Prospective Evaluation of Infants With Spinal Muscular Atrophy:

study id #: NCT02831296

condition: Spinal Muscular Atrophy

status: Recruiting

SPOT SMA is a prospective NIH-supported clinical study targeting pre-symptomatic or recently diagnosed infants and children with Spinal Muscular Atrophy (SMA) types 1, 2, or 3 and their healthy control siblings less than 36 months of age at the time of study enrollment. The main objective of the study is to prospectively collect longitudinal clinical outcomes and provide counseling and education to parents of newly diagnosed children. The study will assess the impact of current standard of care management paradigms and interventions on health outcomes in newly diagnosed SMA infants and children with type 1, 2 or 3 and age appropriate controls. There is no investigational drug and no specific intervention in this study. Rather, the investigators will document outcomes related to current therapies provided to participating subjects, and will educate participants about possible clinical trial opportunities.

results: https://clinicaltrials.gov/ct2/show/results/NCT02831296

last updated: February 04, 2022

start date: February 2016

last updated: September 2, 2020

size / enrollment: 1000

study description: Overview of data to be collected from enrolled infants followed longitudinally and entered into the NBSTRN Longitudinal Pediatric Data Resource

Past medical history relevant to pregnancy, delivery, complications in the immediate neonatal period, birth parameters, family history and any medical problems other than SMA (ie prematurity, etc)

Ongoing medical history indicating problems related to the following areas:

feeding, growth, respiratory status including use of cough assist and bilevel respiratory support, gastrointestinal issues, cardiac symptoms, neurologic symptoms or signs including muscle weakness, hospitalizations, ER visits, other adverse events

Assessment of dietary intake and use of nutritional supplements
Surgical history and ongoing documentation of assessments and need for g-tube, Nissen, tympanostomy, adenoidectomy/tonsillectomy or other airway surgeries, and orthopedic procedures
Caregiver obtained developmental history and documentation of newly acquired and/or loss of previously acquired gross motor skills at the time of each visit
Documentation of caregiver reported outcomes
Documentation of anthropometric measures, vital signs, general physical examination parameters
Neurological examination using standardized tools
Time to death, permanent invasive ventilation and/or need for > 16 hours/day of bilevel respiratory support
Specific assessment of motor function as measured using age appropriate motor outcome measures such as: the Children's Hospital of Philadelphia Infant Tests of Neuromuscular Disorders (CHOP-INTEND), Test of Infant Motor Performance Screening Inventory, WHO motor milestones or others, and Hammersmith Functional Motor Scale for SMA Expanded for children 18 months and older
Electrophysiologic studies such as maximum ulnar compound muscle action potential (CMAP) amplitude and area
Documentation of range of motion, development of limb contractures and/or presence of scoliosis, lordosis, hip dysplasia or other orthopedic outcomes
Additional optional exploratory biomarker assessments
DEXA measurements to assess body composition and bone density
The option to enroll in an autopsy study at the time of death to contribute samples to a research biorepository

Normal control subjects such as unaffected siblings will undergo these same measurements, as applicable. Unaffected parents' participation will be limited to collection and banking of blood and cell lines.

primary outcomes:

• Time to death and/or full time invasive ventilation or need for > 16 hours/day of bilevel respiratory support
  
• At each visit (every 1-6 months depending on age)
  

secondary outcomes:

• Maximum Ulnar CMAP Amplitude
  At each visit (every 1-6 months depending on age)
• CHOP-INTEND
  At each visit (every 1-6 months depending on age, or until deemed no longer appropriate by PI/physical therapist)
• WHO Motor Milestones
  At each visit (every 1-6 months depending on age)
• Hammersmith Functional Motor Scale - Expanded
  At each visit (every 1-6 months depending on age, beginning when deemed appropriate by PI/physical therapist)
• Hammersmith Infant Neurological Exam (HINE)
  At each visit (every 1-6 months depending on age, beginning when deemed appropriate by PI/physical therapist)
• Body composition
  Every 6 months
• Bone density
  Every 6 months
• Need for tube feeding
  At each visit (every 1-6 months depending on age)
• Caregiver Questionnaire total score and subscores
  At each visit (every 1-3 months depending on age and SMA type)

inclusion criteria:

exclusion criteria: Criteria:

None

sponsor: Massachusetts General Hospital

contacts: Maria S Herrmann, MD, 617-312-8318, msherrmann@mgh.harvard.edu

investigators: Kathryn J Swoboda, MD,Massachusetts General Hospital

trial center locations: United States

• Prospective Evaluation of Infants With Spinal Muscular Atrophy:
  Maria Herrmann, 617-312-8318, msherrmann@mgh.harvard.edu