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TerminatedNCT03822013EMTISTDUpdated Sep 17, 2025

Effects of Miglustat Therapy on Infantile Type of Sandhoff and Taysachs Diseases (EMTISTD)

A Phase 3 interventional study of Miglustat in GM2 Gangliosidosis and Supportive Care, sponsored by Tehran University of Medical Sciences. Terminated at 3 sites in Iran. Open to participants aged 6 Months to 24 Months. Per ClinicalTrials.gov, last updated 2025-09-17.

Sponsored by Tehran University of Medical Sciences · Phase 3, Interventional, and Supportive care

Why this study was terminated
The number of controls was insufficient compared to case.
Phase
Phase 3
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
6 Months to 24 Months
Sex
All
01

Study summary

GM2 gangliosidosis is an autosomal recessive subtype of Lysosomal Storage Diseases in which, Hexosaminidase A-B deficiency is caused by HEXA-B gene. HEXA deficiency is seen in Tay sachs and HEXB deficiency causes Sandhoff disease.

Infantile forms of Sandhoff and Tay sachs are often lethal and management of the patients is supportive including nutrition, hydration, seizure control and management of respiratory problems. Recent studies have suggested new methods of treatment, such as enzyme replacement therapy, bone marrow transplantation and substrate reduction therapy.

The first drug used in SRT was Miglustat. It was introduced in 1980 as an anti HIV agent and later, it was registered under the trademark of Zavesca in 2009 and was used in treatment of Gaucher and Niemann-Pick disease. Zavesca passes blood brain barrier, so causes reduction of cholesterol and glycosphingolipids CNS neurons and relief of neurologic manifestations. Improvements were seen in oculomotor function, cognition, swallowing, motor disturbances and psychological problems after treatment with Zavesca. No effect has been proved on visceral involvement. Weight loss during first year of treatment, diarrhea and dyspepsia are seen as side effects.

Studies on SRT in lysosomal storage disease have different results. Some show improvements in manifestations of Gausche, Sandhoff \& Tay sachs disease, while others show no valuable benefit for this method of treatment.

Finding an effective treatment for these chronic diseases can improve quality of life for the patients and their families, and also reduce costs for healthcare services. The controversy persists and more studies are needed for judgment. So this study is done to evaluate the effect of Miglustat therapy in Sandhoff and Tay sachs disease, and is believed to help for further studies in this field.

Read the detailed description

This study is a case- control, open label clinical trial. Patients are all registered with diagnosis of Sandhoff and Tay sachs, and recruited at children's medical center Tehran-IRAN. Diagnosis is confirmed by enzyme level and genetic tests. Case group receive Miglustat therapy for 1 year and frequently assessed. Patients in control group are also assessed for 1 year without receiving Miglustat.

Patients are evaluated for neurologic examination, seizure, nasogastric tube insertion, aspiration pneumonia and quality of life at the beginning of study and every 3 months. Miglustat is considered as an Orphan drug so clinical trials about this drug are designed small and adjusted to limited population.

Variables in neurologic examination are Muscle tone, Muscular atrophy and contracture. motor function is scored according to "Gross Motor Function Classification System" (GMFCS) and quality of life is assessed by Infant Toddle Quality Of Life (ITQOL) questionnaire, with confirmed validity and stability.

Data gathered during frequent visits is registered in check lists and analyzed with SPSS version 18. Quantitative variables express with mean and standard deviation and qualitative variables with frequency and percentile. Analysis of variance for repeated measurements (ANOVA) and nonparametric freedman are tests using for comparisons of Outcomes. Sample size is calculated by formula for clinical trials with repeated measures.

Miglustat is FDA approved for Gaucher and Niemann pick diseases. All patients fill the informed consent and the nature of the study is explained to them. The information of participants is kept confidential. They are informed about side effects of the drug. If any cases at any time decides to exclude themselves from the study they are free to do so.

02

Conditions studied

  • GM2 Gangliosidosis
  • Supportive Care

Keywords

  • Sandhoff Disease
  • Tay-Sachs Disease
  • Miglustat
03

In context

Gangliosidoses, GM2

26 studies on the registry are indexed under Gangliosidoses, GM2; 6 are open to participants now.

This study's enrollment of 30 is above the median of 21 across 14 interventional studies indexed under Gangliosidoses, GM2.

Browse Gangliosidoses, GM2 studies →

Lead sponsor

Tehran University of Medical Sciences is the lead sponsor of 231 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
6 Months to 24 Months
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Clinically and enzymatically suspected infants of Sandhoff (SD)/Tay-Sachs (TSD) diseases followed confirmation by molecular study.

Exclusion criteria

Exclusion Criteria:

  • Renal impairment
  • Loss of follow up
  • Other systemic diseases
  • Concomitant drug therapy which may affect neurological system function
05

Study design

Phase
Phase 3
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    Miglustat

    Miglustat is administered, dose is adjusted according to Body Surface Area as below: \>1.25 : 200 mg TDS 0.88-1.25 : 200mg BID 0.73-0.88 :100mg TDS 0.47-0.73 : 100mg BID \<0.47 :100mg daily

    Drug: Miglustat

  • No intervention
    No Miglustat

Interventions

  • Treatment with Zavesca regimen based on body surface area as follows: SQRT \[Height (cm) × Weight (kg)\] / 3600 \<1.25 : 200mg TDS 0.88- 1.25: 200mg BID 0.73- 0.88: 100 mg TDS 0.47- 0.73: 100 mg BID \<0.47: 100 mg Daily

    Also known as: Zavesca

06

What researchers measure

Primary outcomes

  1. Hospitalization frequency change

    Method of measurement is checklist.

    Time frame: Baseline and 4, 8, 12 months after intervention and 1-year without intervention

  2. Pneumonia aspiration frequency change

    Method of measurement is checklist.

    Time frame: Baseline and 4, 8, 12 months after intervention and 1-year without intervention

  3. Seizure Frequency change

    Method of measurement is checklist.

    Time frame: Baseline and 4, 8, 12 months after intervention and 1-year without intervention

  4. Route of feeding change

    Method of measurement is checklist.

    Time frame: Baseline and 4, 8, 12 months after intervention and 1-year without intervention

  5. motor function change

    Method of measurement is checklist.

    Time frame: Baseline and 4, 8, 12 months after intervention and 1-year without intervention

Secondary outcomes

  1. quality of life change

    A total score is reported according to Pediatric Quality Of Life Inventory Infant Scales. Total score range is between 0-45 and higher values represent worse outcomes.

    Time frame: Baseline and 1year

07

Study locations

3 sites
  • Kashan University Of Medical Sciences
    Kashan, Isfahan, Iran
  • Mashhad University Of Medical Sciences
    Mashhad, Khorasan, Iran
  • Tehran University Of Medical Sciences
    Tehran, Tehran Province, Iran
08

References and documents

Publications

  • Jarnes Utz JR, Kim S, King K, Ziegler R, Schema L, Redtree ES, Whitley CB. Infantile gangliosidoses: Mapping a timeline of clinical changes. Mol Genet Metab. 2017 Jun;121(2):170-179. doi: 10.1016/j.ymgme.2017.04.011. Epub 2017 Apr 29. PubMed 28476546 ↗
  • Villamizar-Schiller IT, Pabon LA, Hufnagel SB, Serrano NC, Karl G, Jefferies JL, Hopkin RJ, Prada CE. Neurological and cardiac responses after treatment with miglustat and a ketogenic diet in a patient with Sandhoff disease. Eur J Med Genet. 2015 Mar;58(3):180-3. doi: 10.1016/j.ejmg.2014.12.009. Epub 2014 Dec 12. PubMed 25497207 ↗
  • Masciullo M, Santoro M, Modoni A, Ricci E, Guitton J, Tonali P, Silvestri G. Substrate reduction therapy with miglustat in chronic GM2 gangliosidosis type Sandhoff: results of a 3-year follow-up. J Inherit Metab Dis. 2010 Dec;33 Suppl 3:S355-61. doi: 10.1007/s10545-010-9186-3. Epub 2010 Sep 4. PubMed 20821051 ↗
  • Shapiro BE, Pastores GM, Gianutsos J, Luzy C, Kolodny EH. Miglustat in late-onset Tay-Sachs disease: a 12-month, randomized, controlled clinical study with 24 months of extended treatment. Genet Med. 2009 Jun;11(6):425-33. doi: 10.1097/GIM.0b013e3181a1b5c5. PubMed 19346952 ↗
  • Wortmann SB, Lefeber DJ, Dekomien G, Willemsen MA, Wevers RA, Morava E. Substrate deprivation therapy in juvenile Sandhoff disease. J Inherit Metab Dis. 2009 Dec;32 Suppl 1:S307-11. doi: 10.1007/s10545-009-1261-2. Epub 2009 Nov 4. PubMed 19898952 ↗
  • Tallaksen CM, Berg JE. Miglustat therapy in juvenile Sandhoff disease. J Inherit Metab Dis. 2009 Dec;32 Suppl 1:S289-93. doi: 10.1007/s10545-009-1224-7. Epub 2009 Nov 4. PubMed 19898953 ↗
  • Bembi B, Marchetti F, Guerci VI, Ciana G, Addobbati R, Grasso D, Barone R, Cariati R, Fernandez-Guillen L, Butters T, Pittis MG. Substrate reduction therapy in the infantile form of Tay-Sachs disease. Neurology. 2006 Jan 24;66(2):278-80. doi: 10.1212/01.wnl.0000194225.78917.de. PubMed 16434676 ↗
  • Jacobs JF, Willemsen MA, Groot-Loonen JJ, Wevers RA, Hoogerbrugge PM. Allogeneic BMT followed by substrate reduction therapy in a child with subacute Tay-Sachs disease. Bone Marrow Transplant. 2005 Nov;36(10):925-6. doi: 10.1038/sj.bmt.1705155. No abstract available. PubMed 16151419 ↗
  • Jeyakumar M, Norflus F, Tifft CJ, Cortina-Borja M, Butters TD, Proia RL, Perry VH, Dwek RA, Platt FM. Enhanced survival in Sandhoff disease mice receiving a combination of substrate deprivation therapy and bone marrow transplantation. Blood. 2001 Jan 1;97(1):327-9. doi: 10.1182/blood.v97.1.327. PubMed 11133779 ↗

Individual participant data

Plan to share: Yes

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 17, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03822013
Collaborators
Mashhad University of Medical Sciences, Kashan University of Medical Sciences
Responsible party
Tavasoli (Principal investigator, Tehran University of Medical Sciences) — Principal investigator
First posted
Jan 30, 2019
Start date
Jan 14, 2019
Primary completion
Sep 10, 2025
Completion
Sep 10, 2025
Last update
Sep 17, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Miglustat

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