- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05924555
Exercise Intolerance Study in Long Chain Fatty Acid Oxidation Disorders (EXCITE LcFAOD)
Study Overview
Status
Detailed Description
Background:Long-chain fatty acid oxidation disorders (LcFAOD) are a group of autosomal recessive disorders that impair the utilization of long-chain fatty acids as an energy source. Exercise intolerance is a commonly reported symptom in adult patients with LcFAOD, but its severity varies significantly among individuals. In addition, little is currently known about the natural progression of exercise intolerance in this group of patients, and reliable outcome measures to assess treatment efficacy remain scarce. In this study, we will evaluate the exercise capacity in LcFAOD patients using intermittent CPX, and determine whether this yields outcome parameters that can be used to determine the course of exercise intolerance over the patients lifetime and evaluate treatment effectiveness.
Hypothesis: Exercise intolerance in LcFAOD patients will be reflected in differences in VO2/VCO2 and heart rate kinetics during short periods of exercise compared to healthy subjects.
Primary Objective: 1. Objectify and quantify exercise intolerance in LcFAOD patients. 2. Determine the relationship between the measured exercise intolerance and patient-reported symptoms, daily life functioning, as well as known markers of disease severity.
Secondary Objective(s): 3. Determine the aetiology of exercise intolerance in LcFAODs. 4. Determine whether the intermittent exercise protocol can be used to establish the course of exercise intolerance and provide clinical outcome measure for future intervention studies.
Methods: Participants will be asked to wear an activity monitor (Activ8) for a period of 7 days. The participants will also perform two cardiopulmonary exercise (CPX) tests (one intermittent and one incremental). During the CPX tests gas exchange, ventilation, blood pressure and cardiac output will be measured and exhaustion level monitored. Blood samples will be taken before the first and after the second CPX test. The grip strength (Maximal Voluntary Contraction) and the leg muscle size (echography) will be assessed. Body composition (using BIA) will be assessed.
Approximately a year later all procedures, including the wearing of the activity monitor, will be repeated in all patients. Some participants will be asked to perform the two exercise tests again within two weeks of their first visit. This way reproducibility of the intermittent exercise protocol can be tested.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Khya Snelder, BSc
- Phone Number: +31 20 5666791
- Email: c.k.snelder@amsterdamumc.nl
Study Locations
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Noord-Holland
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Amsterdam, Noord-Holland, Netherlands, 1105 AZ
- Amsterdam UMC, location AMC
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- LC-FAOD patients:
- Men and women (age ≥18 years) with a confirmed diagnosis of carnitine palmitoyltransferase 2 (CPT2) deficiency, Carnitine-acylcarnitine translocase (CACT) deficiency, Mitochondrial Trifunctional protein (MTP) deficiency, Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency or Long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency.
Healthy control subjects:
- Healthy men and women age ≥ 18 years
Exclusion Criteria:
LcFAOD patients:
- Pregnancy
- Recent acute myocardial infarction (<6 months prior to inclusion)
- Uncontrolled arrhythmia/severe conduction disorder causing hemodynamic compromise
- Implantable pacemaker or other cardiac device with complete ventricular pacing
- Uncontrolled heart failure with hemodynamic compromise
- Uncontrolled hypertension (Systolic Blood Pressure >150 mmHg and Diastolic Blood Pressure >100 mmHg on repeated measurements)
- Active infection, anemia, severe renal dysfunction (estimated Glomerular filtration rate < 30 ml/min/1,73m2), or other chronic disease likely to significantly impact exercise performance
- History of severe asthma or chronic obstructive pulmonary disease
- Active use of medication likely to affect exercise tolerance
Healthy controls:
- All abovementioned exclusion criteria for LcFOAD patients
- History of smoking - History of asthma, chronic obstructive pulmonary disease, heart failure, heart surgery, heart rhythm disorders or congenital heart diseases
- Chronic illness (including orthopedic, endocrinological, hematological, malignant, gastrointestinal, neurological, muscle or inflammatory disorders) likely to significantly impact on exercise performance
- > 6 alcohol units per day or > 14 alcohol units per week
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
LcFAOD-patients
Patients with long-chain Fatty Acid Oxidation including CPT2-, CACT-, VLCAD-, LCHAD-, or MTP-deficiency
|
Exercise test with step-change from rest to a relatively low constant workload.
Exercise test with incremental workload until maximal workload.
Determine upper leg muscle size
Determine muscle strength
SQUASH, mMRC, questionnaire designed to report myopathic symptoms in LcFAOD patients.
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Healthy controls
Controls are matched based on Age, Sex, BMI and comparable activity score assessed using the SQUASH questionnaire
|
Exercise test with step-change from rest to a relatively low constant workload.
Exercise test with incremental workload until maximal workload.
Determine upper leg muscle size
Determine muscle strength
SQUASH, mMRC, questionnaire designed to report myopathic symptoms in LcFAOD patients.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Anaerobic threshold (ml/kg/min)
Time Frame: During maximum exercise (max 30 min).
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Pulmonary involvement/Cardiac dysfunction/Skeletal muscle alterations
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During maximum exercise (max 30 min).
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Ventilation reserve (L)
Time Frame: During maximum exercise (max 30 min).
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Pulmonary involvement/Skeletal muscle alterations
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During maximum exercise (max 30 min).
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CO2 ventilation equivalent (L/L)
Time Frame: During maximum exercise (max 30 min).
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Pulmonary involvement/Cardiac dysfunction
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During maximum exercise (max 30 min).
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Cardiac Output (L/min)
Time Frame: During maximum exercise (max 30 min).
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Cardiac dysfunction
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During maximum exercise (max 30 min).
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Muscle size on echography (cm)
Time Frame: Baseline
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Skeletal muscle alterations
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Baseline
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1. Differences in V'O2/ V'CO2/heart rate kinetics during the intermittent exercise test between LcFAOD patients and healthy control subjects
Time Frame: At rest (baseline) and during the intermittent CPX test (30 min)
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At rest (baseline) and during the intermittent CPX test (30 min)
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Heart rate reserve (per minute)
Time Frame: During maximum exercise (max 30 min).
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Cardiac dysfunction
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During maximum exercise (max 30 min).
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Muscle strength via resistance test (kg)
Time Frame: Baseline
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Skeletal muscle alterations
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Baseline
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Mirjam Langeveld, MD PhD, Amsterdam UMC, location AMC
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Other Study ID Numbers
- NL83869.018.23
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
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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