Empagliflozin Treatment of GSD-1b patients
Glycogen storage disease type Ib (GSD-Ib) is a type of genetic disease with a prevalence of approximately 1 in 500,000. In addition to phenotypes common to GSD-I such as hypoglycemia, hypoglycemia, lactatemia, hyperlipidemia, hyperuricemia, and hepatomegaly, GSD-Ib patients also experience neutropenia and dysfunction, causing infections and inflammatory bowel disease (IBD). At present, the only available treatment for neutropenia in GSD-Ib patients is subcutaneous injection of granulocyte-colony stimulating factor (G-CSF). G-CSF increases the number of neutrophils, but does not improve neutrophil dysfunction, and is also associated with the risk of concurrent splenomegaly and malignancy. The most recent research findings demonstrated that substantial accumulation of 1,5-anhydroglucitol-phosphate is the cause of neutropenia and neutrophil dysfunction in GSD Ib patients. Empagliflozin, an SGLT2 inhibitor, is an efficient and secure approach of treating neutropenia in these patients by inhibiting renal glucose and 1,5-anhydroglucitol reabsorption. Our study's objective is to assess the efficacy and safety of empagliflozin (Jardiance®) in patients with GSD Ib.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Oral administration of Empagliflozin: The starting dose was 0.3 mg/kg/day in 2 divided doses for 3 months. If the subject had an absolute neutrophil count \> 1.0 × 10\^9/L and clinical improvement (decreased number of infections and/or decreased IBD activity within 3 months), the maintenance dose was maintained. If the subject had an absolute neutrophil count \< 1.0 × 10\^9/L but clinical improvement (decreased number of infections and/or decreased IBD activity within 3 months), the maintenance dose was maintained and reassessed 1 month later. If the subject had an absolute neutrophil count \< 1.0 × 10\^9/L and no clinical improvement (no change in number of infections and/or no change in IBD activity within 3 months), the dose was increased by 0.1 mg/kg/day and reassessed 3 months later. Assessments were then performed every 3 months with the same dose modification criteria as above.
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, China
RECRUITINGChange from Baseline in Absolute neutrophil count at 1 year
Efficacy of Empaglifozin measured by the change in absolute neutrophil count after 12 months of treatment compared to the period before study
Time frame: 1 year
Occurrence of hypoglycemia
Safety and tolerability of Empaglifozin measured by hypoglycemia
Time frame: 1 year
Number of infections
Efficacy of Empaglifozin measured by the number of respiratory tract, skin, and urinary tract infections
Time frame: 1 year
Inflammatory bowel disease activity
Measured as classical Crohn 's disease activity index (CDAI) for adults (range from 0 to 600; remission \<150; mildly active disease 150-219; moderately active disease 220- 450; severely active disease ≥ 450) or pediatric Crohn' s disease activity index (PCDAI) for children (range from 0 to 100; remission \<10; mildly active disease 10-27.5; moderately active disease 30-37.5; severely active disease 40-100) after 3, 6, 9, and 12 months of treatment compared to the period before study
Time frame: 1 year
Endoscopic scores of inflammatory bowel disease
Measured as difference in Crohn 's Disease Simplified Endoscopic Score (SES-CD) (range from 0 to 17; remission 0-2; mild endoscopic activity 3-6; moderate endoscopic activity 7-15; severe endoscopic activity \>15) before and after 1 year of empagliflozin treatment
Time frame: 1 year
Change of triglycerides
Measured as change of triglycerides (mmol/L) compared to the period before study
Time frame: 1 year
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Change of total cholesterol
Measured as change of total cholesterol (mmol/L) compared to the period before study
Time frame: 1 year
Change of lactate
Measured as change of lactate (mmol/L) compared to the period before study
Time frame: 1 year
Change of uric acid
Measured as change of uric acid (mmol/L) compared to the period before study
Time frame: 1 year