Chinese Multicenter Clinical Outcome Cohort Study of Myotonic Dystrophy Type 1 (C-DMCOS-DM1) (C-DMCOS-DM1)

May 30, 2026 updated by: Chongbo Zhao, Huashan Hospital

A Multicenter, Prospective, Observational Cohort Study of Multi-System Involvement and Disability-Related Clinical Outcomes in Chinese Patients With Myotonic Dystrophy Type 1 (C-DMCOS-DM1)

Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disorder caused by an expanded CTG trinucleotide repeat in the 3' untranslated region of the DMPK gene. Beyond myotonia and progressive skeletal muscle weakness, DM1 involves the cardiac, respiratory, central nervous, gastrointestinal, endocrine, and ocular systems, and respiratory and cardiac involvement are the leading causes of disability and death. Systematic, long-term outcome data in Chinese DM1 patients are lacking.

C-DMCOS-DM1 is a multicenter, prospective, observational cohort study that systematically records demographic data, multisystem involvement, and predefined disability-related clinical outcome events in genetically confirmed Chinese DM1 patients, with regular follow-up every 3 to 6 months. The study also collects residual blood, skeletal muscle, myocardium (when a pacemaker is implanted), and urine specimens for transcriptomic and other molecular studies. The aims are to characterize the disease burden of Chinese DM1 patients, identify risk and prognostic factors for disabling outcomes, and build risk-prediction models to inform follow-up, management, and future clinical trials.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

This multicenter, prospective, observational cohort study (no randomization, no control, no intervention) enrolls genetically confirmed DM1 patients across Chinese neuromuscular centers and follows them every 3 to 6 months. At baseline and each visit, the study collects demographics, clinical subtype, symptoms and rating scales, manual muscle testing and the Muscular Impairment Rating Scale (MIRS), quantitative motor measures (grip strength, 10-Metre Walk Test [10MWT], Video Hand Opening Time [vHOT]), cardiac assessment (electrocardiography and 24-hour Holter), pulmonary function testing, echocardiography, laboratory tests, computerized cognitive assessment, and video and voice recordings of gait, hand grip, and facial movement for artificial-intelligence analysis. Wearable devices are encouraged for continuous monitoring of heart rate and heart rate variability, blood oxygen saturation, respiratory rate, sleep and nocturnal respiratory events, and daily physical activity.

Predefined disability-related outcome events are tracked cumulatively, including loss of independent ambulation, respiratory failure, non-invasive or invasive mechanical ventilation, tracheostomy, cardiac pacemaker or implantable cardioverter-defibrillator (ICD) implantation, early cataract surgery, malignancy, and death. Residual blood, skeletal muscle, myocardium (when a pacemaker is implanted), and urine specimens are collected for RNA sequencing, mitochondrial DNA analysis, and other molecular studies. Statistical analysis includes descriptive characterization, Kaplan-Meier and Cox proportional-hazards survival analysis, competing-risk models, and multivariable regression to identify risk and prognostic factors and to build risk-prediction models.

Study Type

Observational

Enrollment (Estimated)

1000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
      • Shanghai, China, 200040
        • Huashan Hospital
    • Beijing Municipality
      • Beijing, Beijing Municipality, China
        • Peking University First Hospital
      • Beijing, Beijing Municipality, China
        • Chinese People's Liberation Army General Hospital
    • Chongqing Municipality
      • Chongqing, Chongqing Municipality, China
        • First Affiliated Hospital of Chongqing Medical University
    • Fujian
      • Fuzhou, Fujian, China
        • Fujian Medical University Union Hospital
    • Guangdong
      • Guangzhou, Guangdong, China
        • Southern Hospital of Southern Medical University
    • Hebei
      • Shijiazhuang, Hebei, China
        • The Third Hospital of Hebei Medical University
    • Hubei
      • Wuhan, Hubei, China
        • Wuhan University People's Hospital
    • Jiangsu
      • Nanjing, Jiangsu, China
        • Zhongda Hospital Southeast University
      • Suzhou, Jiangsu, China
        • The First Affiliated Hospital of Soochow University
      • Yancheng, Jiangsu, China
        • The First People's Hospital of Yancheng
    • Jiangxi
      • Nanchang, Jiangxi, China
        • The First Affiliated Hospital of Nanchang University）
    • Jilin
      • Changchun, Jilin, China
        • The First Bethune Hospital of Jilin University
    • Neimenggu
      • Chifeng, Neimenggu, China
        • Chifeng Municipal Hospital
    • Shandong
      • Jinan, Shandong, China
        • Qilu Hospital of Shandong University
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, China
        • Children's Hospital of Fudan University
    • Shanxi
      • Taiyuan, Shanxi, China
        • First Hospital Of ShanXi Medical University
      • Xi’an, Shanxi, China
        • Xi'an Gaoxin Hospital
      • Xi’an, Shanxi, China
        • Xi'an People's Hospital
    • Sichuan
      • Chengdu, Sichuan, China
        • Sichuan Provincial People's Hospital
      • Chengdu, Sichuan, China
        • The General Hospital of Western Theater Command
    • Yunnan
      • Kunming, Yunnan, China
        • Yunnan Provincial People's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The patients will be diagnosed and invited to join this trial in each participating neuromuscular diagnostic centers.

Description

Inclusion Criteria:

  1. Genetically confirmed DM1 (CTG repeat expansion in the 3' untranslated region of the DMPK gene).
  2. Any sex.
  3. Able to attend regular follow-up and willing to provide and store residual blood, urine, and other biospecimens for research.
  4. Voluntary participation with signed informed consent (signed by legal guardian for minors).
  5. Consent to use of routine clinical, examination, and follow-up data for research.

Exclusion Criteria:

  1. Unable to comply with study procedures.
  2. Unable to provide informed consent, or guardian declines participation.
  3. Pregnancy (for MRI safety).
  4. Severe, unstable medical condition that precludes assessments.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
DM1 patients
Patient cohort
Diagnostic test: MRI scan
Brain MRI scan to evaluate the integrity of the nervous system; lower limb muscle MRI scan to evaluate fat infiltration in skeletal muscles of the lower limb
Diagnostic test: Electrocardiography
Standard 12-lead electrocardiography or Holter monitoring performed to assess cardiac conduction abnormalities and arrhythmias in patients with DM1.
Diagnostic test: Pulmonary function test
Comprehensive pulmonary function testing including spirometry to assess respiratory muscle weakness and restrictive lung disease in DM1 patients.
Diagnostic test: Electrocardiography and 24-hour Holter monitoring
Electrocardiography and 24-hour Holter monitoring
Procedure: Skeletal muscle biopsy (residual specimen)
Skeletal muscle biopsy (residual specimen)
Device: Wearable-device continuous physiological monitoring
Wearable-device continuous physiological monitoring (heart rate, blood oxygen saturation, respiration, physical activity, sleep)
Behavioral: Video and voice recording for AI analysis
Video and voice recording for AI analysis (gait, hand grip, facial movement, speech)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cumulative incidence and time to first major disability-related clinical outcome event
Time Frame: From enrollment up to 10 years
Proportion of participants experiencing, and time to first occurrence of, predefined disability-related outcome events: loss of independent ambulation, respiratory failure, non-invasive mechanical ventilation, invasive mechanical ventilation, tracheostomy, cardiac pacemaker implantation, implantable cardioverter-defibrillator (ICD) implantation, early cataract surgery, malignancy, and death. Each event is recorded with its date of first occurrence.
From enrollment up to 10 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in 10-Metre Walk Test (10MWT)
Time Frame: Baseline, Year 1, Year 3, Year 5, Year 10
Time in seconds to walk 10 metres, assessing functional mobility.
Baseline, Year 1, Year 3, Year 5, Year 10
Change in Video Hand Opening Time (vHOT)
Time Frame: Baseline, Year 1, Year 3, Year 5, Year 10
Time to fully open the hand after making a fist, an objective measure of myotonia severity.
Baseline, Year 1, Year 3, Year 5, Year 10
Change in Muscular Impairment Rating Scale (MIRS)
Time Frame: Baseline, Year 1, Year 3, Year 5, Year 10
Five-point clinical rating of muscle impairment in DM1.
Baseline, Year 1, Year 3, Year 5, Year 10
Change in forced vital capacity (FVC, % predicted)
Time Frame: Baseline, Year 1, Year 3, Year 5, Year 10
Pulmonary function measure reflecting respiratory involvement.
Baseline, Year 1, Year 3, Year 5, Year 10
Change in Epworth Sleepiness Scale (ESS)
Time Frame: Baseline, Year 1, Year 3, Year 5, Year 10
0 to 24 scale of daytime sleepiness; higher scores indicate greater sleepiness.
Baseline, Year 1, Year 3, Year 5, Year 10
Change in Fatigue Severity Scale (FSS)
Time Frame: Baseline, Year 1, Year 3, Year 5, Year 10
9-item fatigue scale; higher scores indicate more severe fatigue.
Baseline, Year 1, Year 3, Year 5, Year 10

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Huashan Hospital

Investigators

  • Study Director: Chongbo Zhao, PhD, Huashan Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2021

Primary Completion (Estimated)

August 1, 2030

Study Completion (Estimated)

December 30, 2035

Study Registration Dates

First Submitted

August 2, 2021

First Submitted That Met QC Criteria

October 20, 2023

First Posted (Actual)

October 26, 2023

Study Record Updates

Last Update Posted (Actual)

June 2, 2026

Last Update Submitted That Met QC Criteria

May 30, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KY2020-008

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared publicly. The data are subject to China's Regulations on the Administration of Human Genetic Resources. All participant data are managed anonymously and identified by study number rather than name, and are accessible only to authorized study personnel.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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