Tuberous sclerosis complex (TSC) is a genetic disease that leads to mental retardation in over 50% of patients, and to learning problems, behavioral problems, autism and epilepsy in up to 90% of patients. The underlying deficit of TSC, loss of inhibition of the mammalian target of rapamycin (mTOR) protein due to dysfunction of the tuberin/hamartin protein complex, can be rescued by everolimus. Everolimus has been registered as treatment for renal cell carcinoma and giant cell astrocytoma (SEGA). Evidence in human and animal studies suggests that mTOR inhibitors improve learning and development in patients with TSC.
Randomized double-blind placebo controlled intervention study in children with TSC between age 4 and 15 years with an intelligence quotient (IQ) estimated \<80 and/or special schooling and/or autism spectrum disorder and/or learning disability requiring remedial teaching. Patients are randomised to receive everolimus or placebo during a period of 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
60
Everolimus once daily titrated to trough levels of 5-10 ng/ml.
Erasmus Medical Center
Rotterdam, Netherlands
RECRUITINGCognitive ability measured by IQ
Assessed by Wechsler scales: Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III NL) and Wechsler Intelligence Scale for Children (WISC-III-NL)
Time frame: 12 months
Autistic features
Assessed by Autism Diagnostic Observation Schedule (ADOS)
Time frame: 12 Months
Social and communicational skills
Assessed by social responsiveness scale (SRS) and Dutch Children's Communication Checklist (CCC-2-NL) questionnaires
Time frame: 12 Months
Working memory and attention, information processing
Assessed by Cambridge Neuropsychological Test Automated Battery (CANTAB)
Time frame: 6 and 12 Months
Visual-motor integration
Assessed by BEERY Visual-Motor Integration (BEERY VMI), grooved pegboard
Time frame: 12 Months
Child behavior
Assessed by Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) questionnaires
Time frame: 12 Months
Executive functioning
Assessed by Behavior Rating Inventory of Executive Functioning (BRIEF) questionnaire Dutch version
Time frame: 12 Months
Sleeping problems
Assessed by Sleep Disturbance Scale for Children (SDSC) questionnaire
Time frame: 12 Months
Child health
Assessed by Child Health Questionnaire Parent Form (CHQ-PF50) questionnaire
Time frame: 12 Months
Sensory related difficulties
Assessed by Short Sensory Profile (SSP) questionnaire
Time frame: 12 Months
Epilepsy
Comparison of epilepsy frequency during month previous to study start and last month of trial participation. EEG abnormalities
Time frame: 12 Months
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