L-Acetylleucine

A Phase III clinical trial is underway to investigate the effects of N-Acetyl-L-Leucine on patients with Niemann-Pick disease type C (NPC). This randomized, placebo-controlled, double-blind, crossover study aims to evaluate the drug’s efficacy, safety, and tolerability in treating NPC symptoms, particularly focusing on ataxia (loss of coordination) and overall quality of life for patients aged 4 years and older.

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What is L-Acetylleucine?

L-Acetylleucine, also known as N-Acetyl-L-Leucine, is a medication currently being studied for the treatment of a rare genetic disorder called Niemann-Pick Disease Type C (NPC)[1]. This drug is considered a “small molecule,” which means it’s a low molecular weight compound that can easily enter cells to perform its function[1].

Niemann-Pick Disease Type C

Niemann-Pick Disease Type C is a rare genetic disorder that affects the body’s ability to process and transport fats (lipids) within cells. This leads to an accumulation of lipids in various organs, particularly the brain, liver, and spleen. NPC is classified as a congenital familial and genetic disorder, meaning it’s inherited and present from birth[1].

Ongoing Research

A Phase III clinical trial is currently underway to evaluate the effectiveness and safety of L-Acetylleucine in treating NPC[1]. This is an advanced stage of research, indicating that the drug has shown promise in earlier studies and is now being tested on a larger group of patients.

How L-Acetylleucine Works

The main goal of using L-Acetylleucine in NPC patients is to improve their ataxia, which refers to problems with balance, coordination, and speech. Researchers are using a special scale called the Scale for the Assessment and Rating of Ataxia (SARA) to measure how well the drug works[1].

Eligibility for the Study

To participate in the study, patients must meet certain criteria:

  • Be at least 4 years old
  • Have a confirmed diagnosis of NPC
  • Have specific scores on tests that measure ataxia and hand function
  • Weigh at least 15 kg (about 33 pounds)

Some factors that might prevent a person from participating include:

  • Known allergies to the drug or its ingredients
  • Participation in other clinical trials
  • Certain physical or psychiatric conditions that might interfere with the study
  • Diagnosed arthritis or other musculoskeletal disorders that significantly affect mobility

Study Design

The study is designed as a randomized, placebo-controlled, double-blind, crossover study. This means:

  1. Participants are randomly assigned to receive either L-Acetylleucine or a placebo (a substance with no active ingredients).
  2. Neither the patients nor the researchers know who is receiving the real drug or the placebo during the study.
  3. After a period of time, the groups switch, so everyone gets a chance to receive the real drug.

This design helps ensure that the results are as accurate and unbiased as possible[1].

Potential Benefits

If successful, L-Acetylleucine could potentially improve several aspects of life for NPC patients:

  • Better control of ataxia symptoms
  • Improved overall functioning
  • Enhanced quality of life

Researchers are using various tests to measure these potential improvements, including the Spinocerebellar Ataxia Functional Index (SCAFI) and quality of life questionnaires[1].

Safety Considerations

The study is also closely monitoring the safety and tolerability of L-Acetylleucine. The dosage being tested is 4 g/day for patients 13 years and older, with weight-adjusted doses for younger patients (ages 4 to 12)[1]. As with any medication, it’s important to be aware of potential side effects, which will be carefully documented throughout the study.

Aspect Details
Study Type Phase III, randomized, placebo-controlled, double-blind, crossover study
Drug Name N-Acetyl-L-Leucine (IB1001)
Condition Niemann-Pick disease type C (NPC)
Primary Objective Evaluate efficacy based on the Scale for the Assessment and Rating of Ataxia (SARA)
Secondary Objectives Assess clinical efficacy on symptoms, functioning, and quality of life; Evaluate safety and tolerability
Eligibility Age ≥4 years, confirmed NPC diagnosis, specific SARA score range, weight ≥15 kg
Dosage 4 g/day for patients ≥13 years; weight-tiered doses for patients 4-12 years
Primary Endpoint Scale for the Assessment and Rating of Ataxia (SARA)
Secondary Endpoints SCAFI, Quality of Life assessments, mDRS, CGI-I

Ongoing Clinical Trials on L-Acetylleucine

  • Study of N-Acetyl-L-Leucine in Patients with Ataxia-Telangiectasia: A Phase III Trial

    Recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Germany Slovakia Spain
  • Study on N-Acetyl-L-Leucine for Patients with Niemann-Pick Disease Type C

    Recruiting

    1 1
    Investigated drugs:
    Czechia Germany The Netherlands Slovakia
  • A study to evaluate the effects of N-Acetyl-L-Leucine in patients with CACNA1A disorders

    Not yet recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Austria Germany Italy

Glossary

  • Niemann-Pick disease type C (NPC): A rare genetic disorder that affects the body's ability to process and transport fats (lipids) within cells, leading to an accumulation of lipids in various organs, particularly the brain.
  • Ataxia: A neurological condition characterized by a lack of muscle control or coordination of voluntary movements, such as walking or picking up objects.
  • Scale for the Assessment and Rating of Ataxia (SARA): A clinical scale used to measure the severity of ataxia in patients with cerebellar disorders.
  • Spinocerebellar Ataxia Functional Index (SCAFI): A composite measure of cerebellar function that includes tests of gait, speech, and hand coordination.
  • Modified Disability Rating Scale (mDRS): A scale used to assess the level of disability in patients with neurological conditions.
  • Clinical Global Impression of Improvement (CGI-I): A scale used by healthcare providers to evaluate a patient's response to treatment and overall clinical improvement.
  • Randomized: A method of assigning participants to different treatment groups by chance, reducing bias in clinical trials.
  • Placebo-controlled: A study design where some participants receive an inactive substance (placebo) instead of the active treatment, allowing researchers to compare the effects of the drug to no treatment.
  • Double-blind: A study design where neither the participants nor the researchers know who is receiving the active treatment or placebo, reducing potential bias.
  • Crossover study: A type of clinical trial where participants receive both the active treatment and placebo at different times during the study, allowing each participant to serve as their own control.

References

  1. http://clinicaltrials.eu/trial/study-on-n-acetyl-l-leucine-for-patients-with-niemann-pick-disease-type-c/