Prospective Evaluation of Infants With Spinal Muscular Atrophy: SPOT SMA
试验速览
- 阶段
- 不适用
- 入组人数
- 1,000
- 试验地点
- 1
- 主要终点
- Time to death and/or full time invasive ventilation or need for > 16 hours/day of bilevel respiratory support
研究概览
简要总结
SPOT SMA is a prospective NIH-supported clinical study targeting pre-symptomatic or recently diagnosed infants and children with Spinal Muscular Atrophy (SMA) types 1, 2, or 3 and their healthy control siblings less than 36 months of age at the time of study enrollment. The main objective of the study is to prospectively collect longitudinal clinical outcomes and provide counseling and education to parents of newly diagnosed children. The study will assess the impact of current standard of care management paradigms and interventions on health outcomes in newly diagnosed SMA infants and children with type 1, 2 or 3 and age appropriate controls. There is no investigational drug and no specific intervention in this study. Rather, the investigators will document outcomes related to current therapies provided to participating subjects, and will educate participants about possible clinical trial opportunities.
详细描述
Overview of data to be collected from enrolled infants followed longitudinally and entered into the NBSTRN Longitudinal Pediatric Data Resource
- Past medical history relevant to pregnancy, delivery, complications in the immediate neonatal period, birth parameters, family history and any medical problems other than SMA (ie prematurity, etc)
- Ongoing medical history indicating problems related to the following areas:
feeding, growth, respiratory status including use of cough assist and bilevel respiratory support, gastrointestinal issues, cardiac symptoms, neurologic symptoms or signs including muscle weakness, hospitalizations, ER visits, other adverse events 3. Assessment of dietary intake and use of nutritional supplements 4. Surgical history and ongoing documentation of assessments and need for g-tube, Nissen, tympanostomy, adenoidectomy/tonsillectomy or other airway surgeries, and orthopedic procedures 5. Caregiver obtained developmental history and documentation of newly acquired and/or loss of previously acquired gross motor skills at the time of each visit 6. Documentation of caregiver reported outcomes 7. Documentation of anthropometric measures, vital signs, general physical examination parameters 8. Neurological examination using standardized tools 9. Time to death, permanent invasive ventilation and/or need for > 16 hours/day of bilevel respiratory support 10. Specific assessment of motor function as measured using age appropriate motor outcome measures such as: the Children's Hospital of Philadelphia Infant Tests of Neuromuscular Disorders (CHOP-INTEND), Test of Infant Motor Performance Screening Inventory, WHO motor milestones or others, and Hammersmith Functional Motor Scale for SMA Expanded for children 18 months and older 11. Electrophysiologic studies such as maximum ulnar compound muscle action potential (CMAP) amplitude and area 12. Documentation of range of motion, development of limb contractures and/or presence of scoliosis, lordosis, hip dysplasia or other orthopedic outcomes 13. Additional optional exploratory biomarker assessments 14. DEXA measurements to assess body composition and bone density 15. The option to enroll in an autopsy study at the time of death to contribute samples to a research biorepository
Normal control subjects such as unaffected siblings will undergo these same measurements, as applicable. Unaffected parents' participation will be limited to collection and banking of blood and cell lines.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •For affected subjects: genetic diagnosis of SMA
- •For unaffected family members: parent or sibling of any age (without genetic diagnosis of SMA) of affected subject enrolled in study
排除标准
- 未提供
结局指标
主要结局
Time to death and/or full time invasive ventilation or need for > 16 hours/day of bilevel respiratory support
时间窗: At each visit (every 1-6 months depending on age)
次要结局
- WHO Motor Milestones(At each visit (every 1-6 months depending on age))
- Body composition(Every 6 months)
- Caregiver Questionnaire total score and subscores(At each visit (every 1-3 months depending on age and SMA type))
- Hammersmith Functional Motor Scale - Expanded(At each visit (every 1-6 months depending on age, beginning when deemed appropriate by PI/physical therapist))
- Need for tube feeding(At each visit (every 1-6 months depending on age))
- Maximum Ulnar CMAP Amplitude(At each visit (every 1-6 months depending on age))
- CHOP-INTEND(At each visit (every 1-6 months depending on age, or until deemed no longer appropriate by PI/physical therapist))
- Hammersmith Infant Neurological Exam (HINE)(At each visit (every 1-6 months depending on age, beginning when deemed appropriate by PI/physical therapist))
- Bone density(Every 6 months)
研究者
Kathryn J Swoboda
Katherine B. Sims MD Endowed Chair in Neurogenetics
Massachusetts General Hospital
