Study of Disease Progression in Adults With Inherited Forms of Spastic Paraplegia

NCT ID: NCT05008874

Last Updated: 2025-10-30

Basic Information

• Recruitment Status: TERMINATED
• Total Enrollment: 65 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2021-06-21
• Study Completion Date: 2025-05-16

Brief Summary

The course of AMN-related disabilities over time is poorly or incompletely understood due to a limited number of patients and lack of treatments. This study will help obtain a better understanding of the progression of disease with AMN and facilitate efficient clinical development of future interventional medications.

Detailed Description

Progressive weakness and spasticity of the legs are characteristics of numerous disorders and conditions, including those that are inherited neurological disorders.

Adrenomyeloneuropathy (AMN) is an example of an inherited form of spastic paraplegia.

Adrenoleukodystrophy (ALD) is a progressive neurodegenerative disorder caused by a mutation in the ABCD1 gene localized to the X-chromosome (Xq28). The ABCD1 gene encodes a peroxisomal adenosine triphosphate (ATP) binding cassette transporter responsible for transport of very long chain fatty acids (VLCFA) from the cytosol into the peroxisome for degradation. A mutation in ABCD1 results in reduction in the degradation of the VLCFA by peroxisomal β-oxidation, and saturated VLCFA, in particular C26:0, accumulate in tissues and body fluids (i.e., brain, nervous system, adrenal glands). One of the key clinical symptoms during aging of ALD patients is a slowly progressive axonopathy affecting sensory ascending and motor descending spinal cord tracts with 100% penetrance in men, an ALD phenotype known as AMN. There are no treatment options available, which leaves AMN patients with a progressive disorder that leads to lifelong physical disability. The progressive dying-back axonopathy represents the core clinical feature of AMN, with onset usually between 20 and 30 years of age in male participants. The initial symptoms include progressive stiffness and weakness of the legs, impaired vibration and position senses in the lower limbs, falls, sphincter disturbances and impotence, as well as scarce scalp hair (alopecia). About 66% of male AMN patients have adrenocortical insufficiency (Addison disease).

The course of AMN-related disabilities over time is poorly or incompletely understood due to a limited number of patients and lack of treatments. This study will help obtain a better understanding of the progression of disease with AMN and facilitate efficient clinical development of future SwanBio interventional medications.

Conditions

AMN; AMN Gene Mutation; X-ALD

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: OTHER

Study Groups

Males with AMN

Adult males with confirmed diagnosis of ALD and symptoms of AMN.

Natural History Observation

Intervention Type: OTHER

Data collection on progression of disease

Interventions

Natural History Observation

Data collection on progression of disease

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Male adults aged ≥18 years

2. Diagnosed with ALD based on elevated VLCFA assay and pedigree analysis

3. Clinical evidence of spinal cord involvement with EDSS score between 1 and 6.5

Exclusion Criteria

1. Diagnosed with cerebral inflammatory disease or has a history of diagnosis with cerebral inflammatory disease

2. Unstable, clinically significant neurologic (other than the disease being studied), psychiatric, cardiovascular, ophthalmologic, pulmonary, hepatic, renal, metabolic, gastrointestinal, urologic, immunologic, hematopoietic, or endocrine disease (other than adrenal insufficiency) or other abnormality, which may impact the ability to participate in the study or that may potentially confound the study results

3. Participant who, in the opinion of the Investigator, has any other medical or psychological condition or social circumstances which would impair their ability to participate reliably in the assessments, or who may increase the risk to themselves or others by participating

• Minimum Eligible Age: 18 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

SwanBio Therapeutics, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Stanford Neuroscience Health Center

Stanford, California, United States

Massachusetts General Hospital

Boston, Massachusetts, United States

Weill Medical College of Cornell University

New York, New York, United States

University of Utah

Salt Lake City, Utah, United States

University of Leipzig Medical Center

Leipzig, , Germany

Amsterdam UMC

Amsterdam, , Netherlands

Countries

United States; Germany; Netherlands

Other Identifiers

SBTNHX-CT901

Identifier Type: -

Identifier Source: org_study_id