Safety and Efficacy Study of Antioxidants for the Treatment of the Fragile X Syndrome

NCT ID: NCT01329770

Last Updated: 2015-04-14

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

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-12-31

Study Completion Date

2015-04-30

Brief Summary

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The Fragile X syndrome (FXS) was first described by Dr. Martin and Dr. Bell in 1943, in families with several patients affected by sex-linked mental disability. This disorder is the most common cause of inherited mental disability. The prevalence of the Fragile X syndrome has been established at 1 in 2,500 males and 1 in 4000 females.

Despite moderate to severe mental retardation, fragile X patients exhibit macroorchidism, an elongated face, long ears, connective tissue dysplasia, hyperactivity, autistic-like and stereotypical behaviours, speech delay and increased sensory sensitivity.

Objective: To evaluate the effect of the combination of the antioxidant Ascorbic acid and tocopherol, as therapy of the Fragile X Syndrome in young males.

Hypothesis: It is proposed that part of the pathophysiology of the central nervous system in the animal model of the fragile X syndrome may be determined by oxidative stress. In addition, Fragile X patients showed a significantly low level of ascorbic acid in plasma. The biochemical characteristics of oxidative stress may be reversed in the FMR1-KO mice, by a chronic treatment with antioxidant compounds such as tocopherol or melatonin, it may also normalize several hallmarks of the Syndrome such as hyperactivity, anxiety and cognitive deficits. The normalization of the oxidative stress is proposed as a new therapeutic pathway to alleviate conditions caused by an excess of free radicals that are crucial in neurodevelopmental diseases such as autism, down syndrome and other diseases of the central nervous system.

Detailed Description

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* Objective: To evaluate the effect of the combination of the antioxidant Ascorbic acid and tocopherol, as therapy of the Fragile X Syndrome in young males.
* Design: Pilot clinical trial, Phase II , 6-month randomized, double-blind placebo-controlled one-way crossover clinical trial, with two treatment periods of 12 weeks duration.
* Setting: IMABIS Foundation. Carlos Haya Hospital, Malaga.
* Subjects: Children aged 5-11 years (infants) and 12-18 years (adolescents) diagnosed with Fragile X syndrome.
* Intervention: 30 participants randomly assigned, to receive antioxidant vitamins C (ascorbic acid) and vitamin E (d-alpha-tocopherol) once a day or placebo for 12 weeks double-blind. In Study Period 2, all participants receive (open) active treatment. Outcome measures: improvement in plasma antioxidant levels, oxidative stress (indicated by glutathione status, thiobarbituric acid reacting substances (TBARS) and carbonyl content of proteins) and HPA axis response. Behavioral problems will be studied using "Developmental behavior checklist" and "Teacher's and Parent´s Questionnaire, C. Keith Conners", also learning improvement will be analyzed using "Wechsler Intelligence Scale for children" at 0, 3, 6 months during the trial and 3 months after completing the treatment.

Conditions

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Fragile X Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Ascorbic Acid and alpha-tocopherol

Two daily doses of the combination of antioxidants, administered at breakfast and dinner

Group Type EXPERIMENTAL

Ascorbic Acid (Vitamin C) and Alpha-tocopherol (Vitamin E)

Intervention Type DIETARY_SUPPLEMENT

* Vitamin E (D-alpha-Tocopherol) 10 mg/kg/day (with a maximum of 600mg/day)
* Vitamin C (L-Ascorbic Acid) 10 mg/kg/day (with a maximum of 800mg/day) For 12 weeks

Placebo

Two daily doses of placebo, administered at breakfast and dinner

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

Two daily dose of placebo, administered at breakfast and dinner for 12 weeks

Interventions

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Ascorbic Acid (Vitamin C) and Alpha-tocopherol (Vitamin E)

* Vitamin E (D-alpha-Tocopherol) 10 mg/kg/day (with a maximum of 600mg/day)
* Vitamin C (L-Ascorbic Acid) 10 mg/kg/day (with a maximum of 800mg/day) For 12 weeks

Intervention Type DIETARY_SUPPLEMENT

Placebo

Two daily dose of placebo, administered at breakfast and dinner for 12 weeks

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Molecular genetics diagnosis of the syndrome (number of CGG repeats in the FMR1 gene over 200).
* Presenting characteristic symptoms of fragile X syndrome.
* Patients older than 6 years and younger that 19 years.
* Signed informed consent by parents and/or legal tutor prior to enrolment in the trial.
* Both parents and patients must commit to participate for the duration of the 30 week trial.

Exclusion Criteria

* The study excludes individuals with other neurological disorders not linked to the syndrome.
* Patients that have had serious medical problems in the previous 12 months.
* Are taking more than 100mg of vitamin E or vitamin C daily for the past 4 months.
* Have physical problems, mental or sensory impairments that preclude the assessment of effectiveness.
* Hypersensitivity to any component of the preparation.
Minimum Eligible Age

6 Years

Maximum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Yolanda de Diego Otero

OTHER

Sponsor Role lead

Responsible Party

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Yolanda de Diego Otero

MSc PhD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Yolanda de Diego Otero, PhD

Role: PRINCIPAL_INVESTIGATOR

IMABIS Foundation. Hospital Carlos Haya. Malaga

Lucia M Perez Costillas, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Carlos Haya. Malaga

Locations

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Psychiatric Service. Hospital Carlos Haya

Málaga, Malaga, Spain

Site Status

Countries

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Spain

References

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de Diego-Otero Y, Romero-Zerbo Y, el Bekay R, Decara J, Sanchez L, Rodriguez-de Fonseca F, del Arco-Herrera I. Alpha-tocopherol protects against oxidative stress in the fragile X knockout mouse: an experimental therapeutic approach for the Fmr1 deficiency. Neuropsychopharmacology. 2009 Mar;34(4):1011-26. doi: 10.1038/npp.2008.152. Epub 2008 Oct 8.

Reference Type BACKGROUND
PMID: 18843266 (View on PubMed)

Romero-Zerbo Y, Decara J, el Bekay R, Sanchez-Salido L, Del Arco-Herrera I, de Fonseca FR, de Diego-Otero Y. Protective effects of melatonin against oxidative stress in Fmr1 knockout mice: a therapeutic research model for the fragile X syndrome. J Pineal Res. 2009 Mar;46(2):224-34. doi: 10.1111/j.1600-079X.2008.00653.x. Epub 2008 Dec 23.

Reference Type BACKGROUND
PMID: 19141086 (View on PubMed)

el Bekay R, Romero-Zerbo Y, Decara J, Sanchez-Salido L, Del Arco-Herrera I, Rodriguez-de Fonseca F, de Diego-Otero Y. Enhanced markers of oxidative stress, altered antioxidants and NADPH-oxidase activation in brains from Fragile X mental retardation 1-deficient mice, a pathological model for Fragile X syndrome. Eur J Neurosci. 2007 Dec;26(11):3169-80. doi: 10.1111/j.1460-9568.2007.05939.x. Epub 2007 Nov 14.

Reference Type BACKGROUND
PMID: 18005058 (View on PubMed)

de Diego-Otero Y, Calvo-Medina R, Quintero-Navarro C, Sanchez-Salido L, Garcia-Guirado F, del Arco-Herrera I, Fernandez-Carvajal I, Ferrando-Lucas T, Caballero-Andaluz R, Perez-Costillas L. A combination of ascorbic acid and alpha-tocopherol to test the effectiveness and safety in the fragile X syndrome: study protocol for a phase II, randomized, placebo-controlled trial. Trials. 2014 Sep 3;15:345. doi: 10.1186/1745-6215-15-345.

Reference Type DERIVED
PMID: 25187257 (View on PubMed)

Related Links

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http://www.imabis.org

Foundation IMABIS

Other Identifiers

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2009-017837-23

Identifier Type: -

Identifier Source: org_study_id

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