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Limb-Girdle Muscular Dystrophy Type 2I in Norway

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ClinicalTrials.gov Identifier: NCT03930628
Recruitment Status : Recruiting
First Posted : April 29, 2019
Last Update Posted : December 2, 2019
Sponsor:
Collaborators:
University of Tromso
Norwegian Muscle Disease Association (FFM)
Norwegian National Advisory Unit on Rare Disorders (NKSD)
Norwegian Competence Center for Sleep Disorders
Information provided by (Responsible Party):
University Hospital of North Norway

Brief Summary:

Key goals are to establish the natural history of limb-girdle muscular dystrophy type 2I (LGMD 2I) and identify feasible and sensitive tools and biomarkers to measure disease affection and progression, determine the Norwegian LGMD 2I prevalence, carrier frequency and genotypes, and to assess health-related quality of life in the Norwegian LGMD 2I population.

Main aims are to facilitate future clinical trials and contribute to good clinical practice with suitable methodology and to complete health and social care in order to optimize the function and quality of daily living of the patient group.


Condition or disease
Limb Girdle Muscular Dystrophy, Type 2I Limb Girdle Muscular Dystrophy Muscular Dystrophies

Detailed Description:
A single-center study with Norwegian nationwide enrollment. Data is based on questionnaires, patient journals, clinical examination, a set of functional tests and biomarkers, and patient reported outcomes. Clinical/ paraclinical tests are repeated after 2-years in order to measure disease progression. Both skeletal muscle, heart and respiratory function will be examined. At baseline there will also be performed a sleep study in order to find if they are prone to sleep-disordered breathing.

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Study Type : Observational
Estimated Enrollment : 75 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Limb-Girdle Muscular Dystrophy Type 2I in Norway - a Cohort Study
Estimated Study Start Date : December 2020
Estimated Primary Completion Date : September 2022
Estimated Study Completion Date : September 2022





Primary Outcome Measures :
  1. Echo intensity of muscles [ Time Frame: Baseline and 2 years ]
    Change in echo intensity at a defined cross-sectional level in muscles in limbs, musculus rectus abdominis and paraspinal muscles from baseline at 2 years. Echo intensity is measured as grayscale pixels ranging from 0 (black) to 255 (white) through histogram analysis by an ultrasound software program. It calculates the mean value from the superficial 1/3 of a manually selected region of interest in three consecutive images from same location. Increase in echo intensity indicates increase in pathology.

  2. Muscle thickness [ Time Frame: Baseline and 2 years ]
    Using ultrasound to measure changes in muscle thickness at a defined cross-sectional level in muscles in limbs, musculus rectus abdominis and paraspinal muscles from baseline at 2 years.

  3. Age at important disease stages [ Time Frame: Retrospective data collection at baseline ]
    Document the variation in age of onset, age of loss of walking ability, age of established cardiac failure and age of established respiratory failure.

  4. Rate of symptom progression [ Time Frame: Retrospective data collection at baseline ]
    Document the variation in time from disease onset to loss of walking ability/ cardiac failure/ respiratory failure respectively.

  5. Prevalence of detected heart failure [ Time Frame: Retrospective data collection at baseline ]
    The percentage of patients with detected heart failure related to LGMD 2I.

  6. Prevalence of established respiratory failure [ Time Frame: Retrospective data collection at baseline ]
    The percentage of patients with detected respiratory failure.

  7. Motor task performance [ Time Frame: Baseline and 2 years ]
    Using the standardised scoring instrument "Motor Function Measure for neuromuscular diseases" (MFM) to measure the ability to perform 32 different motor tasks. The individual item score ranges from 0 (cannot initiate the task) to 3 (performs fully and normally). The items are divided into 3 domains: 1) Standing and transfers (13 tasks), 2) Axial and proximal motor function (12 tasks), 3) Distal motor function (7 tasks). The 3 domains give rise to 3 subscores. Both subscores and total score (0-96 points) will be measured. Baseline and changes from baseline at two years.

  8. Disease-specific health-related quality of life (HRQOL) [ Time Frame: Baseline, at 6 months, 1 year, 2 years ]
    Using the "Individualized Neuromuscular Quality of Life" (INQOL)-questionnaire to measure the burden of disease. It consists of 45 items. Each item is graded by a 7-point Likert scale (0-6/1-7).The 45 items make up 3 dimensions/domains: muscular symptoms, effects on life-domains (activities, independence, emotions, body image, social relationships) and effects of treatment. The 3 domains are together subdivided into 11 subdimensions, each with its own subscale. In addition there is a QOL-score which is a composite score from the "Life-domain". The scores range from 0-100 and are determined by the item responses and a weighting algorithm. The higher the scores, the more negative impact. Both subscales and QOL-score will be determined - at baseline and changes from baseline at 6 months, 1 year and 2 years.

  9. Echocardiography strain speckle-tracking [ Time Frame: Baseline and 2 years ]
    Measure cardiac function at baseline and changes from baseline at 2 years

  10. Nocturnal arterial carbon dioxide (CO2)-level [ Time Frame: Baseline and 2 years ]
    Monitor transcutaneous CO2 during sleep at baseline and changes from baseline at two years. High level indicates hypoventilation.


Secondary Outcome Measures :
  1. 6 Minute Walk Test (6MWT) [ Time Frame: Baseline (2 tests with 1 day interval) and two years (2 tests with 1 day interval) ]
    Walk distance in 6 minutes, Borgs scale for dyspnoea and fatigue pre and post test, and for self-reported exertion. Changes from baseline in 6MWT at 2 years

  2. 4-step stair climb test [ Time Frame: Baseline and 2 years ]
    Changes from baseline in time to ascend and to descend a 4-steps stair at two years

  3. Level of motor independence: "Vignos Grade" [ Time Frame: Baseline and 2 years ]
    Using "Vignos grade" to score level of motor independence. The score ranges from 1 (walk and climb without assistance) to 10 (confined to bed).

  4. Upper limb movement ability: "Brooks Grade" [ Time Frame: Baseline and 2 years ]
    Using "Brooks Grade" to score the ability to raise arms above the head, ranging from 1 (normal: full abduction until the hands touch above the head) to 6 (cannot raise hands to mouth and has no useful function of hands). Baseline and changes from baseline at two years.

  5. Hand held dynamometry [ Time Frame: Baseline and 2 years ]
    Changes from baseline in muscular strength in the limbs at two years

  6. Manual Muscular Testing (MMT) [ Time Frame: Baseline and 2 years ]
    Changes from baseline in muscular strength in the limbs at two years

  7. General health-related quality of life [ Time Frame: Baseline, 6 months, 1 year, 2 years ]
    Using the Norwegian translation of general HRQOL-instrument "Short Form Health Survey" (SF-36). It is a questionnaire with 36 questions (items) investigating 8 domains/dimensions (physical function, physical role limitations, emotional role limitations, social functioning, bodily pain, general health perceptions, vitality, mental health). The 8 domain scores will be determined. The scores range from 0-100 and are based on item-responses and weighting algorithm. High score stands for good health. Measure at baseline and changes from baseline at 6 months, 1 year and 2 years.

  8. Plethysmography [ Time Frame: Baseline and 2 years ]
    Lung volumes at baseline, and changes from baseline at two years.

  9. Mean Inspiratory and Expiratory Pressure (MIP/MEP) [ Time Frame: Baseline and 2 years ]
    Static respiratory pressures at baseline, and changes from baseline at two years

  10. Forced Vital Capacity (FVC) [ Time Frame: Baseline and 2 years ]
    Dynamic spirometry while sitting, and supine when normal sitting. Baseline and changes from baseline at 2 years

  11. Slow vital capacity (SVC) [ Time Frame: Baseline and 2 years ]
    Static spirometry at baseline and changes from baseline at 2 years

  12. Diaphragm thickness ratio [ Time Frame: Baseline and 2 years ]
    Using ultrasound to measure thickness of diaphragm at maximum inspiration and at end-expiration. Ratio < 1,2 indicates reduced diaphragm movement. Bott left and right side will be measured.

  13. Nocturnal oxygen saturation [ Time Frame: Baseline and 2 years ]
    Monitor transcutaneous oxygen saturation during sleep.

  14. Cough Peak Flow [ Time Frame: Baseline and 2 years ]
    Cough Peak Flow at baseline and changes from baseline at 2 years

  15. Apnea-hypopnea index [ Time Frame: Baseline ]
    Using polysomnography to calculate the number of obstructive and non-obstructive apnea and hypopnea events pr hour sleep.

  16. Respiratory disturbance index [ Time Frame: Baseline ]
    Using polysomnography to calculate the number of respiratory events in terms of apneas, hypopneas and respiratory effort-related arousals pr hour sleep.

  17. Thoracoabdominal breathing pattern during sleep [ Time Frame: Baseline ]
    Using polysomnography to detect paradoxal breathing movements during sleep (abdomen moving in on inspiration when supine).

  18. Echocardiography - conventional [ Time Frame: Baseline and 2 years ]
    Measure cardiac function at baseline and changes from baseline at 2 years

  19. Electrocardiography (ECG) [ Time Frame: Baseline and 2 years ]
    Assessment of cardiac electrical activity at baseline and changes from baseline at 2 years

  20. Pain (visual analogous scale, VAS) [ Time Frame: Baseline and 2 years ]
    Patient-reported pain on VAS at baseline and at 2 years

  21. Fatigue (Visual Analogous Scale, VAS) [ Time Frame: Baseline and 2 years ]
    Patient-reported fatigue on VAS tat baseline and at 2 years

  22. Fatigue Severity Scale (FSS) [ Time Frame: Baseline and 2 years ]
    Fatigue at baseline and at 2 years

  23. Epworth Sleepiness Scale (ESS) [ Time Frame: Baseline ]
    Assessment of daytime sleepiness at baseline

  24. Capillary blood gas [ Time Frame: Baseline and 2 years ]
    Capillary CO2 at baseline and at 2 years

  25. Serum Creatine Kinase (s-CK) [ Time Frame: Baseline and 2 years ]
    s-CK at baseline and at 2 years


Biospecimen Retention:   Samples Without DNA
Serum


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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
The population of limb-girdle muscular dystrophy type 2I genetically confirmed in Norway and who live in Norway.
Criteria

Inclusion Criteria:

  • Genetical confirmed limb-girdle muscular dystrophy type 2I in Norway
  • Live in Norway
  • Written consent

Exclusion Criteria:

  • Children < 16 years are excluded from the assessment of quality of life and from the clinical/paraclinical part, but may contribute with information through questionnaires and patient journal.

The study of prevalence and genotypes is anonymous and consent independent and will include everyone that is genetically LGMD 2I-confirmed in Norway.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03930628


Contacts
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Contact: Jensen 776 27217 synnove.magnhild.jensen@unn.no
Contact: Arntzen kjell.arne.arntzen@unn.no

Locations
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Norway
National Neuromuscular Centre, Norway Recruiting
Tromsø, Norway, 9038
Contact: Irene Lund       Irene.Lund@unn.no   
Principal Investigator: Kjell Arne Arntzen, PhD         
Sponsors and Collaborators
University Hospital of North Norway
University of Tromso
Norwegian Muscle Disease Association (FFM)
Norwegian National Advisory Unit on Rare Disorders (NKSD)
Norwegian Competence Center for Sleep Disorders

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Responsible Party: University Hospital of North Norway
ClinicalTrials.gov Identifier: NCT03930628     History of Changes
Other Study ID Numbers: 2018/1968(REK)
First Posted: April 29, 2019    Key Record Dates
Last Update Posted: December 2, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Muscular Dystrophies
Muscular Dystrophies, Limb-Girdle
Muscular Disorders, Atrophic
Muscular Diseases
Musculoskeletal Diseases
Neuromuscular Diseases
Nervous System Diseases
Genetic Diseases, Inborn