A Randomized Controlled Trial of SGS-742, a γ-aminobutyric acid B (GABA-B) Receptor Antagonist, for Succinic Semialdehyde Dehydrogenase Deficiency.

John M Schreiber, Edythe Wiggs, Rose Cuento, Gina Norato, Irene H Dustin, Rachel Rolinski, Alison Austermuehle, Xiangping Zhou, Sara K Inati, K Michael Gibson, Phillip L Pearl, William H Theodore

Journal: Journal of child neurology 2022;36(13-14):1189-1199

PMID: 34015244

Abstract

We examined safety, tolerability, and efficacy of SGS-742, a γ-aminobutyric acid B (GABA-B) receptor antagonist, in patients with succinic semialdehyde dehydrogenase deficiency. This was a single-center randomized, double-blind crossover phase II clinical trial of SGS-742 versus placebo in patients with succinic semialdehyde dehydrogenase deficiency. Procedures included transcranial magnetic stimulation and the Adaptive Behavior Assessment Scale. Nineteen subjects were consented and enrolled; the mean age was 14.0 ± 7.5 years and 11 (58%) were female. We did not find a significant effect of SGS-742 on the Adaptive Behavior Assessment Scale score, motor threshold, and paired-pulse stimulation. The difference in recruitment curve slopes between treatment groups was 0.003 ( = .09). There was no significant difference in incidence of adverse effects between drug and placebo arms. SGS-742 failed to produce improved cognition and normalization of cortical excitability as measured by the Adaptive Behavior Assessment Scale and transcranial magnetic stimulation. Our data do not support the current use of SGS-742 in succinic semialdehyde dehydrogenase deficiency.Trial registry number NCT02019667. Phase 2 Clinical Trial of SGS-742 Therapy in Succinic Semialdehyde Dehydrogenase Deficiency. https://clinicaltrials.gov/ct2/show/NCT02019667.

Address: Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, 35053National Institutes of Health (NIH), Bethesda, MD, USA.; Division of Epilepsy, Neurophysiology, and Critical Care Neurology, 8404Children's National Hospital, Washington, DC, USA.; Office of the Clinical Director, 35053National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD, USA.; Office of the Clinical Director, 35053National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD, USA.; Clinical Trials Unit, National Institute of Neurological Disorders and Stroke, 2511National Institutes of Health (NIH), Bethesda, MD, USA.; Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, 35053National Institutes of Health (NIH), Bethesda, MD, USA.; Department of Pharmacotherapy, College of Pharmacy and Pharmaceutical Sciences, 53424Washington State University, Spokane, WA, USA.; Department of Epilepsy and Clinical Neurophysiology, 1862Boston Children's Hospital, Boston, MA, USA.
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