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NCT Number: NCT04404764

Characterization of the Clinical-epidemiological Profile of Patients With SMA5q Types II and III: Observational Study

This study aims to characterize the clinical-epidemiological profile and baseline characteristics of patients with spinal muscular atrophy (SMA) 5q types II and III in follow-up at the Brazilian Unified Public Health System (SUS). The study data will be based on patients´ medical records from several Brazilian public hospitals, which will be defined by the Brazilian Ministry of Health (MS).

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Key information

Age range

6 month and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Universidade Federal de Minas Gerais - Hospital das Clínicas, Belo Horizonte, Brazil

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About this study

This is a retrospective cross-sectional observational study to characterize the clinical and epidemiological profile of patients with spinal muscular atrophy (SMA) 5q types II and III, in follow-up at the Brazilian Unified Public Health System (SUS). This study aims to provide baseline data, which in the future may be used by the Brazilian Ministry of Health (MS) to assess the effectiveness of nusinersen. The clinical and epidemiological data will be collected from patients´ medical records, such as the score for the Hammersmith Functional Motor Scale - Expanded (HFMSE) and the Revised Upper Limb Module (RULM) at baseline, the WHO motor milestones at baseline, disease duration, age at the time of disease diagnosis, age at the time of disease screening, SMN2 (gene copy number), history of hospitalizations, history and characterization of previous surgical procedures, treatment dosage used, patient caregiver´s profile (ie, a family member or companion, who is responsible for taking care of the patient for most of the time). Other variables of interest that will also be collected are patient´s age and gender, geographic distribution, attending physician expertise and care structure where the patients were treated. The data acquisition will be performed using a paper and eletronic CRF (Case report Form). Written informed consent will be obtained from patients who meet the study elegibility criteria. The study will be performed in Brazilian public hospitals (centers) that are able to provide the treatment with nusinersen under the SUS scope. The total sample of patients and number of participating centers will be defined by the MS - SCTIE (Secretariat of Science, Technology and Strategic Supplies)/ DECIT (Department of Science and Technology). However, the initial estimation is a sample of 100 patients to be included in 10-15 centers.

Who can participate

Healthy volunteers accepted: Yes

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

Patient Eligibility Criteria:

Inclusion criteria

  • Participants of both sexes, in any age group, who have a clinical diagnosis of SMA 5q type II or type III, in follow-up at SUS, undergoing treatment with nusinersen or not
  • Clinical and molecular diagnosis of SMA 5q type II (disease started after 6 months of age), or Clinical and molecular diagnosis of SMA 5q type III (disease started after 18 months of age)

Exclusion criteria

  • Refusal to provide written informed consent (either the patient or a legal representative)
  • Symptom onset after 19 years of age
  • Need for invasive ventilatory support for 16 hours or more per day for more than 21 consecutive days
  • Be participating or have participated in another clinical study aimed at specific treatment of SMA 5q other than with the drug nusinersen
  • Having undergone treatment with gene therapy

Caretaker Eligibility Criteria:

Inclusion criteria

  • First-degree family member or companion responsible for taking care of the patient with clinical diagnosis of SMA 5q type II or type III

Exclusion criteria

  • Illiteracy
  • Refusal to participate in the study

Treatment and study plan

Nusinersen Injectable Product

Drug

The patient´s treatment is provided by SUS. The following dosage scheme of nurinersen is the one approved by ANVISA (Brazilian National Health Surveillance Agency): Nusinersen, 12 mg (5 mL) on days 0 (zero), 14 and 28. A fourth dose will be on day 63 with a maintenance dose once every 4 (four) months. The study will NOT have direct influence on the care received by patients. Data on adherence, interventions, hospitalizations, mechanical ventilation, procedures and adverse events will be obtained from the patients´ medical records.

Other names: Spinraza

Primary outcomes

  1. Expanded Hammersmith Functional Motor Scale

    Time frame: Baseline

    Hammersmith Functional Motor Scale-Expanded (HFMSE) scores range from 0 to 66, with higher scores indicating better motor function.

Secondary outcomes

  1. Revised Upper Limb Module

    Time frame: In the inclusion of the study

    Revised Upper Limb Module (RULM) scores range from 0 to 37, with higher scores indicating better function.

  2. WHO motor milestones

    Time frame: Unique evaluation at the time of inclusion

    The six World Health Organization (WHO) motor milestones are sitting without support, standing with assistance, hands and knees crawling, walking with assistance, standing alone, and walking alone.

  3. Disease duration

    Time frame: At the time of inclusion in the study

    Time between diagnosis and age at inclusion in the study

  4. Clinical features

    Time frame: Unique evaluation

    SMN2 (gene copy number);

  5. History of hospitalizations

    Time frame: Documented in the period prior to the inclusion of the study

    Records of need for hospitalizations

  6. History and characterization of previous surgical procedures

    Time frame: In the period prior to the inclusion of the study

    History of comorbidities

  7. Treatment with nusinersen

    Time frame: Registration of the dose used at the time of inclusion in the study

    To undergo intrathecal administration of nusinersen at a dose of 12 mg

Sponsors and collaborators

Lead sponsor

Hospital Israelita Albert Einstein

Other

Collaborators

  • Ministry of Health, Brazil

Registry information

Official study title

Characterization of the Clinical-epidemiological Profile of Patients With Spinal Muscular Atrophy (SMA) 5q Types II and III in Follow-up in the Brazilian Unified Public Health System: A Cross-sectional Observational Study (Registry)

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
May 27, 2020
Registry last updated
Apr 27, 2021

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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