Spinal Muscular AtrophyPHENO SMARTNCT06321965
Characterization of New Phenotypes of Patients With Spinal Muscular Atrophy Treated With SMN Restoring Therapy
A study testing evaluation of muscle function, First-line cognitive assessment and second-line cognitive assessment in people with Spinal Muscular Atrophy, run by Hospices Civils de Lyon at 8 sites in France.
Trial summary
With the advent of new treatments for ASI, new phenotypes are emerging. The investigators propose to describe these new phenotypes by prospectively following children with ASI of all types treated with TRS and aged under 16 for 2 years. Read more about this study
- Who is it for?
- Ages 0 to 16 years
- Conditions the study is for
- Spinal Muscular Atrophy
- What is being tested?
- evaluation of muscle function, First-line cognitive assessment and second-line cognitive assessment
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 8 sitesFrance
- Study dates
- 24 Jul 2024to 24 Jan 2029
- Phase
- Interventional
- 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 16 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Genetically confirmed infantile or juvenile spinal muscular atrophy
- Treated with a therapy that restores SMN protein expression (e.g. nusinersen, risdiplam, onasemnogene abeparvovec)
- Aged 0 to 15 years inclusive
- Informed consent signed by both parent(s)/legal guardian(s) and patient's assent
- Affiliated or beneficiary of a health insurance plan*. * for inclusion in France
Who cannot join
- Other condition likely to interfere significantly with ASI assessment and clearly unrelated to the disease
- Other associated neurological disease
- Current pregnancy or breast-feeding (a pregnancy test will also be performed at inclusion).
- Please note that patients with a specific contraindication to MRI (i.e. metallic foreign body, claustrophobia and other reasons determined by the investigators) will be allowed to participate in the study, but MRI will not be performed.
Trial locations and contacts
8 sites in 1 country. Contact the study team or a site near you to ask about taking part.
8 sites in 1 country
France8 sites, 8 recruiting
- Not yet recruiting
CHRU of Brest
Brest, 29609
Juliette ROPARS, Dr, 02.98.22.33.89 ext. +33, Juliette.ropars@chu-brest.fr
Juliette ROPARS, Dr
- Recruiting
Pediatric Rehabilitation Service - L'Escale Mother and Child Hospital
Bron, Rhone, 69500
Laure LE GOFF, PI, 04.72.12.95.04 ext. +33, laure.le-goff@chu-lyon.fr
Laure LE GOFF
- Not yet recruiting
Pediatric Neurology and Resuscitation Raymond-Poincare Hospital
Garche, 92380
Susana QUIJANO-ROY, Pr, 01.47.10.79.16 ext. +33, Susana.quijano-roy@aphp.fr
Susana QUIJANO-ROY, Pr
- Not yet recruiting
Pediatric Neurology Swynghedauw Hospital
Lille, 59037
Jean-Baptiste DAVION, Dr, 03.20.44.58.31 ext. +33, Jeanbaptiste.davion@chru-lille.fr
Jean-Baptiste DAVION, Dr
- Not yet recruiting
Marseille University Hospital - Timone Hospital Department of Pediatric Neurology - Specialized Pediatrics and Child Medicine
Marseille, 13005
Brigitte CHABROL, Pr, 04.91.38.68.08 ext. +33, brigitte.chabrol@ap-hm.fr
Brigitte CHABROL, Pr
- Not yet recruiting
I-Motion Pediatric Clinical Trial Platform Armand Trousseau Hospital
Paris, 75012
Andreea SEFERIAN, Dr, 01.71.73.80.50 ext. +33, a.seferian@institut-myologie.org
Andreea SEFERIAN
- Not yet recruiting
Hautepierre Hospital - Mother and Child Hospital
Strasbourg, 67200
Vincent LAUGEL, Pr, 03.88.12.77.43 ext. +33, vincent.laugel@chru-strasbourg.fr
Vincent LAUGEL, Pr
- Not yet recruiting
Department of Pediatrics - Neurology and Infectious Diseases Toulouse University Hospital - Children's Hospital
Toulouse, 31059
Claude CANCES, Pr, 05.34.55.74.08 ext. +33, cances.c@chu-toulouse.fr
Claude CANCES, Pr
About this study
With the advent of new treatments for ASI, new phenotypes are emerging. The investigators propose to describe these new phenotypes by prospectively following children with ASI of all types treated with TRS and aged under 16 for 2 years.
The investigators also propose to evaluate potential assessment tools to determine whether they are relevant for monitoring this population, either routinely or for future clinical trials. The investigators also aim to collect the total costs associated with ASI in order to propose a first prospective medico-economic study in France.
- Conditions
- Spinal Muscular Atrophy
- Being tested
- evaluation of muscle function, First-line cognitive assessment, second-line cognitive assessment, Cardiac evaluation, MRI
- Keywords
- Natural history, Spinal Muscular atrophy (SMA), Risdiplam, Onasemnogene abeparvovec, Nusinersen
- Medical subject headings
- Muscular Atrophy, Spinal
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
evaluation of muscle functionOther
Myogrip (≥ 6 years): precise dynamometric measurement of gripping force, measuring force in Newton up to 90kg with 0.01kg resolution. It's evaluated at D0, M6, M12, M18, and M24 Myopinch (≥ 6 years) : measure thumb-index force up to 15 kg with a resolution of 0.001 kg using a precision sensor equipped with two steel distance blades. It's evaluated at D0, M6, M12, M18, and M24
First-line cognitive assessmentOther
Vineland-II (All patients) : is a scale for assessing adaptive behaviors. will be carried out during the telephone call at M1/V2.
All tests are evaluated at D0, and M18 :
Bayley-4 language part (< 42 months) PVSE (≥ 4 years) CELF-5 (≥ 5 years) Conners-3 (≥ 6 years) AQ (≥ 4 years), EQ (≥ 11 years)
M-CHAT-R (< 4 years) :
SRS-2 (≥ 2 years)
second-line cognitive assessmentOther
In the event of positive cognitive screening at D0 or M18, a second-line cognitive assessment will be carried out at a subsequent visit. A list of tests is proposed below, but will be adapted according to the tests available at each center.
- EVALO BB (0-2 years) or EVALO (2-6 years) or full CELF-5 (5-18 years) following positive screening in the communication domain of first-line tests (Vineland II communication domain, Bayley 4, CELF-5 pragmatic profile)
- FEE and DSM-5 diagnostic criteria for ADHD (from age 6 only) following positive screening in the attention and executive functions domain of first-line tests (Conners 3, BRIEF)
- M-CHAT-R/F (< 4 years) or SCQ (≥ 4 years) and ADOS-2 (≥ 12 years) following a positive screening in the area of social cognition and autistic traits on first-line tests (Vineland II, M-CHAT-R, SRS-2, EQ, AQ).
Cardiac evaluationOther
All tests are evaluated at D0, M12, and M24 :
Electrocardiogram (ECG) : This examination will be carried out in accordance with the 12 leads recording the following parameters: verification of sinus rhythm, P wave, PR interval, QRS complex (interval), ST segment, T wave, QT complex, heart rate.
Cardiac ultrasound: Non-invasive ultrasound will focus on the following parameters measured from 2-dimensional images, to look for cardiomyopathy and/or structural abnormality:
- end-diastolic/end-systolic diameter/left ventricular ejection fraction
- Septal wall thickness / left ventricular posterior wall
- Fractional shortening 24-hour Holter-ECG : This examination consists of a continuous test recording the heart rhythm for 24 hours.
MRIRadiation
Cerebral MRI : Performed at D0, only for patients with ASI type 1 ≥ 6 years, or younger patients for whom the investigator considers that the examination can be performed without sedation or general anesthesia. It will include sequences:
- 3D T1, gradient echo, 1.1 mm voxel, sagittal acquisition
- axial T2, spin-echo, slice thickness 4 mm
- 3D FLAIR, spin-echo, 1 mm voxel, sagittal acquisition Muscular MRI: performed at V1/J0, and V6/M24. The examination will include water-fat imaging (Dixon) in full-body, 3D mode, with proton density weighting and millimeter resolution.
Assessment of activity and muscle fatigueOther
Syde® : evaluated at D0, M6, M12, M24. Patients aged 2 and over will receive the Syde® wearable device to collect their daily activities.
Muscular endurance tests (≥ 6 years) : evaluated at D0, M12, M24 ( only one of 3 tests based on motor function level) oESNHPT : In this test, patients are asked to walk a 10-meter path. oESBBT : In this test, patients have to move 10 blocks over a partition. oESWT: In this test, patients must repeatedly place and remove 9 sticks in 9 holes.
PedsQL Fatigue (≥ 2 years): evaluated at D0, M12, M24. Scale designed to measure fatigue in patients with acute and chronic conditions, as well as in healthy school and community populations.
Fatigue rating scale (≥ 6 years): evaluated at D0, M12, M24. The fatigue assessment scale has 11 numerical points ranging from 0 to 10. The patient is asked to give a rating that best reflects his or her perception of fatigue at that particular moment.
Assessment of bulbar functionOther
DDD-pNMD (≥ 2 years) : evaluated at D0, M6, M12, M18, and M24, is a list of 9 questions used by doctors to screen for dysphagia and dysarthria.
NdSSS (All Patients) : evaluated at D0, M6, M12, M18, and M24, is an 8-level scale for assessing swallowing.
TOMASS-c : (≥ 4 years of age, in patients able to eat solids safely, after assessment of the risk of a false route by the speech therapist): this is a score designed to assess mastication when eating a cracker. Age-dependent standards exist for different types of cracker.
- Fluid intake test (> 110 cm, in patients able to drink a liquid safely, after assessment of the risk of a false route by the speech therapist): swallowing limit.
Evaluation of body composition and metabolismOther
Food survey : The dietary survey questionnaire will be sent to parents at D0 and M18. Parents will be asked to complete it for 3 days before the M6 and M24.
Bioelectrical impedancemetry: Evaluated at M6 and M24. Renal ultrasound: Evaluated at M6, is a non-invasive examination that analyzes the appearance of the kidney and urinary tract.
Dual-energy X-ray absorptiometry (DXA) : Evaluated at M6, it measures body composition using spectral imaging, including fat mass, lean mass and bone mineral density.
Fibroscan : Evaluated at M6 and M24. This examination uses pulse elastography to measure liver elasticity, which provides information on the presence of hepatic fibrosis, and sound attenuation, which provides information on the presence of liver fat overload.
Indirect calorimetry : Evaluated at M6. This device enables precise measurement of Resting Energy Expenditure , Respiratory Quotient and metabolic substrate oxidation.
QuestionnairesOther
SMAIS : The questionnaire has been developed specifically for ASI. At D0, M6, M12, M18 and M24.
HUI2 : specializes in preference-based measures of health-related quality of life. At D0, M6, M12, M18 and M24.
Peds QL : is a modular instrument designed to measure health-related quality of life and disease-specific symptoms. At D0, M6, M12, M18 and M24.
Neuromuscular module : 17 disease-related items. It is evaluated at D0, M6, M12, M18 and M24.
Family impact module : It measures parents' reported physical, emotional, social and cognitive functioning, communication and concerns. At D0, M12, and M24.
ASI cost questionnaire: At visit 1 (D0): This questionnaire, completed by the parents, includes information on occupation, parents' working hours and any reduction in them due to the child's pathology, the number of working days missed by the parents or school days missed by the child, and disability-related costs.
BiocollectionBiological
A blood bio collection (optional) will be offered to patients at D0, M6 , M12, M18, M24.
Patients receiving intrathecal injections will also be offered the opportunity to participate in a CSF (cerebrospinal fluid) biocollection (optional).
Skinfold measurementOther
The tricipital point should be marked on the posterior aspect of the arm, on the midline of the tricipital muscle, midway between the acromion and the radius. At D0, M6, M12, M18 and M24
| Study group | Role | What they receive |
|---|---|---|
| SMA patient treated with SRT | Experimental | Patients aged 0-15 with SMA type 1, 2 or 3, treated with TRS (nusinersen/risdiplam/onasemnogene abeparvovec/other). Receives: Other: evaluation of muscle function; Other: First-line cognitive assessment; Other: second-line cognitive assessment; Other: Cardiac evaluation; Radiation: MRI; Other: Assessment of activity and muscle fatigue; Other: Assessment of bulbar function; Other: Evaluation of body composition and metabolism; Other: Questionnaires; Biological: Biocollection; Other: Skinfold measurement |
What is being measured
The primary outcome is the main question the study is designed to answer.
Markers of disease progression and description of different phenotypes, at : muscular and functional
A composite score indicating the overall motor development trajectory for patients from study inclusion to Month 24 (M24).
Calculation: Assign numerical values or categories to represent the motor development stages, with higher scores indicating positive development and lower scores indicating decline.
Measured: Every 6 months from inclusion (Day 0, Month6, Month12, Month18, Month24)
Markers of disease progression and description of different phenotypes, at : muscular and functional
The trajectory of mean scores for motor function and muscle strength measured using CHOP-INTEND for patients aged 0-2 years. Scores are assessed every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24).
Scale: CHOP-INTEND scale (0-64) Minimum Value: 0 Maximum Value: 64 Interpretation: Higher scores indicate improved motor function and muscle strength.
Measured: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Markers of disease progression and description of different phenotypes, at : muscular and functional
Motor Function Measure 32 (MFM-32), is a quantitative scale created to measure global motor functional abilities in a person with neuromuscular disease. It contains 32 items, each marked from 0 to 3. The total score and the sub-scores are expressed as a percentage of the maximum possible score.
Scale Range: 0 to 100 (Minimum to Maximum Values)
Interpretation: Higher scores on the Motor Function Measure 32 (MFM-32) indicate improved motor function and muscle strength.
The lower the total score, the more severe the impairment.
Measured: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Markers of disease progression and description of different phenotypes, at : muscular and functional
Motor function and muscle strength: Trajectory of mean score between inclusion and M24: 6-minute walk test (≥ 6 years walking)
Measured: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Markers of disease progression and description of different phenotypes, at : muscular and functional
Motor function and muscle strength: Trajectory of mean score between inclusion and M24:
Myogrip (≥ 6 years), Myopinch (≥ 6 years)
Measured: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Markers of disease progression and description of different phenotypes, at : Fatigue
For All:
Upper limb kinematics and power
For Walkers:
Gait variables, arm swing variables, walking perimeter Interpretation: Specific statistical quantities related to upper limb kinematics and power, and additional variables for walkers.
Calculation: Analyze statistical quantities at each time point for Syde
Measured: Syde: At Day 0, Month 6, Month 12 and Month 24
Markers of disease progression and description of different phenotypes, at : Fatigue
Endurance time from 0 to 1200 The primary outcome measure for fatigue-related markers involves the endurance test (≥ 6 years), specifically assessing ESNHPT, ESBBT, and ESWT. The primary focus is on the proportion of patients who stop before completing the test (yes/no) and, if applicable, the mean time to stop in seconds.
ESNHPT: Endurance Test - Non-Handheld Propulsion Task ESBBT: Endurance Test - Bodyweight Bearing Task ESWT: Endurance Test - Walking Task
Measured: Endurance test (≥ 6 years)
Markers of disease progression and description of different phenotypes, at : Fatigue
Pediatric Quality of Life Inventory (PedsQL) Fatigue Total Score Minimum Value: 0 Maximum Value: 24 Interpretation: A higher score within the range indicates increased fatigue, while a lower score suggests less fatigue.
Measured: at Day 0, Month 12 and Month 24
Markers of disease progression and description of different phenotypes, at Orthopaedic level
Joint amplitudes: Trajectory of joint amplitude changes (angle) between Day 0 and Month 24 for each location:
Hip (right and left), Knee (right and left), Ankles, Elbow, Wrist, Long fingers.
Measured: Joint amplitudes at Day 0, Month 6, Month 12 and Month 24
Markers of disease progression and description of different phenotypes, at Orthopaedic level
(For Non-Operated Patients): Presence or Absence of Radiological Scoliosis
Measured: Clinic and spinal radiography at Day 0, Month 12,Month 18, Month 24
Markers of disease progression and description of different phenotypes, at Orthopaedic level
Clinical and pelvic radiography:
Proportion of patients with hip eccentricity (>10% on Reimers index) at Day 0 and Month 24
Measured: at Day 0, Month 24+/- Month 6, Month 12, Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: Vineland-II
Vineland II Adaptive Behaviour scales (VABS) total mean score and subscale mean scores.
Standardized questionnaire filled by the Neupsy during an interview with the parents or the patient himself if possible. 5 domains. Maximum score 160, minimum score 20, mean score 100, standard deviation 15
Measured: At Month 1
Markers of disease progression and description of different phenotypes, at the cognitive level: Bayley-4
Bayley-4 Scales of Infant and Toddler Development is standardized developmental assessment tool for determining a child's developmental status at a given age (up to 42 months) BAYLEY-4 assess development in children of 1-42 months old in 5 domains: cognition, motor, language, socio-emotional, and adaptive behavior.
The Bayley-4 raw scores from 0-84 for the receptive communication subtest, 0-74 for the expressive communication subtest a higher score denotes a better outcome. The Bayley-4 standard score norms are converted to percentiles from <0.1 to >99.9 for the language
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: BRIEF (Behavioral Rating Inventory of Executive Function)
BRIEF provides scores that are used to evaluate different aspects of executive function. The scores are typically presented in various subscales, each focusing on a specific domain of executive function.
composite T-score for overall developmental function equal to or greater than 65 (-1.5 SD)
The " composite T-score for overall developmental function equal to or greater than 65 (-1.5 SD)" indicates that a T-score composite for the overall developmental function is considered elevated or clinically significant if it equals or exceeds 65, which is 1.5 standard deviations above the mean in a standardized population. Higher scores on the BRIEF suggest greater difficulties in executive functioning, with a T-score of 65 or above indicating a higher level of impairment or challenges in this domain.
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: Conners-3
- CONNERS-3 : 108-item hetero-questionnaire to assess the presence of symptoms of inattention, hyperactivity, impulsivity and other frequently associated disorders in children and adolescents aged 6 to 18. Symptoms are rated on a Likert scale with severity ratings from 0 (not at all/never) to 3 (very much/ very frequently). The Conners t-score range from 0 - 100. The higher the number, the worse the outcome
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: CELF-5 (Language and communication assessment battery)
Standard Score: This score are derived from the total raw scores for each test and are on a normalized score scale that has a mean of 10 and a standard deviation (SD) of 3
The mean score is 100, with a standard deviation of 15, meaning:
that standard scores between 85-115 are within the normal range. Score Mild: 70-85, Moderate: 55-70, Severe: 55 and lower
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: EQ (Empathy quotient), AQ (Autism Quotient)
Evaluation of the French Version of Screening Questionnaires for Autism and Asperger Syndrome: Autism Spectrum Quotient (AQ) Empathy Quotient (EQ) EQ is a 40-item questionnaire designed to measure empathy for patients aged 11 and above. The maximum score for this questionnaire is 80.
Threshold score: ↓30 . Scores of 30 or less indicate a lack of empathy common in people with Autism.
AQ comprises 50 questions, with 5 groups of 10 questions assessing imagination, social skills, attention switching, attention to detail and communication skills. Each of these items scores 1 point if the respondent records abnormal or autistic like behaviour. The minimum score on the AQ is 0 and the maximum 50 with high scores indicating high autistic traits.
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: M-CHAT-R (Modified Checklist for Autism in Toddlers)
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a screener that will ask a series of 20 questions about the child's behavior.
To score the M-CHAT-R, we add up the number of at-risk responses, and follow the algorithm below:
LOW RISK:
Total score between 0 and 2
MEDIUM RISK:
Total score between 3 and 7
HIGH RISK:
Total score between 8 and 20
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: SRS-2 (Social Responsiveness Scale, Second Edition)
SRS measures social ability of children from 2 years to 18 years old. It is used primarily with individuals with Autism Spectrum Disorder (ASD), family members of individuals with ASD, and others who have social impairments. Parent or teacher questionnaire (65 items on a 4-point Likert scale). High scores are associated with more severe social impairments.
Raw total scores are converted to gender-normed T scores
SRS-2 total T-scoring:
- Less than or equal to 59 = Within normal limits (generally not associated with ASD)
- Between 60-65 = Mild range
- Between 66-75 = Moderate range
- Greater than or equal to 76 = Severe range (strongly associated with clinical diagnosis of ASD)
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the cognitive level: PVSE (Basic visuo-spatial perception)
- Proportion of patients with overall score:
- < OL_inf
- OL_inf ≤ x < Q1
- Q1 ≤ x < M
- M ≤ x < Q3
- Q3 ≤ x < Q3
- ≥ OL sup
Measured: At Day 0 and Month 18
Markers of disease progression and description of different phenotypes, at the brain level
Cerebral MRI :
Proportion of patients with :
- Posterior fossa anomaly
- Midline anomaly
- White matter anomaly
- Cortical anomaly
- Basal ganglia anomaly
- Ventricular system anomaly
- Pericerebral space abnormality
- Brain MRI abnormality (including above variables)
Measured: At Day 0
Markers of disease progression and description of different phenotypes, at Cardiology level
Electrocardiogram (ECG): An abnormal ECG, with proportion for each type of abnormality Holter-ECG: An abnormal Holter-ECG, with proportion for each type of abnormality Echocardiography (only if troponin anomaly): Abnormal echocardiography, with proportions for each type of abnormality
Measured: At Day 0 +/- Month 12, Month 24
Markers of disease progression and description of different phenotypes, at metabolic level : Anthropometric measurement trends
Anthropometric measurements may be used to monitor growth and nutritional status.
Outcome of tracking these measurements could be the identification of trends related to weight gain and muscle mass development. Assessing changes in weight and body composition over time can provide valuable insights into the impact of SMA on physical development, guide nutritional interventions, and help healthcare providers tailor supportive care to address the unique needs of children with SMA
Measured: Anthropometric measurements at Day 0, Month 6, Month 12, Month 18, Month 24
Markers of disease progression and description of different phenotypes, at metabolic level :
Food survey: average food intake
Measured: Food survey at Month 6, Month 24
Markers of disease progression and description of different phenotypes, at metabolic level : fractures
Number of fractures by location and mechanism
Measured: at Day 0, Month 6, Month 12, Month 18, Month 24
Markers of disease progression and description of different phenotypes, at metabolic level : renal ultrasound
Proportion of patients with abnormal renal ultrasound
Measured: at Month 6
Markers of disease progression and description of different phenotypes, at metabolic level : Absorptiometry (DXA)
DXA measurement will be performed to assess patient's body composition.
Average values + SD (Standard Deviation):
Lean mass and fat mass (kg) with deficit or excess of lean mass and fat mass (%) Total bone mineral content (g) Bone mineral density (z-score) at the spine, femoral neck, and distal femur
Measured: at Month 6
Markers of disease progression and description of different phenotypes, at metabolic level: Calorimetry
Potential outcome of using this device is the accurate measurement of Resting Energy Expenditure (REE). This information can be particularly important in managing the nutritional needs of individuals with SMA, helping healthcare providers optimize dietary plans to meet the specific energy requirements of patients dealing with this neuromuscular disorder. Resting Energy Expenditure (REE).
Measured: at Month 6
Markers of disease progression and description of different phenotypes, at metabolic level : Impedancemetry
Average +SD values of Impedancemetry results
Measured: at Month 6 and Month 24
Markers of disease progression and description of different phenotypes, at metabolic level : Fibroscan
The FibroScan result is reported in kilopascals (kPa), representing the liver stiffness. The numerical value indicates the degree of stiffness, which correlates with the extent of liver fibrosis. The interpretation of the FibroScan score is as follows:
Low Stiffness (Low kPa): Indicates a healthier, less fibrotic liver.
Intermediate Stiffness: May suggest some degree of fibrosis, and further evaluation may be needed to determine the extent.
High Stiffness (High kPa): Indicates more advanced liver fibrosis or cirrhosis.
Measured: At Month 6 and Month 24
Markers of disease progression and description of different phenotypes, at biological analysis
Proportion of patients with biological abnormalities for each parameter:
Blood/platelet count: Hb, leukocytes, platelets, ASAT, ALAT, GGT, PAL, TP, Sodium, potassium, bicarbonates, calcium, phosphorus, creatinine, glucose, proteins, urea, cystatin C, Troponin, BNP, NT-pro-BNP, Iron, Ferritin, copper, zinc, selenium, magnesium, Vitamins A,C,D,E, B12, Folates, Albumin, prealbumin, retinol-binding protein, ultra-sensitive C-reactive protein (CRP), FibroTest, PTH (parathormone) For these patients : % above normal
- above
- or below
Measured: At Day 0, Month 6, Month 12, Month 18, Month 24
Markers of disease progression and description of different phenotypes, at In terms of quality of life and autonomy
Score evolution trajectory :
PedsQL (Pediatric Quality of Life Inventory™) family impact The 36-item PedsQL™ Family Impact Module Scales encompass 6 scales measuring parent self-reported functioning: 1) Physical Functioning (6 items), 2) Emotional Functioning (5 items), 3) Social Functioning (4 items), 4) Cognitive Functioning (5 items), 5) Communication (3 items), 6) Worry (5 items), and 2 scales measuring parent-reported family functioning; 7) Daily Activities (3 items) and 8) Family Relationships (5 items).
Scale Scores are computed as the sum of the items divided by the number of items answered.
higher scores indicate better functioning (less negative impact)
Measured: PedsQL family impact at Day 0, Month 12, Month 24
Markers of disease progression and description of different phenotypes, at In terms of quality of life and autonomy
HUI2 classification system consists of attributes (domains) of health to 6 levels of functional ability/disability within each attribute. For each attribute, singleattribute utility functions range from 0.00 for highly disabled (deaf) to 1.00 Score total : 0 - 1
Measured: HUI-2, generic PedsQL and neuromuscular module at Day 0, Month 6, Month 12, Month 18 and Month 24
Markers of disease progression and description of different phenotypes, at respiratory level : Chest/head circumference ratio (PT/PC ratio) (up to 3 years)
Outcome measure related to hospitalizations in the context is "Proportion of Patients with Escalation of Respiratory Assistance." This measure assesses the percentage of patients who experienced an escalation in respiratory support during their hospital stay, encompassing variables such as increased settings on home machines, use of resuscitative NIV, or intubation. This outcome provides critical insights into the respiratory management and support needs of patients during their hospitalizations.
Measured: at Day 0, Month 6, Month 12, Month 18 and Month 24
Markers of disease progression and description of different phenotypes, at respiratory level : Chest/head circumference ratio (PT/PC ratio)
Evolution of the PT/PC ratio trajectory
Measured: at Day 0, Month 6, Month 12, Month 18 and Month 24
Markers of disease progression and description of different phenotypes, at respiratory level : O2 saturation and nocturnal TcPCO2
Evolution trajectory: This measure focuses on the percentage of children experiencing elevated levels of transcutaneous carbon dioxide (TcPCO2), specifically defined as time spent with TcPCO2 levels exceeding 50mmHg. This outcome is crucial in assessing the severity of respiratory compromise and may guide interventions to address and manage hypercapnia in the pediatric population.
Measured: at Day 0, Month 12, Month 24
Markers of disease progression and description of different phenotypes, at respiratory level: Respiratory function tests (≥ 6 years)
Evolutionary trajectory: Evolution of Inspiratory Vital Capacity in Different Positions (% of Theoretical). This measure assesses changes over time in the percentage of theoretical inspiratory vital capacity achieved while standing or sitting and while lying down. This outcome provides valuable information about respiratory muscle function and potential changes in the ability to generate inspiratory volumes in different body positions.
Measured: at Day 0, Month 12, Month 24
Markers of disease progression at respiratory level
Evolutionary trajectory :
Proportion of patients with central sleep apnea syndrome Proportion of patients with obstructive sleep apnea syndrome Proportion of patients with alveolar hypoventilation syndrome
Measured: points (Day 0, between Day 0-Month 12, between Month 12 and Month 24)
Markers of disease progression and description of different phenotypes, at bulbar level (Evaluation of dysphagia and dysarthria): DDD-pNMD (Diagnostic list for Dysphagia and Dysarthria in pediatric NeuroMuscular Disorders)
The DDD-pNMD is a scale where items are scored by a Speech-Language Therapist (SLT) on a 4-point scale, ranging from 0 (normal) to 3 (severe problems/impossible). The scale is designed to assess various aspects of swallowing and speech in children with neurological conditions.
The DDD-pNMD screening is positive if score greater than or equal to 1.
Measured: At Day 0, Month 6, Month 12, Month 18, Month 24
Markers of disease progression and description of different phenotypes, at bulbar level (Evaluation of dysphagia and dysarthria): NdSSS (Neuromuscular Disease Swallowing Status Scale).
An 8-stage Neuromuscular Disease Swallowing Status Scale (NdSSS) Positive if the level on the NdSSS scale is less than or equal to 7
Measured: At Day 0, Month 6, Month 12, Month 18, Month 24
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: age of patient
+ SD: Age, age of onset of symptoms, age at start of treatment
Measured: At Day 0
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion : patient gender
Proportion of male patients
Measured: At Day 0
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: SMA TYPE
Proportion of patients by type of SMA (1, 2, 3) and by treatment
Measured: At Day 0
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: number of copy
SMN2 copy number distribution
Measured: At Day 0
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: treatment
Calculate the proportion of patients who underwent treatment changes, expressed as a percentage of the total study population.This measure provides insights into the adaptability and potential issues with the current therapeutic approach or side effects.
A higher proportion of treatment changes may prompt further investigation and adjustments in treatment protocols, aiming to enhance overall patient outcomes.
This focused outcome measure aims to capture the essence of treatment dynamics within the SMA patient population.
Measured: At Day 0
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Mar 2024
- Study start24 Jul 2024
- Primary completion24 Jan 2029 (estimated)
- Study completion24 Jan 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Spinal Muscular AtrophyStudies of the same condition, open and under way.
- More trials run by Hospices Civils de LyonThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Prospective, longitudinal, multicenter, international study
- Masking
- None (open label)
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hospices Civils de Lyon
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06321965
- Sponsor's protocol ID
- 69HCL22_0599
- Acronym
- PHENO SMART
- Status last verified
- Jan 2026
- First submitted
- 6 Feb 2024
- Last updated
- 30 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 30 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Characterization of New Phenotypes of Patients With Spinal Muscular Atrophy Treated With SMN Restoring Therapy
- ClinicalTrials.gov ID
- NCT06321965
- Acronym / sponsor ID
- PHENO SMART / 69HCL22_0599
- Conditions
- Spinal Muscular Atrophy
- Keywords
- Natural history, Spinal Muscular atrophy (SMA), Risdiplam, Onasemnogene abeparvovec, Nusinersen
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Hospices Civils de LyonUniversity, hospital or other
- Study start
- 24 Jul 2024 (actual)
- Primary completion
- 24 Jan 2029 (estimated)
- Study completion
- 24 Jan 2029 (estimated)
- First posted
- 20 Mar 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
With the advent of new treatments for ASI, new phenotypes are emerging. The investigators propose to describe these new phenotypes by prospectively following children with ASI of all types treated with TRS and aged under 16 for 2 years.
The investigators also propose to evaluate potential assessment tools to determine whether they are relevant for monitoring this population, either routinely or for future clinical trials. The investigators also aim to collect the total costs associated with ASI in order to propose a first prospective medico-economic study in France.
Study design
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Prospective, longitudinal, multicenter, international study
| Arm | Type | Receives |
|---|---|---|
| SMA patient treated with SRT | Experimental | Other: evaluation of muscle function, Other: First-line cognitive assessment, Other: second-line cognitive assessment, Other: Cardiac evaluation, Radiation: MRI, Other: Assessment of activity and muscle fatigue, Other: Assessment of bulbar function, Other: Evaluation of body composition and metabolism, Other: Questionnaires, Biological: Biocollection, Other: Skinfold measurementPatients aged 0-15 with SMA type 1, 2 or 3, treated with TRS (nusinersen/risdiplam/onasemnogene abeparvovec/other). |
Who may qualify
- Ages
- 0 to 16 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- Genetically confirmed infantile or juvenile spinal muscular atrophy
- Treated with a therapy that restores SMN protein expression (e.g. nusinersen, risdiplam, onasemnogene abeparvovec)
- Aged 0 to 15 years inclusive
- Informed consent signed by both parent(s)/legal guardian(s) and patient's assent
- Affiliated or beneficiary of a health insurance plan*. * for inclusion in France
Key exclusion criteria (4 listed)
- Other condition likely to interfere significantly with ASI assessment and clearly unrelated to the disease
- Other associated neurological disease
- Current pregnancy or breast-feeding (a pregnancy test will also be performed at inclusion).
- Please note that patients with a specific contraindication to MRI (i.e. metallic foreign body, claustrophobia and other reasons determined by the investigators) will be allowed to participate in the study, but MRI will not be performed.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| evaluation of muscle functionMyogrip (≥ 6 years): precise dynamometric measurement of gripping force, measuring force in Newton up to 90kg with 0.01kg resolution. It's evaluated at D0, M6, M12, M18, and M24 Myopinch (≥ 6 years) : measure thumb-index force up to 15 kg with a resolution of 0.001 kg using a precision sensor equipped with two steel distance blades. It's evaluated at D0, M6, M12, M18, and M24 | Other | SMA patient treated with SRT |
| First-line cognitive assessmentVineland-II (All patients) : is a scale for assessing adaptive behaviors. will be carried out during the telephone call at M1/V2. All tests are evaluated at D0, and M18 : Bayley-4 language part (< 42 months) PVSE (≥ 4 years) CELF-5 (≥ 5 years) Conners-3 (≥ 6 years) AQ (≥ 4 years), EQ (≥ 11 years) M-CHAT-R (< 4 years) : SRS-2 (≥ 2 years) | Other | SMA patient treated with SRT |
| second-line cognitive assessmentIn the event of positive cognitive screening at D0 or M18, a second-line cognitive assessment will be carried out at a subsequent visit. A list of tests is proposed below, but will be adapted according to the tests available at each center. * EVALO BB (0-2 years) or EVALO (2-6 years) or full CELF-5 (5-18 years) following positive screening in the communication domain of first-line tests (Vineland II communication domain, Bayley 4, CELF-5 pragmatic profile) * FEE and DSM-5 diagnostic criteria for ADHD (from age 6 only) following positive screening in the attention and executive functions domain of first-line tests (Conners 3, BRIEF) * M-CHAT-R/F (< 4 years) or SCQ (≥ 4 years) and ADOS-2 (≥ 12 years) following a positive screening in the area of social cognition and autistic traits on first-line tests (Vineland II, M-CHAT-R, SRS-2, EQ, AQ). | Other | SMA patient treated with SRT |
| Cardiac evaluationAll tests are evaluated at D0, M12, and M24 : Electrocardiogram (ECG) : This examination will be carried out in accordance with the 12 leads recording the following parameters: verification of sinus rhythm, P wave, PR interval, QRS complex (interval), ST segment, T wave, QT complex, heart rate. Cardiac ultrasound: Non-invasive ultrasound will focus on the following parameters measured from 2-dimensional images, to look for cardiomyopathy and/or structural abnormality: * end-diastolic/end-systolic diameter/left ventricular ejection fraction * Septal wall thickness / left ventricular posterior wall * Fractional shortening 24-hour Holter-ECG : This examination consists of a continuous test recording the heart rhythm for 24 hours. | Other | SMA patient treated with SRT |
| MRICerebral MRI : Performed at D0, only for patients with ASI type 1 ≥ 6 years, or younger patients for whom the investigator considers that the examination can be performed without sedation or general anesthesia. It will include sequences: * 3D T1, gradient echo, 1.1 mm voxel, sagittal acquisition * axial T2, spin-echo, slice thickness 4 mm * 3D FLAIR, spin-echo, 1 mm voxel, sagittal acquisition Muscular MRI: performed at V1/J0, and V6/M24. The examination will include water-fat imaging (Dixon) in full-body, 3D mode, with proton density weighting and millimeter resolution. | Radiation | SMA patient treated with SRT |
| Assessment of activity and muscle fatigueSyde® : evaluated at D0, M6, M12, M24. Patients aged 2 and over will receive the Syde® wearable device to collect their daily activities. Muscular endurance tests (≥ 6 years) : evaluated at D0, M12, M24 ( only one of 3 tests based on motor function level) oESNHPT : In this test, patients are asked to walk a 10-meter path. oESBBT : In this test, patients have to move 10 blocks over a partition. oESWT: In this test, patients must repeatedly place and remove 9 sticks in 9 holes. PedsQL Fatigue (≥ 2 years): evaluated at D0, M12, M24. Scale designed to measure fatigue in patients with acute and chronic conditions, as well as in healthy school and community populations. Fatigue rating scale (≥ 6 years): evaluated at D0, M12, M24. The fatigue assessment scale has 11 numerical points ranging from 0 to 10. The patient is asked to give a rating that best reflects his or her perception of fatigue at that particular moment. | Other | SMA patient treated with SRT |
| Assessment of bulbar functionDDD-pNMD (≥ 2 years) : evaluated at D0, M6, M12, M18, and M24, is a list of 9 questions used by doctors to screen for dysphagia and dysarthria. NdSSS (All Patients) : evaluated at D0, M6, M12, M18, and M24, is an 8-level scale for assessing swallowing. TOMASS-c : (≥ 4 years of age, in patients able to eat solids safely, after assessment of the risk of a false route by the speech therapist): this is a score designed to assess mastication when eating a cracker. Age-dependent standards exist for different types of cracker. - Fluid intake test (> 110 cm, in patients able to drink a liquid safely, after assessment of the risk of a false route by the speech therapist): swallowing limit. | Other | SMA patient treated with SRT |
| Evaluation of body composition and metabolismFood survey : The dietary survey questionnaire will be sent to parents at D0 and M18. Parents will be asked to complete it for 3 days before the M6 and M24. Bioelectrical impedancemetry: Evaluated at M6 and M24. Renal ultrasound: Evaluated at M6, is a non-invasive examination that analyzes the appearance of the kidney and urinary tract. Dual-energy X-ray absorptiometry (DXA) : Evaluated at M6, it measures body composition using spectral imaging, including fat mass, lean mass and bone mineral density. Fibroscan : Evaluated at M6 and M24. This examination uses pulse elastography to measure liver elasticity, which provides information on the presence of hepatic fibrosis, and sound attenuation, which provides information on the presence of liver fat overload. Indirect calorimetry : Evaluated at M6. This device enables precise measurement of Resting Energy Expenditure , Respiratory Quotient and metabolic substrate oxidation. | Other | SMA patient treated with SRT |
| QuestionnairesSMAIS : The questionnaire has been developed specifically for ASI. At D0, M6, M12, M18 and M24. HUI2 : specializes in preference-based measures of health-related quality of life. At D0, M6, M12, M18 and M24. Peds QL : is a modular instrument designed to measure health-related quality of life and disease-specific symptoms. At D0, M6, M12, M18 and M24. Neuromuscular module : 17 disease-related items. It is evaluated at D0, M6, M12, M18 and M24. Family impact module : It measures parents' reported physical, emotional, social and cognitive functioning, communication and concerns. At D0, M12, and M24. ASI cost questionnaire: At visit 1 (D0): This questionnaire, completed by the parents, includes information on occupation, parents' working hours and any reduction in them due to the child's pathology, the number of working days missed by the parents or school days missed by the child, and disability-related costs. | Other | SMA patient treated with SRT |
| BiocollectionA blood bio collection (optional) will be offered to patients at D0, M6 , M12, M18, M24. Patients receiving intrathecal injections will also be offered the opportunity to participate in a CSF (cerebrospinal fluid) biocollection (optional). | Biological | SMA patient treated with SRT |
| Skinfold measurementThe tricipital point should be marked on the posterior aspect of the arm, on the midline of the tricipital muscle, midway between the acromion and the radius. At D0, M6, M12, M18 and M24 | Other | SMA patient treated with SRT |
Primary outcome
Markers of disease progression and description of different phenotypes, at : muscular and functional
Time frame: Every 6 months from inclusion (Day 0, Month6, Month12, Month18, Month24)
A composite score indicating the overall motor development trajectory for patients from study inclusion to Month 24 (M24). Calculation: Assign numerical values or categories to represent the motor development stages, with higher scores indicating positive development and lower scores indicating decline.
Markers of disease progression and description of different phenotypes, at : muscular and functional
Time frame: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
The trajectory of mean scores for motor function and muscle strength measured using CHOP-INTEND for patients aged 0-2 years. Scores are assessed every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24). Scale: CHOP-INTEND scale (0-64) Minimum Value: 0 Maximum Value: 64 Interpretation: Higher scores indicate improved motor function and muscle strength.
Markers of disease progression and description of different phenotypes, at : muscular and functional
Time frame: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Motor Function Measure 32 (MFM-32), is a quantitative scale created to measure global motor functional abilities in a person with neuromuscular disease. It contains 32 items, each marked from 0 to 3. The total score and the sub-scores are expressed as a percentage of the maximum possible score. Scale Range: 0 to 100 (Minimum to Maximum Values) Interpretation: Higher scores on the Motor Function Measure 32 (MFM-32) indicate improved motor function and muscle strength. The lower the total score, the more severe the impairment.
Markers of disease progression and description of different phenotypes, at : muscular and functional
Time frame: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Motor function and muscle strength: Trajectory of mean score between inclusion and M24: 6-minute walk test (≥ 6 years walking)
Markers of disease progression and description of different phenotypes, at : muscular and functional
Time frame: Every 6 months from inclusion (Day 0, Month 6, Month 12, Month 18, Month 24)
Motor function and muscle strength: Trajectory of mean score between inclusion and M24: Myogrip (≥ 6 years), Myopinch (≥ 6 years)
Markers of disease progression and description of different phenotypes, at : Fatigue
Time frame: Syde: At Day 0, Month 6, Month 12 and Month 24
For All: Upper limb kinematics and power For Walkers: Gait variables, arm swing variables, walking perimeter Interpretation: Specific statistical quantities related to upper limb kinematics and power, and additional variables for walkers. Calculation: Analyze statistical quantities at each time point for Syde
Markers of disease progression and description of different phenotypes, at : Fatigue
Time frame: Endurance test (≥ 6 years)
Endurance time from 0 to 1200 The primary outcome measure for fatigue-related markers involves the endurance test (≥ 6 years), specifically assessing ESNHPT, ESBBT, and ESWT. The primary focus is on the proportion of patients who stop before completing the test (yes/no) and, if applicable, the mean time to stop in seconds. ESNHPT: Endurance Test - Non-Handheld Propulsion Task ESBBT: Endurance Test - Bodyweight Bearing Task ESWT: Endurance Test - Walking Task
Markers of disease progression and description of different phenotypes, at : Fatigue
Time frame: at Day 0, Month 12 and Month 24
Pediatric Quality of Life Inventory (PedsQL) Fatigue Total Score Minimum Value: 0 Maximum Value: 24 Interpretation: A higher score within the range indicates increased fatigue, while a lower score suggests less fatigue.
Markers of disease progression and description of different phenotypes, at Orthopaedic level
Time frame: Joint amplitudes at Day 0, Month 6, Month 12 and Month 24
Joint amplitudes: Trajectory of joint amplitude changes (angle) between Day 0 and Month 24 for each location: Hip (right and left), Knee (right and left), Ankles, Elbow, Wrist, Long fingers.
Markers of disease progression and description of different phenotypes, at Orthopaedic level
Time frame: Clinic and spinal radiography at Day 0, Month 12,Month 18, Month 24
(For Non-Operated Patients): Presence or Absence of Radiological Scoliosis
Markers of disease progression and description of different phenotypes, at Orthopaedic level
Time frame: at Day 0, Month 24+/- Month 6, Month 12, Month 18
Clinical and pelvic radiography: Proportion of patients with hip eccentricity (>10% on Reimers index) at Day 0 and Month 24
Markers of disease progression and description of different phenotypes, at the cognitive level: Vineland-II
Time frame: At Month 1
Vineland II Adaptive Behaviour scales (VABS) total mean score and subscale mean scores. Standardized questionnaire filled by the Neupsy during an interview with the parents or the patient himself if possible. 5 domains. Maximum score 160, minimum score 20, mean score 100, standard deviation 15
Markers of disease progression and description of different phenotypes, at the cognitive level: Bayley-4
Time frame: At Day 0 and Month 18
Bayley-4 Scales of Infant and Toddler Development is standardized developmental assessment tool for determining a child's developmental status at a given age (up to 42 months) BAYLEY-4 assess development in children of 1-42 months old in 5 domains: cognition, motor, language, socio-emotional, and adaptive behavior. The Bayley-4 raw scores from 0-84 for the receptive communication subtest, 0-74 for the expressive communication subtest a higher score denotes a better outcome. The Bayley-4 standard score norms are converted to percentiles from <0.1 to >99.9 for the language
Markers of disease progression and description of different phenotypes, at the cognitive level: BRIEF (Behavioral Rating Inventory of Executive Function)
Time frame: At Day 0 and Month 18
BRIEF provides scores that are used to evaluate different aspects of executive function. The scores are typically presented in various subscales, each focusing on a specific domain of executive function. composite T-score for overall developmental function equal to or greater than 65 (-1.5 SD) The " composite T-score for overall developmental function equal to or greater than 65 (-1.5 SD)" indicates that a T-score composite for the overall developmental function is considered elevated or clinically significant if it equals or exceeds 65, which is 1.5 standard deviations above the mean in a standardized population. Higher scores on the BRIEF suggest greater difficulties in executive functioning, with a T-score of 65 or above indicating a higher level of impairment or challenges in this domain.
Markers of disease progression and description of different phenotypes, at the cognitive level: Conners-3
Time frame: At Day 0 and Month 18
- CONNERS-3 : 108-item hetero-questionnaire to assess the presence of symptoms of inattention, hyperactivity, impulsivity and other frequently associated disorders in children and adolescents aged 6 to 18. Symptoms are rated on a Likert scale with severity ratings from 0 (not at all/never) to 3 (very much/ very frequently). The Conners t-score range from 0 - 100. The higher the number, the worse the outcome
Markers of disease progression and description of different phenotypes, at the cognitive level: CELF-5 (Language and communication assessment battery)
Time frame: At Day 0 and Month 18
Standard Score: This score are derived from the total raw scores for each test and are on a normalized score scale that has a mean of 10 and a standard deviation (SD) of 3 The mean score is 100, with a standard deviation of 15, meaning: that standard scores between 85-115 are within the normal range. Score Mild: 70-85, Moderate: 55-70, Severe: 55 and lower
Markers of disease progression and description of different phenotypes, at the cognitive level: EQ (Empathy quotient), AQ (Autism Quotient)
Time frame: At Day 0 and Month 18
Evaluation of the French Version of Screening Questionnaires for Autism and Asperger Syndrome: Autism Spectrum Quotient (AQ) Empathy Quotient (EQ) EQ is a 40-item questionnaire designed to measure empathy for patients aged 11 and above. The maximum score for this questionnaire is 80. Threshold score: ↓30 . Scores of 30 or less indicate a lack of empathy common in people with Autism. AQ comprises 50 questions, with 5 groups of 10 questions assessing imagination, social skills, attention switching, attention to detail and communication skills. Each of these items scores 1 point if the respondent records abnormal or autistic like behaviour. The minimum score on the AQ is 0 and the maximum 50 with high scores indicating high autistic traits.
Markers of disease progression and description of different phenotypes, at the cognitive level: M-CHAT-R (Modified Checklist for Autism in Toddlers)
Time frame: At Day 0 and Month 18
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a screener that will ask a series of 20 questions about the child's behavior. To score the M-CHAT-R, we add up the number of at-risk responses, and follow the algorithm below: LOW RISK: Total score between 0 and 2 MEDIUM RISK: Total score between 3 and 7 HIGH RISK: Total score between 8 and 20
Markers of disease progression and description of different phenotypes, at the cognitive level: SRS-2 (Social Responsiveness Scale, Second Edition)
Time frame: At Day 0 and Month 18
SRS measures social ability of children from 2 years to 18 years old. It is used primarily with individuals with Autism Spectrum Disorder (ASD), family members of individuals with ASD, and others who have social impairments. Parent or teacher questionnaire (65 items on a 4-point Likert scale). High scores are associated with more severe social impairments. Raw total scores are converted to gender-normed T scores SRS-2 total T-scoring: * Less than or equal to 59 = Within normal limits (generally not associated with ASD) * Between 60-65 = Mild range * Between 66-75 = Moderate range * Greater than or equal to 76 = Severe range (strongly associated with clinical diagnosis of ASD)
Markers of disease progression and description of different phenotypes, at the cognitive level: PVSE (Basic visuo-spatial perception)
Time frame: At Day 0 and Month 18
- Proportion of patients with overall score: * < OL_inf * OL_inf ≤ x < Q1 * Q1 ≤ x < M * M ≤ x < Q3 * Q3 ≤ x < Q3 * ≥ OL sup
Markers of disease progression and description of different phenotypes, at the brain level
Time frame: At Day 0
Cerebral MRI : Proportion of patients with : * Posterior fossa anomaly * Midline anomaly * White matter anomaly * Cortical anomaly * Basal ganglia anomaly * Ventricular system anomaly * Pericerebral space abnormality * Brain MRI abnormality (including above variables)
Markers of disease progression and description of different phenotypes, at Cardiology level
Time frame: At Day 0 +/- Month 12, Month 24
Electrocardiogram (ECG): An abnormal ECG, with proportion for each type of abnormality Holter-ECG: An abnormal Holter-ECG, with proportion for each type of abnormality Echocardiography (only if troponin anomaly): Abnormal echocardiography, with proportions for each type of abnormality
Markers of disease progression and description of different phenotypes, at metabolic level : Anthropometric measurement trends
Time frame: Anthropometric measurements at Day 0, Month 6, Month 12, Month 18, Month 24
Anthropometric measurements may be used to monitor growth and nutritional status. Outcome of tracking these measurements could be the identification of trends related to weight gain and muscle mass development. Assessing changes in weight and body composition over time can provide valuable insights into the impact of SMA on physical development, guide nutritional interventions, and help healthcare providers tailor supportive care to address the unique needs of children with SMA
Markers of disease progression and description of different phenotypes, at metabolic level :
Time frame: Food survey at Month 6, Month 24
Food survey: average food intake
Markers of disease progression and description of different phenotypes, at metabolic level : fractures
Time frame: at Day 0, Month 6, Month 12, Month 18, Month 24
Number of fractures by location and mechanism
Markers of disease progression and description of different phenotypes, at metabolic level : renal ultrasound
Time frame: at Month 6
Proportion of patients with abnormal renal ultrasound
Markers of disease progression and description of different phenotypes, at metabolic level : Absorptiometry (DXA)
Time frame: at Month 6
DXA measurement will be performed to assess patient's body composition. Average values + SD (Standard Deviation): Lean mass and fat mass (kg) with deficit or excess of lean mass and fat mass (%) Total bone mineral content (g) Bone mineral density (z-score) at the spine, femoral neck, and distal femur
Markers of disease progression and description of different phenotypes, at metabolic level: Calorimetry
Time frame: at Month 6
Potential outcome of using this device is the accurate measurement of Resting Energy Expenditure (REE). This information can be particularly important in managing the nutritional needs of individuals with SMA, helping healthcare providers optimize dietary plans to meet the specific energy requirements of patients dealing with this neuromuscular disorder. Resting Energy Expenditure (REE).
Markers of disease progression and description of different phenotypes, at metabolic level : Impedancemetry
Time frame: at Month 6 and Month 24
Average +SD values of Impedancemetry results
Markers of disease progression and description of different phenotypes, at metabolic level : Fibroscan
Time frame: At Month 6 and Month 24
The FibroScan result is reported in kilopascals (kPa), representing the liver stiffness. The numerical value indicates the degree of stiffness, which correlates with the extent of liver fibrosis. The interpretation of the FibroScan score is as follows: Low Stiffness (Low kPa): Indicates a healthier, less fibrotic liver. Intermediate Stiffness: May suggest some degree of fibrosis, and further evaluation may be needed to determine the extent. High Stiffness (High kPa): Indicates more advanced liver fibrosis or cirrhosis.
Markers of disease progression and description of different phenotypes, at biological analysis
Time frame: At Day 0, Month 6, Month 12, Month 18, Month 24
Proportion of patients with biological abnormalities for each parameter: Blood/platelet count: Hb, leukocytes, platelets, ASAT, ALAT, GGT, PAL, TP, Sodium, potassium, bicarbonates, calcium, phosphorus, creatinine, glucose, proteins, urea, cystatin C, Troponin, BNP, NT-pro-BNP, Iron, Ferritin, copper, zinc, selenium, magnesium, Vitamins A,C,D,E, B12, Folates, Albumin, prealbumin, retinol-binding protein, ultra-sensitive C-reactive protein (CRP), FibroTest, PTH (parathormone) For these patients : % above normal * above * or below
Markers of disease progression and description of different phenotypes, at In terms of quality of life and autonomy
Time frame: PedsQL family impact at Day 0, Month 12, Month 24
Score evolution trajectory : PedsQL (Pediatric Quality of Life Inventory™) family impact The 36-item PedsQL™ Family Impact Module Scales encompass 6 scales measuring parent self-reported functioning: 1) Physical Functioning (6 items), 2) Emotional Functioning (5 items), 3) Social Functioning (4 items), 4) Cognitive Functioning (5 items), 5) Communication (3 items), 6) Worry (5 items), and 2 scales measuring parent-reported family functioning; 7) Daily Activities (3 items) and 8) Family Relationships (5 items). Scale Scores are computed as the sum of the items divided by the number of items answered. higher scores indicate better functioning (less negative impact)
Markers of disease progression and description of different phenotypes, at In terms of quality of life and autonomy
Time frame: HUI-2, generic PedsQL and neuromuscular module at Day 0, Month 6, Month 12, Month 18 and Month 24
HUI2 classification system consists of attributes (domains) of health to 6 levels of functional ability/disability within each attribute. For each attribute, singleattribute utility functions range from 0.00 for highly disabled (deaf) to 1.00 Score total : 0 - 1
Markers of disease progression and description of different phenotypes, at respiratory level : Chest/head circumference ratio (PT/PC ratio) (up to 3 years)
Time frame: at Day 0, Month 6, Month 12, Month 18 and Month 24
Outcome measure related to hospitalizations in the context is "Proportion of Patients with Escalation of Respiratory Assistance." This measure assesses the percentage of patients who experienced an escalation in respiratory support during their hospital stay, encompassing variables such as increased settings on home machines, use of resuscitative NIV, or intubation. This outcome provides critical insights into the respiratory management and support needs of patients during their hospitalizations.
Markers of disease progression and description of different phenotypes, at respiratory level : Chest/head circumference ratio (PT/PC ratio)
Time frame: at Day 0, Month 6, Month 12, Month 18 and Month 24
Evolution of the PT/PC ratio trajectory
Markers of disease progression and description of different phenotypes, at respiratory level : O2 saturation and nocturnal TcPCO2
Time frame: at Day 0, Month 12, Month 24
Evolution trajectory: This measure focuses on the percentage of children experiencing elevated levels of transcutaneous carbon dioxide (TcPCO2), specifically defined as time spent with TcPCO2 levels exceeding 50mmHg. This outcome is crucial in assessing the severity of respiratory compromise and may guide interventions to address and manage hypercapnia in the pediatric population.
Markers of disease progression and description of different phenotypes, at respiratory level: Respiratory function tests (≥ 6 years)
Time frame: at Day 0, Month 12, Month 24
Evolutionary trajectory: Evolution of Inspiratory Vital Capacity in Different Positions (% of Theoretical). This measure assesses changes over time in the percentage of theoretical inspiratory vital capacity achieved while standing or sitting and while lying down. This outcome provides valuable information about respiratory muscle function and potential changes in the ability to generate inspiratory volumes in different body positions.
Markers of disease progression at respiratory level
Time frame: points (Day 0, between Day 0-Month 12, between Month 12 and Month 24)
Evolutionary trajectory : Proportion of patients with central sleep apnea syndrome Proportion of patients with obstructive sleep apnea syndrome Proportion of patients with alveolar hypoventilation syndrome
Markers of disease progression and description of different phenotypes, at bulbar level (Evaluation of dysphagia and dysarthria): DDD-pNMD (Diagnostic list for Dysphagia and Dysarthria in pediatric NeuroMuscular Disorders)
Time frame: At Day 0, Month 6, Month 12, Month 18, Month 24
The DDD-pNMD is a scale where items are scored by a Speech-Language Therapist (SLT) on a 4-point scale, ranging from 0 (normal) to 3 (severe problems/impossible). The scale is designed to assess various aspects of swallowing and speech in children with neurological conditions. The DDD-pNMD screening is positive if score greater than or equal to 1.
Markers of disease progression and description of different phenotypes, at bulbar level (Evaluation of dysphagia and dysarthria): NdSSS (Neuromuscular Disease Swallowing Status Scale).
Time frame: At Day 0, Month 6, Month 12, Month 18, Month 24
An 8-stage Neuromuscular Disease Swallowing Status Scale (NdSSS) Positive if the level on the NdSSS scale is less than or equal to 7
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: age of patient
Time frame: At Day 0
+ SD: Age, age of onset of symptoms, age at start of treatment
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion : patient gender
Time frame: At Day 0
Proportion of male patients
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: SMA TYPE
Time frame: At Day 0
Proportion of patients by type of SMA (1, 2, 3) and by treatment
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: number of copy
Time frame: At Day 0
SMN2 copy number distribution
Markers of disease progression and description of different phenotypes, at the level of Characteristics at inclusion: treatment
Time frame: At Day 0
Calculate the proportion of patients who underwent treatment changes, expressed as a percentage of the total study population.This measure provides insights into the adaptability and potential issues with the current therapeutic approach or side effects. A higher proportion of treatment changes may prompt further investigation and adjustments in treatment protocols, aiming to enhance overall patient outcomes. This focused outcome measure aims to capture the essence of treatment dynamics within the SMA patient population.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jan 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
8 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing evaluation of muscle function, First-line cognitive assessment and second-line cognitive assessment in people with Spinal Muscular Atrophy, run by Hospices Civils de Lyon at 8 sites in France.
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 30 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 8 sites in France. 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 Laure LE GOFF, PI (04.72.12.95.04 ext. +33, laure.le-goff@chu-lyon.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Markers of disease progression and description of different phenotypes, at : muscular and functional (time frame: Every 6 months from inclusion (Day 0, Month6, Month12, Month18, Month24)). The study lists 45 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 30 Jan 2026; AzTrials last refreshed its copy on 8 Nov 2026.