This phase I/II clinical trial is an open-label clinical trial design to verify safety and dosing for TAVT-18 (sirolimus) powder for oral solution in TSC infants (N=5).
Tuberous Sclerosis Complex (TSC) is caused by genetic mutation in TSC1 or TSC2, resulting in dysregulation of the mechanistic target of rapamycin (mTOR) signaling pathway. Age at time of seizure onset in TSC infants has been linked to long-term neurodevelopmental outcome in this high-risk population. TAVT-18 is a novel formulation of sirolimus, an mTOR inhibitor. This study evaluates TAVT-18 as a targeted, disease-modifying drug therapy for preventing or delaying seizure onset in TSC using a rational, mechanism-based therapeutic approach.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
5
The investigational drug product to be used in this study is TAVT-18, a proprietary formulation of sirolimus in clinical development, by Tavanta Therapeutics, Inc. It is provided in a powder formulation in pre-measured vials.
Cincinnati Children's Hospital
Cincinnati, Ohio, United States
Safety - Adverse Events
Percentage of subjects reporting severe (CTCAE v5.0 grade \>= 3) adverse event (AE) or serious adverse event (SAE)
Time frame: 12 months of age
Efficacy - Time to Seizure Onset
Time from treatment initiation to seizure onset
Time frame: 12 months of age
Treatment Discontinuance Due to Adverse Events
Percentage of subjects that reduce or discontinue treatment due to an AE or SAE (any grade)
Time frame: 12 months of age
Treatment Disruption Due to Adverse Events
Number of days treatment is withheld due to an AE or SAE (any grade).
Time frame: 12 months of age
Precision Dosing Accuracy
Blood trough concentration of sirolimus (ng/ml)
Time frame: 12 months of age
Age at Seizure Onset
Patient age in months at time of seizure onset
Time frame: 12 and 24 months of age
Seizure Type
Percentage of subjects reporting infantile spasms, focal seizures, or other seizure types
Time frame: 12 and 24 months of age
Seizure Frequency
Number of seizures in past 30 days
Time frame: 12 and 24 months of age
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TAND Severity Assessed by the TAND-L Checklist
Overall severity rating on the TSC-associated Neuropsychiatric Disorders-Lifetime Version (TAND-L) Checklist. The TAND-L Checklist severity rating ranges from 0-10, with higher values indicating greater concern. Parent Rating: "Considering all of the issues reported today how much have these bothered, troubled, or distressed you/your child/family?"; Min = 0 Max = 10; higher values indicate greater concern. Clinician Rating: "Interviewer's judgement of impact/burden on the individual/child/family."; Min = 0 Max = 10; higher values indicate greater concern
Time frame: 12 and 24 months of age
Adaptive Behavior Assessed by the the VABS
Composite score on the Vineland Adaptive Behavior Scales (VABS). The VABS composite score is normed to 100 = average or 50% percentile in normal populations, with lower values indicative of greater concern. Adaptive Scale: Minimum = 20, Maximum = 140, Standard deviation is +/- 15
Time frame: 12 and 24 months of age
Global Neurodevelopment Assessed by the Bayley Scales of Infant Development
Composite score on the Bayley Scales of Infant Development. The Bayley Scales of Infant Development is normed to 100 = average or 50% percentile in normal populations, with lower values indicative of greater concern. Cognitive Domain: Minimum = 40, Maximum = 160, Standard Deviation is +/- 15 Language Domain: Minimum = 40, Maximum = 160, Standard Deviation is +/- 15 Motor Doman: Minimum = 40, Maximum = 160, Standard Deviation is +/- 15
Time frame: 12 and 24 months of age