Clinical trial NCT06354790: Natural History Study of Children With LAMA2-related Dystrophies
Official title: A Prospective, Longitudinal, Interventional Natural History Study of Children With LAMA2-related Dystrophies
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Merosin Deficient Congenital Muscular Dystrophy
Keywords: LAMA2
Congenital Muscular Dystrophy
Natural history
Lead sponsor: Institut de Myologie, France
Sponsor class: OTHER
Collaborators: name: Association Française contre les Myopathies (AFM), Paris
First posted: 2024-04-09
Enrollment: 40
Sex: ALL
Minimum age (years): 2
Maximum age (years): 15
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: 40 young patients aged between 2 and 15 years old (inclusive) at time of consent, with a confirmed LAMA2 diagnosis (muscle biopsy with absence of merosin (laminin-211) and at least one pathogenic variant in the LAMA2 gene)

Brief summary: The goal of this natural history study is to characterize the disease course, characteristics in paediatric population of LAMA2-RD (related dystrophies) patients.

The aim of the study is to establish a well-described cohort of patients in France with LAMA2-RD for prospective follow-up and recruitment for future clinical trials.

Participants will be follow up during a two years period regarding exhaustive aspects of the pathology:

* Muscular function
* Respiratory function
* Cognitive phenotyping
* Quality of life
* Growth parameters
* Biomarkers

Detailed description: The international workshop on LAMA2-RD, held in 2019 in Maastricht, stressed the importance of the identification of LAMA2-RD patients and the natural history studies worldwide. Together with the recent progress in preclinical applications, the road to therapy is paved.

However, no effective treatment has currently received market approval. Given the phenotype variability in LAMA2-RD patients, even in very young ones, determining which outcome measure(s) could be the most appropriate to assess the efficacy of potential therapies, and which variables are prognostic of the disease course, is required. In consequence, it is clearly necessary to explore all the aspects of the pathology: physiological, clinical/motor, biological, aligning with current or future international studies though collaboration.

Unlike results obtained through a retrospective study, data from a prospective natural history will be less subject to bias and error. Control of the studied population will also lead to reduce the variability of the results. The different variables explored during this study aim to cover all aspects of the disease and appear to be relevant candidates as outcomes.

The aim of the study is to focus on the clinical phenotyping and to establish a well-described cohort of patients in France with LAMA2-RD for prospective follow-up and recruitment for future clinical trials. One other objective is to validate the use of a large subset of outcome measures in LAMA2-RD. Adding an electrophysiological data will give more insight to the neuropathology of the disease and enlarge the scope of futures therapies.

An exploratory part will test if denaturation profiling of plasma from patients can be used to follow disease progression. Finally, serum and plasma samples from patients will also be stored for future studies focused on searching and validating novel biomarkers in LAMA2-RD.

Eligibility criteria: Inclusion Criteria:

* Signed informed consent by the Legal Authority Responsible and/or assent by the subject (starting from 6 years old)
* Subject must be
* Supportive clinical phenotype and diagnosis of LAMA2-RD, confirmed by:

  * Two pathogenic variants in the LAMA2 gene (via a diagnostic laboratory included on an approved list of genetic testing laboratories (Annex 1)) or
  * Muscle biopsy with absence of merosin (laminin-211) and at least one pathogenic variant in the LAMA2 gene
* Absence of another confirmed neurological genetic disease
* Willingness to maintain current exercise and/or physical therapy regimen for the duration of the clinical study
* Willingness to comply with the study protocol, including all the mandatory study procedures and visits
* Affiliated to or a beneficiary of a French or acknowledged in France, social security scheme

Exclusion Criteria:

* Developmental quotient less than 70 and/or behavioral disorder requiring general anesthesia to perform an MRI
* Acute medical illness or hospitalization within 30 days prior to informed consent
* Participation in a previous trial of any investigational agent for LAMA2-RD, or use of any other investigational therapy within 30 days prior to informed consent, or participation in other clinical studies, within 30 days (or 5 half-lives, whichever is longer) prior to informed consent, which, in the opinion of the PI, may potentially confound results from this study
* Other significant medical condition and/or overall fragility of medical status, which in the opinion of the Investigator may confound interpretation of the clinical course of LAMA2-RD
* Pregnant or breastfeeding women

Primary outcomes:
measure: Change in Motor function Measurement (MFM32) score
timeFrame: Through study completion, an average of 2 years
measure: Change in Motor Milestone Checklist
timeFrame: Through study completion, an average of 2 years
measure: Change in Revised Upper Limb Module (RULM) score
timeFrame: Through study completion, an average of 2 years
measure: Change in grip strength measured by dynamometer tool
timeFrame: Through study completion, an average of 2 years
measure: Change in pinch strength measured by dynamometer tool
timeFrame: Through study completion, an average of 2 years
measure: Change in arm flexion/extension strength measured by dynamometer tool
timeFrame: Through study completion, an average of 2 years
measure: Change in 6 Minutes Walking Test
timeFrame: Through study completion, an average of 2 years
measure: Change in 4 Stairs Climbing Test (4SCT)
timeFrame: Through study completion, an average of 2 years
measure: Change in 10m Walking Test
timeFrame: Through study completion, an average of 2 years
measure: Change in Rise from Floor Test
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's Forced Vital Capacity (FVC) results
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's Peak Cough Flow (PCF) results
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's Maximum Expiratory Pressure (MEP) results
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's Maximal Inspiratory Pressure (MIP) results
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's Sniff Nasal Inspiratory Pressure (SNIP) results
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's muscle fat replacement measured by Magnetic Nuclear Resonance
timeFrame: Through study completion, an average of 2 years
measure: Change in patient's cross-sectional area of the residual muscle measured by MNR
timeFrame: Through study completion, an average of 2 years
Secondary outcomes:
measure: Change in Wechsler Preschool and Primary Scale of Intelligence-IV (WPPSI-IV) results
timeFrame: Through study completion, an average of 2 years
measure: Change in Wechsler Intelligence Scale for Children-V (WISC-V) results
timeFrame: Through study completion, an average of 2 years
measure: Change in PedsQL questionnaire results
timeFrame: Through study completion, an average of 2 years
measure: Change in CGI-S questionnaire results
timeFrame: Through study completion, an average of 2 years
measure: Change in CGI-I questionnaire results
timeFrame: Through study completion, an average of 2 years
measure: Change in Faces pain rating scale results
timeFrame: Through study completion, an average of 2 years
measure: Change in Fatigue Severity Scale results
timeFrame: Through study completion, an average of 2 years
measure: Change in ACTIVLIM questionnaire results
timeFrame: Through study completion, an average of 2 years
measure: Change in Egen Klassifikation Scale Version 2 (EK2) results
timeFrame: Through study completion, an average of 2 years
measure: Change in Caregiver burden questionnaire (LMDIS) results
timeFrame: Through study completion, an average of 2 years
Other outcomes:
Locations:
city: Garches
country: France
facility: Centre de Référence GNMH, Pédiatrie Hôpital Raymond-Poincaré
city: Lyon
country: France
facility: Service de MPR pédiatrique L'Escale - HCL
city: Montpellier
country: France
facility: Département de neuropédiatrie Pôle Femme Mère Enfant CHU de Montpellier - Hôpital Gui de Chauliac
city: Paris
country: France
facility: Plateforme d'essais cliniques pédiatriques iMotion
Study officials:
References: