Oxaloacetate in Myasthenia Gravis

Myasthenia Gravis Clinical Trial

Official title:

A Phase I, Double-Blind, Pilot Study of Oxaloacetate in Myasthenia Gravis

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT04965987
• Other study ID #: MG OAA
• Status: Not yet recruiting
• Phase: Phase 1
• Start date: October 2021
• Est. completion date: April 2023

Study information

• Verified date: July 2021
• Source: University of Kansas Medical Center
• Contact: Andrew J Heim
• Phone: 9139459926
• Email: aheim2[@]kumc.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a phase 1 clinical trial studying whether or not oxaloacetate has a positive effect on patients with Myasthenia Gravis. Patients will be assigned to one of three cohorts which will determine the dose of oxaloacetate they will be given. Subjects will take the study drug for 4 weeks and be on placebo for 4 weeks.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 12
• Est. completion date: April 2023
• Est. primary completion date: April 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Patients 18 and older.

2. Patients must have prior or current documentation of MGFA MG grades 2, 3, or 4A generalized MG, according to the MGFA classification system. These grades correspond to mild (2), moderate (3), and severe (4).

3. Patient's signs and symptoms should not be better explained by another disease process.

4. Patients must be willing to complete the study and return for follow-up visits.

5. Patients must be willing to give written informed consent before participating in this study. A copy of the signed consent must be kept in the patient's medical record.

6. Patients can be on the following drugs as long as there has been no dose change for 60 days: azathioprine, cyclosporine, cyclophosphamide, mycophenolate mofetil, tacrolimus, methotrexate, IVIg or other immunosuppressive drugs.

7. Patients can be on prednisone as long as there has been no dose change for 30 days.

8. No planned changes in MG medications during the study

Exclusion Criteria:

1. MGFA grade V within 6 months of screening.

2. A history of chronic degenerative, severe psychiatric, or neurologic disorder other than MG that can produce weakness or fatigue.

3. Other major chronic or debilitating illnesses within six months prior to study entry.

4. Female patients who are premenopausal and are: (a) pregnant on the basis of a serum pregnancy test, (b) breast-feeding, or (c) not using an effective method of double barrier (1 hormonal plus 1 barrier method or 2 simultaneous barrier methods) birth control (birth control pills, male condom, female condom, intrauterine device, Norplant, tubal ligation, or other sterilization procedures).

5. Thymectomy in the previous three months.

6. History of severe reactions to OAA

7. Participation in a research study within the last 3 months

Related Conditions & MeSH terms

• Muscle Weakness
• Myasthenia Gravis

Intervention

Drug:
• Oxaloacetate
Oxaloacetate (OAA) is a four-carbon molecule involved in many metabolic pathways, including gluconeogenesis, citric acid cycle, glyoxylate cycle, urea cycle, and amino acid metabolism. In the glyoxylate and citric acid cycles, oxaloacetate is formed as the result of the catalysis by malate dehydrogenase. In this reaction, the hydrogen atoms from malate are transferred to NAD+, forming NADH, H+ and oxaloacetate. Oxaloacetate can be converted to citrate with the addition of acetyl-CoA by the enzyme citrate synthase. Oxaloacetate is a critical component in the production of ATP and must be constantly regenerated in order for the citric acid cycle and the electron transport chain to continue
• Placebo
Placebo

Locations

Country	Name	City	State
United States	University of Kansas Medical Center	Kansas City	Kansas

Sponsors (2)

Lead Sponsor	Collaborator
University of Kansas Medical Center	Terra Biological LLC

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Safety (Frequency and Severity of Adverse Events)	The primary endpoint of safety will be reported as counts of subjects experiencing adverse events events (including abnormal laboratory results and vital signs). Measures of safety will be reported for the last visit observed for each participant.	At weeks 2, 4, 6, 8, 10, and 12
Secondary	Myasthenia Gravis-specific Activities of Daily Living Scale (MG-ADL) Score	Myasthenia Gravis-specific Activities of Daily Living scale (MG-ADL): Composite measure of scores from measurement scales. The MG-ADL has a scale of 0 - 24 with 0 being the lowest (no symptoms) and 24 being the highest (most severe symptoms. The MG-ADL is a staff-administered, patient-reported questionnaire that measures 8 commons symptoms of myasthenia gravis and grades them on a scale of 0 - 3.	Change from Week 4 to Week 8
Secondary	Quantitative Myasthenia Gravis (QMG) Score	The QMG is a 13 item ordinal scale which measures ocular, bulbar, extremity fatigue and strength, along with respiratory function. The scale is from 0 - 3 for each item, with 0 meaning normal and 3 is severe. Total score can range from 0 to 39.	Change from Week 4 to Week 8