Magnetic Resonance Spectroscopy in Acid Sphingomyelinase Deficiency

NCT ID: NCT05904366

Last Updated: 2023-06-15

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 34 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-05-05
• Study Completion Date: 2024-09-01

Brief Summary

The goal of this study is to assess the ability of MRI techniques to detect early stages of lipid accumulation in the liver of ASMD patients with the chronic visceral subtype compared to healthy subjects.

Participants will undergo an MRI with MR Spectroscopy (MRS) to measure lipid accumulation (steatosis) and MR Elastography (MRE) to measure liver stiffness (fibrosis).

Detailed Description

Rationale: Acid sphingomyelinase deficiency (ASMD) is a rare lysosomal storage disorder caused by a deficiency of sphingomyelinase resulting in accumulation of the sphingolipid sphingomyelin (SM) in the liver, spleen and lungs. Accumulation of SM in the liver leads to liver fibrosis in a subset of ASMD patients. Enzyme replacement therapy (ERT, olipudase alfa, Sanofi Genzyme) is currently investigated in a phase 2/3 trial and recently received market authorization by the EMA and FDA. As ASMD is a slowly progressive disease, detection of early stages of SM storage in the liver might aid in identifying patients at risk for major complications who would benefit from therapy. Two magnetic resonance (MR) based techniques might be of interest: MR Spectroscopy (MRS) to measure lipid accumulation (steatosis) and MR Elastography (MRE) to measure liver stiffness (fibrosis).

Objective: To assess the ability of MRI techniques to detect early stages of lipid accumulation in the liver of ASMD patients with the chronic visceral subtype compared to healthy subjects.

Study design: Cross-sectional pilot study in which MRS and MRE measurements of ASMD patients will be compared to measurements in healthy subjects. All ASMD patients who participate will undergo an MRI during their yearly assessments. Patients eligible for therapy will also undergo an MRI after one year of treatment.

Study population: All adult patients with ASMD visiting the outpatient clinic for metabolic disorders of the Amsterdam UMC will be invited to participate. Participating ASMD patients will be matched to healthy controls based on age, sex and BMI in a ratio of 1:1.

Main study endpoint: Fat fraction in volume percentage (%) of liver tissue of ASMD patients measured with MRS compared to values of healthy subjects.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: The MRI procedure yields no risk: at most patients might feel uncomfortable lying in the tight space. Patients and healthy subjects will not directly benefit from participation in the study. The results of the study may improve clinical care in the future.

Conditions

Asmd, Visceral Type

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Study Groups

Patients

Participants will undergo an MRI with MR Spectroscopy (MRS) and MR Elastography (MRE) measurements

Group Type: OTHER

MR Spectroscopy (MRS)

Intervention Type: DIAGNOSTIC_TEST

MR Spectroscopy (MRS)

MR Elastography (MRE)

Intervention Type: DIAGNOSTIC_TEST

MR Elastography (MRE) with a device that induces shear waves in the body. This device is placed upon the abdomen of the subject and is hold in place by straps. The device will produce low-frequency vibrations (e.g. 30-60 Hz) which are not painful to the participant. A declaration of conformity and a safety document are provided in the study dossier.

Healthy controls

Participants will undergo an MRI with MR Spectroscopy (MRS) and MR Elastography (MRE) measurements

Group Type: OTHER

MR Spectroscopy (MRS)

Intervention Type: DIAGNOSTIC_TEST

MR Spectroscopy (MRS)

MR Elastography (MRE)

Intervention Type: DIAGNOSTIC_TEST

MR Elastography (MRE) with a device that induces shear waves in the body. This device is placed upon the abdomen of the subject and is hold in place by straps. The device will produce low-frequency vibrations (e.g. 30-60 Hz) which are not painful to the participant. A declaration of conformity and a safety document are provided in the study dossier.

Interventions

MR Spectroscopy (MRS)

MR Spectroscopy (MRS)

Intervention Type: DIAGNOSTIC_TEST

MR Elastography (MRE)

MR Elastography (MRE) with a device that induces shear waves in the body. This device is placed upon the abdomen of the subject and is hold in place by straps. The device will produce low-frequency vibrations (e.g. 30-60 Hz) which are not painful to the participant. A declaration of conformity and a safety document are provided in the study dossier.

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

Patients:

• The patient has biochemically proven ASMD (preferably genetically confirmed)
• The patient is willing and able to provide written informed consent prior to the study-related procedure.
• The patient is ≥ 18 years of age

Healthy controls:

• The individual is willing and able to provide written informed consent prior to the study-related procedure
• The individual is ≥ 18 years of age
• General good health as determined by medical history

Exclusion Criteria

Patients and healthy controls:

• Inability to adhere to the study protocol
• Inability to undergo an MRI procedure

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Eline C. B. Eskes

OTHER

Sponsor Role: lead

Responsible Party

Eline C. B. Eskes

MD

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Carla EM Hollak, prof dr

Role: PRINCIPAL_INVESTIGATOR

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

xx xx xx, xx

Role: STUDY_DIRECTOR

Locations

Amsterdam UMC

Amsterdam, North Holland, Netherlands

Site Status: RECRUITING

Countries

Netherlands

Central Contacts

Eline CB Eskes, MD

Role: CONTACT

e.c.eskes@amsterdamumc.nl

0205669111

Facility Contacts

Eline CB Eskes, MD

Role: primary

e.c.eskes@amsterdamumc.nl

0205669111

Other Identifiers

2022.0444

Identifier Type: -

Identifier Source: org_study_id