A Randomized, Parallel-arm, Double Blind, Placebo-controlled Study to Assess the Efficacy of Fampridine for Patients With Spinocerebellar Ataxia SCA27B Caused by a GAA Expansion in the FGF14 Gene

Status: Recruiting
Location: See all (9) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

Spinocerebellar ataxias 27B (SCA27B) is caused by an expansion of ≥ 250 GAA triplets in the FGF14 gene and accounts for 15% of cerebellar ataxias (around 500 patients in France). It is a late-onset form often presenting paroxysmal episodes of ataxia and/or diplopia. The disease progresses slowly, with an average increase of 0.10 points/year on the Friedreich's Ataxia Rating Scale (FARS) - Functional Staging and by 0.23 points/year on the Scale for the Assessment and Rating of Ataxia (SARA). To date, no treatment has been proven to be effective in these patients. Three open-label studies using 4-aminopyridine, have shown improvements in visual symptoms and gait in a total of 36 out of 44 patients, although these improvements were evaluated through diverse methodologies. In a subgroup of patients (n=7), administration of 4-aminopyridine resulted in a reduction in FARS - Functional Staging, ranging from 0.5 to 2 points. Notably, this beneficial effect rapidly disappearing in all patients stopping the drug. 4-aminopyridine, a potassium channel blocker, may involve restoration of cerebellar Purkinje cell rhythmic firing property, impaired with the loss of FGF14 function. Although these results appear very promising, the positive effect of 4-aminopyridine is reported only in restricted sample sizes and open-label experiences. Therefore, a robust clinical trial is necessary to provide the level of evidence required for a definitive conclusion on the benefit-risk of fampridine and before introducing the treatment into the regular patient clinical management. Hence, to confirm the beneficial effect of 4-aminopyridine treatment, this study will compare fampridine 10 mg bid (sustained-release form) to placebo during a 3-month treatment in a randomized, double-blind, multicenter, placebo-controlled study, on functional handicap in SCA27B cerebellar ataxia patients.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Genetic diagnosis of spinocerebellar ataxia SCA27B caused by an expansion ≥ 250 GAA repeats in the FGF14 gene

• At least 18 years of age

• SARA total score \> 3 and score ≥ 1 on the gait item of the SARA scale.

• Physically able and expected to complete the trial as designed and having the ability to take oral medication

• Signature of informed consent

• Covered by social security

Locations
Other Locations
France
Neurology Department, CHU d'Angers
NOT_YET_RECRUITING
Angers
Genetics Department, CHU de Bordeaux
RECRUITING
Bordeaux
Neurology and Gentics Department, CHU de Dijon
RECRUITING
Dijon
Neurology Department, Hôpital Pierre Wertheimer Hospital
NOT_YET_RECRUITING
Lyon
Neurology Department, Gui De Chauliac Hospital
RECRUITING
Montpellier
Genetics Department, Pitié-Salpêtrière University Hospital
RECRUITING
Paris
Genetics Department, CHU de Rouen
NOT_YET_RECRUITING
Rouen
Neurology Department, CHRU de Strasbourg
NOT_YET_RECRUITING
Strasbourg
Neurology Department, CHU de Toulouse
NOT_YET_RECRUITING
Toulouse
Contact Information
Primary
Giulia COARELLI
giulia.coarelli@aphp.fr
+ 33 (0)1 57 27 46 82
Backup
Alexandra DURR
alexandra.durr@icm-institute.org
Time Frame
Start Date: 2025-10-21
Estimated Completion Date: 2027-05-21
Participants
Target number of participants: 70
Treatments
Experimental: Fampridine
Placebo_comparator: Placebo
Sponsors
Leads: Assistance Publique - Hôpitaux de Paris

This content was sourced from clinicaltrials.gov