Open-label Extension Study to Evaluate the Long-term Safety and Efficacy of Mexiletine in Paediatric Patients with Myotonic Disorders Who Have Completed the MEX-NM-301 study.
This is an open-label extension study evaluating the long-term efficacy and safety of mexiletine in paediatric patients with myotonic disorders who have completed the initial parent paediatric study with mexiletine (Protocol No. MEX-NM-301 (PIP Study 4) for children and adolescents aged 6 to \< 18 years and who continue to meet the eligibility criteria. Patients who meet the eligibility criteria and provide consent for this study will be enrolled sequentially by decreasing age groups. Patients aged 12 to \< 18 years will enter first as this is the first cohort expected to complete the parent study PIP Study 4 based on top down recruiting. Once initial pharmacokinetics (PK), safety and efficacy are confirmed in this population, patients aged 6 to \<12 years will be first enrolled in PIP Study 4 and subsequently this study (PIP Study 7). Enrolled patients will receive mexiletine at a dose determined in the parent study. Dosing is determined according to body weight and tolerability. The study includes 9 clinic visits - V1 (baseline), and V2 to V9 every 3 months, approximately, thereafter. The total duration of study will be 24 months per patient. End-of-treatment (EOT) visit will occur at 24 months or in accordance with the availability of product. The overall study duration would be approximately 5 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Patients will be enrolled sequentially into 2 cohorts. Cohort 1 - (patients aged 12 to \< 18 years): approximately 8 weeks - 4 weeks of dose titration period + 4 weeks of maintenance period. Cohort 2- (patients aged 6 to \< 12 years,): approximately 8 weeks - 4 weeks of dose titration period + 4 weeks of maintenance period. Enrolment for Cohort 2 will begin after initial pharmacokinetics (PK), safety and efficacy are confirmed in this population, of patients in Cohort 1
Hôpital Necker-Enfants-Malades
Paris, France
Assess the long-term safety and tolerability of mexiletine by AEs
Assess the long-term safety and tolerability of mexiletine in paediatric patients by number and frequency of AEs/SAEs, throughout the study while on treatment
Time frame: Approximately 24 months
Assess the long-term safety and tolerability of mexiletine by hand relaxation
Mean time (in seconds) to relaxation of hand muscles and reduction in relaxation time from the first to the fifth contraction
Time frame: Approximately 24 months
Assess the long-term safety and tolerability of mexiletine measurement of AESI
Assess the long-term safety and tolerability of mexiletine in paediatric patients by Incidence of adverse events of special interest (AESI),
Time frame: Approximately 24 months
Assess the long-term safety and tolerability of mexiletine by changes in ECG
Assess the long-term safety and tolerability of mexiletine in paediatric patients by changes in ECG assessments from baseline, repeated at each study visit
Time frame: Approximately 24 months
Assess the long-term safety and tolerability of mexiletine by muscle stiffness
Score for muscle stiffness (myotonia severity) as self-reported by the patients on a Visual Analog Scale (VAS) or Faces scale
Time frame: Approximately 24 months
Mean change in VAS
Mean change in VAS (8 to \< 18 years) or Faces (6 to \< 8 years) score for severity of muscle stiffness (if not a primary endpoint) pain, weakness and fatigue (every 3 months).
Time frame: Approximately 24 months
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Clinical myotonia assessment
Mean change in time to open the eyes after forced eye closure as measured on a stopwatch (when eyelid myotonia present)
Time frame: Approximately 24 months
Mean change in health-related quality-of-life
Mean change in health-related quality-of-life as measured by the Paediatric Quality of Life (PedsQL) score (secondary endpoint for patients aged 6 years to \<18 years; every 6 months).
Time frame: Approximately 24 months
Clinical Global Impression (CGI) scores
Clinical Global Impression (CGI) scores (efficacy and tolerability) evaluated by the patient, a parent or proxy and by the investigator. Measured every 6 months
Time frame: Approximately 24 months
Mean change in Myotonia Behaviour Scale (MBS) scores
Mean change in Myotonia Behaviour Scale (MBS) scores (for patients aged 6 years to \< 18 years; measured every 6 months).
Time frame: Approximately 24 months
Mean change in time to perform Timed-up and go (TUG) test
Mean change in time to perform Timed-up and go (TUG) test (patients aged 6 to \<18 years only)
Time frame: Approximately 24 months