Multiple Sclerosis Clinical Trial
Official title:
Phase 2 Study of Riluzole Effects on Patients With Chronic Cerebellar Ataxia
Cerebellar disorders are often disabling and symptomatic therapies are limited to few
options that are partially effective. It seems therefore appropriate to search for
additional approaches.
Purkinje cells are the sole output of the cerebellar cortex: they project inhibitory signals
to the deep cerebellar nuclei (DCN), which have a critical role in cerebellar function and
motor performance. DCN neurons fire spontaneously in the absence of synaptic input from
Purkinje neurons and modulation of the DCN response by Purkinje input is believed to be
responsible for coordination of movement. Recent evidences support the notion that an
increase in DCN excitability may be an important step in the development of cerebellar
ataxia and point to the underlying molecular mechanisms: the inhibition of small-conductance
calcium-activated potassium (SK) channels, that causes an increase of the firing frequency
in DCN, correlates with cerebellar ataxia.
The rationale of the present project is that SK channel openers, such as riluzole, may have
a beneficial effect on cerebellar ataxia.
The researchers propose to perform a pilot study investigating safety and efficacy of
riluzole, an approved treatment for amyotrophic lateral sclerosis, as a symptomatic approach
in patients with chronic cerebellar ataxia.
Forty patients with chronic cerebellar ataxia will be enrolled in a double-bind, randomized,
placebo-controlled trial.
By central randomisation, patients will take 50 mg of riluzole or placebo twice daily for 8
weeks.
Electrocardiogram routine laboratory tests and pregnancy tests will be performed before drug
administration, after 4 weeks of treatment and at the end of the study (after 8 weeks of
treatment).
At the same time points the International Cooperative Ataxia Rating Scale (ICARS) for
pharmacological assessment of the cerebellar syndrome will be administered to the two groups
(riluzole and placebo) of patients. To guarantee the evaluation of the results in blind
conditions, the neurologists who will evaluate the ICARS scores will be different from those
who will deal with randomisation and follow-up of patients.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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