Subcutaneous Injection of Sodium Thiosulfate for Ectopic Calcifications or Ossifications. A Pilot Study
Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
Age6+
SponsorUniversity Hospital, Limoges
About this trial
Ectopic soft tissue calcifications or ossifications can complicate the course of numerous diseases; most of them are rare or very rare. Even if the clinical, radiological and pathological presentation of ectopic calcifications and ossifications are different, the same hypotheses are discussed considering their hypothetical pathophysiology. Indeed, high calcium phosphate product, local cellular lesions and abnormal transdifferentiation of mesenchymal cells are regularly evoked when pathophysiology of such calcifications or ossifications are discussed. Apart from several case reports that have not been confirmed so far, no medical treatments are available, leading to significant pain and impairment of quality of life for patients. Therefore, only surgical treatment can be proposed when the volume or the consequences of these calcifications/ossifications become too important.
Sodium thiosulfate (STS) is currently used as a cyanide poisoning antagonist and a chemoprotectant against adverse effects of several chemotherapies such as Cisplatin. Numerous case reports and several studies have revealed the potential interest of STS in the treatment of uremic induced vascular or soft tissues calcifications. Recently, our group has developed an expertise in the use of STS for the treatment of ectopic soft tissue calcifications or ossifications. Considering these promising preliminary data, and their limits, we developed a strategy to treat soft tissue calcifications or ossifications based on a local administration of STS. The first results of this therapeutic strategy are highly promising and the local or systemic safety is satisfactory so far. These preliminary data also reported by others deserve to be confirmed in a prospective study.
We propose in this project to conduct a prospective open controlled phase II trial in order to assess the efficacy and the safety of intralesional administration of STS for the treatment of calcifications secondary to dermatomyositis or systemic sclerosis and ectopic ossifications secondary to pseudo-hypoparathyroidism 1a type (PHP1A/iPPSD2) (inactivating parathyroid hormone / parathyroid-hormone-related peptid (PTH/PTHrP) signalling disorder).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
ectopic ossification secondary to iPPSD2 or
ectopic calcification secondary to dermatomyositis or
ectopic calcification secondary to systemic sclerosis
Patient aged 2 years or over
Disqualifiers
Allergy to STS or one of the excipients used
Contraindication to local injection of STS
Anticoagulant therapy
Pregnant, parturient or breastfeeding woman
Trial design
Design model
Single group
Treatments tested in this trial
STS
DrugM0-M6 (run-in phase): medical care and follow-up as usual M6-M12 (STS phase): * Patients with iPPSD2 will be treated with subcutaneous infusion using a portable pump. * Patients with dermatomyositis or systemic sclerosis will be treated with repeated injections every two weeks. Patients will receive a maximal total number of 11 STS injections. M12: final visit (V5): clinical evaluation, photograph and CT scan of the treated lesion, pain and quality of life evaluation.
Treatment groups
40 Participants
are divided into 1 treatment groupGroup A: TreatedExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Change of the percentage of volume of the treated calcifications / ossifications
Calculation of percentage of volume evolution of the treated calcification / ossification between the beginning and the end of STS treatment, in each of the three diseases (dermatomyositis, systemic sclerosis and iPPSD2), evaluated on CT-scan measurements.
Time frame
between Month 6 and Month 12Secondary outcomes
1
Change of the volume of the treated calcifications / ossifications
Calculation of volume of the treated calcification / ossification at (i) inclusion, the end of the run-in period (6 month) and after 6 months of local injections of STS in each disease (12 month), evaluated on CT-scan measurements.
Time frame
Month 0, Month 6 and Month 122
Adverse events
Collection of adverse events (clinical and biological): causality, severity, and seriousness during the STS treatment.
Time frame
Month 123
Change of the Hounsfield density of the treated ectopic calcifications/ossifications
Hounsfield density analysis of the treated ectopic calcifications/ossifications at inclusion, the end of the run-in period (6 month) and after 6 months of local injections of STS (12 month), evaluated on CT-scan measurements.
Time frame
Month 0, Month 6 and Month 124
Change of the percentage of patient with a clinically pertinent variation in pain
Calculation of Percentage of patients with a clinically pertinent variation in pain evaluated with pain scales: difference in hetero-evaluation scale of pain in children (HEDEN) ≥ 2 (2-7 years old) between M0-M6 and M6-M12
Time frame
Between Month0 and Month 6 and Between Month 6 and Month 12Sponsors and contacts
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Source ClinicalTrials.gov