Effect of Riluzole as a Symptomatic Approach in Patients With Chronic Cerebellar Ataxia

NCT ID: NCT00202397

Last Updated: 2024-12-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-06-30

Study Completion Date

2008-08-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Hereditary Ataxia Multiple Sclerosis Cerebellar Ataxia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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2

placebo bid for 8 weeks

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type OTHER

capsule-shaped tablet bid for 8 weeks

1

Riluzole, capsule-shaped 50 mg tablets bid for 8 weeks

Group Type EXPERIMENTAL

Riluzole

Intervention Type DRUG

capsule-shaped 50 mg tablets bid for 8 weeks

Interventions

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Riluzole

capsule-shaped 50 mg tablets bid for 8 weeks

Intervention Type DRUG

placebo

capsule-shaped tablet bid for 8 weeks

Intervention Type OTHER

Other Intervention Names

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Rilutek ATC Code N07X X02

Eligibility Criteria

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Inclusion Criteria

* Patients with cerebellar degeneration (heredoataxias, sporadic idiopathic ataxia, multiple system atrophy type C)
* Patients who meet McDonald criteria for probable or definite multiple sclerosis (MS) with chronic cerebellar ataxia (not acute cerebellar ataxia due to relapse)
* Age between 18 and 80 years

Exclusion Criteria

* Ataxia due to other diseases
* Acute cerebellar ataxia
* Use of other drugs for chronic ataxia
* Serious concomitant illnesses (cardiac arrhythmias, haematological and hepatic diseases)
* Pregnancy or breast feeding
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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S. Andrea Hospital

OTHER

Sponsor Role lead

Responsible Party

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Giovanni Ristori

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marco Salvetti, Assoc. Prof

Role: STUDY_DIRECTOR

S.Andrea Hospital, University of Rome "La Sapienza"

Giovanni Ristori, MD

Role: PRINCIPAL_INVESTIGATOR

University of Roma La Sapienza

Locations

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S.Andrea Hospital - University of Rome "La Sapienza"

Rome, , Italy

Site Status

Countries

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Italy

References

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Shakkottai VG, Chou CH, Oddo S, Sailer CA, Knaus HG, Gutman GA, Barish ME, LaFerla FM, Chandy KG. Enhanced neuronal excitability in the absence of neurodegeneration induces cerebellar ataxia. J Clin Invest. 2004 Feb;113(4):582-90. doi: 10.1172/JCI20216.

Reference Type BACKGROUND
PMID: 14966567 (View on PubMed)

Aizenman CD, Huang EJ, Linden DJ. Morphological correlates of intrinsic electrical excitability in neurons of the deep cerebellar nuclei. J Neurophysiol. 2003 Apr;89(4):1738-47. doi: 10.1152/jn.01043.2002.

Reference Type BACKGROUND
PMID: 12686564 (View on PubMed)

Raman IM, Gustafson AE, Padgett D. Ionic currents and spontaneous firing in neurons isolated from the cerebellar nuclei. J Neurosci. 2000 Dec 15;20(24):9004-16. doi: 10.1523/JNEUROSCI.20-24-09004.2000.

Reference Type BACKGROUND
PMID: 11124976 (View on PubMed)

Cao YJ, Dreixler JC, Couey JJ, Houamed KM. Modulation of recombinant and native neuronal SK channels by the neuroprotective drug riluzole. Eur J Pharmacol. 2002 Aug 2;449(1-2):47-54. doi: 10.1016/s0014-2999(02)01987-8.

Reference Type BACKGROUND
PMID: 12163105 (View on PubMed)

Doble A. The pharmacology and mechanism of action of riluzole. Neurology. 1996 Dec;47(6 Suppl 4):S233-41. doi: 10.1212/wnl.47.6_suppl_4.233s.

Reference Type BACKGROUND
PMID: 8959995 (View on PubMed)

Trouillas P, Takayanagi T, Hallett M, Currier RD, Subramony SH, Wessel K, Bryer A, Diener HC, Massaquoi S, Gomez CM, Coutinho P, Ben Hamida M, Campanella G, Filla A, Schut L, Timann D, Honnorat J, Nighoghossian N, Manyam B. International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. The Ataxia Neuropharmacology Committee of the World Federation of Neurology. J Neurol Sci. 1997 Feb 12;145(2):205-11. doi: 10.1016/s0022-510x(96)00231-6.

Reference Type BACKGROUND
PMID: 9094050 (View on PubMed)

Related Links

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Other Identifiers

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NEU - RLZ - 05

Identifier Type: -

Identifier Source: org_study_id