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Completed

NCT Number: NCT02016365

Safety and Efficacy Study of Doxycycline/UrsoDeoxyCholicAcid on Disease Progression in ATTR Amyloidosis

The primary objective for this study is to evaluate the efficacy of doxycycline + ursodeoxycholic acid (UDCA) on disease progression in Transthyretin Amyloidosis (ATTR) subjects with cardiomyopathy with or without neuropathy.

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Key information

Age range

50 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Dept of Clinical Medicin, Ptieå Hospital, Piteå, Sweden

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Cardiomyopathy with septal thickness > 15 mm and/or S-NT-ProBNP > 300 ng/
  • Age >50 years
  • Male and females after menopause. Menopause is defined as 6 to 12 months of amenorrhea in a woman over 45 years of age.
  • Written informed consent to be obtained prior to any study procedure
  • Histochemical diagnosis of amyloidosis as based on detection by polarizing microscopy of green birefringent material in Congo red-stained tissue specimens, and typing of amyloid deposits as TTR and identification of amyloid fibril type.
  • Molecular definition of the TTR mutation or immunohistochemical staining of amyloid fibrils with anti TTR antibody
  • New York Heart Association (NYHA) class <III
  • Systolic blood pressure >100 mmHg (standing)
  • Must have symptomatic organ involvement with amyloid to justify therapy

Exclusion criteria

  • Liver transplantation in the previous 6 months or liver transplantation anticipated in less than 6 months;
  • ALT and/or AST > 2 x upper normal limit (UNL);
  • Creatinine clearance < 30 ml/min (Cockcroft -Gault Formula)
  • Any other lab values, illness or condition that in the opinion of the investigator might place the subject at unacceptable risk for participation in the study;
  • History of hypersensitivity to any of the ingredients of the study therapies;
  • Use of any investigational drug, device (or biologic) within 4 weeks prior to study entry or during the study.

Treatment and study plan

Doxycycline

Drug

200 mg/day (100 mg twice daily, orally) for 4 weeks with a pause of 2 weeks in combination with UDCA

Other names: Doxyferm

Ursodeoxycholic acid

Drug

750 mg/day (500 mg +250mg orally) continuously

Other names: Ursofalk

Primary outcomes

  1. The efficacy on serum N terminal proBNP (NT-proBNP)

    Time frame: At 12 month treatment

    The primary endpoint of the study is the response rate to doxycycline + UDCA treatment at month 12. A responder is an ATTR subject with:

    • a reduction of, or an increase in serum NT-proBNP concentration of less than 30% of pre-treatment level will be regarded as consistent with treatment efficacy

Secondary outcomes

  1. Modified Body Mass Index (mBMI) reduction

    Time frame: 12 month

    mBMI-reduction of less than 10%

  2. Increase of septum thickness

    Time frame: 12 month

    Increase of septum thickness ≤ 2 mm

  3. Neurologic Kumamoto Scale

    Time frame: 6, 12 and 18 month

    To assess the change from baseline in the neurologic Kumamoto Scale

  4. Number of patients with adverse events

    Time frame: During 12 month treatment and during 6 month follow-up

    To assess the tolerability and safety of the treatment, the number of patients with adverse reactions will be recorded.

    Monthly phone contacts will be performed for monitoring of the treatment safety.

    The safety profile of doxycycline + UDCA will be assessed through the recording, reporting and analysis of baseline medical conditions, physical examination findings including vital signs and laboratory tests. These will be compared to analysis results observed during the study.

  5. Blood work for potential drug-related adverse events

    Time frame: 18 months

    To assess the tolerability and safety of the treatment, blood work [e.g.complete blood count, creatinine and aspartate transaminase (AST), alkaline phosphatase(ALT)] for potential drug-related adverse events will be drawn at 1, 3, 6, 9, 12 and 18 month.

    The safety profile of doxycycline + UDCA will be assessed through the recording, reporting and analysis of baseline medical conditions, physical examination findings including vital signs and laboratory tests. These will be compared to analysis results observed during the study.

Sponsors and collaborators

Lead sponsor

Umeå University

Other

Registry information

Official study title

A Phase II Multicenter Pilot Study of the Safety and Efficacy of Doxycycline/UrsoDeoxyCholicAcid on Disease Progression in ATTR Amyloidosis

Acronym: Dox/Urso

Important dates

Study start
2012
Primary completion
2014
Study completion
2014
First posted
Dec 20, 2013
Registry last updated
May 12, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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