinetics of Imiglucerase activity into target
cellular compartment depending on dose and frequency of infusions.
Secondary purposes : 1) to establish a possible relationship between the intra-monocytic
activity of glucocerebrosidase and the clinical and biological activity of Gaucher disease
and to define a possible threshold value of enzyme activity; 2) to establish a better
correlation with known biomarkers of disease (routine markers and markers recently
identified), which would better predict and / or monitor response to treatment ; 3) to
compare the residual and natural rate of activity enzyme intra-monocytic for untreated
patients (low severity disease).
Status | Recruiting |
Enrollment | 60 |
Est. completion date | June 2016 |
Est. primary completion date | February 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 12 Years and older |
Eligibility |
Inclusion Criteria: - Patient older than 12 years old with Gaucher disease type 1 or type 3 and having signed an informed consent - Treated with imiglucerase (Cerezyme ®) with a stable therapeutic strategy for at least 3 months. OR - Untreated patient, with no therapeutic indication at the time of inclusion and having a diagnosis older than 2 years (non progressive disease) - Patients must have a social security system Exclusion Criteria: - Age <12 years old - Gaucher disease unproven - Gaucher disease treated with therapeutic changes in the previous 3 months, or current treatment different from imiglucerase - Gaucher disease untreated whose diagnosis was established for under 2 years |
Allocation: Non-Randomized, Endpoint Classification: Pharmacokinetics Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
France | CHU Clermont-Ferrand | Clermont-Ferrand |
Lead Sponsor | Collaborator |
---|---|
University Hospital, Clermont-Ferrand |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Enzyme intra-monocyte activity (sum of endogenous enzyme activities and therapeutic enzyme)in patients treated with imiglucerase | Enzyme intra-monocyte activity (sum of endogenous enzyme activities and therapeutic enzyme) in patients treated with imiglucerase will be assessed at different times between infusions (8 to 10 time points), and just before an infusion (residual rate). The population pharmacokinetics method allows to perform this analysis in measurement windows that are not necessarily included in the period between two consecutive infusions of imiglucerase but may be spread over several cycles. | at day 1 | No |
Secondary | Residual rate | Pharmacokinetics descriptive criteria are the area under curve at balance, the terminal half-life and the residual rate. | every 6 months during 2 years. | No |
Secondary | Endogeneous intra-monocyte glucocérébrosidase activity from untreated patients | every 6 months during 2 years | No | |
Secondary | Biomarker dosages will provide serum concentration values | 1) routine biomarkers (ACE, TRAP, chitotriosidase, ferritin) and 2) potentially interesting biomarkers but not routinely evaluated in France (CCL18, MIP1a, MIP1b, MCP1, IL-8, glycated ferritin). - Gaucher disease status will be assessed by clinical and biological criteria defined by the HAS (Haute Autorité de Santé = High Health Authority). We will consider the two-year periods before and after treatment to identify progressive diseases (clinical or biological significant events associated with Gaucher disease in the two years before and 2 years after the enrolment time |
at D0, M3, M6 and every 6 months during 2 years: | No |
Status | Clinical Trial | Phase | |
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