Sikkerhed, tolerabilitet, farmakodynamisk, effektivitet og farmakokinetisk undersøgelse af DYNE-101 hos deltagere med myotonisk dystrofi type 1 (ACHIEVE)
Et randomiseret, placebo-kontrolleret, multiple stigende dosisstudie, der vurderer sikkerhed, tolerabilitet, farmakodynamik, effektivitet og farmakokinetik af DYNE-101 administreret til deltagere med myotonisk dystrofi type 1
The primary purpose of the study is to evaluate the safety and tolerability of multiple intravenous (IV) doses of DYNE-101 administered to participants with Myotonic Dystrophy Type 1 (DM1).
The study consists of 4 periods: A Screening Period (up to 8 weeks), a Placebo-Controlled Period (24 weeks), a Treatment Period (24 weeks) and a Long-Term Extension (LTE) Period (208 weeks) in both multiple-ascending dose (MAD) and dose expansion cohorts.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
- Fase 1
Kontakter og lokationer
Studiesteder
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Victoria
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Fitzroy, Victoria, Australien, 3065
- St. Vincent's Hospital
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London, Det Forenede Kongerige, NW1 2BU
- University College London Hospitals
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Newcastle upon Tyne, Det Forenede Kongerige
- John Walton Muscular Dystrophy Research Centre
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Salford, Det Forenede Kongerige, M6 8HD
- Salford Royal Hospital
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California
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Stanford, California, Forenede Stater, 94305
- Stanford University
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Florida
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Gainesville, Florida, Forenede Stater, 32610
- University of Florida College of Medicine
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Indiana
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Indianapolis, Indiana, Forenede Stater, 46202
- Indiana University School of Medicine
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Iowa
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Iowa City, Iowa, Forenede Stater, 52242
- University of Iowa
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Missouri
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St Louis, Missouri, Forenede Stater, 63110
- Washington University in St. Louis
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New York
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Rochester, New York, Forenede Stater, 14642
- University of Rochester Medical Center
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Texas
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Denton, Texas, Forenede Stater, 76208
- Neurology Rare Disease Center
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Virginia
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Richmond, Virginia, Forenede Stater, 23298
- Virginia Commonwealth University (VCU)
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Nantes, Frankrig, 44093
- CHU de Nantes
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Paris, Frankrig, 75013
- Institut de Myologie
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Nijmegen, Holland
- Radboud Medical Center
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Milan, Italien, 20162
- Centro Clinico Nemo
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Rome, Italien, 00168
- Fondazione Policlinico Universitario A Gemelli-Rome
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Auckland, New Zealand, 1023
- NZCR Auckland
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Berlin, Tyskland, 10117
- Charité - Universitätsmedizin Berlin
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Munich, Tyskland, 80336
- Ludwig Maximilians University, Munich - Friedrich Baur Institut
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Diagnosis of DM1 with trinucleotide repeat size >100.
- Age of onset of DM1 muscle symptoms ≥12 years.
- Clinically apparent myotonia equivalent to hand opening time of at least 2 seconds in the opinion of the Investigator.
- Hand grip strength and ankle dorsiflexion strength.
- Able to complete 10-MWRT, stair ascend/descend (MAD cohorts only), and 5×STS at screening without the use of assistive devices such as canes, walkers, or orthoses.
Exclusion Criteria:
- History of major surgical procedure within 12 weeks prior to the start of investigative product administration or an expectation of a major surgical procedure (eg, implantation of cardiac defibrillator) during the study.
- History of anaphylaxis.
- Medical condition other than DM1 that would significantly impact ambulation or participation in functional assessments.
- Treatment with medications that can improve myotonia within a period of 5 half-lives of the medication prior to performing screening assessments.
- Electrocardiogram (ECG) with the corrected QT interval by Fridericia's Formula (QTcF) ≥450 milliseconds (ms) in men and QTcF ≥460 ms in women, PR ≥240 ms, left bundle-branch block, or a conduction defect, which is clinically significant in the opinion of the Investigator.
- Percent predicted forced vital capacity (FVC) <50%.
- History of tibialis anterior biopsy within 3 months of Day 1 or planning to undergo tibialis anterior biopsies during study period for reasons unrelated to the study.
- Participant has a history of suicide attempt, suicidal behavior, or has any suicidal ideation within 6 months prior to Screening that meets criteria at a level of 4 or 5 of the Columbia Suicide Severity Rating Scale (C-SSRS) or who, in the opinion of the Investigator, is at significant risk to commit suicide.
- Use of glucagon-like peptide 1 (GLP-1) agonist medications including semaglutide, dulaglutide, liraglutide, exenatide, or tirzepatide within a period of 5 half-lives of the medication prior to performing screening assessments.
- Significant weight loss during study participation may impact weight-based dosing, performance on muscle function assessments, and pharmacodynamic (PD) biomarkers.
Note: Other inclusion and exclusion criteria may apply.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Sekventiel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: MAD Cohort: Placebo-Controlled Period: DYNE-101
Participants will be randomized to receive ascending doses of DYNE-101, once every 4 weeks (Q4W) or once every 8 weeks (Q8W) for up to 24 weeks. |
Administered by IV infusion |
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Placebo komparator: MAD Cohort: Placebo-Controlled Period: Placebo
Participants will be randomized to receive DYNE-101 matching placebo, Q4W or Q8W for up to 24 weeks. |
Administered by IV infusion |
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Eksperimentel: MAD Cohort: Treatment Period: DYNE-101
Participants who receive DYNE-101 in Placebo-Controlled Period will continue to receive DYNE-101, Q4W or Q8W for up to 24 weeks. Participants who receive placebo in Placebo-Controlled Period will receive DYNE-101, Q4W or Q8W for up to 24 weeks. |
Administered by IV infusion Administered by IV infusion |
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Eksperimentel: MAD Cohort: Long-Term Extension Period: DYNE-101
Participants will receive DYNE-101, Q4W or Q8W for up to 208 weeks. |
Administered by IV infusion |
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Eksperimentel: Dose Expansion Cohort: Placebo-Controlled Period: DYNE-101
Participants will receive DYNE-101, Q8W for up to 24 weeks. |
Administered by IV infusion |
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Eksperimentel: Dose Expansion Cohort: Placebo-Controlled Period: Placebo
Participants will receive DYNE-101 matching placebo, Q8W for up to 24 weeks. |
Administered by IV infusion |
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Eksperimentel: Dose Expansion Cohort: Treatment Period: DYNE-101
Participants who receive DYNE-101 in Placebo-Controlled Period will continue to receive DYNE-101, Q8W for up to 24 weeks. Participants who receive placebo in Placebo-Controlled Period will receive DYNE-101, Q8W for up to 24 weeks. |
Administered by IV infusion Administered by IV infusion |
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Eksperimentel: Dose Expansion Cohort: Long-Term Extension Period: DYNE-101
Participants will receive DYNE-101, Q8W for up to 208 weeks. |
Administered by IV infusion |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
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Dosisekspansionskohorter: Skift fra baseline i myotonia målt ved åbningstid for videovirksomhed (VHOT)
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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MAD Cohorts: Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Tidsramme: Through study completion, up to Week 257
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Through study completion, up to Week 257
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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MAD -kohorter: Skift fra baseline i dystrofi myotonica proteinkinase (DMPK) ribonukleinsyre (RNA) ekspression i muskelvæv
Tidsramme: Baseline op til uge 45
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Baseline op til uge 45
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MAD -kohorter: Skift fra baseline i håndgrebets afslapningstid
Tidsramme: Baseline op til uge 121
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Baseline op til uge 121
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MAD-kohorter: Skift fra baseline i trappesag/nedgangstest
Tidsramme: Baseline op til uge 121
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Baseline op til uge 121
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MAD-kohorter: Antisense oligonukleotid (ASO) koncentration af DYNE-101 i muskelvæv
Tidsramme: Op til uge 45
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Op til uge 45
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MAD -kohorter: Skift fra baseline i sammensat alternativt splejsningsindeks (CASI) i skeletmuskelvæv
Tidsramme: Baseline op til uge 45
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Baseline op til uge 45
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Dosisudvidelseskohorter: Skift fra baseline i CASI i skeletmuskelvæv
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i QMT i alt
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i 10-MWRT
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i 5 × STS
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i 9-HPT
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisekspansionskohorter: Skift fra baseline i myotonisk dystrofi Sundhedsindeks (MDHI) Total score
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisekspansionskohorter: Patient Globalt indtryk af forandring (PGI-C)
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Kliniker Global Impression of Change (CGI-C)
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisekspansionskohorter: Skift fra baseline i patientens globale indtryk af sværhedsgrad (PGI-S)
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i klinikeren Globalt indtryk af sværhedsgrad (CGI-S)
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i MDHI -underskala -scoringer
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline ved i myotonisk dystrofi Type 1 Aktivitet og deltagelsesskala (DM1-Activ^C) Total score
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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Dosisudvidelseskohorter: Skift fra baseline i procent forudsagt håndgrebstyrke
Tidsramme: Baseline op til uge 25
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Baseline op til uge 25
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MAD Cohorts: Change From Baseline in Myotonia as Measured by vHOT
Tidsramme: Baseline up to Week 257
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Baseline up to Week 257
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MAD Cohorts: Change From Baseline in Quantitative Myometry Testing (QMT)
Tidsramme: Baseline up to Week 257
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Baseline up to Week 257
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MAD Cohorts: Change From Baseline in 10-Meter Walk/Run Test (10-MWRT)
Tidsramme: Baseline up to Week 257
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Baseline up to Week 257
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MAD Cohorts: Change From Baseline in 5 Times Sit to Stand (5×STS)
Tidsramme: Baseline up to Week 257
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Baseline up to Week 257
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MAD Cohorts: Change From Baseline in 9-Hole Peg Test (9-HPT)
Tidsramme: Baseline up to Week 257
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Baseline up to Week 257
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MAD Cohorts: Maximum Observed Plasma Drug Concentration (Cmax) of DYNE-101
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Time to Maximum Observed Plasma Concentration (tmax) of DYNE-101
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Area Under the Concentration-time Curve From Hour 0 to the Last Measurable Plasma Concentration (AUCtlast) of DYNE-101
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Area Under the Concentration-time Curve Extrapolated to Infinity (AUC∞) of DYNE-101 in Plasma
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Apparent Terminal Elimination Rate Constant (λz) of DYNE-101 in Plasma
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Apparent Terminal Elimination Half-Life (t1/2) of DYNE-101 in Plasma
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Clearance (CL) of DYNE-101 in Plasma
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Volume of Distribution at the Terminal Phase (Vz) of DYNE-101 in Plasma
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Volume of Distribution at Steady State (Vss) of DYNE-101 in Plasma
Tidsramme: Pre-dose, and at multiple timepoints up to Week 257
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Pre-dose, and at multiple timepoints up to Week 257
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MAD Cohorts: Number of Participants With Antidrug Antibodies (ADAs)
Tidsramme: Up to Week 257
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Up to Week 257
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Muskuloskeletale sygdomme
- Sygdomme i nervesystemet
- Muskelsygdomme
- Neuromuskulære sygdomme
- Genetiske sygdomme, medfødte
- Neurodegenerative sygdomme
- Heredodegenerative lidelser, nervesystem
- Muskellidelser, atrofisk
- Muskeldystrofier
- Myotoniske lidelser
- Medfødte, arvelige og neonatale sygdomme og abnormiteter
- Myotonisk dystrofi
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- DYNE101-DM1-201
- 2023-510353-42-00 (Ctis)
- 2023 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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