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.
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
100
Centre hospitalier Universitaire d'Angers
Angers, France
CHU de Lille - Hôpital
Lille, France
CHU LA TIMONE - Service des Maladies
Marseille, France
Centre de référence des maladies neuromusculaires
Nantes, France
Hôpital Pitié Salpêtrière
Paris, France
CHU de Toulouse - Hôpital
Toulouse, France
Change in stiffness severity assessed by Visual Analog Scale (VAS)
Absolute change in VAS stiffness score (0-100mm) between Baseline and Month 12
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: Baseline to Month 24
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).
Time frame: 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
Time frame: 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.
Time frame: 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.
Time frame: Baseline and all scheduled study timepoints.
Safety and Tolerability
Evaluation of adverse events, clinical laboratory parameters (hematology and biochemistry) and concomitant medication use.
Time frame: 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
Time frame: 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).
Time frame: 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).
Time frame: 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.
Time frame: 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.
Time frame: Baseline and all scheduled study timepoints
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