A study to determine the best measurements for patients with ryanodine receptor 1-related muscle disorders

ISRCTN ISRCTN29338211
DOI https://doi.org/10.1186/ISRCTN29338211
IRAS number 332878
Secondary identifying numbers CL-EPI-001, IRAS 332878
Submission date
29/04/2024
Registration date
15/05/2024
Last edited
09/05/2025
Recruitment status
No longer recruiting
Overall study status
Ongoing
Condition category
Genetic Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Background and study aims
Ryanodine receptor 1-related myopathies (RYR1-RM) are rare diseases that result in a wide range of symptoms including muscle weakness, pain and fatigue. Individuals are born with RYR1-RM, inheriting either a gene mutation from one or both parents (which affects the severity of the disease) or through spontaneous mutation within the DNA of the gene. There is no current treatment available. ARM210 is a new medication that is being tested as a treatment for these patients. The treatment is safe in healthy volunteers thus far, is progressing through clinical trials and is soon to be tested in patients with RYR1-RM. This study aims to test the strength of muscles in patients with RYR1-RM so that researchers can understand how much these muscles are affected by the disease, and how to measure a consistent result of muscle strength (baseline strength) to inform the design of future clinical trials.

Who can participate?
Adult RYR1-RM patients aged 18 years old and older at screening

What does the study involve?
This study will involve up to 4 visits to a specialist treatment centre over 3 months to undergo study assessments. This will include muscle strength measurements conducted by trained medical staff, the use of a wearable device to track activity and movements for 1 month during the study and answering questions about symptoms caused by the disease including tiredness and pain. There will be no treatment provided as part of this study.

What are the possible benefits and risks of participating?
The results from this study will be used to inform further studies, including the clinical trial to test new treatments for patients with RYR1-RM. The possible risks include that the muscle strength tests - QMA, HHD and MMT may cause discomfort or muscle fatigue in patients but are generally considered low-risk.

Where is the study run from?
RyCarma Therapeutics Inc. (United States)

When is the study starting and how long is it expected to run for?
June 2023 to May 2025

Who is funding the study?
RyCarma Therapeutics Inc. (United States)

Who is the main contact?
Prof. Rosaline Quinlivan, r.quinlivan@ucl.ac.uk

Contact information

Mr Matthew Knight
Public

The Point, 37 N Wharf Road, Paddington
London
W2 1AF
United Kingdom

Phone +44 (0)7917 426098
Email matthew.knight@iqvia.com
Miss Elima Jedy-Agba
Scientific

The Point, 37 N Wharf Road, Paddington
London
W2 1AF
United Kingdom

Phone None provided
Email elima.jedy-agba@iqvia.com
Dr Rosaline Quinlivan
Principal Investigator

University College London, 8-11 Queen Square, MRC Centre for Neuromuscular Disease
London
WC1 3BG
United Kingdom

Phone +44 (0)20 3448 8132
Email r.quinlivan@ucl.ac.uk

Study information

Study designObservational strength measurement study
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital, Medical and other records
Study typeScreening
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleAn observational study in participants with ryanodine receptor 1-related myopathies (RYR1-RM) to determine optimal endpoint measurements
Study acronymRYR1 EP
Study hypothesisThis study aims to assess the extent to which the strength of proximal muscle movements is affected in patients with RYR1-RM with autosomal dominant mutations and the number of measurements for these movements to establish a stable baseline of the strength in these patients.
Ethics approval(s)

1. Approved 19/02/2024, Health Research Authority and North West - Preston Research Ethics Committee (2 Redman Place, London, E20 1JQ, United Kingdom; +44 (0)2071048364; approvals@hra.nhs.uk), ref: 24/NW/0022

2. Approved 30/07/2024, METC East Netherlands and CMO Radboud university medical center (METC Oost-Nederland en CMO Radboudumc Gebouw Tandheelkunde, Nijmegen, 6500, Netherlands; +31 (024) 361 31 54; METCoost-en-CMO@radboudumc.nl), ref: 2024-17184

3. Approved 04/07/2024, Comité de protection des personnes Ile de France I (Hôpital Hôtel Dieu - 1, place du Parvis Notre dame 75004 PARIS France, Paris, 75004, France; +33 0142348052; RIPH@sante.fr), ref: 24.01418.000306

ConditionRyanodine receptor 1-related myopathies with autosomal dominant mutations
InterventionThis is an observational, prospective, multi-centre study to assess muscle strength in patients with RYR1-RM with autosomal dominant mutations. The study aims to determine the optimal endpoints for these muscle strength measurements for future studies.

The study will consist of up to four visits:
1. Screening Visit conducted at baseline
2. Visit 1 (30 ± 3 days)
3. Visit 2 (60 ± 3 days)
4. End of Study (EOS) Visit (90 ± 3 days).

Six muscle movements will be tested at each visit to inform optimal endpoints. These will include shoulder abduction, elbow flexion and extension, knee flexion and extension and neck flexion. All except neck flexion will be measured using Quantitative Muscle Assessment (QMA). Neck flexion will be measured using Hand-Held Dynamometry (HHD) and Manual Muscle Testing (MMT). Patients will also be asked to wear a medical device to passively monitor their activity in terms of mobility. This device will be fitted during the screening visit and worn for 1 month only. In addition to QMA, HHD and MMT, additional assessments to be carried out and corresponding timepoints are outlined below:
1. Quantitative muscle assessment, hand-held dynamometry and manual muscle test (Screening, V1, V2, EOS)
2. 10-meter walk test (Screening, V1, V2, EOS)
3. 1 Minute Sit-to-stand test (Screening, V1, V2, EOS)
4. 4 Stair-climb test (Screening, V1, V2, EOS)
5. Questionnaires (International Physical Activity Questionnaire [IPAQ], PROMIS measures of physical function and fatigue) (Screening, EOS)
6. Symptom diary (Screening, EOS)
7. Neurological/physical assessment (Screening, EOS)
8. Wearable device (Fitted at Screening, removed at V1)

The assessments will be carried out by physiotherapists, neurologists or biomedical scientists (depending on which site) at the sites. They will already have training or will receive appropriate training (i.e. for QMA) before conducting the assessments. The assessments must be done in person on-site where all equipment is accessible and will be done individually during a patient visit. The enrolment period is expected to last 2.5 months and the follow-up period is 3 months. The study’s overall duration will be approximately 9-12 months, which will include enrolment, follow-up, data collection, analysis and reporting of results.
Intervention typeMixed
Primary outcome measureThe following primary outcome variables will be assessed at Screening, V1, V2, and EOS:
1. Knee flexion and extension, elbow flexion and extension, and shoulder abduction measured using a quantitative muscle assessment (QMA)
2. Neck flexion measured using a hand-held dynamometer (HHD) and manual muscle test (MMT)
3. Muscle strength measured using a 10-meter walk test (10-MWT), a 1-minute sit-to-stand test, and a 4-Stair climb test

The study will consist of up to four visits:
1. Screening Visit conducted at baseline
2. Visit 1 (V1: 30 ± 3 days)
3. Visit 2 (V2: 60 ± 3 days)
4. End of Study (EOS) Visit (90 ± 3 days)
Secondary outcome measures1. Fatigue and physical function measured using the PROMIS Fatigue, PROMIS-physical function domains at Screening and EOS
2. Physical activity measured using the International Physical Activity Questionnaire (IPAQ) at Screening and EOS
3. Demographics measured using data collected in medical records at screening
4. Clinical characteristics of patients measured using data collected in medical records and full physical assessments at Screening and EOS
5. Syptoms measured using a diary at screening and EOS

The study will consist of up to four visits:
1. Screening Visit conducted at baseline
2. Visit 1 (V1: 30 ± 3 days)
3. Visit 2 (V2: 60 ± 3 days)
4. End of Study (EOS) Visit (90 ± 3 days)
Overall study start date14/06/2023
Overall study end date30/05/2025

Eligibility

Participant type(s)Patient
Age groupMixed
Lower age limit18 Years
Upper age limit100 Years
SexBoth
Target number of participants20
Total final enrolment8
Participant inclusion criteria1. Male and female patients (biological sex*) aged 18 years or older at Screening; Adult males and females aged 18 years and older at Screening
2. Confirmed genetic diagnosis of RYR1-RM with autosomal dominant mutation and supporting clinical phenotype with demonstrable proximal weakness on at least one of the baseline study assessments
3. Evidence of at least one demonstratable muscle/motor function deficit assessed through MMT and scored using the MRC Scale for muscle strength on physical examination
4. Able to walk 10 meters, with or without assistance - e.g., with a cane (assessed using the 10-MWT)
5. Willingness and ability to comply with scheduled visits, and study procedures
6. Willingness to be fitted with the Syde® device at Screening Visit (for inclusion in the exploratory objective only)
7. Able to provide written informed consent and understand the study procedures in the informed consent form (ICF)
Participant exclusion criteriaParticipants meeting at least one of the following criteria will not be eligible for the study:
1. Severe pulmonary dysfunction at Screening (FVC < 40% predicted) or evidence of pulmonary exacerbation (note that pulmonary exacerbations refer to acute worsening respiratory symptoms resulting from a decline in lung function)
2. Significant cognitive impairment in the judgement of the investigator who will be unable to follow the protocol
3. Patients with progressive neurological conditions (e.g., Parkinson’s disease)
4. Non-ambulant patients
5. Pregnant women
Recruitment start date13/05/2024
Recruitment end date28/02/2025

Locations

Countries of recruitment

  • England
  • France
  • Netherlands
  • United Kingdom

Study participating centres

University College London Hospitals NHS Foundation Trust
250 Euston Road
London
NW1 2PG
United Kingdom
Radboud University Medical Centre
Clinical Research Unit, Route 923, Geert Grooteplein Zuid 10
Nijmegen
6525
Netherlands
Association Institut de Myologie
Association Institut de Myologie, Groupe Hospitalier Pitié-Salpêtrière, Bâtiment Babinski RDC bas
47-83 boulevard de l'Hôpital
Paris
75651
France

Sponsor information

RyCarma Therapeutics Inc.
Industry

200 Clarendon Street, 22nd Floor
Boston
MA 02116
United States of America

Phone +1 (0)7384 783639
Email amy.dirico@rycarma.com

Funders

Funder type

Industry

RyCarma Therapeutics Inc.

No information available

Results and Publications

Intention to publish date01/09/2026
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication in a peer-reviewed journal
IPD sharing planThe data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol file version 4.0 10/09/2024 17/10/2024 No No

Additional files

ISRCTN29338211 ARMGO_RYR1_Protocol_V4.0_10SEP2024.pdf

Editorial Notes

09/05/2025: Total final enrolment added.
21/03/2025: Sponsor details updated.
21/02/2025: Contact, sponsor and funder details updated. ARMGO Pharma was changed to RyCarma Therapeutics Inc.
25/10/2024: The following changes were made:
1. Ethics approval was updated.
2. The overall study end date was changed from 15/09/2025 to 30/05/2025.
17/10/2024: The following changes were made to the trial record:
1. Uploaded protocol (not peer-reviewed) as an additional file.
2. The recruitment end date was changed from 21/10/2024 to 28/02/2025.
3. The overall end date was changed from 15/07/2025 to 15/09/2025.
30/04/2024: Study's existence confirmed by the Health Research Authority and North West - Preston Research Ethics Committee.