Brief Title
Lithium and Acetate for Canavan Disease
Official Title
Evaluation of the Tolerance and Efficiency of a Combined Oral Therapy With Lithium and GTA in Patients With Canavan Disease
Brief Summary
The aim of this study is to determine whether oral supplementation with lithium and acetate may improve the biological and clinical prognosis in patients with Canavan Disease.
Detailed Description
Canavan Disease is an autosomal recessive devastating demyelinating disease caused by a deficiency in Aspartoacylase (ASPA) enzyme. There is no available treatment. ASPA deficiency leads to:- the accumulation of high levels of N-acetylaspartate (NAA), involved in myelin degeneration and epilepsy;- the deficient synthesis of acetate in oligodendrocytes, that could impair CNS myelination.Lithium administration induces a decrease in NAA in the brain of the tremor rats (animal model for CD) and in one patient (JANSON, 2005). On the other hand, administration of acetate could improve myelination in Canavan patients.For this reason, we propose to combine both treatments: Lithium Gluconate and Glyceryl Triacetate (GTA). Eighteen patients, aged 1 to 15 years, will receive oral GTA or Lithium during 4 months, then both treatment in association during 6 months. Patients will be sequentially evaluated up to the end of the treatment and 2 months thereafter for:-tolerance of the therapy (careful monitoring of clinical and biological parameters).- efficacy of the therapy on clinical, biological and radiological parameters. Particularly, we will evaluate using MRI-spectroscopy and CSF samples the decrease in NAA and increase in acetate levels in the brain.
Study Phase
Phase 2
Study Type
Interventional
Primary Outcome
The primary outcome will be a decrease of the NAA peak (> 20%) or the appearance of an acetate peak at the end of the treatment (10 months), using spectroscopy-MRI.
Secondary Outcome
Secondary outcomes will be assessed at 10 months (end of the treatment): -Improvement of neuromotor performances (GMFM and Mullen scales), spasticity, and neurological severity
Condition
Canavan Disease
Intervention
Lithium Gluconate (drug) Glyceryl Triacetate GTA (drug)
Study Arms / Comparison Groups
1
Description:
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
0
Start Date
September 2009
Completion Date
January 2011
Primary Completion Date
September 2010
Eligibility Criteria
Inclusion Criteria: - Clinical and biochemical diagnosis of Canavan disease Exclusion Criteria: - Renal disease - Thyroid disease - Cardiac disease - Impossibility to perform brain MRI
Gender
All
Ages
1 Year - 15 Years
Accepts Healthy Volunteers
No
Contacts
Patrick Aubourg, MD, PhD, ,
Administrative Informations
NCT ID
NCT00657748
Organization ID
P070803
Study Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
European Leukodystrophy Association
Study Sponsor
Patrick Aubourg, MD, PhD, Principal Investigator, Assistance Publique - Hôpitaux de Paris
Verification Date
April 2015