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SMA1ExSpAnD SMANCT05954455

Exploring Bulbar Function, Speech And Communication Development in SMA Type 1

An observational study of SMA1, run by Institute of Child Health at 1 site in United Kingdom.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

5q-spinal muscular atrophy (5q-SMA) is a rare, autosomal recessive neuromuscular disease characterized by degeneration of motor neurons in the spinal cord and lower brainstem with progressive muscle atrophy, weakness, and paralysis. The incidence is 1 in 7-10,000 live births. Read more about this study

Who is it for?
Ages 0 to 18 years
Conditions the study is for
SMA1
How many people
30 participants
Where
1 siteUnited Kingdom
Study dates
21 Mar 2024to Dec 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 0 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Study population: In the first instance, we will recruit SMA 1 paediatric patients (up to 18 years of age) who are under the care of the Neuromuscular team at the Dubowitz Neuromuscular Centre, London, UK, and who are being treated with any approved disease-modifying therapies. A total number of 30 patients is expected to be enrolled in the pilot phase of the study.

Who may be able to join

  • genetic documentation of 5q SMA;
  • onset of clinical signs and symptoms at ≤ 6 months (180 days) of age;
  • 0 - 18 years of age
  • treatment with any of the approved disease-modifying therapies;
  • parent(s)/legal guardian(s) willing and able to complete the informed consent process and comply with study procedures and visit schedule.

Who cannot join

  • any clinically significant medical finding that - in the judgment of the Investigator - will make the patient unsuitable for participation in, and/or unable to complete the study procedures;
  • parent(s)/legal guardian(s) unable or unwilling to comply with study procedures and/or refuses to sign consent form.
  • any clinically significant medical finding that - in the judgment of the Investigator - will make the patient unsuitable for participation in, and/or unable to complete the study procedures;
  • parent(s)/legal guardian(s) unable or unwilling to comply with study procedures and/or refuses to sign consent form.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Giovanni Baranello, MD contact

02079052872

g.baranello@ucl.ac.uk

Marta Zancolli, PhD contact

02079052188

m.zancolli@ucl.ac.uk

United Kingdom1 site, 1 recruiting
  • Great Ormond Street Hospital

    London, WC1N 3JH

    Giovanni Baranello

    Recruiting

Other trials in United Kingdom

About this study

Official title: Exploring Bulbar Function, Speech And Communication Development in SMA Type 1 (ExSpAnD SMA)

5q-spinal muscular atrophy (5q-SMA) is a rare, autosomal recessive neuromuscular disease characterized by degeneration of motor neurons in the spinal cord and lower brainstem with progressive muscle atrophy, weakness, and paralysis. The incidence is 1 in 7-10,000 live births. 5q-SMA presents a wide range of phenotypes that are classified into five clinical groups depending on age of onset and maximum motor milestone achieved. SMA type 1 presents shortly after birth and before six months of age with inability to achieve independent sitting and limited life expectancy due to respiratory complications (high mortality rate by 2 years of age). In addition to the severe gross-motor and respiratory impairment, bulbar weakness and dysfunction represent an obstacle to the development of verbal skills in these patients. To date, very little is known about these functions in children with SMA 1. With the increasing number of long-term SMA 1 survivors worldwide thanks to the availability of new pharmacological treatments, it has become obvious that treated children show new phenotypes, presenting changes not only in motor and respiratory function, but also in other domains, including bulbar function, speech and communication development. We aim to investigate the evolution of bulbar function and speech/communication development in children with SMA type 1 treated with approved disease-modifying therapies through validate scales and questionnaires for the paediatric population. Additional neurophysiological and neuroimaging studies will be offered on an optional basis to further investigate the underlying brain electrical activity, and brain structural and functional organization. The information gathered would promote the definition of additional outcome measures capturing improvement at these levels. A better understanding of the development of these areas would help to plan SMA 1- tailored supportive programs provided by speech and language therapists, thus enhancing the current recommendations for management in SMA.

Read the detailed description

Study design: observational longitudinal study. In the first instance, this is intended as a single-centre pilot study with a total duration of 3 years. A larger longitudinal study in a wider national and international cohort will be planned according to preliminary results and insights from this pivotal study. The first appointment will be the screening visit. Initially the trial will be discussed, and informed consent will be obtained for participation in the trial. Information will be collected from the patient and their family including demographics, medical history and detail on medications used by the patient. The investigator will discuss and obtain information on feeding and nutritional support required by the patient, speech and language interventions in place including if they are an augmentative alternative communication user and/or eye tracking device user. After this the investigator will be able to confirm eligibility for the trial. The second visit is the baseline, during this a set of assessments will take place to establish the patients' baseline function. This will include a bulbar function assessment (speech and swallowing), a speech and communication assessment and a cognitive assessment (Thinking abilities; memory, language, reasoning and perception). The investigator will collect further data on respiratory function (breathing) and gross motor function (Muscle strength and abilities). The investigator will assess any adverse events which have occurred since the last visit including symptoms, signs, illness etc. There are further tests which could take place at this visit which are an optional part of the study these include event-related potentials, Brain scan (MRI) and additional communication tests. Patients will then be seen at 6 monthly intervals, at 6m, 12m, 18m, 24m, 30m and 36 months. At each of these appointments and changes to medications will be documented. The investigator will discuss and obtain information on feeding and nutritional support required by the patient, speech and language interventions in place including if they are an augmentative alternative communication user and/or eye tracking device user. Assessments which took place at baseline will be repeated including a bulbar function assessment (speech and swallowing), a speech and communication assessment and we will collect data on respiratory function (breathing) and gross motor function (muscle strength and abilities). Cognitive testing will occur at visits at 12, 24 and 36 months.

At all visits the investigator will assess any adverse events which have occurred since the last visit including symptoms, signs, illness etc. If patients have decided to take part in additional cognitive testing, then this will occur at each 6 monthly visit. The month 36 visit will be the end of study visit so as well as the above will include repeat testing of the optional event-related potentials and brain scan (MRI).

Conditions
SMA1

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Bulbar function - Changes from baseline

    Paediatric-Functional Oral Intake Scale (p-FOIS/CEDAS)

    Min score( Worse) - Max score 6 (Better performance)

    Measured: Baseline, Visit Month 12, Month 24, and Months 36

  2. Bulbar function

    Paediatric-Functional Oral Intake Scale (p-FOIS/CEDAS)

    Min score 1( Worse) - Max score 6 (Better performance)

    Measured: Visit Month 6

  3. Bulbar function

    Paediatric-Functional Oral Intake Scale (p-FOIS/CEDAS)

    Min score 1 (Worse) - Max score 6 (Better performance)

    Measured: Visit Month 18

  4. Bulbar function

    Paediatric-Functional Oral Intake Scale (p-FOIS/CEDAS)

    Min score 1( Worse) - Max score 6 (Better performance)

    Measured: Visit Month 30

  5. Speech and Communication - Changes from baseline

    MacArthur-Bates Communicative Development Inventory (MCDI) - Words and Gestures or Words and Sentences

    For 8-18 month-olds looking at words and gestures, the following min score (worse performance) - max scores (better performance) exist:

    Phrases understood: 0/28 Vocabulary understood: 0/396 Vocabulary used: 0/396 Early gestures: 0/18 Later gestures: 0/45 Total gestures: 0/63

    For 18-30 month-olds looking at words and sentences, the following min score (worse performance) - max scores (better performance) exist:

    Words produced = 0/680 Irregular words = 0/25 Overregularized words = 0/45 Sentence complexity = 0/37

    Measured: Baseline, Month 12, Month 24, and Months 36

  6. Speech and Communication

    MacArthur-Bates Communicative Development Inventory (MCDI) - Words and Gestures or Words and Sentences

    For 8-18 month-olds looking at words and gestures, the following min score (worse performance) - max scores (better performance) exist:

    Phrases understood: 0/28 Vocabulary understood: 0/396 Vocabulary used: 0/396 Early gestures: 0/18 Later gestures: 0/45 Total gestures: 0/63

    For 18-30 month-olds looking at words and sentences, the following min score (worse performance) - max scores (better performance) exist:

    Words produced = 0/680 Irregular words = 0/25 Overregularized words = 0/45 Sentence complexity = 0/373

    Measured: Visit Month 6

  7. Speech and Communication

    MacArthur-Bates Communicative Development Inventory (MCDI) - Words and Gestures or Words and Sentences

    For 8-18 month-olds looking at words and gestures, the following min score (worse performance) - max scores (better performance) exist:

    Phrases understood: 0/28 Vocabulary understood: 0/396 Vocabulary used: 0/396 Early gestures: 0/18 Later gestures: 0/45 Total gestures: 0/63

    For 18-30 month-olds looking at words and sentences, the following min score (worse performance) - max scores (better performance) exist:

    Words produced = 0/680 Irregular words = 0/25 Overregularized words = 0/45 Sentence complexity = 0/37

    Measured: Visit Month 18

  8. Speech and Communication

    MacArthur-Bates Communicative Development Inventory (MCDI) - Words and Gestures or Words and Sentences

    For 8-18 month-olds looking at words and gestures, the following min score (worse performance) - max scores (better performance) exist:

    Phrases understood: 0/28 Vocabulary understood: 0/396 Vocabulary used: 0/396 Early gestures: 0/18 Later gestures: 0/45 Total gestures: 0/63

    For 18-30 month-olds looking at words and sentences, the following min score (worse performance) - max scores (better performance) exist:

    Words produced = 0/680 Irregular words = 0/25 Overregularized words = 0/45 Sentence complexity = 0/37

    Measured: Visit Month 30

  9. Speech and Communication - Changes from baseline

    Peabody Picture Vocabulary Test (PPVT)

    Measured: Baseline, Visit Month 6, Month 12, Month 18, Month 24, Month 30 and Months 36

  10. Speech and Communication

    Peabody Picture Vocabulary Test (PPVT)

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Visit Month 6

  11. Speech and Communication

    Peabody Picture Vocabulary Test (PPVT)

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Visit Month 18

  12. Speech and Communication

    Peabody Picture Vocabulary Test (PPVT)

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Visit Month 30

  13. Speech and Communication - Changes from Baseline

    Social Communication Questionnaire (SCQ)

    Minimum value is 0, maximum value is 39, higher score means worse outcome (The threshold varies depending on countries and researchers).

    Measured: Baseline, Month 12, Month 24, and Months 36

  14. Speech and Communication

    Social Communication Questionnaire (SCQ)

    Minimum value is 0, maximum value is 39, higher score means worse outcome (The threshold varies depending on countries and researchers).

    Measured: Visit Month 6

  15. Speech and Communication

    Social Communication Questionnaire (SCQ)

    Minimum value is 0, maximum value is 39, higher score means worse outcome (The threshold varies depending on countries and researchers).

    Measured: Visit Month 18

  16. Speech and Communication

    Social Communication Questionnaire (SCQ)

    Minimum value is 0, maximum value is 39, higher score means worse outcome (The threshold varies depending on countries and researchers).

    Measured: Visit Month 30

Secondary outcomes (4)
  1. Cognitive function - Changes from baseline

    Bayley Scales of Infant \& Toddler Development - Forth Edition

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Baseline, Month 12, Month 24, and Months 36

  2. Cognitive function

    Bayley Scales of Infant \& Toddler Development - Forth Edition

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Visit Month 6

  3. Cognitive function

    Bayley Scales of Infant \& Toddler Development - Forth Edition

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Visit Month 18

  4. Cognitive function

    Bayley Scales of Infant \& Toddler Development - Forth Edition

    Age-based standard scores (M = 100, SD = 15). Minimum value of normal range is 85, maximum value of normal range is 115, higher score means better outcome.

    Measured: Visit Month 30

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jul 2023
  2. Study start21 Mar 2024
  3. Primary completionSep 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05954455
Sponsor's protocol ID
19NM18
Acronym
ExSpAnD SMA
Status last verified
Aug 2024
First submitted
29 Jun 2023
Last updated
16 Aug 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of SMA1, run by Institute of Child Health at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 16 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Giovanni Baranello, MD (02079052872, g.baranello@ucl.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Bulbar function - Changes from baseline (time frame: Baseline, Visit Month 12, Month 24, and Months 36). The study lists 16 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Aug 2024.

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