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Trial · Interventional

CompletedPhase 2Results postedRegistry data

Clinical Trial in 22q13 Deletion Syndrome(Phelan-McDermid Syndrome)

NCTNCT01525901 (opens ClinicalTrials.gov in a new tab)Other idGCO 12-0929Other idIF# 1358648Other id1R34MH100276-01Other idGCO 11-1555

Overview

Status
Completed
Phase
Phase 2
Enrollment
19 participants (actual)
Sponsor
Icahn School of Medicine at Mount Sinai · Other
Design
Randomized · Quadruple masking
Countries
1 country

United States

Start
Feb 2012
Primary completion
23 Aug 2016
Completion
23 Aug 2016
First posted
3 Feb 2012 (estimated)
Last update posted
12 May 2022
Conditions
22q13 Deletion Syndrome · Phelan-McDermid Syndrome

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
201220132014201520162017
  1. Ph 2

    Clinical Trial in 22q13 Deletion Syndrome(Phelan-McDermid Syndrome)

    NCT01525901

    Feb 2012 to 23 Aug 2016

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

The purpose of this study is to pilot the use of Insulin-Like Growth Factor-1 (IGF-1) treatment in 22q13 Deletion Syndrome (Phelan-McDermid Syndrome) caused by SHANK3 gene deficiency in order to evaluate safety, tolerability, and efficacy. IGF-1 is an injection under the skin that contains human IGF-1. IGF-1 is approved by the FDA under the brand name Increlex for the treatment of children with short stature due to primary IGF-1 deficiency. It is being used off-label in the current study and is not FDA approved, nor has it yet been studied in humans for the treatment of SHANK3 deficiency.

Interventions

  • Insulin-Like Growth Factor-1 (IGF-1)Drug
  • Normal salineDrug

Arms2

  • Experimental

    Insulin-Like Growth Factor-1 (IGF-1)

    Injection

  • Placebo comparator

    Normal saline

    Injection

Primary outcomes2

Outcomes the sponsor listed as primary.

  1. Change in Aberrant Behavior Checklist - Social Withdrawal (ABC-SW) Subscale - Study 1

    Time frame · Baseline and Week 12

    Registry description

    16 items on ABC-SW subscale, Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). Total score from 0 to 48 with higher score indicating poorer health outcomes.

  2. Change in Aberrant Behavior Checklist - Social Withdrawal (ABC-SW) Subscale Study 2

    Time frame · Baseline and Week 12

    Registry description

    16 items on ABC-SW subscale, Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). Total score from 0 to 48 with higher score indicating poorer health outcomes..

Secondary outcomes(5)
  1. Change in Repetitive Behavior Scale - Study 2

    Time frame · Baseline and Week 12

    Registry description

    Repetitive Behavior Scale (RBS) - Total Score 43 items, each item scored on 4-point scale: 0-Behavior does not occur, 1-Behavior occurs and is a mild problem, 2-Behavior occurs and is a moderate problem, 3-Behavior occurs and is a severe problem. with total score from 0 (mild) to 129 (severe). The subscales are stereotyped behaviors 6 items (subscale 0-18), self-injurious behaviors 8 items (subscale 0-24), Compulsive behaviors- 8 items (subscale 0-24), Ritualistic Behaviors 6 items (subscale from 0-18), Sameness 11 items (subscale 0-33), restricted behaviors 4 items (subscale 0-12). Total score is the sum of all items in the subscale with total score range from 0 to 129. Higher scores indicate greater symptom severity.

  2. Change in CGI-Improvement and Severity Scales; - Study 2

    Time frame · Baseline and Week 12

    Registry description

    The Clinical Global Impression - Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Considering total clinical experience, a patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill. The Clinical Global Impression - Improvement scale (CGI-I) is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention. and rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.

  3. Change in Caregiver Strain Questionnaire

    Time frame · Baseline and Week 12

    Registry description

    21 question tool, about caregiver strain, where each question uses a Likert scale where 1 is "Not at all" and 5 is "Very much." The full scale ranges from 21-105, where higher scores indicate more severe strain.

  4. Change in Sensory Profile (SP) - Study 2

    Time frame · Baseline and Week 12

    Registry description

    The SP is a standardized parent-completed questionnaire that assesses sensory processing and its impact on the functioning of children ages 3-10 yr. The 125 items represent behaviors that can be interpreted as responses to sensory experiences. The parent rates the observed frequency of these behaviors on a 5-point Likert scale (ranging from 1 always to 5 never). The tool consists of 14 sections, listed below, that refer to sensory processing, modulation, and behavioral and emotional responses. Subscale scores are listed below. Each section's raw score is compared with a threshold value to determine a category of performance: typical performance, probable difference (1 standard deviation below the mean), and definite difference (2 standard deviations below the mean). A lower raw score means a greater difference.

  5. Change in Short Sensory Profile (SSP) - Study 2

    Time frame · Baseline and 12 weeks

    Registry description

    The Short Sensory Profile is a caregiver report measure consisting of 38 items, each scored on a 1-point (always) to 5-point (never) Likert scale. SSP Subscales Tactile Sensitivity (7 to 35) Taste/Smell Sensitivity (4 to 20), Movement Sensitivity (3 to 15), Under-Responsive/Seek Sensation (7 to 35) , Auditory Filtering (6 to 30), Low Energy/Weak (6 to 30), Visual/Auditory Sensitivity (5 to 25), with total scale from (38 to 190) Lower scores indicate more sensory alterations.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeMean· Baseline and Week 12

Change in Aberrant Behavior Checklist - Social Withdrawal (ABC-SW) Subscale - Study 1

GroupValue (score on a scale)Spread
Study 1: Insulin-Like Growth Factor-1 (IGF-1)15.789.16
Study 1: Normal Saline11.227.29
Primary outcomeMean· Baseline and Week 12

Change in Aberrant Behavior Checklist - Social Withdrawal (ABC-SW) Subscale Study 2

GroupValue (score on a scale)Spread
Study 2: IGF-1-5.57.46
Study 2: Placebo-6.35.38
Secondary and other outcome results(5)
Secondary outcomeMean· Baseline and Week 12

Change in Repetitive Behavior Scale - Study 2

GroupValue (score on a scale)Spread
Study 2: IGF-1-0.32.63
Study 2: Placebo-0.82.19
Secondary outcomeMean· Baseline and Week 12

Change in CGI-Improvement and Severity Scales; - Study 2

GroupValue (score on a scale)Spread
Study 2: IGF-1-0.20.42
Study 2: Placebo-0.10.32
Secondary outcomeMean· Baseline and Week 12

Change in Caregiver Strain Questionnaire

GroupValue (score on a scale)Spread
Study 1: Insulin-Like Growth Factor-1 (IGF-1)64.1117.32
Study 1: Normal Saline63.2220.48
Study 2: Insulin-Like Growth5818.89
Study 2: Normal Saline55.0019.54
Secondary outcomeMean· Baseline and Week 12

Change in Sensory Profile (SP) - Study 2

GroupValue (units on a scale)Spread
Study 2: IGF-11.62.46
Study 2: Placebo0.22.39
Secondary outcomeMean· Baseline and 12 weeks

Change in Short Sensory Profile (SSP) - Study 2

GroupValue (score on a scale)Spread
Study 2: IGF-10.92.73
Study 2: Placebo0.72.45

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Insulin-Like Growth Factor-1 (IGF-1)IGF-1 is an aqueous solution for injection containing human insulin-like growth factor-1 (Increlex; Ipsen Biopharmaceuticals, Inc)) produced by recombinant DNA technology. Dose titration was initiated at 0.04 mg/kg twice daily by subcutaneous injection, and increased, as tolerated, every week by 0.04 mg/kg per dose to a maximum of 0.12 mg/kg twice daily. Medication was administered subcutaneously twice daily with meals and glucose monitoring was performed by parents prior to each injection and at bedtime.0 / 190 / 1919 / 19
Normal SalinePlacebo0 / 190 / 1919 / 19

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies0

Studies that cite this trial.

No study cites this trial.

Other registry references

References listed at the registry that are not in PepBank. They link to PubMed.

  • ResultKolevzon A, Bush L, Wang AT, Halpern D, Frank Y, Grodberg D, Rapaport R, Tavassoli T, Chaplin W, Soorya L, Buxbaum JD. A pilot controlled trial of insulin-like growth factor-1 in children with Phelan-McDermid syndrome. Mol Autism. 2014 Dec 12;5(1):54. doi: 10.1186/2040-2392-5-54. eCollection 2014. PMID 25685306
  • DerivedKolevzon A, Breen MS, Siper PM, Halpern D, Frank Y, Rieger H, Weismann J, Trelles MP, Lerman B, Rapaport R, Buxbaum JD. Clinical trial of insulin-like growth factor-1 in Phelan-McDermid syndrome. Mol Autism. 2022 Apr 8;13(1):17. doi: 10.1186/s13229-022-00493-7. PMID 35395866

Eligibility

Who could join, as posted.

Sex
All
Age
from 5 Years up to 12 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * 5 to 12 years old * pathogenic deletions or mutations of the SHANK3 gene * stable medication regimens for at least three months prior to enrollment Exclusion Criteria: * closed epiphyses * active or suspected neoplasia * intracranial hypertension * hepatic insufficiency * renal insufficiency * cardiomegaly / valvulopathy * history of allergy to IGF-1 or any component of the formulation (mecasermin) * history of extreme prematurity (\<1000 grams) with associated early neo-natal complications, e.g. intra-cerebral hemorrhage, prolonged hypoxia, prolonged hypoglycemia * patients with comorbid conditions deemed too medically compromised to tolerate the risk of experimental treatment with IGF-1

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