Study of Zoledronic Acid, Pravastatin, and Lonafarnib for Patients With Progeria
Information source: Children's Hospital Boston
Information obtained from ClinicalTrials.gov on October 19, 2009
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Progeria
Intervention: Lonafarnib, Zoledronic Acid, and Pravastatin (Drug)
Phase: Phase 2
Status: Recruiting
Sponsored by: Children's Hospital Boston Official(s) and/or principal investigator(s):
Mark Kieran, MD, PhD, Principal Investigator, Affiliation: Children's Hospital Boston/ Dana-Farber Cancer Instittue
Overall contact:
Kiera I McKendrick, Phone: 617 632 4595, Email: kiera_mckendrick@dfci.harvard.edu
Summary
Hutchinson-Gilford Progeria Syndrome (Progeria) is a rare autosomal disease that results in
premature death at a median age of 13 years due to cardiovascular and cerebralvascular
compromise. The mutation for this disease has been identified and results in a mutant form
of lamin A that cannot be de-farnesylated. This study evaluates the combination of
pravastain (a statin), lonafarnib (a farnesyltransferase inhibitor) and zoledronic acid (a
bisphosphonate) in an open label phase II efficacy trial in children with Progeria. These
agents all target farnesylation pathways at different points. Patients with genetically
confirmed progeria will be eligible for this protocol. Treatment will be initiated for 24
months duration. Clinical and biologic parameters will be examined to assess response.
Clinical Details
Official title: An Open Label Phase II Trial of Zoledronic Acid, Pravastatin, and Lonafarnib for Patients With Hutchinson-Gilford Progeria Syndrome(HGPS) and Progeroid Laminopathies
Study design: Treatment, Open Label, Single Group Assignment, Efficacy Study
Primary outcome: To evaluate the therapeutic effects of the combination of zoledronic acid, pravastatin and lonafarnib in patients with HGPS.
Secondary outcome: To describe any acute and chronic toxicities associated with treating progeria patients with the combination of zoledronic acid, pravastatin and lonafarnib.To investigate which clinical and laboratory studies are needed to monitor or alter therapy to prevent unacceptable toxicity. To assess the pharmacokinetics of lonafarnib in patients with progeria. To assay for the inhibition of HDJ-2 farnesylation in Peripheral Blood Leukocytes (PBL). To assay for changes in research-based potential markers of efficacy such as levels of prelamin A, mature lamin A, progerin, and HP1 in protein isolated from PBL. To assess changes in leptin levels, glucose utilization, skeletal abnormalities including bone mineral density and X-ray finding, joint contracture and function, and growth To assess changes in auditory function, dental anomalies, dermatologic changes including hair density, nutrition with calorie analysis and energy expenditure, body composition analysis by DXA scan, and cardiovascular structure and function. To compare and incorporate clinical and laboratory data obtain from this study with that obtained during the single agent lonafarnib trial as well as the pilot combination trial of zoledronic acid, pravastatin and lonafarnib
Eligibility
Minimum age: N/A.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Genetic Diagnosis: All patients must have confirmatory mutational analysis showing
mutation in the lamin A gene.
- Clinical Diagnosis: Patients must display clinical signs of progeria as per the
clinical trial team.
- Travel: Patients must be willing and able to come to Boston for appropriate studies
and examinations at initiation of study and at months 6, 12, 18 and 24 on study.
- Patient must have adequate organ and marrow function as defined by the following
parameters:
- Blood: APC (ANC + bands + monocytes = APC) > 1,000/microliters, Platelets >
75,000/microliters (transfusion independent); Hemoglobin >9g/dl.
- Renal: creatinine Less than or equal 1. 5 times normal for age or GFR > 70
ml/min/1. 73m2.
- Hepatic: bilirubin Less than or equal to 1. 5 x upper limit of normal for age; SGPT
(ALT) < and SGOT (AST) < 5 x normal range for age.
- PT/PTT: PT/PTT < 120% upper limit of normal OR PI approval
- No overt renal, hepatic, pulmonary disease or immune dysfunction.
- 25-hydroxyvitamin D ≥ 20 ng/ml within 4 weeks of bisphosphonate infusion.
- Signed informed consent according to institutional guidelines must be obtained and
patient must begin therapy within twenty eight (28) days.
Exclusion Criteria:
- Other than the drugs used in this protocol, drugs targeted to treat Progeria are
excluded. Drugs to treat symptoms of Progeria are permitted.
- Patients must not be taking medications that significantly affect the metabolism of
lonafarnib at the time they start lonafarnib
- Patient must have no uncontrolled infection.
- Subjects who have known or suspected hypersensitivity to any of the excipients
included in the formulation should not be treated.
- Patients must not be pregnant or breast-feeding. Female patients of childbearing
potential must have negative serum or urine pregnancy test. Male and female patients
of reproductive potential must agree to use a medically accepted form of birth
control while on study and up to 10 weeks after treatment. It is permissible for
female patients to take oral contraceptives or other hormonal methods while receiving
treatment with lonafarnib.
Locations and Contacts
Kiera I McKendrick, Phone: 617 632 4595, Email: kiera_mckendrick@dfci.harvard.edu
Children's Hospital Boston, Boston, Massachusetts 02115, United States; Recruiting
Mark Kieran, MD, PhD, Principal Investigator
Additional Information
The Progeria Research Foundation
Starting date: August 2009
Ending date: November 2011
Last updated: September 11, 2009
|
