Summary

Eligibility
for people ages 18-70 (full criteria)
Location
at UCLA
Dates
study started
estimated completion

Description

Summary

Building on previous work of the Myotonic Dystrophy Clinical Research Network (DMCRN), the present study seeks to overcome insufficient data on natural history; lack of reliable biomarkers; and incomplete characterization and limited biological understanding of the phenotypic heterogeneity of Myotonic Dystrophy 1 by examining strategies to improve the reliability by making further refinements in our sample collection and analysis procedures by developing strategies for managing patient heterogeneity going forward.

Details

Approximately 700 adult participants (18 to 70 years old, inclusive) with DM1 will be enrolled at 15 centers (up to 70 patients will be recruited at each site). No treatment will be administered as part of this study. Participants will receive standard of care as determined by the investigators. Study visits occur at baseline/0 months, 12 months, and 24 months. Few restrictions are placed on participation in the study because the investigators aim to capture the full spectrum of disease severity. Studies of splicing biomarkers in muscle biopsy samples will be conducted on a subset of 95 participants. These participants will have an additional study visit at 3 months.

Keywords

Myotonic Dystrophy 1 Myotonic Dystrophy END DM-1 Muscular Dystophy DMCRN Study Visits

Eligibility

You can join if…

Open to people ages 18-70

  • Age 18 to 70 (inclusive)
  • Competent to provide informed consent
  • Clinical diagnosis of DM1 based on research criteria1 or positive genetic test
  • Comment: The clinical research criteria require myotonia, muscle weakness in a characteristic distribution, and history of similar findings in a first degree relative. Genetic testing confirmed the diagnosis of DM1 in > 99% of individuals who satisfied these criteria.2

You CAN'T join if...

  • Symptomatic renal or liver disease, uncontrolled diabetes or thyroid disorder, or active malignancy other than skin cancer.
  • Current alcohol or substance abuse
  • Concurrent enrollment in clinical trial for DM1, or participation in trial within 6 months of entry.
  • Concurrent pregnancy or planned pregnancy during the course of the study.
  • Concurrent medical condition that would, in the opinion of the investigator or clinical evaluator, compromise performance on study measures.
  • Note: non-ambulatory participants are not excluded, but are limited to <15% of enrollment.

Inclusion criteria for participants in the muscle biopsy sub-study:

• Of the 95 patients undergoing the tibialis anterior muscle biopsy, at least half will have at least moderate weakness of ankle dorsiflexion, defined as MRC score ≤ 4+. This is in order to obtain a muscle tissue sample in a person more severely affected with myotonic dystrophy. Approximately 10 patients at each site will undergo the muscle biopsy.

Exclusion criteria for 95 participants in the muscle biopsy sub-study:

  • Known CTG repeat expansion size less than 100 repeats, unless there are clear cut signs of limb weakness and muscle wasting. This is in order to obtain a muscle tissue sample in a person more severely affected with myotonic dystrophy.
  • Use of anticoagulant such as warfarin or a direct oral anticoagulant (e.g. dabigatran) due to the increased risk of bleeding.
  • Use of aspirin or non-steroidal anti-inflammatory agents should be discontinued 3 days prior to the biopsy procedure, if possible.
  • Platelet count <50,000 (if known) due to the increased risk of bleeding.
  • History of a bleeding disorder due to the increased risk of bleeding.
  • Advanced wasting of tibialis anterior (TA) muscle that precludes needle muscle biopsy in order to ensure that a sample taken would be of muscle and not just fat and fascia.
  • Previous muscle biopsy of either TA in order to provide muscle tissue samples of non-biopsied muscles.

Locations

  • Stanford University accepting new patients
    Stanford California 94305 United States
  • University of Colorado - Denver accepting new patients
    Denver Colorado 80204 United States

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
Virginia Commonwealth University
ID
NCT03981575
Study Type
Observational
Participants
Expecting 700 study participants
Last Updated