Characterization of DupEx2 Duchenne Muscular Dystrophy (DMDDup2)
Characterization of the Phenotypic Diversity in DupEx2 Duchenne Muscular Dystrophy and Identification of Predictive/Prognostic Markers
To characterize the clinical phenotype and possible predictive/prognostic factors of patients with Duchenne muscular dystrophy (DMD) due to duplication of exon 2 (Dup2). Specifically, we aim 1) to describe the progression of motor, respiratory and cardiac function; 2) to enquire if the phenotypic spectrum of Dup2 is milder than classic DMD, 3) to perform whole genome sequencing (WGS) to characterize DNA breakpoints to correlate with the phenotype; 4) to collect material for future proteomic/transcriptomic studies.
Background/Rationale DMD is caused by mutations in the DMD gene and in 11% of cases is due to duplications. The most promising therapeutic approaches include mutation-specific therapies. Notably, there is increasing evidence that specific groups of mutations may underlie different disease trajectories compared to the "average" DMD population. It is thus mandatory to have more information on genotype-phenotype correlations and patterns of progression related to different genotypes.
Dup2 is the most common DMD duplication and the only one for which a AAV-mediated exon skipping study is ongoing. Despite most case series and databases ascribe Dup2 to severe phenotype, our preliminary findings sustain that these patients have collectively a milder progression of the disease and in 1/3 of cases a significantly milder phenotype. Moreover, our attempts to reveal mechanism involved in attenuating the phenotype would confute the hypothesis of alternative spicing transcripts as previously described for DMD with deletion of exon 2.
Research design and methods Clinical information regarding a cohort of 26 Italian Dup2 patients will be collected. Differences in time to loss of ambulation compared to a DMD control group will be achieved. Finally, we will retrieve DNA for correlative WGS studies.
Anticipated output We expect that Dup2 patients present a milder DMD phenotype , which might be predicted by genomic studies.
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
The primary clinical endpoint is time to loss of ambulation (LOA).
Secondary endpoints include:
The change over time of the following functional measurements:
1.1 Motor function: The 6 Minute Walk test (6MWT) and North Star Ambulatory Assessment (NSAA) including sub-items such as Time to Rise from the floor.
1.2 Respiratory function: Forced Vital Capacity (FVC) Liters (L) and % of predicted; time to FVC% < 50%. Time to Nocturnal Ventilation initiation.
1,3 Cardiac function: Left ventricular ejection fraction (EF) as measured by echocardiogram.
- To characterize DNA breakpoints in mild vs severe phenotypes
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Stefano C Previtali, MD
- Phone Number: 00390226433036
- Email: neuromuscolare@hsr.it
Study Contact Backup
- Name: Alberto A Zambon, MD
- Phone Number: 00390226431
- Email: neuromuscolare@hsr.it
Study Locations
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Milano, Italy, 20132
- Recruiting
- Dept. of Neurology, IRCCS Ospedale San Raffaele
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Contact:
- Stefano C Previtali, MD
- Phone Number: 00390226433036
- Email: neuromuscolare@hsr.it
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- pediatric and adult DMD patients harboring a genetically confirmed duplication of the exon 2 in the dystrophin gene
Exclusion Criteria:
- patients lacking genetic confirmation of Dup2 mutation
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Age at loss of ambulation
Time Frame: 12 months
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Age at loss of ambulation
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12 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time test for motor function
Time Frame: 12 months
|
The 6 Minute Walk test (6MWT) and North Star Ambulatory Assessment (NSAA) including sub-items such as Time to Rise from the floor.
|
12 months
|
|
Respiratory function
Time Frame: 12 months
|
Forced Vital Capacity (FVC) Liters (L) and % of predicted; time to FVC% < 50%.
Time to Nocturnal Ventilation initiation
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Stefano C Previtali, MD, IRCCS Ospedale San Raffaele
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- OSRSCP-GUP21006
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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