Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00931164
Other study ID # 32164
Secondary ID 103932
Status Completed
Phase Phase 1/Phase 2
First received June 30, 2009
Last updated March 3, 2014
Start date August 2009
Est. completion date September 2011

Study information

Verified date March 2014
Source University of Utah
Contact n/a
Is FDA regulated No
Health authority United States: Food and Drug Administration
Study type Interventional

Clinical Trial Summary

WHO: The investigators are recruiting children and young adults to participate in a research study who:

1. Have been diagnosed with Alternating Hemiplegia of Childhood (AHC)

2. Are between the ages of 6 months - 25 years old

3. Have at least three 10-minute-long AHC episodes during a typical week

4. Can commit to 12 weeks of completing of a daily log describing AHC episodes and to a multi-night hospital stay at the University of Utah Center for Clinical and Translational Science (CCTS)

WHY: The goal of this study is to evaluate whether the study drug can safely and effectively decrease AHC episodes and improve the quality of life of individuals with AHC.

WHAT and WHERE: This study involves at least 12 weeks of completing and submitting daily AHC Episode Logs and a five-day hospital stay at the University of Utah CCTS.

There are 4 phases of the study, and they include:

1. Six weeks of daily log completion prior to starting study drug

2. Five day stay at the University of Utah CCTS

3. Six additional weeks of daily log completion while using study drug at home

4. One day clinic visit to the University of Utah for follow up

COMPENSATION:

There is no fee to participate. All procedures performed specifically for this study will be covered by the study and will not be billed to you or your insurance company.

The study drug will be dispensed to you free of charge. Meals and lodging at the study site will be provided free of charge for the study participant and one care provider. Additionally, the research team will assist subjects with booking and obtaining free transportation, such as an airline tickets, to and from the study site.


Recruitment information / eligibility

Status Completed
Enrollment 6
Est. completion date September 2011
Est. primary completion date January 2011
Accepts healthy volunteers No
Gender Both
Age group 6 Months to 25 Years
Eligibility Inclusion Criteria:

Subjects must meet all of the following inclusion criteria.

- AHC classic criteria:

- Onset of symptomatology prior to 18 months of age

- Repeated attacks of hemiplegia involving either side of the body

- Paroxysmal disturbances, including tonic or dystonic spells, oculomotor abnormalities, and various autonomic phenomena, during hemiplegic bouts or in isolation

- Episodes of bilateral hemiplegia or quadriplegia starting either as generalization of a hemiplegic episode or bilateral from the beginning

- Immediate disappearance of symptoms upon sleeping, with possible resumption 10-20 minutes after waking

- Evidence of developmental delay and neurologic abnormalities including choreoathetosis, dystonia, or ataxia

In addition:

- Provision of a complete daily event log for 6 weeks prior to initiation of sodium oxybate therapy, including the: (1) frequency, (2) duration, (3) type, (4) severity of episodes, and (5) therapies, if any, used in an attempt to abort the episode

- Ages 6 months to 25 years at the time of study enrollment

- Minimum of 3 AHC episodes weekly, lasting at least 10 minutes each, on average prior to study enrollment

- Brain neuroimaging studies excluding alternative etiology for symptoms

- Documented absence of epileptiform features on EEG during typical ictal events

- Ability of primary caregivers of study participants to submit online daily AHC Episode Logs indicating frequency and duration of ictal episodes over the entire study period

- Written informed consent from parents/guardians and assent from children 7 years or older

- Girls/women > 12 years of age will be required to be on birth control continuously if they are considered at risk to become pregnant. Those not on birth control will be required to have a screening pregnancy test at baseline, and to confirm their willingness to practice birth control or abstain from sexual activity for the duration of treatment with study medication.

Exclusion Criteria:

Subjects who meet any of the following criteria will be excluded from participation.

- History of hepatic insufficiency, renal insufficiency, significant respiratory disease, cardiac arrhythmia, congenital heart defect, hypertension, or ischemic stroke

- History of allergy/sensitivity to sodium oxybate

- Use of sodium oxybate within 30 days of study enrollment

- Serious illness requiring systemic treatment and/or hospitalization within two weeks prior to study enrollment

- Change in neurologic medication regimen within 30 days of study enrollment.

- Inability to stay at the Center for Clinical and Translational Science (CCTS) for 5 days due to behavioral issues

- Unwillingness or inability to travel to study site during the necessary 1 week titration period to determine the most appropriate dose of GHB for subsequent administration

- Noncompliance with AHC Episode Log or study visit requirements

- Sleep apnea not adequately treated with C-PAP and oxygen saturation monitoring prior to drug therapy initiation

- Succinic semialdehyde dehydrogenase deficiency

Study Design

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
Sodium Oxybate
dosage is by weight

Locations

Country Name City State
United States University of Utah Hospital Salt Lake City Utah

Sponsors (3)

Lead Sponsor Collaborator
University of Utah Alternating Hemiplegia of Childhood Foundation, Jazz Pharmaceuticals

Country where clinical trial is conducted

United States, 

References & Publications (43)

A 12-month, open-label, multicenter extension trial of orally administered sodium oxybate for the treatment of narcolepsy. Sleep. 2003 Feb 1;26(1):31-5. — View Citation

A randomized, double blind, placebo-controlled multicenter trial comparing the effects of three doses of orally administered sodium oxybate with placebo for the treatment of narcolepsy. Sleep. 2002 Feb 1;25(1):42-9. — View Citation

Addolorato G, Cibin M, Capristo E, Beghe F, Gessa G, Stefanini GF, Gasbarrini G. Maintaining abstinence from alcohol with gamma-hydroxybutyric acid. Lancet. 1998 Jan 3;351(9095):38. Erratum in: Lancet 1998 Mar 7;351(9104):760. Caprista E [corrected to Capristo E]. — View Citation

Arnold DL, Silver K, Andermann F. Evidence for mitochondrial dysfunction in patients with alternating hemiplegia of childhood. Ann Neurol. 1993 Jun;33(6):604-7. — View Citation

Bourgeois M, Aicardi J, Goutières F. Alternating hemiplegia of childhood. J Pediatr. 1993 May;122(5 Pt 1):673-9. Review. — View Citation

Bourgeois M, Aicardi J. The treatment of alternating hemiplegia of childhood with flunarizine: experience with 17 patients. Alternating Hemiplegia of Childhood, edited by F Andermann, J Aicardi, and F Vigevano. 1995;191-194.

Caputo F, Addolorato G, Stoppo M, Francini S, Vignoli T, Lorenzini F, Del Re A, Comaschi C, Andreone P, Trevisani F, Bernardi M; Alcohol Treatment Study Group. Comparing and combining gamma-hydroxybutyric acid (GHB) and naltrexone in maintaining abstinence from alcohol: an open randomised comparative study. Eur Neuropsychopharmacol. 2007 Dec;17(12):781-9. Epub 2007 Jul 3. — View Citation

Casaer P, Azou M. Flunarizine in alternating hemiplegia in childhood. Lancet. 1984 Sep 8;2(8402):579. — View Citation

Casaer P. Flunarizine in alternating hemiplegia in childhood. An international study in 12 children. Neuropediatrics. 1987 Nov;18(4):191-5. — View Citation

Defossez M, Le Bec G, Sancier A, Manelfe C, Espagno MT, Bouzat A, Sevely A. [Neuro-sedation and cranial C.-T. scan in infants and children (author's transl)]. Anesth Analg (Paris). 1979;36(11-12):525-9. French. — View Citation

Ferrara SD, Giorgetti R, Zancaner S, Orlando R, Tagliabracci A, Cavarzeran F, Palatini P. Effects of single dose of gamma-hydroxybutyric acid and lorazepam on psychomotor performance and subjective feelings in healthy volunteers. Eur J Clin Pharmacol. 1999 Jan;54(11):821-7. — View Citation

Frucht SJ, Bordelon Y, Houghton WH, Reardan D. A pilot tolerability and efficacy trial of sodium oxybate in ethanol-responsive movement disorders. Mov Disord. 2005 Oct;20(10):1330-7. — View Citation

Haan J, Kors EE, Terwindt GM, Vermeulen FL, Vergouwe MN, van den Maagdenberg AM, Gill DS, Pascual J, Ophoff RA, Frants RR, Ferrari. Alternating hemiplegia of childhood: no mutations in the familial hemiplegic migraine CACNA1A gene. Cephalalgia. 2000 Oct;20(8):696-700. — View Citation

Hunter AS, Long WJ, Ryrie CG. An evaluation of gamma-hydroxybutyric acid in paediatric practice. Br J Anaesth. 1971 Jun;43(6):620-8. — View Citation

Jen J, Yue Q, Nelson SF, Yu H, Litt M, Nutt J, Baloh RW. A novel nonsense mutation in CACNA1A causes episodic ataxia and hemiplegia. Neurology. 1999 Jul 13;53(1):34-7. — View Citation

Jiang W, Chi Z, Ma L, Du B, Shang W, Guo H, Wu W. Topiramate: a new agent for patients with alternating hemiplegia of childhood. Neuropediatrics. 2006 Aug;37(4):229-33. — View Citation

Kanavakis E, Xaidara A, Papathanasiou-Klontza D, Papadimitriou A, Velentza S, Youroukos S. Alternating hemiplegia of childhood: a syndrome inherited with an autosomal dominant trait. Dev Med Child Neurol. 2003 Dec;45(12):833-6. Erratum in: Dev Med Child Neurol. 2004 Apr;46(4):288. — View Citation

Katchan B, Mamelak M, Hwang P. Alternating Hemiplegia of Childhood: Rationale for the use of Gammahydroxybutyrate, Reprints from the 10th International Child Neurology Congress, Montreal, June 2006.

Kemp GJ, Taylor DJ, Barnes PR, Wilson J, Radda GK. Skeletal muscle mitochondrial dysfunction in alternating hemiplegia of childhood. Ann Neurol. 1995 Oct;38(4):681-4. — View Citation

Kothare SV, Adams R, Valencia I, Faerber EC, Grant ML. Improved sleep and neurocognitive functions in a child with thalamic lesions on sodium oxybate. Neurology. 2007 Apr 3;68(14):1157-8. — View Citation

Kyriakides T, Drousiotou A. No structural or biochemical evidence for mitochondrial cytopathy in a case of alternating hemiplegia of childhood. Ann Neurol. 1994 Nov;36(5):805-6. — View Citation

Mamelak M, Black J, Montplaisir J, Ristanovic R. A pilot study on the effects of sodium oxybate on sleep architecture and daytime alertness in narcolepsy. Sleep. 2004 Nov 1;27(7):1327-34. — View Citation

Meyer S, Gottschling S, Georg T, Lothschütz D, Graf N, Sitzmann FC. Gamma-hydroxybutyrate versus chlorprothixene/phenobarbital sedation in children undergoing MRI studies. Klin Padiatr. 2003 Mar-Apr;215(2):69-73. — View Citation

Micieli G, Sances G, Pacchetti C, Trucco M, Magri M, Piazza D. Flunarizine: a wide spectrum prophylactic for migraine headache. Int J Clin Pharmacol Res. 1984;4(3):239-45. — View Citation

Mikati M. Alternating hemiplegia of childhood. Pediatr Neurol. 1999 Oct;21(4):764. — View Citation

Mikati MA, Kramer U, Zupanc ML, Shanahan RJ. Alternating hemiplegia of childhood: clinical manifestations and long-term outcome. Pediatr Neurol. 2000 Aug;23(2):134-41. — View Citation

Murali H, Kotagal S. Off-label treatment of severe childhood narcolepsy-cataplexy with sodium oxybate. Sleep. 2006 Aug;29(8):1025-9. — View Citation

Nimmerrichter AA, Walter H, Gutierrez-Lobos KE, Lesch OM. Double-blind controlled trial of gamma-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcohol. 2002 Jan-Feb;37(1):67-73. — View Citation

Pöschl J, Kölker S, Bast T, Brüssau J, Ruef P, Linderkamp O, Bettendorf M. Gamma-hydroxybutyric acid sedation in neonates and children undergoing MR imaging. Klin Padiatr. 2007 Jul-Aug;219(4):217-9. — View Citation

Priori A, Bertolasi L, Pesenti A, Cappellari A, Barbieri S. gamma-hydroxybutyric acid for alcohol-sensitive myoclonus with dystonia. Neurology. 2000 Apr 25;54(8):1706. — View Citation

Ricci S. Sleep studies of children with alternating hemiplegia of childhood. Alternating Hemiplegia of Childhood, edited by Andermann, Aicardi, and Vigevano. 1995;95-98.

Rinalduzzi S, Valeriani M, Vigevano F. Brainstem dysfunction in alternating hemiplegia of childhood: a neurophysiological study. Cephalalgia. 2006 May;26(5):511-9. — View Citation

Sasaki M, Sakuragawa N, Osawa M. Long-term effect of flunarizine on patients with alternating hemiplegia of childhood in Japan. Brain Dev. 2001 Aug;23(5):303-5. — View Citation

Scrima L, Hartman PG, Johnson FH Jr, Thomas EE, Hiller FC. The effects of gamma-hydroxybutyrate on the sleep of narcolepsy patients: a double-blind study. Sleep. 1990 Dec;13(6):479-90. — View Citation

Silver K, Andermann F. Alternating hemiplegia of childhood: a study of 10 patients and results of flunarizine treatment. Neurology. 1993 Jan;43(1):36-41. — View Citation

Silver K, Andermann F. Alternating hemiplegia of childhood: treatment with flunarizine. Alternating Hemiplegia of Childhood, edited by F Andermann, J Aicardi, and F Vigevano. 1995;195-198.

Suner S, Szlatenyi CS, Wang RY. Pediatric gamma hydroxybutyrate intoxication. Acad Emerg Med. 1997 Nov;4(11):1041-5. — View Citation

Swoboda KJ, Kanavakis E, Xaidara A, Johnson JE, Leppert MF, Schlesinger-Massart MB, Ptacek LJ, Silver K, Youroukos S. Alternating hemiplegia of childhood or familial hemiplegic migraine? A novel ATP1A2 mutation. Ann Neurol. 2004 Jun;55(6):884-7. — View Citation

U.S. Xyrem Multicenter Study Group. Sodium oxybate demonstrates long-term efficacy for the treatment of cataplexy in patients with narcolepsy. Sleep Med. 2004 Mar;5(2):119-23. — View Citation

Verret S, Steele JC. Alternating hemiplegia in childhood: a report of eight patients with complicated migraine beginning in infancy. Pediatrics. 1971 Apr;47(4):675-80. — View Citation

Weaver TE, Cuellar N. A randomized trial evaluating the effectiveness of sodium oxybate therapy on quality of life in narcolepsy. Sleep. 2006 Sep;29(9):1189-94. — View Citation

Xyrem International Study Group. A double-blind, placebo-controlled study demonstrates sodium oxybate is effective for the treatment of excessive daytime sleepiness in narcolepsy. J Clin Sleep Med. 2005 Oct 15;1(4):391-7. — View Citation

Xyrem International Study Group. Further evidence supporting the use of sodium oxybate for the treatment of cataplexy: a double-blind, placebo-controlled study in 228 patients. Sleep Med. 2005 Sep;6(5):415-21. — View Citation

* Note: There are 43 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Time Duration of AHC Episodes Week 7 Yes
Primary Observed Safety Data During 5-day Hospitalization for Drug Dose Identification Week 7 Yes
Primary Number of Participants Who Reported Side Effects During Home Drug Maintenance Phase 1 year Yes
Secondary Mean Daily Percentage of Time That Functional Status is Affected Due to Episodes Week 14 Yes
Secondary Quality of Life Questionnaires Week 14 Yes
Secondary Mood and Behavior Questionnaires Week 14 Yes
Secondary Functional Skills Questionnaires Week 14 Yes
Secondary Neuropsychological Tests Week 14 Yes
See also
  Status Clinical Trial Phase
Recruiting NCT03857607 - Natural History Study of ATP1A3-related Disease
Completed NCT04944927 - HEmiplegia Arrhythmia Retrospective Trial
Not yet recruiting NCT06248645 - Oxygen as an Acute Treatment in Alternating Hemiplegia of Childhood Phase 2
Completed NCT02408354 - Pilot Study, Comparative, Single-center, Randomized, Crossover, Double-blind, Against Placebo, Testing the Effectiveness of Triheptanoin Oil in Alternating Hemiplegia of Childhood Phase 2