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NCT Number: NCT06132750

A 5-year Natural History Study in LAMA2-related Muscular Dystrophy and SELENON-related Myopathy.

SELENON-related myopathy (SELENON-RM) and LAMA2-related muscular dystrophy (LAMA2-MD) are congenital neuromuscular disorders presenting with slowly, progressive axial muscle weakness, spinal rigidity, scoliosis and respiratory insufficiency. Currently, no curative treatment options exist, yet promising preclinical trials are ongoing. Clinical trials are expected to start within 5 years. Natural history data and outcome measures for measuring therapy effectiveness were lacking. Therefore, the LAST STRONG Study (a 1.5-year natural history study) started in 2020. With the extended LAST STRONG Study, we aim to further analyze and expand the 1.5-year natural history data on SELENON-RM or LAMA2-MD to provide a detailed clinical description of the Dutch and Flemish cohort. This will enable a smooth transition towards implementation into clinical care and clinical trials.

The extended LAST STRONG Study is a prospective, observational natural history study in Dutch-speaking patients of all ages diagnosed with SELENON-RM and LAMA2-MD. Patients will be invited to visit our hospital two times (3- and 5-years) after the first visit in the LAST STRONG Study. During both visits, patients will undergo a subset of tests (neurological examination, functional measurements, questionnaires, muscle ultrasound, MRI, pulmonary assessment and accelerometry). All measurements are adapted to the patient's age and functional disabilities.

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Key information

Conditions

LAMA2-related Muscular Dystrophy Muscular dystrophy congenital, merosin negative SELENON-related Myopathy

Age range

1 day–100 year

Sex eligibility

All sexes

Study type

Observational

Primary location

About this study

Rationale: A long-term prospective natural history study in an unselected group of patients including clinical and functional outcome measures is lacking in both SELENON-related myopathy (SELENON-RM) and LAMA2-related muscular dystrophy (LAMA2-MD). Due to the promising ongoing preclinical trials, there is a high need to obtain natural history data in order to reach trial readiness for both diseases. With the extended LAST STRONG study, we aim to further analyze and expand our 1.5-year natural history data on SELENON-RM and LAMA2-MD to provide a detailed clinical description of the Dutch and Flemish cohort. This will enable a smooth transition towards implementation into clinical care and clinical trials that are expected to start within 5 years.

Objective: (1) To collect 3- and 5-year natural history data in patients with SELENON-RM and LAMA2-MD. (2) Implementation of natural history data collection into clinical care and international guidelines, and reach trial readiness.

Study design: This is an observational study. A variety of tests will be performed to get a full impression of the patient's abilities and disabilities (standard medical history, neurological examination, functional measurements, questionnaires, imaging, pulmonary assessment and accelerometry). The tests that the patient undergoes depend on the age/abilities/wishes. The tests are selected based on our previously performed 1.5-year natural history study in LAMA2-MD and SELENON-RM. Each participant will perform these measurements during the two scheduled visits at 3- and 5-year after the first visit during the LAST STRONG Study.

Risk and benefit assessment: This study does not concern any product (medicinal product, food product or medical device). There is a small risk for minor injury, e.g. when a participant falls. However since the investigators use all functional tests using movements to which most participants are familiar (i.e. walking, transfers, etc.), the participant will be able to estimate his/her own risk. The investigators don't include tests in which they push participants to their physical limits. the investigators conclude that this study has a negligible risk. A benefit includes the possibility for participants to get a detailed analysis on their own health. Additionally, participants will contribute to the design of future clinical trials on possible treatment options.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Willing and able to complete (part of) the measurement protocol at the Radboudumc, Nijmegen. If patients do not wish or not able to visit our neuromuscular center, they are offered to participate in our study through home visits.
  • Genetic conformation of LAMA2-related muscular dystrophy or SELENON-related myopathy by two recessive (likely) pathologic mutations in the LAMA2 or SELENON gene.
  • Typical clinical and histological characteristics combined with genetic confirmation in a first degree relative.
  • Dutch speaking

Exclusion criteria

  • Insufficient understanding of the Dutch language

Treatment and study plan

No intervention

Other

No intervention

Primary outcomes

  1. Change of Motor Function Measure (MFM)-32 (older than 7 years) of MFM-20 (2 to 7 years old)

    Time frame: Change from baseline to 3 years and 5 years

    Global motor functioning. The items of the MFM are classified in 3 domains: D1: standing and transfers, D2: Axial and proximal motor function, D3: Distal motor function. Higher scored indicate a better outcome. The range of the total score is 0-96. The main point of interest includes the change of MFM score over a period of 5 years.

Secondary outcomes

  1. Change of physical activity in daily life assessed by an accelerometer (GENEActiv original devices) for 7 days

    Time frame: Change from baseline to 3 years and 5 years

    Physical activity in daily life will be assessed by wearing an accelerometer (GENEActiv original devices) for 7 days.

  2. Change of activity limitations assessed using ACTIVLIM (6 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    ACTIVLIM assesses the ability to perform 22 activities of daily life on a 3-point scale from impossible to easy.

  3. Change of bone density assessed using DEXA-scan (2 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    The bone density of the spine and hip will be measured by a DEXA scan.

  4. Change of The Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) score (children under the age of 2 years)

    Time frame: Change from baseline at 3 years and 5 years

    CHOP INTEND assesses motor skills of children below 2 years of age.

  5. Change of fatigue (pediatric 2-17 years old) assessed by PedsQL Multidimensional Fatigue Scale (MFS)

    Time frame: Change from baseline at 3 years and 5 years

    PedsQL MFS assesses subjective fatigue in three domains.

  6. Change of functional ability in daily life assessed by Egen klassification scale version 2 (EK2) (16 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    The EK2 is a questionnaire that was designed to measure functional ability of activities in daily living in non-ambulant Duchenne muscular dystrophy patients. This questionnaire is only available in English. Therefore, only participants of 16 years and older who have a sufficient understanding of the English language will be asked to complete this questionnaire.

  7. Change of Functional Ambulation Category (FAC) (5 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    The FAC assesses functional ambulation in participants.

  8. Change of Graded and Timed function tests

    Time frame: Change from baseline at 3 years and 5 years

    The time (in sec) it takes to complete functions of the lower extremity will be assessed with the 30 seconds sit to stand test, the time it takes to climb 4 stairs, the time it takes to descend 4 stairs and the time it takes to rise from the floor.

  9. Change of Hammersmith Infant Neurological Examination (HINE) (under the age of 2 years)

    Time frame: Change from baseline at 3 years and 5 years

    HINE is designed to be a simple and scorable method for evaluating infants from 2 months to 2 years of age. It includes three sections that assess different aspects of neurologic function, including neurological examination, developmental milestones and behavioral assessment.

  10. Change of Impact on Participation and Autonomy (IPA) (18 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    Questionnaire about participation and autonomy in daily life.

  11. Change of maximal voluntary isometric contraction (5 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    Maximal voluntary isometric contraction will be measured by hand-held dynamometry.

  12. Change of location, level and characteristics of pain assessed by McGill pain questionnaire (12 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    Questionnaire in which the location, level and characteristics of pain are assessed.

  13. Change of muscle atrophy (cm) assessed by muscle ultrasound

    Time frame: Change from baseline at 3 years and 5 years

    Muscle atrophy of the leg, arm and abdominal muscles will be assessed by muscle ultrasound.

  14. Change of muscle fattening (echo-intensity) assessed by muscle ultrasound

    Time frame: Change from baseline at 3 years and 5 years

    Muscle fattening of the leg, arm and abdominal muscles will be assessed by muscle ultrasound.

  15. Change of muscle fattening by quantitative lower extremity muscle MRI (10 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    A lower extremity MRI will be performed in participants who are able to lie supine and still for 20 minutes and who are not dependent on respiratory equipment. Muscle fattening will be assessed by Regions of interest (ROIs) and modified Mercuri score.

  16. Change of muscle atrophy by quantitative lower extremity muscle MRI (10 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    A lower extremity MRI will be performed in participants who are able to lie supine and still for 20 minutes and who are not dependent on respiratory equipment. Muscle atrophy will be assessed by muscle volume score.

  17. Change of muscle power assessed by muscle power measurements (Medical Research Council (MRC) scale) (2 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    Muscle power of individual muscle groups can be assessed by muscle power measurements and graded in correspondence with the MRC scale.

  18. Pulmonary function (5 years and older) - change of forced vital capacity (percentage predicted)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld spirometry in sit and supine.

  19. Pulmonary function (5 years and older) - change of forced expiratory volume in the first second (liter) (percentage predicted)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld spirometry in sit and supine

  20. Pulmonary function (5 years and older) - change of peak expiratory flow (liter per second)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld spirometry in sit and supine

  21. Pulmonary function (5 years and older) - change of vital capacity (percentage predicted)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld spirometry in sit and supine

  22. Pulmonary function (5 years and older) - change of peak cough flow (liter per second)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld spirometry in sit and supine

  23. Pulmonary function (5 years and older) - change of maximal expiratory pressure (cmH2O)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld device

  24. Pulmonary function (5 years and older) - change of maximal inspiratory pressure (cmH2O)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld device

  25. Pulmonary function (5 years and older) - change of sniff nasal inspiratory pressure (cmH2O)

    Time frame: Change from baseline at 3 years and 5 years

    Obtained with handheld device

  26. Change of Quality of life (adult) assessed by SF36/RAND36

    Time frame: Change from baseline at 3 years and 5 years

    The Quality of Life is measured by the SF36/RAND36 questionnaire. This questionnaire addresses eight concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. It also includes a singe item that provides an indication of perceived change in health.

  27. Change of Quality of Life (adult) assessed by Individualized Neuromuscular Quality of Life (INQoL)

    Time frame: Change from baseline at 3 years and 5 years

    The INQoL is a validated muscle disease specific measure of quality of life, which can be used for individuals or large samples.

  28. Change of Quality of Life (pediatric; 2-17 years old) assessed by PedsQL neuromuscular module (NMM)

    Time frame: Change from baseline at 3 years and 5 years

    The PedsQL NMM questionnaire consists of 25 questions in three domains: Neuromuscular disease, communication and family resources.

  29. Change of range of motion of elbows, wrist, hips, knee and ankle

    Time frame: Change from baseline at 3 years and 5 years

    The range of motion of elbows, wrist, hips, knee and ankle is noted bilaterally by goniometry.

  30. Change of Brooke and Vignos scale (2 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    The Brooke and Vignos scale provide ordinal data to assess the upper and lower extremity functions.

  31. Change of Wong-Baker Faces Pain Scale (2 years and older)

    Time frame: Change from baseline at 3 years and 5 years

    The Wong-Baker Faces Pain Scale was originally created for children to help them communicate about their pain.

Study contacts

Contact information is provided by the study sponsor or research team.

Ilse de Laat

CONTACT

[email protected]

+31611469112

Nicol Voermans, MD PhD

CONTACT

[email protected]

+31650155770

Sponsors and collaborators

Lead sponsor

Radboud University Medical Center

Other

Registry information

Official study title

A 5-year Natural History Study in LAMA2-related Muscular Dystrophy and SELENON-related Myopathy: the Extended LAST STRONG Study

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Nov 15, 2023
Registry last updated
Nov 15, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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