NAD+ Precursor Supplementation in Friedreich's Ataxia

NCT ID: NCT04817111

Last Updated: 2023-07-17

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

7 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-17

Study Completion Date

2022-05-19

Brief Summary

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The primary objective is to test the safety and tolerability of short-term therapy with a nicotinamide adenine dinucleotide (NAD+) precursor (MIB-626) in adults with Friedreich's Ataxia (FA) without overt heart failure and with a left ventricular ejection fraction ≥ 40%. A key secondary objective is to test the effects of MIB-626 on cardiac and skeletal muscle bioenergetics.

Detailed Description

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The primary focus for this protocol is safety and tolerability. We will systematically assess for adverse events using a safety monitoring uniform report form. We will also use cardiac 31-Phosphorus-Magnetic Resonance Spectroscopy (MRS) to measure the Phosphocreatine(PCr)/Adenosine triphosphate (ATP)- γ ratio before and after treatment with MIB-626. In addition, if time permits we will use proton (1H)-MRS to measure skeletal muscle nicotinamide adenine dinucleotide (NAD+) before and after treatment.

Conditions

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Friedreich Ataxia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Open Label, 14 Days (+/- 2 Days)
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Open Label - MIB-626

MIB-626

Group Type OTHER

MIB-626

Intervention Type DRUG

Two (2) 500 mg Tablets, By Mouth, Daily

Interventions

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MIB-626

Two (2) 500 mg Tablets, By Mouth, Daily

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Molecular diagnosis of Friedreich's Ataxia (FA).
* Males and females, ages 18 years to \< 65 years.

Exclusion Criteria

* Known sensitivity to nicotinamide-containing compounds.
* Concurrent use of Vitamin B3 supplements and/or any medications likely to increase risk of MIB-626 toxicity.
* HgbA1c \> (great than or equal to) 8.5% and or Diabetes Mellitus (DM) requiring insulin or insulin secretagogue.
* Kidney disease (Estimated Glomerular Filtration Rate (eGFR) \< 60 ml/min/1.73 m2) using serum creatinine and MDRD equation. The eGFR levels will be calculated using the Modified Diet in Renal Disease Study (MDRD) equation, which is the equation used by the Children's Hospital Of Philadelphia laboratory.
* Liver disease (Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) \> 3 x Upper Limit of Normal)
* Severe co-existing cardiac disease (Ejection Fraction (EF) \< 40%, known arrhythmia) as demonstrated by an echocardiogram within 12 months of screening.
* Any contraindication to MRI, including spinal rods (related to unknown safety considerations for cardiac 31-Phosphorus -MRS).
* Use of any investigational agent within 4 weeks of enrollment.
* Females: Pregnant/lactating or planning to become pregnant during their participation.
* Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Children's Hospital of Philadelphia

OTHER

Sponsor Role collaborator

Metro International Biotech, LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Shana McCormack

Attending Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Shana E McCormack, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Locations

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The Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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DeBrosse C, Nanga RPR, Wilson N, D'Aquilla K, Elliott M, Hariharan H, Yan F, Wade K, Nguyen S, Worsley D, Parris-Skeete C, McCormick E, Xiao R, Cunningham ZZ, Fishbein L, Nathanson KL, Lynch DR, Stallings VA, Yudkoff M, Falk MJ, Reddy R, McCormack SE. Muscle oxidative phosphorylation quantitation using creatine chemical exchange saturation transfer (CrCEST) MRI in mitochondrial disorders. JCI Insight. 2016 Nov 3;1(18):e88207. doi: 10.1172/jci.insight.88207.

Reference Type BACKGROUND
PMID: 27812541 (View on PubMed)

Bagga P, Wilson N., DeBrosse D., Hariharan H., Reddy R., editor. In vivo detection of NAD+ in human calf muscle at 7T using 28-channel knee volume coil. International Society for Magnetic Resonance in Medicine; 2019; Montreal, Canada.

Reference Type BACKGROUND

Patel M, Isaacs CJ, Seyer L, Brigatti K, Gelbard S, Strawser C, Foerster D, Shinnick J, Schadt K, Yiu EM, Delatycki MB, Perlman S, Wilmot GR, Zesiewicz T, Mathews K, Gomez CM, Yoon G, Subramony SH, Brocht A, Farmer J, Lynch DR. Progression of Friedreich ataxia: quantitative characterization over 5 years. Ann Clin Transl Neurol. 2016 Jul 25;3(9):684-94. doi: 10.1002/acn3.332. eCollection 2016 Sep.

Reference Type BACKGROUND
PMID: 27648458 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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MIB-626-201

Identifier Type: OTHER

Identifier Source: secondary_id

19-016525

Identifier Type: -

Identifier Source: org_study_id

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