An Ambispective Natural History Study in Myotonic Dystrophy Patients Linking Retrospective Data Captured From the DM-Scope Registry With a Prospective 24-month Follow-up Period (Track-DM)

An Ambispective 24-Month Longitudinal Natural History Study in Myotonic Dystrophy Patients Using DM-Scope Registry (TRACK-DM Study)

This natural history observational study is being conducted to follow patients with DM1 or DM2 over a 2 year period to study the presence of myotonia, how it's perceived and its impact on patients quality of life. This study will be conducted at 6 study sites located in France.100 Patients will be recruited from the DM Scope Registry only. The study involves two parts. Part 1 will look back up to 18 months of past medical history that is already available from the DM Scope Registry. Part 2 will follow the same patients for 24 months, with study visits at Day 1 (Baseline), 12 months and 24 months. The goal is to better understand how myotonia symptoms and complications such as heart and other systemic problems develop and change over time. A smaller, sub-study will take place at one site, using new exploratory methods in about 40 patients with DM1 who are also part of the Track DM Study.

Study Overview

• Status: Not yet recruiting
• Conditions: Myotonic Dystrophy 1; Myotonic Dystrophy 2

Detailed Description

The rationale of the study is to gather longitudinal data on patients with DM1 and DM2 in order to better understand disease progression and evolution of myotonia and other symptoms and their associated complications/risks, particularly in relation to cardiac and other systemic manifestations. The primary objective is to investigate the evolution of myotonia presence, perception and its impact on the burden of disease over time in patients with Myotonic dystrophy type 1 (DM1) and type 2 (DM2). The secondary objective is to evaluate the progression of other DM-related multisystemic symptom manifestation such as cardiac, pulmonary, gastrointestinal (GI), hepatic, and renal impairments/disorders, muscle weakness, stumbling and falls in DM patients over 24-months. Additionally, the study will assess the use of pharmacological and non-pharmacological treatments for myotonia during the data collection period.

All of the patients will be recruited through the DM-Scope Registry. The registry database will be the source of the retrospective data to be used in the study. The study will begin with a detailed retrospective medical history assessment (up to -18 months to baseline) based on the annual routine DM-scope visits in the database. This will provide a comprehensive view of the patients' health status before the study. The 24-month prospective assessment period visits will occur at baseline, 12 months and 24 months. This approach allows for detailed tracking of disease progression and associated complications/risks over time.

The exploratory sub-study aims to broaden the understanding of DM1 pathophysiology by incorporating biophysical, functional, and behavioral measurements beyond traditional motor function and muscle strength. It also aims to evaluate the reliability of several innovative assessments, including advanced tools to deliver a multidimensional view of disease progression.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: Director of Clinical Operations, Lupin Research Inc.; Phone Number: 14433013146; Email: jackieshaw@lupin.com
• Study Contact Backup: Name: Head, Global Medical Affairs & Clinical Development; Email: allazweidenfeller@lupin.com

Study Locations

• France
  • Angers, France, 75651
    • Centre Hospitalier Universitaire D'Angers
    • Contact: Principal Investigator; Email: Marco.Spinazzi@chu-angers.fr
    • Principal Investigator: Marco SPINAZZI, MD, PhD
  • Lille, France, 59037
    • CHU de Lille - Hôpital
    • Contact: Principal Investigator; Email: CELINE.TARD@chu-lille.fr
    • Principal Investigator: Celine TARD, MD, PhD
  • Marseille, France, 13005
    • CHU LA TIMONE - Service des Maladies
    • Contact: Principal Investigator; Email: Shahram.ATTARIAN@ap-hm.fr
    • Principal Investigator: Shahram ATTARIAN, MD, PhD
  • Nantes, France, 44093
    • Centre de référence des maladies neuromusculaires
    • Principal Investigator: Yann PEREON, MD, PhD
    • Contact: Principal Investigator; Email: Yann.Pereon@univ-nantes.fr
  • Paris, France, 75013
    • Hôpital Pitié Salpêtrière
    • Principal Investigator: Guillaume BASSEZ, MD
    • Contact: Coordinating investigator; Email: guillaume.bassez@aphp.fr
  • Toulouse, France, 40031
    • CHU de Toulouse - Hôpital
    • Principal Investigator: Pascal CINTAS, MD
    • Contact: Principal Investigator, MD; Email: cintas.p@chu-toulouse.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All patients will be recruited from DM-Scope Registry

Description

Inclusion Criteria:

• Enrolled in DM-scope registry genetically diagnosed with DM1 or DM2.
• Affiliation or beneficiary of a social security system or of such a regime.
• Ability to comprehend and willingness to sign an informed consent (ICF).
• Male or non-pregnant female ≥18 years of age at screening.
• Body Mass Index (BMI) of 18.5 kg/m2 to 30 kg/m2, and weight ≥45 kg.
• Medical history data covering up to 18 months prior to enrollment.
• Clinical sign of myotonia
• DM1 patients only - Muscular impairment rating scale (MIRS) score of 2, 3 or 4.
• Be able to walk independently 10 meters (cane, walker, orthoses allowed).

Exclusion Criteria:

• No informed consent.
• Pregnant or lactating women.
• Subjects benefiting from laws aimed at protecting vulnerable adults: subjects being deprived of liberty by judicial or administrative decision, subjects under guardianship /curatorship.
• Any medical condition or serious medical illness which in the opinion of the Investigator, precludes the participant's participation in the study or the participant is unlikely to comply with the protocol-defined procedures and therefore is unlikely to complete the study.
• Medical conditions that could affect hand functioning including (but not limited to) rheumatoid arthritis, Dupuytren's contracture, hand deformity, severe arthritis or any other medical condition (other than DM1/DM2) that would significantly impact ambulation.
• Patients with no documented record of myotonia assessment in the clinical records of the DM-scope database or myotonia absence at last visit prior to study enrolment.
• Not able to perform study specific performance tests and evaluations e.g. hand grip dynamometry, 10mWT, etc. (in the opinion of the investigator).
• Treatment with mexiletine within 18 months prior to baseline (Day 1).

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Exploratory Sub-study; Approximately 40 patients with DM1 who are enrolled in the Track DM core study will also participate in the substudy. These patients will undergo all visits and assessments as outlined in the core study Schedule of Assessments. In addition, patients participating in the substudy will also complete exploratory assessments at Baseline, Day 14, Month 6, Month 12 and Month 24 visits. All additional exploratory assessments will be conducted at a single site and will include a set of innovative measures designed to provide an integrative, multi-dimensional view of disease progression. These assessments will complement conventional clinical evaluations by incorporating emerging and innovative biomarkers.
DM1 Patients; 90 Patients with Myotonic Dystrophy Type 1 (DM1) will be enrolled in the study and data for this group will be analyzed separately
DM2 Patients; 10 Patients with Myotonic Dystrophy Type 2 (DM2) will be enrolled in the study and data for this group will be analyzed separately.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in stiffness severity assessed by Visual Analog Scale (VAS)	Absolute change in VAS stiffness score (0-100mm) between Baseline and Month 12	Baseline to Month 24
Change in myotonia severity assessed by the Myotonia Behavior Scale (MBS)	Absolute change in MBS score (1-6) between Baseline and Month 24.	Baseline to Month 24
Change in disease-related activity and participation assessed by DM1-Activ	Absolute change in DM1-Activ score (0-100) between Baseline and Month 24.	Baseline to Month 24
Change in health-related quality of life assessed by the Individualized Neuromuscular Quality of Life Questionnaire (INQoL)	Absolute change in INQoL: symptom subscores, life-domain subscores, overall total score, and treatment impact score (0-4 Likert) between Baseline and Month 24.	Baseline to Month 24
Change in walking performance assessed by the 10-Meter Walk Test (10mWT)	Absolute change in 10mWT (sec) performance between Baseline and Month 24.	Baseline to Month 24
Change in mobility and functional performance assessed by the Timed Up and Go Test (TUG)	Absolute change in TUG performance (sec) between Baseline and Month 24.	Baseline to Month 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in cardiac function	Assessment of cardiac manifestations of DM1 using ECG and echocardiography, including LVEF, heart rate, PR interval, QRS interval, QT interval (QTcB and QTcF), and classification of cardiac function status (Normal, Abnormal-Not Clinically Significant, Abnormal-Clinically Significant).	Baseline and all scheduled study timepoints, including retrospective assessments up to 18 months before enrollment.
Progression of opthalmologic manifestations	Presence or absence of cataracts at each study timepoint	Scheduled study timepoints, including retrospective assessments up to 18 months before enrollment.
Change in respiratory function	Absolute change in respiratory function as measured by spirometry, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio.	Baseline and all scheduled study timepoints, including retrospective data up to 18 months.
Change in Physical Examination Findings	Assessment and absolute changes in physical examination parameters, including BMI (weight (kg)/Height (m2)) and other clinically relevant findings (CS/NCS) at each study timepoint.	Baseline and all scheduled study timepoints.
Safety and Tolerability	Evaluation of adverse events, clinical laboratory parameters (hematology and biochemistry) and concomitant medication use.	Throughout study participation.
Change in Gastrointestinal (GI) manifestations	Assessment of gastrointestinal and related symptoms using a specific questionnaire used in DM-scope, including age of onset, coughing while eating or drinking (response options: never or <2 times/month, >2 times/month, >1 time/week, not investigated), feeling of food blockage, digestive difficulties (Yes/No, if yes, specify: constipation, diarrhea, alternating diarrhea-constipation), fecal incontinence, urinary incontinence, gastroesophageal reflux	Baseline and all scheduled study timepoints, including retrospective assessments up to 18 months before enrollment.
Change in muscle-related manifestations	Assessment of disease-related muscular symptoms including dysphagia, muscle pain assessed by VAS (0-100mm), hand-opening time after contraction (sec), and swallowing function assessed by the Timed Water Swallowing Test (sec).	Baseline and all scheduled study timepoints.
Change in mobility and functional performance	Assessment of mobility and physical function, including number of accidental falls, 10-Meter Walk Test (10mWT), and Timed Up and Go Test (TUG).	Baseline and all scheduled study timepoints
Change in Quality of Life	Assessment of health-related quality of life using the Individualized Neuromuscular Quality of Life Questionnaire (INQoL), including symptom subscales, life-domain subscales, total score, and treatment impact score.	Baseline and all scheduled study timepoints.
Clinical Global Impression of disease severity and change	Assessment of disease severity using the Clinical Global Impression (CGI) scale (7-point scale from normal, not at all ill, to amongst the most extremely ill) at each study timepoint.	Baseline and all scheduled study timepoints

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exploratory Sub-study - Change in Motor Function Measures (MFM-32)	Assessment of muscle weakness and functional limitations over time using MFM-32 Scale (score 0-96)	Baseline and all scheduled study timepoints.
Exploratory Sub-Study - Video Hand Opening Test (vHOT)	Assessment of delayed hand opening using the standardized Video Hand Opening Test. Myotonia is quantified as the time required for hand opening following voluntary contraction. Unit of Measurement: Seconds	Baseline and all scheduled study timepoints.
Exploratory Sub Study - QMA-Based Myotonia Assessment	Detailed characterization of grip myotonia using Quantitative Muscle Assessment (QMA). Participants perform three series of six maximal grip contractions every 15 seconds, with a 10-minute rest between series. Myotonia is quantified as the average relaxation time from the first trial of each series. Unit of Measurement: seconds	Baseline and all scheduled study timepoints
Exploratory Sub-Study - Myotone Device Myotonia Assessment	Assessment of delayed muscle relaxation using the MyoTone handheld device. The device applies a brief mechanical impulse and records muscle oscillation response to quantify stiffness and relaxation properties. Unit of measure N/m.	Baseline and all scheduled study timepoints
Exploratory Substudy- Quadriceps Myotonia	Assessment of Myotonia using MyoTone test during knee extension to possibly detect myotonia in other muscle territories. Unit of measurement: seconds.	Baseline and all scheduled timepoints.
Exploratory Sub-study: Muscle Imaging	Assessment of muscle fatty degenerative changes, muscle volume changes and active muscle damage by MRI. Unit of Measure: imaging derived values	All scheduled timepoints
Exploratory Sub Study - Shear Wave Elastography (SWE) of vastus lateralis and forearm flexor compartment	Assess change in the mechanisms of myotonia at rest and during grip contractions using SWE ultrasound imaging technique. Unit of Measurement: kilopascals (kPa)	Baseline and all scheduled timepoints
Exploratory Sub Study - Bioelectrical Impedance analysis (BIA) of the Thigh.	Change in thigh composition measured by BIA. Unit of measurement: ohms or impedance index	Baseline and all scheduled study timepoints
Exploratory Sub Study - 30 second sit to stand test	Change in number of sit to stand repetitions completed in 30 seconds.	Baseline and all scheduled study timepoints
Ankle Dorsiflexion Strength	Change in ankle dorsiflexion force measured by MyoAnkle dynamometry	Baseline and all scheduled study timepoints
Swallowing Sound and Vibration Analysis	Change in swallowing acoustics and vibration patterns. Unit of Measure: device acoustic/vibration units	Baseline and all scheduled study timepoints
Exploratory Sub Study - Home monitoring of physical activity using a wearable actimetry device	Assessment of changes in daily physical activity captured by wearable device.	Baseline and all scheduled study timepoints

Collaborators and Investigators

• Sponsor: Lupin Ltd.
• Collaborators: Lupin Atlantis Holdings S.A.
• Investigators: Study Chair: Alla Zozulya-Weidenfeller, PhD, Lupin Atlantis Holdings S.A.

Study record dates

Study Major Dates

• Study Start (Estimated): August 3, 2026
• Primary Completion (Estimated): September 1, 2029
• Study Completion (Estimated): September 1, 2029

Study Registration Dates

• First Submitted: June 17, 2026
• First Submitted That Met QC Criteria: July 23, 2026
• First Posted (Actual): July 28, 2026

Study Record Updates

• Last Update Posted (Actual): July 28, 2026
• Last Update Submitted That Met QC Criteria: July 23, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Natural History; Observational; DM1; Prospective; Retrospective; DM2; Ambispective; DM-Scope Registry
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Nervous System Diseases; Muscular Diseases; Neuromuscular Diseases; Genetic Diseases, Inborn; Neurodegenerative Diseases; Heredodegenerative Disorders, Nervous System; Muscular Disorders, Atrophic; Muscular Dystrophies; Myotonic Disorders; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Myotonic Dystrophy
• Other Study ID Numbers: NHS-DM-401; ID-RCB Number: 2025-A02624-45 (Other Identifier: ANSM)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No