- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03458832
Clinical Trial Readiness to Solve Barriers to Drug Development in FSHD
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The overall aim of this study is to hasten drug development for facioscapulohumeral muscular dystrophy (FSHD). Recent breakthroughs in FSHD research have identified the primary disease mechanism as the aberrant expression of a normally silenced gene, DUX4, resulting in a toxic gain-of-function. This disease mechanism is particularly amenable to knock-down of DUX4 using epigenetic strategies or RNA therapies, as well as to other interventions targeting the downstream effects of DUX4 expression. There are many drug companies actively working towards disease-targeted therapies, and two clinical trials either under way now, or planned to start in early Fall 2016. However, meetings with industry, advocacy groups, and FSHD researchers have identified several gaps in the clinical trial arsenal, and clinical trial planning as a major goal for the community. Consequently, there is an urgent need to establish the tools necessary for the conduct of currently planned and expected therapeutic trials in FSHD.
To this end, the researchers propose to develop two novel clinical outcome assessments (COA), a composite functional outcome measure (FSH-COM) and skeletal muscle biomarker, electrical impedance myography (EIM). In addition there is broad consensus a better understanding of the relationship of genetic and demographic features to disease progression will be necessary for enumerating eligibility criteria.
The specific aims are to: 1. Determine the multi-site validity of the COAs, 2. Compare the responsiveness of new COAs to other FSHD outcomes and determine the minimal clinically meaningful changes, and 3. establish FSHD cohort characteristics useful for determining clinical trial eligibility criteria. To achieve these aims, the researchers are conducting a multicenter, prospective, 24 months study of 160 subjects.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
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California
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Los Angeles, California, United States, 90095
- University of California Los Angeles
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Kansas
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Kansas City, Kansas, United States, 66160
- University of Kansas Medical Center
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Maryland
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Baltimore, Maryland, United States, 21205
- Kennedy Krieger Institute
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New York
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Rochester, New York, United States, 14642
- University of Rochester Medical Center
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Ohio
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Columbus, Ohio, United States, 43210
- The Ohio State University
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Utah
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Salt Lake City, Utah, United States, 84132
- University of Utah
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Virginia
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Richmond, Virginia, United States, 23298
- Virginia Commonwealth University
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Washington
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Seattle, Washington, United States, 98195
- University of Washington
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with genetically confirmed FSHD1 or clinical diagnosis of FSHD with characteristic findings on exam and an affected parent or offspring
- Patients with symptomatic limb weakness
- Patients must be able to walk 30 feet without the support of another person or assistance (canes, walking sticks, and braces allowed; no walker).
- If taking over the counter supplements, willing to remain consistent with supplement regimen throughout the course of the study
Exclusion Criteria:
- Patients with cardiac or respiratory dysfunction (deemed clinically unstable, or would interfere with safe testing, in the opinion of the Investigator)
- Patients with orthopedic conditions that preclude safe testing of muscle function
- Patients that regularly use available muscle anabolic/catabolic agents such as corticosteroids, oral testosterone or derivatives, or oral beta agonists
- Patients that have used an experimental drug in an FSHD clinical trial within the past 30 days
- Patients that are pregnant
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
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FSHD-COM
All participants will be asked to undergo FSHD-specific functional rating scale tests and procedures and Electrical Impedance Myography.
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The FSHD-COM is composed of disease-relevant functional tasks such as leg function; shoulder and arm function; trunk function, hand function, and balance.
Other Names:
EIM is a non-invasive, painless, and fast technique for obtaining information on how a patient's muscle structure is changing.
EIM uses a small electrical current to measure the health of the underlying muscle.
The patient will be asked to lie down and a trained clinical evaluator will perform testing on 16 total muscles (8 on each side) on your arms and legs.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Validate FSHD-COM as COA
Time Frame: 24 Months
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The FSHD-COM is an 18-item evaluator-administered instrument comprised of individually validated functional motor tasks.
The body regions represented match areas of importance identified by patients and include: leg function; shoulder and arm function; trunk function, hand function; and balance.
Each item is scored on a 0-4 scale, with 0 representing unaffected/normal performance, and the divisions based on healthy population normative values, or the relative degree of ability to perform the functional task.
The total scale has 72 points, with larger weight given to the two most frequently patient-cited areas of functional motor concern - leg function and shoulder and arm function.
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24 Months
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Validate EIM as COA
Time Frame: 24 Months
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24 Months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Motor Function Measure (MFM) Domain 1
Time Frame: 24 Months
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The MFM domain 1 is a validated evaluator administered functional measure for neuromuscular disorders, with 13 items related to standing and transfers.
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24 Months
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Facial Function
Time Frame: 24 Months
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The Iowa Oral Performance Instrument (IOPI) is a means to quantify lip, tongue, and buccal strength using a validated tool with published ranges for normative data for lingual measurements.
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24 Months
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Reachable Workspace
Time Frame: 24 Months
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Subjects are seated in front of a 3D camera and asked to perform a standardized upper extremity movement protocol under the supervision of a study clinical evaluator.
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24 Months
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Manual Muscle Testing
Time Frame: 24 Months
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Strength testing will be performed using manual muscle testing (MMT) using a hand held force dynamometer.
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24 Months
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Respiratory Function
Time Frame: 24 Months
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The researchers will obtain forced vital capacity and forced expiratory volume in 1 second using bedside spirometry.
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24 Months
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Whole body and regional lean muscle mass (LMM)
Time Frame: 24 Months
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Whole body and regional lean muscle mass (LMM) will be measured via Dual Energy X-Ray Absorptiometry (DEXA).
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24 Months
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Severity Scores
Time Frame: 24 Months
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A limited physical exam and strength testing will be used to derive two FSHD clinical severity scores.
These severity scores both rank weakness in the face, shoulders, arms, distal, and proximal lower extremities on either a 10 or 15 point scale.
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24 Months
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FSHD-Health Inventory (HI)
Time Frame: 24 Months
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The HI is a 15 domain questionnaire designed and based on patient interviews to measure total FSHD health-related quality-of-life, including both motor impairment and the social and emotional impact of FSHD.
116 questions are combined into a total score, the score is transformed onto a percentage scale, with 100 representing maximal disability, and lower scores representing decreasing disability.
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24 Months
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Patient-Reported Outcomes Measurement Information System-57 (PROMIS57)
Time Frame: 24 Months
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The PROMIS57 is an instrument developed by the NIH which generates scores for physical function, and the impact of physical limitations on daily life.
57 questions are summed into a total score, which is transformed into a normalized t-score with 50 representing normal, and lower scores representing increasing disability.
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24 Months
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The Upper Extremity Functional Index
Time Frame: 24 Months
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This index measures upper extremity dysfunction.
20 questions are combined into a total score, the score is transformed into a normalized score with 80 representing normal, and lower scores representing increasing disability.
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24 Months
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The Facial Disability Index (FDI)
Time Frame: 24 Months
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The FDI is a short 5 item questionnaire.
The five questions are summed into total score which transformed onto a percentage scale, with 100 representing normal, and lower scores representing increasing disability.
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24 Months
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Fall assessment
Time Frame: Total between Month 3 and Month 6 Visit
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Fall assessment will be completed weekly for 3 months after the month 3 visit.
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Total between Month 3 and Month 6 Visit
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Quantitative myometry
Time Frame: 24 Months
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Force will be measured on digital myometer, in KG-force.
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24 Months
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Collaborators and Investigators
Investigators
- Principal Investigator: Rabi Tawil, MD, University of Rochester
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY00140842
- U01NS101944 (U.S. NIH Grant/Contract)
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
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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