Clinical Trial: A Cohort of Patients With Cystinosis : Compliance to Cysteamine and Neurological Complications

Study Status: Terminated
Recruit Status: Unknown status
Study Type: Interventional

Official Title: A Cohort of Patients With Cystinosis : Compliance to Cysteamine and Neurological Complications

Brief Summary:

Preventing late onset of Cystinosis such as neurological complications and improving compliance to cysteamine treatment remain major challenges in management of subjects with cystinosis.

This study is designed to describe the relationship between compliance of patients with cystinosis treated with cysteamine and treatment efficacy and to understand the pathophysiologic mechanism of neurological disorders. Is cysteamine crossing the blood brain barrier? What is the impact of cystine accumulation in Cerebro Spinal Fluid and Central Nervous System? Our Primary objective is to study the relationship between compliance of patients treated with cysteamine and the WBC cystine level.

Secondary, the study will assess relationship between compliance to cysteamine and its neurological consequences.

The expected duration of the study is 48 months. The enrolment period is 24 months and the study participation of each subject is 24 months. Eligible participants are male and female (age > 4 years) with confirmed diagnosis of cystinosis and receiving any oral cysteamine treatment: Cystagon or RP103.

The compliance under cysteamine is measured using electronic devices, accountability of study treatment, and information in patients' diary. Specific memory and visuoperceptual tests are performed at the beginning and at the end of patients'participation. Nuclear Magnetic Resonance spectroscopy is used to detect possible sites of cystine accumulation in the CNS and their relationship with compliance to cysteamine treatment. NMRS is also used to establish a relationship with the neuropsychological status of the subject.

To describe absorption, distribution and elimination of cysteamine, and its

Detailed Summary:
Sponsor: Hospices Civils de Lyon

Current Primary Outcome: WBC cystine levels [ Time Frame: Day1and every three months : Month1, Month3, Month6, Month9, Month12, Month15, Month18, Month21 and Month24. ]

PD measurements will be performed at D1, M1, M3, M6, M9, M12, M15, M18, M21 and M24.

Compliance under cysteamine will be measured from D1 to M24 using electronic devices (date and time of bottle opening are recorded), accountability of study treatment and information of patients' diary. Compliance measurement between two consecutive study visits will be expressed as the proportion of the observed number of opening compared to the expected number and the cumulated dose taken compared to the expected dose.Compliance will be first considered as a dichotomous variable, the compliance being described as satisfactory if greater than 95% during a specific period.Compliance will then be considered as a quantitative variable



Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Presence or absence and accountability of cystine crystals. [ Time Frame: Every 6 month : Month1, Month6, Month12, Month18, Month24 ]
    Eye examination
  • Memory and visuoperceptual tests repeated during the study [ Time Frame: at Day 1 and two years ]
  • presence or absence of cystine accumulation, determination of the sites of cystine accumulation in the CNS and relationship with the compliance to cysteamine treatment, relationship with neuropsychological status. [ Time Frame: at Month 1 and two years ]
    NMRS assessments
  • Concentration of cysteamine in the CSF, associated to a measurement of the CSF pressure [ Time Frame: at any visit ]
  • concentration of cysteamine in blood (measured by toxicological HPLC analysis with fluorescence detection) [ Time Frame: at Day1 and every 3 months : month1, month3, month6, month9, month12, month15, month18, month21, month24 ]
  • discrimination of urine and blood samples,from metabolic spectroscopic data obtained by nuclear magnetic resonance. [ Time Frame: Every 3 months during 6 months and every 6 months to month 6 until two years ]
    Perturbed metabolic network resulting from the intake of cysteamine in comparison to controls,using urine and blood samples available for patients with cystinosis and their controls
  • Concentration effect, dose effect model. [ Time Frame: at month 6 ]
    pharmacokinetic profile and 2 timepoints pharmacodynamics.


Original Secondary Outcome: Same as current

Information By: Hospices Civils de Lyon

Dates:
Date Received: December 11, 2012
Date Started: December 2011
Date Completion: May 2015
Last Updated: December 10, 2013
Last Verified: December 2013